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Sample records for embryo implantation failure

  1. Uterine artery blood flow and microvessel density by vaginal color Doppler ultrasonography in embryo implantation failure.

    Science.gov (United States)

    Li, Zhen; Wang, Xingling; Guan, Yichun; Yu, Xiaona; Liu, Jing; Zhang, Zhan

    2017-11-01

    The purpose of this study was to investigate the clinical application of uterine artery blood flow parameters by vaginal color Doppler ultrasonography in patients with repeated embryo implantation failure and to examine the correlation between uterine artery blood flow parameters and microvessel density (MVD). We monitored the outcomes of in vitro fertilization and embryo transfer in eighty patients. We divided the patients into two groups: Pregnancy (successful pregnancy, n=50) and repeated implantation failure (more than two failures of in vitro fertilization-embryo transfer, n=30). The patients were subjected to vaginal color Doppler ultrasonography to measure endometrial thickness, peak systolic velocity/end diastolic velocity (S/D), pulsatility index (PI), resistance index (RI), and other uterine artery blood flow parameters. We found no significant differences in endometrial thickness (human chorionic gonadotropin endometrial thickness) and uterine artery blood flow parameters (S/D, PI) between the two groups. The RI value of endometrial blood flow was significantly higher in the repeated implantation failure group than that in pregnancy group. The endometrium MVD in the repeated implantation failure group was significantly lower than that of the pregnancy group. Spearman correlation analysis showed that S/D value of uterine artery blood flow in repeated implantation failure group was not correlated with MVD or uterine artery blood flow PI, but was positively correlated with RI. Endometrium MVD in patients with repeated implantation failure was significantly lower than that in patients with successful pregnancy during the implantation window. We also found a significant difference in uterine artery blood flow RI between the two groups. The uterine artery blood flow RI in patients with repeated implantation failure was positively correlated with MVD, which has clinical significance in predicting the outcome of embryo transfer.

  2. The Uterine Immune Profile May Help Women With Repeated Unexplained Embryo Implantation Failure After In Vitro Fertilization.

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    Lédée, Nathalie; Petitbarat, Marie; Chevrier, Lucie; Vitoux, Dominique; Vezmar, Katia; Rahmati, Mona; Dubanchet, Sylvie; Gahéry, Hanne; Bensussan, Armand; Chaouat, Gerard

    2016-03-01

    Embryo implantation remains the main limiting factor in assisted reproductive medicine (20% success rate). An endometrial immune profiling was performed among 394 women with the previous history of repeated embryo implantation failures (RIF). The endometrial immune profile documented the ratio of IL-15/Fn-14 mRNA as a biomarker of uNK cell activation/maturation (together with the uNK cell count) and the IL-18/TWEAK mRNA ratio as a biomarker of both angiogenesis and the Th1/Th2 balance. According to their profile, we recommended personalized care to counteract the documented dysregulation and assessed its effects by the live birth rate (LBR) for the next embryo transfer. Endometrial immune profiles appeared to be dysregulated in 81.7% of the RIF patients compared to control. Overactivation was diagnosed in 56.6% and low activation in 25%. The LBR among these dysregulated/treated patients at the first subsequent embryo transfer was 39.8%. Endometrial immune profiling may improve our understanding of RIF and subsequent LBR if treated. © 2016 The Authors. American Journal of Reproductive Immunology Published by John Wiley & Sons Ltd.

  3. Intrauterine insemination of cultured peripheral blood mononuclear cells prior to embryo transfer improves clinical outcome for patients with repeated implantation failures.

    Science.gov (United States)

    Madkour, Aicha; Bouamoud, Nouzha; Louanjli, Noureddine; Kaarouch, Ismail; Copin, Henri; Benkhalifa, Moncef; Sefrioui, Omar

    2016-02-01

    Implantation failure is a major limiting factor in assisted reproduction improvement. Dysfunction of embryo-maternal immuno-tolerance pathways may be responsible for repeated implantation failures. This fact is supported by immunotropic theory stipulating that maternal immune cells, essentially uterine CD56+ natural killer cells, are determinants of implantation success. In order to test this hypothesis, we applied endometrium immuno-modulation prior to fresh embryo transfer for patients with repeated implantation failures. Peripheral blood mononuclear cells were isolated from repeated implantation failure patients undergoing assisted reproductive technology cycles. On the day of ovulation induction, cells were isolated and then cultured for 3 days and transferred into the endometrium cavity prior to fresh embryo transfer. This immunotherapy was performed on 27 patients with repeated implantation failures and compared with another 27 patients who served as controls. Implantation and clinical pregnancy were increased significantly in the peripheral blood mononuclear cell test versus control (21.54, 44.44 vs. 8.62, 14.81%). This finding suggests a clear role for endometrium immuno-modulation and the inflammation process in implantation success. Our study showed the feasibility of intrauterine administration of autologous peripheral blood mononuclear cells as an effective therapy to improve clinical outcomes for patients with repeated implantation failures and who are undergoing in vitro fertilization cycles.

  4. A Randomized Trial to Evaluate the Effect of Local Endometrial Injury on the Clinical Pregnancy Rate of Frozen Embryo Transfer Cycles in Patients With Repeated Implantation Failure

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    Ensieh Shahrokh-Tehraninejad

    2016-12-01

    Full Text Available Objective: Repeated implantation failure (RIF is a condition in which the embryos implantation decreases in the endometrium. So, our aim was to evaluate the effect of local endometrial injury on embryo transfer results.Materials and methods: In this simple randomized clinical trial (RCT, a total of 120 patients were selected. The participants were less than 40 years old, and they are in their minimum two cycles of vitro fertilization (IVF. Patients were divided randomly into two groups of LEI (Local endometrial injury and a control group (n = 60 in each group. The first group had four small endometrial injuries from anterior, posterior, and lateral uterus walls which were obtained from people who were in 21th day of their previous IVF cycle. The second group was the patients who have not received any intervention.Results: The experimental and control patients were matched in the following factors. Regarding the clinical pregnancy rate, there was no significant difference noted between the experimental and the control group.Conclusion: Local endometrial injury in a preceding cycle does not increase the clinical pregnancy rate in the subsequent FET cycle of patients with repeated implantation failure.

  5. Failures in implants

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    E Prashanti

    2011-01-01

    Full Text Available The burning problem that all the implantologists are confronted today is the complications and failures occurring with the treatment of osseointegrated implants. To further optimize the treatment outcome, etiologies and factors associated with implant failures should be elucidated. Conceivably such knowledge is needed for developing adequate treatment and prevention strategies. Hence, this paper is intended to provide an insight regarding various aspects of failures that affect dental implants.

  6. Role of microRNAs in embryo implantation

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    Jingjie Liang

    2017-11-01

    Full Text Available Abstract Failure of embryo implantation is a major limiting factor in early pregnancy and assisted reproduction. Determinants of implantation include the embryo viability, the endometrial receptivity, and embryo-maternal interactions. Multiple molecules are involved in the regulation of implantation, but their specific regulatory mechanisms remain unclear. MicroRNA (miRNA, functioning as the transcriptional regulator of gene expression, has been widely reported to be involved in embryo implantation. Recent studies reveal that miRNAs not only act inside the cells, but also can be released by cells into the extracellular environment through multiple packaging forms, facilitating intercellular communication and providing indicative information associated with physiological and pathological conditions. The discovery of extracellular miRNAs shed new light on implantation studies. MiRNAs provide new mechanisms for embryo-maternal communication. Moreover, they may serve as non-invasive biomarkers for embryo selection and assessment of endometrial receptivity in assisted reproduction, which improves the accuracy of evaluation while reducing the mechanical damage to the tissue. In this review, we discuss the involvement of miRNAs in embryo implantation from several aspects, focusing on the role of extracellular miRNAs and their potential applications in assisted reproductive technologies (ART to promote fertility efficiency.

  7. Embryo Implantation: War in Times of Love.

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    Ashary, Nancy; Tiwari, Abhishek; Modi, Deepak

    2018-02-01

    Contrary to widespread belief, the implantation of an embryo for the initiation of pregnancy is like a battle, in that the embryo uses a variety of coercive tactics to force its acceptance by the endometrium. We propose that embryo implantation involves a three-step process: (1) identification of a receptive endometrium; (2) superimposition of a blastocyst-derived signature onto the receptive endometrium before implantation; and finally (3) breaching by the embryo and trophoblast invasion, culminating in decidualization and placentation. We review here the story that is beginning to emerge, focusing primarily on the cells that are in "combat" during this process. Copyright © 2018 Endocrine Society.

  8. The endometrial factor in human embryo implantation

    NARCIS (Netherlands)

    Boomsma, C.M.

    2009-01-01

    The studies presented in this thesis aimed to explore the role of the endometrium in the implantation process. At present, embryo implantation is the major rate-limiting step for success in fertility treatment. Clinicians have sought to develop clinical interventions aimed at enhancing implantation

  9. The Role of Heparin in Embryo Implantation in Women with Recurrent Implantation Failure in the Cycles of Assisted Reproductive Techniques (Without History of Thrombophilia.

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    Kobra Hamdi

    2015-06-01

    Full Text Available Several studies have shown the improving effect of heparin on the outcomes of ART. Moreover, it has been reported that adding heparin in non-thrombophilia patients with RIF is useful.The aim of this study was to evaluate the beneficial effects of heparin on ART outcomes in women with history of recurrent implantation failure (RIF and without history of congenital or acquired thrombophilia in a randomized, controlled clinical trial (RCT.In this study, 100 patients with a history of two or more failures in implantation in cycles of ART were randomly subdivided into two groups of study and control. Patients of the control group just received the luteal phase support. In the patients of study group, in addition to the routine support of luteal phase following in vitro fertilization (IVF or intra cytoplasmic sperm injection (ICSI, 5000 units of subcutaneous heparin was administered for 15 days from the day of oocyte pick up. Pregnancy test (β-HCG was done for patient of two groups 15 days after IVF.In the study group, pregnancy test was positive in 16 (32% patients and negative in 34 (68% patients. In the control group, pregnancy test was positive in 15 (30% patients and negative in 35 (70% patients. There was no significant difference between two groups for the role of heparin in the pregnancy rate (p = 0.5.Although the effect of heparin on pregnancy was not statistically significant in this study, with regard to the numerous benefits of this agent, it is recommended to study its effects in further studies with lager sample size.

  10. Maternal KIR haplotype influences live birth rate after double embryo transfer in IVF cycles in patients with recurrent miscarriages and implantation failure.

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    Alecsandru, D; Garrido, N; Vicario, J L; Barrio, A; Aparicio, P; Requena, A; García-Velasco, J A

    2014-12-01

    In patients with recurrent miscarriages (RM) or recurrent implantation failure (RIF), does the maternal killer immunoglobulin-like receptor (KIR) haplotype have an impact on live birth rates per cycle after embryo transfer with the patient's own or donated oocytes? After double embryo transfer (DET) in patients with the maternal KIR AA haplotype, a significantly increased early miscarriage rate was observed when the patient's own oocytes were used, and a significantly decreased live birth rate per cycle after embryo transfer was observed when donated oocytes were used. Interactions between fetal HLA-C and maternal KIR influence placentation during human pregnancy. There is an increased risk of RM, pre-eclampsia or fetal growth restriction in mothers with the KIR AA haplotype when the fetus has more HLA-C2 genes than the mother. Between 2010 and 2014, we performed a retrospective study that included 291 women, with RM or RIF, who had a total of 1304 assisted reproductive cycles. Pregnancy, miscarriage and live birth rates per cycle after single or DET, categorized by the origin of the oocytes and the presence of maternal KIR haplotypes, were studied. KIR haplotype regions were defined by the presence of the following KIR genes: Cen-A/2DL3; Tel-A/3DL1 and 2DS4; Cen-B/2DL2 and 2DS2; as well as Tel-B/2DS1 and 3DS1. Higher rates of early miscarriage per cycle after DET with the patient's own oocytes in mothers with the KIR AA haplotype (22.8%) followed by those with the KIR AB haplotype (16.7%) compared with mothers with the KIR BB haplotype (11.1%) were observed (P = 0.03). Significantly decreased live birth rates per cycle were observed after DET of donated oocytes in mothers with the KIR AA haplotype (7.5%) compared with those with the KIR AB (26.4%) and KIR BB (21.5%) haplotypes (P = 0.006). No statistically significant differences were observed for pregnancy, miscarriage and live birth rates per cycle among those with maternal KIR AA, AB and BB haplotypes after

  11. DEALING WITH DENTAL IMPLANT FAILURES

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    Levin, Liran

    2008-01-01

    An implant-supported restoration offers a predictable treatment for tooth replacement. Reported success rates for dental implants are high. Nevertheless, failures that mandate immediate implant removal do occur. The consequences of implant removal jeopardize the clinician's efforts to accomplish satisfactory function and esthetics. For the patient, this usually involves further cost and additional procedures. The aim of this paper is to describe different methods and treatment modalities to deal with dental implant failure. The main topics for discussion include identifying the failing implant, implants replacing failed implants at the exact site, and the use of other restorative options. When an implant fails, a tailor made treatment plan should be provided to each patient according to all relevant variables. Patients should be informed regarding all possible treatment modalities following implant failure and give their consent to the most appropriate treatment option for them. PMID:19089213

  12. Dealing with dental implant failures

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    Liran Levin

    2008-06-01

    Full Text Available An implant-supported restoration offers a predictable treatment for tooth replacement. Reported success rates for dental implants are high. Nevertheless, failures that mandate immediate implant removal do occur. The consequences of implant removal jeopardize the clinician's efforts to accomplish satisfactory function and esthetics. For the patient, this usually involves further cost and additional procedures. The aim of this paper is to describe different methods and treatment modalities to deal with dental implant failure. The main topics for discussion include identifying the failing implant, implants replacing failed implants at the exact site, and the use of other restorative options.When an implant fails, a tailor made treatment plan should be provided to each patient according to all relevant variables. Patients should be informed regarding all possible treatment modalities following implant failure and give their consent to the most appropriate treatment option for them.

  13. Hysteroscopic Subendometrial Embryo Delivery (SEED,Mechanical Embryo Implantation

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    Michael Kamrava

    2010-01-01

    Full Text Available Background: A major hurdle to improved in vitro fertilization (IVF success rate is defectiveendometrial receptivity and implantation. Various techniques have been advocated to increaseimplantation while reducing side effects. Currently, embryo transfer (ET is performed blindlywithout direct visualization. As such, we sought to develop a technique utilizing a flexible minihysteroscopewith a flexible catheter for direct implantation of the blastocyst(s.Materials and Methods: This was a case study performed at West Coast IVF Clinic, Inc., BeverlyHills, California 90212. A total of 15 IVF Cycles in 13 patients (average age = 29 underwentvisually directed ET and endometrial implantation. All women received luteal support.The main outcome measure in this study, both clinically and procedurally, was the relevantdevelopment and assessment of a novel surgical technology.Results: In this study, eight (60% pregnancies ensued [5 (62.5% clinical and 3 (37.5%biochemical]. Of note, there was no uterine scratching, uterine bleeding, or ectopic pregnancies.Significantly, high-order pregnancies were decreased; only one twin was conceived.Conclusion: Preliminary data suggest mechanically assisting implantation with a hysteroscopicblastocyst ET (SEED offers a viable option for improving pregnancy outcome.

  14. Embryo implantation: Shedding light on the roles of ovarian ...

    African Journals Online (AJOL)

    Successful implantation requires coordinated interactions between the blastocyst and uterus. Uterine receptivity for embryo implantation is regulated by the ovarian hormones estrogen and progesterone. Some cytokines and growth factors play important roles in embryo implantation under the influence of ovarian hormones.

  15. Implantation of the human embryo requires Rac1-dependent endometrial stromal cell migration.

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    Grewal, Seema; Carver, Janet G; Ridley, Anne J; Mardon, Helen J

    2008-10-21

    Failure of the human embryo to implant into the uterine wall during the early stages of pregnancy is a major cause of infertility. Implantation involves embryo apposition and adhesion to the endometrial epithelium followed by penetration through the epithelium and invasion of the embryonic trophoblast through the endometrial stroma. Although gene-knockdown studies have highlighted several molecules that are important for implantation in the mouse, the molecular mechanisms controlling implantation in the human are unknown. Here, we demonstrate in an in vitro model for human implantation that the Rho GTPases Rac1 and RhoA in human endometrial stromal cells modulate invasion of the human embryo through the endometrial stroma. We show that knockdown of Rac1 expression in human endometrial stromal cells inhibits human embryonic trophoblast invasion into stromal cell monolayers, whereas inhibition of RhoA activity promotes embryo invasion. Furthermore, we demonstrate that Rac1 is required for human endometrial stromal cell migration and that the motility of the stromal cells increases at implantation sites. This increased motility correlates with a localized increase in Rac1 activation and a reciprocal decrease in RacGAP1 levels. These results reveal embryo-induced and localized endometrial responses that may govern implantation of the human embryo.

  16. Effects of LeY glycan expression on embryo implantation.

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    Gu, J; Sui, L-L; Cui, D; Ma, Y-N; Zhu, C-Y; Kong, Y

    2016-08-01

    To investigate the correlation between LeY glycan expression and embryo implantation. Uterine epithelial cells before implantation were transfected with FUT1siRNA to inhibit FUT1 (the gene encoding the key enzyme of LeY synthesis) expression and treated with 10 ng/ml leukemia inhibitory factor (LIF). Murine embryo implantation model in vitro was prepared by late blastocysts with identical morphology and treated uterine epithelial cells co-culture. Using RT-PCR, dot blot and observation of embryo attachment to analyze FUT1 gene expression and LeY synthesis of uterine epithelial cells and studied further the correlation of LeY expression level and embryo implantation. FUT1 gene expression and LeY synthesis declined after cells were transfected with FUT1siRNA, and LIF promoted FUT1 expression and LeY synthesis. After expression of FUT1 gene was inhibited, attachment rate of embryos lowered, but LIF up-regulated FUT1 expression and increased the attachment rate of embryos. These results indicated regulating FUT1 expression affected LeY synthesis, and then LeY regulated the recognition and attachment of uterus-embryo and participates in embryo implantation further.

  17. Epigenetics and chromosome segregation in human pre-implantation embryos

    NARCIS (Netherlands)

    C. van de Werken (Christine)

    2015-01-01

    markdownabstractAbstract Chapter 1 Currently, the average pregnancy rate per embryo transfer after in vitro fertilization (IVF) is around 32%. In order to achieve better results in the future, we need to gain knowledge on all aspects of the treatment, including pre-implantation embryo

  18. Selecting embryos with the highest implantation potential using data mining and decision tree based on classical embryo morphology and morphokinetics.

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    Carrasco, Beatriz; Arroyo, Gemma; Gil, Yolanda; Gómez, Mª José; Rodríguez, Ignacio; Barri, Pedro N; Veiga, Anna; Boada, Montserrat

    2017-08-01

    The objective of this work was to determine which embryonic morphokinetic parameters up to D3 of in vitro development have predictive value for implantation for the selection of embryos for transfer in clinical practice based upon information generated from embryo transfers with known implantation data (KID). A total of 800 KID embryos (100% implantation rate (IR) per transfer and 0% IR per transfer) cultured in an incubator with Time-Lapse system were retrospectively analysed. Of them, 140 embryos implanted, whereas 660 did not. The analysis of morphokinetic parameters, together with the embryo morphology assessment on D3, enabled us to develop a hierarchical model that places the classical morphological score, the t4 and t8 morphokinetic values, as the variables with the best prognosis of implantation. In our decision tree, the classical morphological score is the most predictive parameter. Among embryos with better morphological scores, morphokinetics permits deselection of embryos with the lowest implantation potential.

  19. Kisspeptin, unexplained infertility and embryo implantation

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    Aaida Mumtaz

    2017-03-01

    Full Text Available Background Kisspeptin (KP is a neuropeptide that causes the release of the gonadotropin releasing hormone, which controls hypothalamo pituitary ovarian axis and exerts a number of peripheral effects on reproductive organs. The primary objective of this study was to compare baseline KP levels in females with different types of infertility and identify possible correlations with risk of failure to conceive, preclinical abortion and pregnancy after intracytoplasmic sperm injection (ICSI. Materials and Methods A longitudinal cohort study was carried out from August 2014 until May 2015 by recruiting 124 female patients undergoing ICSI, after obtaining ethical approval from the Australian Concept Infertility Medical Center. Cause of infertility due to male, female and unexplained factors was at a frequency of 32 (24%, 33 (31% and 59 (45% among the individuals respectively. KP levels were measured by ELISA assay before the initiation of the ICSI treatment protocol. Outcome of ICSI was categorized into three groups of non-pregnant with beta-human chorionic gonadotropin (β-hCG25 mIU/ml and no cardiac activity, and clinical pregnancy declared upon confirmation of cardiac activity. Results based on cause of infertility and outcome groups were analyzed by one-way ANOVA. Results Females with unexplained infertility had significantly lower levels of KP when compared with those with male factor infertility (176.69 ± 5.03 vs. 397.6 ± 58.2, P=0.001. Clinical pregnancy was observed in 28 (23% females of which 17 (71% had a female cause of infertility. In the non-pregnant group of 66 (53% females, common cause of infertility was unexplained 56(85%. A weak positive correlation of KP levels with fertilized oocytes and endometrial thickness was observed (P=0.04 and 0.01 respectively. Conclusion Deficiency of KP in females with unexplained infertility was associated with reduced chances of implantation after ICSI.

  20. Failure analysis of fractured dental zirconia implants.

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    Gahlert, M; Burtscher, D; Grunert, I; Kniha, H; Steinhauser, E

    2012-03-01

    The purpose of the present study was the macroscopic and microscopic failure analysis of fractured zirconia dental implants. Thirteen fractured one-piece zirconia implants (Z-Look3) out of 170 inserted implants with an average in situ period of 36.75±5.34 months (range from 20 to 56 months, median 38 months) were prepared for macroscopic and microscopic (scanning electron microscopy [SEM]) failure analysis. These 170 implants were inserted in 79 patients. The patient histories were compared with fracture incidences to identify the reasons for the failure of the implants. Twelve of these fractured implants had a diameter of 3.25 mm and one implant had a diameter of 4 mm. All fractured implants were located in the anterior side of the maxilla and mandibula. The patient with the fracture of the 4 mm diameter implant was adversely affected by strong bruxism. By failure analysis (SEM), it could be demonstrated that in all cases, mechanical overloading caused the fracture of the implants. Inhomogeneities and internal defects of the ceramic material could be excluded, but notches and scratches due to sandblasting of the surface led to local stress concentrations that led to the mentioned mechanical overloading by bending loads. The present study identified a fracture rate of nearly 10% within a follow-up period of 36.75 months after prosthetic loading. Ninety-two per cent of the fractured implants were so-called diameter reduced implants (diameter 3.25 mm). These diameter reduced implants cannot be recommended for further clinical use. Improvement of the ceramic material and modification of the implant geometry has to be carried out to reduce the failure rate of small-sized ceramic implants. Nevertheless, due to the lack of appropriate laboratory testing, only clinical studies will demonstrate clearly whether and how far the failure rate can be reduced. © 2011 John Wiley & Sons A/S.

  1. Effects of elevated ambient temperature on embryo implantation in rats

    African Journals Online (AJOL)

    Yomi

    2012-03-22

    Mar 22, 2012 ... Effects of elevated ambient temperature on embryo implantation in rats. Huda Yahia Hamid1,2, Md Zuki Abu Bakar Zakaria2*, Nurhusien Yimer3, Goh Yong Meng2, Abd. Wahid Haron4 and Noordin Mohamed Mustapha5. 1Department of Anatomy, Faculty of Veterinary Medicine, University of Khartoum, ...

  2. Factors Influencing Early Dental Implant Failures.

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    Chrcanovic, B R; Kisch, J; Albrektsson, T; Wennerberg, A

    2016-08-01

    The purpose of the present study was to assess the influence of local and systemic factors on the occurrence of dental implant failures up to the second-stage surgery (abutment connection). This retrospective study is based on 2,670 patients who received 10,096 implants and were consecutively treated with implant-supported prostheses between 1980 and 2014 at 1 specialist clinic. Several anatomic-, patient-, health-, and implant-related factors were collected. Descriptive statistics were used to describe the patients and implants. Univariate and multivariate logistic regression models were used at the patient level as well as the implant level to evaluate the effect of explanatory variables on the failure of implants up to abutment connection. A generalized estimating equation method was used for the implant-level analysis to account for the fact that repeated observations (several implants) were available for a single patient. Overall, 642 implants (6.36%) failed, of which 176 (1.74%) in 139 patients were lost up to second-stage surgery. The distribution of implants in sites of different bone quantities and qualities was quite similar between implants lost up to and after abutment connection. Smoking and the intake of antidepressants were the statistically significant predictors in the multivariate model (ClinicalTrials.gov NCT02369562). © International & American Associations for Dental Research 2016.

  3. Site-specific endometrial injury improves implantation and pregnancy in patients with repeated implantation failures

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    Lin Chieh

    2011-10-01

    Full Text Available Abstract Background To test whether a site-specific hysteroscopic biopsy-induced injury in the endometrium during the controlled ovarian hyperstimulation cycle improves subsequent embryo implantation in patients with repeated implantation failure, a total of 30 patients who have had good responses to controlled ovulation stimulation but have failed to achieve pregnancy after two or more transfers of good-quality embryos were recruited in this prospective study. Methods A single, site-specific hysteroscopic biopsy-induced injury was generated on the posterior endometrium at midline 10-15 mm from the fundus during the D4-D7 period of the ongoing controlled ovarian hyperstimulation cycle in six patients. Results Patients received endometrial biopsy protocol achieved a pregnancy rate of 100%. By contrast, only 46% of patients with similar clinical characteristics (N = 24 achieved pregnancy without the hysteroscopic biopsy-induced endometrium injury (p Conclusions Our proof-of-concept study demonstrates that a site-specific hysteroscopic endometrium injury performed during the ongoing in vitro fertilization (IVF cycle, instead of injuries received during prior cycles, significantly improves clinical outcomes in patients with repeated implantation failure.

  4. Embryo quality and impact of specific embryo characteristics on ongoing implantation in unselected embryos derived from modified natural cycle in vitro fertilization

    NARCIS (Netherlands)

    Pelinck, Marie-Jose; Hoek, Annemieke; Simons, Arnold H. M.; Heineman, Maas Jan; van Echten-Arends, Janny; Arts, Eus G. J. M.

    Objective: To study the implantation potential of unselected embryos derived from modified natural cycle IVF according to their morphological characteristics. Design: Cohort study. Setting: Academic department of reproductive medicine. Patient(S): A series of 449 single embryo transfers derived from

  5. Implant Failure : STRATOS System for Pectus Repair

    NARCIS (Netherlands)

    Sharma, Prashant K.; Willems, Tineke P.; Touw, Daan J.; Woudstra, Willem; Erasmus, Michiel E.; Ebels, Tjark

    Background. Three European centers have recently reported dramatic failures of the STRATOS titanium system, approved in Europe and the United States since 2007 and meant for pectus repair, without detailed exploration of its causes. Methods. Failed implants (fractures or loosened crimp connectors)

  6. A multicenter prospective study to assess the effect of early cleavage on embryo quality, implantation, and live-birth rate.

    Science.gov (United States)

    de los Santos, Maria José; Arroyo, Gemma; Busquet, Ana; Calderón, Gloria; Cuadros, Jorge; Hurtado de Mendoza, Maria Victoria; Moragas, Marta; Herrer, Raquel; Ortiz, Agueda; Pons, Carme; Ten, Jorge; Vilches, Miguel Angel; Figueroa, Maria José

    2014-04-01

    To investigate the impact of early cleavage (EC) on embryo quality, implantation, and live-birth rates. Prospective cross-sectional study. Multicenter study. Seven hundred embryo transfers and 1,028 early-stage human embryos. None. Implantation according to the presence of EC and embryo quality. The presence of EC is associated with embryo quality, especially in cycles with autologous oocytes. However, the use of EC as an additional criterion for selecting an embryo for transfer does not appear to significantly improve likelihood of implantation. Furthermore, embryos that presented EC had live-birth rates per implanted embryo similar to those that did not show any sign of cleavage. At least for conventional embryo culture and morphologic evaluations, the additional evaluation of EC in embryos may not be valuable to improve embryo implantation. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Extracellular vesicles: roles in gamete maturation, fertilization and embryo implantation.

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    Machtinger, Ronit; Laurent, Louise C; Baccarelli, Andrea A

    2016-01-01

    Extracellular vesicles (EVs) are membrane-bound vesicles, found in biofluids, that carry and transfer regulatory molecules, such as microRNAs (miRNAs) and proteins, and may mediate intercellular communication between cells and tissues. EVs have been isolated from a wide variety of biofluids, including plasma, urine, and, relevant to this review, seminal, follicular and uterine luminal fluid. We conducted a systematic search of the literature to review and present the currently available evidence on the possible roles of EVs in follicular growth, resumption of oocyte development and maturation (meiosis), sperm maturation, fertilization and embryo implantation. MEDLINE, Embase and Web of Science databases were searched using keywords pertaining to EVs, including 'extracellular vesicles', 'microvesicles', 'microparticles' and 'exosomes', combined with a range of terms associated with the period of development between fertilization and implantation, including 'oocyte', 'sperm', 'semen', 'fertilization', 'implantation', 'embryo', 'follicular fluid', 'epididymal fluid' and 'seminal fluid'. Relevant research articles published in English (both animal and human studies) were reviewed with no restrictions on publication date (i.e. from earliest database dates to July 2015). References from these articles were used to obtain additional articles. A total of 1556 records were retrieved from the three databases. After removing duplicates and irrelevant titles, we reviewed the abstracts of 201 articles, which included 92 relevant articles. Both animal and human studies unequivocally identified various types of EVs in seminal, follicular and ULFs. Several studies provided evidence for the roles of EVs in these biofluids. In men, EVs in seminal fluid were linked with post-testicular sperm maturation, including sperm motility acquisition and reduction of oxidative stress. In women, EVs in follicular fluid were shown to contain miRNAs with potential roles in follicular growth

  8. Non-invasive metabolomic profiling of embryo culture media and morphology grading to predict implantation outcome in frozen-thawed embryo transfer cycles.

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    Li, Xiong; Xu, Yan; Fu, Jing; Zhang, Wen-Bi; Liu, Su-Ying; Sun, Xiao-Xi

    2015-11-01

    Assessment of embryo viability is a crucial component of in vitro fertilization and currently relies largely on embryo morphology and cleavage rate. Because morphological assessment remains highly subjective, it can be unreliable in predicting embryo viability. This study investigated the metabolomic profiling of embryo culture media using near-infrared (NIR) spectroscopy for predicting the implantation potential of human embryos in frozen-thawed embryo transfer (FET) cycles. Spent embryo culture media was collected on day 4 after thawed embryo transfer (n = 621) and analysed using NIR spectroscopy. Viability scores were calculated using a predictive multivariate algorithm of fresh embryos with known pregnancy outcomes. The mean viability indices of embryos resulting in clinical pregnancy following FET were significantly higher than those of non-implanted embryos and differed between the 0, 50, and 100 % implantation groups. Notably, the 0 % group index was significantly lower than the 100 % implantation group index (-0.787 ± 0.382 vs. 1.064 ± 0.331, P  0.05). NIR metabolomic profiling of thawed embryo culture media is independent of morphology and correlates with embryo implantation potential in FET cycles. The viability score alone or in conjunction with morphologic grading is a more objective marker for implantation outcome in FET cycles than morphology alone.

  9. Analysis of the expression of putatively imprinted genes in bovine peri-implantation embryos

    DEFF Research Database (Denmark)

    Tveden-Nyborg, Pernille Yde; Alexopoulos, N.I.; Cooney, M.A.

    2008-01-01

    imprinted genes (Ata3, Dlk1, Gnas, Grb10, Magel2, Mest-1, Ndn and Sgce) in bovine peri-implantation embryos. Two embryonic developmental stages were examined, Day 14 and Day 21. The gene expression pattern of single embryos was recorded for in vivo, in vitro produced (IVP) and parthenogenetic embryos....... The IVP embryos allow us to estimate the effect of in vitro procedures and the analysis of parthenogenetic embryos provides provisional information on maternal genomic imprinting. Among the 8 genes investigated, only Mest-1 showed differential expression in Day 21 parthenogenetic embryos compared...... to in vivo and IVP counterparts, indicating maternal imprinting of this gene. In addition, our expression analysis of single embryos revealed a more heterogeneous gene expression in IVP than in in vivo developed embryos, adding further to the hypothesis of transcriptional dysregulation induced by in vitro...

  10. Effects of embryo culture media do not persist after implantation: a histological study in mice

    NARCIS (Netherlands)

    Hemkemeyer, Sandra A.; Schwarzer, Caroline; Boiani, Michele; Ehmcke, Jens; le Gac, Severine; Schlatt, Stefan; Nordhoff, Verena

    Is post-implantation embryonic development after blastocyst transfer affected by exposure to different assisted reproduction technology (ART) culture media? Fetal development and placental histology of ART embryos cultured in vitro in different ART media was not impaired compared with embryos grown

  11. Sexing bovine pre-implantation embryos using the polymerase ...

    African Journals Online (AJOL)

    The paper aims to present a bovine model for human embryo sexing. Cows were super-ovulated, artificially inseminated and embryos were recovered 7 days later. Embryo biopsy was performed; DNA was extracted from blastomeres and amplified using bovine-specific and bovine-Y-chromosomespecific primers, followed ...

  12. Early dental implant failure in patient associated with oral bisphosphonates

    Directory of Open Access Journals (Sweden)

    Ridhimaa Gupta

    2012-01-01

    Full Text Available Oral bisphosphonates are routinely prescribed to post menopausal women. These have shown to increase the risk of osteonecrosis. However, this action may be augmented by local factors. A case report is presented showing an early implant failure in a patient taking oral bisphosphonates. Two implants were placed in left maxillary incisor area. Central incisor was associated with a previous endodontic failure and extraction. Lateral incisor was avulsed 3 years back. After 4 weeks of an implant placement, necrotic bone was evident along with the failing implant in central incisor area. This case report emphasizes on the incidence and an increased risk of implant failure in patients taking oral bisphosphonates.

  13. Hypothesis: Co-transfer of genuine embryos and implantation-promoting compounds via artificial containers improve endometrium receptivity.

    Science.gov (United States)

    Celik, Onder; Acet, Mustafa; Celik, Sudenaz; Sahin, Levent; Koc, Onder; Celik, Nilufer

    2017-06-01

    As with other organs endometrial functions are altered with the advancing age. Age related decrease in reproductive functions leads to decline in the number of oocytes retrieved and the synthesis of endometrial receptivity molecules. Despite the significant improvement in assisted reproductive technologies we do not have so many options to enhance endometrial receptivity. Due to lack of drugs having endometrium receptivity enhancement properties, oocyte donation seems to be the only solution for women with implantation failure. The euploid oocytes come from young and healthy donors may overcome age associated endometrial receptivity defect. Nevertheless, many reasons restrict us from using oocyte donation in women with implantation failure. We, therefore, hypothesized that by mimicking a young blastocyst's effect on endometrium, the transfer of genuine embryos and implantation-promoting compounds together might be the new treatment option for infertile women with recurrent implantation failure. Artificial beads, MI or GV oocytes, and empty zona can be used as a container for intrauterine replacement of implantation-promoting compounds. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Confirmed dioestrus in pseudopregnant mice using vaginal exfoliative cytology improves embryo transfer implantation rate.

    Science.gov (United States)

    Mamrot, Jared; Pangestu, Mulyoto; Walker, David; Gardner, David K; Dickinson, Hayley

    2015-10-01

    Embryo transfer is a commonly performed surgical technique. In mice, protocols typically specify pairing recipient females with vasectomized males to induce a receptive uterine environment for embryo implantation. However, this induced receptive state is not always maintained until implantation occurs. The use of a well-characterized correlation between oestrous state and exfoliative vaginal cytology was therefore evaluated to assess uterine receptivity immediately before embryo transfer. Eight- to 12-week-old virgin female CD1 mice (n = 22) were paired overnight with vasectomized males and successfully mated, indicated by the presence of a vaginal plug. These dams underwent embryo transfer 3 days later with embryos obtained from superovulated 4-week-old F1 (C57BL/6 × CBA) females. Non-invasive vaginal lavage was conducted immediately before transfer. Dams were killed 6 days after transfer and the uterus collected for histological analysis. Embryo implantation rate in mice was 96% when cytological analysis of the lavage samples signified dioestrus (n = 6), whereas the implantation rate was cytology signified other stages of oestrous. This simple, quick, non-invasive measure of receptivity was accurate and easily adopted and, when applied prospectively, will avoid unnecessary surgery and subsequent culling of non-suitable recipients, while maximizing the implantation potential of each recipient female. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  15. EGF increases expression and activity of PAs in preimplantation rat embryos and their implantation rate

    Directory of Open Access Journals (Sweden)

    Har-Vardi Iris

    2007-01-01

    Full Text Available Abstract Background Embryo implantation plays a major role in embryogenesis and the outcome of pregnancy. Plasminogen activators (PAs have been implicated in mammalian fertilization, early stages of development and embryo implantation. As in-vitro developing embryos resulted in lower implantation rate than those developed in-vivo we assume that a reduced PAs activity may be involved. In the present work we studied the effect of EGF on PAs activity, quantity and embryo implantation. Methods Zygotes were flushed from rat oviducts on day one of pregnancy and grown in-vitro in R1ECM supplemented with EGF (10 ng/ml and were grown up to the blastocyst stage. The control groups were grown in the same medium without EGF. The distribution and quantity of the PAs were examined using fluorescence immunohistochemistry followed by measurement of PAs activity using the chromogenic assay. Implantation rate was studied using the embryo donation model. Results PAs distribution in the embryos was the same in EGF treated and untreated embryos. Both PAs were localized in the blastocysts' trophectoderm, supporting the assumption that PAs play a role in the implantation process in rats. EGF increased the quantity of uPA at all stages studied but the 8-cell stage as compared with controls. The tissue type PA (tPA content was unaffected except the 8-cell stage, which was increased. The activity of uPA increased gradually towards the blastocyst stage and more so due to the presence of EGF. The activity of tPA did not vary with the advancing developmental stages although it was also increased by EGF. The presence of EGF during the preimplantation development doubled the rate of implantation of the treated group as compared with controls.

  16. Aetiology and Patterns of Implant Failure Following Fracture Fixation ...

    African Journals Online (AJOL)

    Background: Implant failure is traumatic for patient as it increases the cost of treatment and may negatively affect the confidence of patients in the superior outcome of operatively treated fractures. Hence the objectives for this study were to determine the proportion of implant fixations that fail, types and causes of implant ...

  17. Management of bilateral fracture femur with implant failure: a case ...

    African Journals Online (AJOL)

    Successful treatment of a fracture by use of implants is a race between rate of fracture healing and metal fatigue of implant used. Implant failure is thus one of the most feared but often encountered complications in the practice of an orthopaedic surgeon. It becomes even more difficult for the surgeon when a patient has ...

  18. Implant failure in osteosynthesis of fractures of long bones ...

    African Journals Online (AJOL)

    Patients who had open operative treatment of fractures of long bones were reviewed retrospectively to identify the incidence of and risk factors for implant failure. One hundred and five patients had open reduction and internal fixation of 117 fractures of long bones, out of which four patients suffered implant failure.

  19. Expression of microRNAs in bovine and human pre-implantation embryo culture media

    Science.gov (United States)

    Kropp, Jenna; Salih, Sana M.; Khatib, Hasan

    2014-01-01

    MicroRNAs (miRNA) are short non-coding RNAs which act to regulate expression of genes driving numerous cellular processes. These RNAs are secreted within exosomes from cells into the extracellular environment where they may act as signaling molecules. In addition, they are relatively stable and are specifically expressed in association to certain cancers making them strong candidates as biological markers. Moreover, miRNAs have been detected in body fluids including urine, milk, saliva, semen, and blood plasma. However, it is unknown whether they are secreted by embryonic cells into the culture media. Given that miRNAs are expressed throughout embryonic cellular divisions and embryonic genome activation, we hypothesized that they are secreted from the embryo into the extracellular environment and may play a role in the developmental competence of bovine embryos. To test this hypothesis, bovine embryos were cultured individually from day 5 to day 8 of development in an in vitro fertilization system and gene expression of 5 miRNAs was analyzed in both embryos and culture media. Differential miRNA gene expression was observed between embryos that developed to the blastocyst stage and those that failed to develop from the morula to blastocyst stage, deemed degenerate embryos. MiR-25, miR-302c, miR-196a2, and miR-181a expression was found to be higher in degenerate embryos compared to blastocyst embryos. Interestingly, these miRNAs were also found to be expressed in the culture media of both bovine and human pre-implantation embryos. Overall, our results show for the first time that miRNAs are secreted from pre-implantation embryos into culture media and that miRNA expression may correlate with developmental competence of the embryo. Expression of miRNAs in in vitro culture media could allow for the development of biological markers for selection of better quality embryos and for subsequent successful pregnancy. PMID:24795753

  20. Expression of microRNAs in bovine and human pre-implantation embryo culture media

    Directory of Open Access Journals (Sweden)

    Jenna eKropp

    2014-04-01

    Full Text Available MicroRNAs (miRNA are short non-coding RNAs which act to regulate expression of genes driving numerous cellular processes. These RNAs are secreted within exosomes from cells into the extracellular environment where they may act as signaling molecules. In addition, they are relatively stable and are specifically expressed in association to certain cancers making them strong candidates as biological markers. Moreover, miRNAs have been detected in body fluids including urine, milk, saliva, semen, and blood plasma. However, it is unknown whether they are secreted by embryonic cells into the culture media. Given that miRNAs are expressed throughout embryonic cellular divisions and embryonic genome activation, we hypothesized that they are secreted from the embryo into the extracellular environment and may play a role in the developmental competence of bovine embryos. To test this hypothesis, bovine embryos were cultured individually from day 5 to day 8 of development in an in vitro fertilization system and gene expression of 5 miRNAs was analyzed in both embryos and culture media. Differential miRNA gene expression was observed between embryos that developed to the blastocyst stage and those that failed to develop from the morula to blastocyst stage, deemed degenerate embryos. MiR-25, mir-302c, miR-196a2, and miR-181a expression was found to be higher in degenerate embryos compared to blastocyst embryos. Interestingly, these miRNAs were also found to be expressed in the culture media of both bovine and human pre-implantation embryos. Overall, our results show for the first time that miRNAs are secreted from pre-implantation embryos into culture media and that miRNA expression may correlate with developmental competence of the embryo. Expression of miRNAs in in vitro culture media could allow for the development of biological markers for selection of better quality embryos and for subsequent successful pregnancy.

  1. Sexing bovine pre-implantation embryos using the polymerase ...

    African Journals Online (AJOL)

    Yomi

    2012-03-06

    Mar 6, 2012 ... can also be applied to human embryos, using different primers, designed for human DNA. Key words: sexing, embryo, PCR, bovine. INTRODUCTION. In vitro fertilization represents nowadays a modern assisted reproductive technology that can be applied to couples with fertility problems that make natural ...

  2. Impact of Different Surgeons on Dental Implant Failure.

    Science.gov (United States)

    Chrcanovic, Bruno Ramos; Kisch, Jenö; Albrektsson, Tomas; Wennerberg, Ann

    To assess the influence of several factors on the prevalence of dental implant failure, with special consideration of the placement of implants by different dental surgeons. This retrospective study is based on 2,670 patients who received 10,096 implants at one specialist clinic. Only the data of patients and implants treated by surgeons who had inserted a minimum of 200 implants at the clinic were included. Kaplan-Meier curves were stratified with respect to the individual surgeon. A generalized estimating equation (GEE) method was used to account for the fact that repeated observations (several implants) were placed in a single patient. The factors bone quantity, bone quality, implant location, implant surface, and implant system were analyzed with descriptive statistics separately for each individual surgeon. A total of 10 surgeons were eligible. The differences between the survival curves of each individual were statistically significant. The multivariate GEE model showed the following variables to be statistically significant: surgeon, bruxism, intake of antidepressants, location, implant length, and implant system. The surgeon with the highest absolute number of failures was also the one who inserted the most implants in sites of poor bone and used turned implants in most cases, whereas the surgeon with the lowest absolute number of failures used mainly modern implants. Separate survival analyses of turned and modern implants stratified for the individual surgeon showed statistically significant differences in cumulative survival. Different levels of failure incidence could be observed between the surgeons, occasionally reaching significant levels. Although a direct causal relationship could not be ascertained, the results of the present study suggest that the surgeons' technique, skills, and/or judgment may negatively influence implant survival rates.

  3. Implantable Cardiac Defibrillator Lead Failure and Management.

    Science.gov (United States)

    Swerdlow, Charles D; Kalahasty, Gautham; Ellenbogen, Kenneth A

    2016-03-22

    The implantable-cardioverter defibrillator (ICD) lead is the most vulnerable component of the ICD system. Despite advanced engineering design, sophisticated manufacturing techniques, and extensive bench, pre-clinical, and clinical testing, lead failure (LF) remains the Achilles' heel of the ICD system. ICD LF has a broad range of adverse outcomes, ranging from intermittent inappropriate pacing to proarrhythmia leading to patient mortality. ICD LF is often considered in the context of design or construction defects, but is more appropriately considered in the context of the finite service life of a mechanical component placed in chemically stressful environment and subjected to continuous mechanical stresses. This clinical review summarizes LF mechanisms, assessment, and differential diagnosis of LF, including lead diagnostics, recent prominent lead recalls, and management of LF and functioning, but recalled leads. Despite recent advances in lead technology, physicians will likely continue to need to understand how to manage patients with transvenous ICD leads. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  4. PreImplantation Factor (PIF correlates with early mammalian embryo development-bovine and murine models

    Directory of Open Access Journals (Sweden)

    Coulam Carolyn B

    2011-05-01

    Full Text Available Abstract Background PreImplantation Factor (PIF, a novel peptide secreted by viable embryos is essential for pregnancy: PIF modulates local immunity, promotes decidual pro-adhesion molecules and enhances trophoblast invasion. To determine the role of PIF in post-fertilization embryo development, we measured the peptide's concentration in the culture medium and tested endogenous PIF's potential trophic effects and direct interaction with the embryo. Methods Determine PIF levels in culture medium of multiple mouse and single bovine embryos cultured up to the blastocyst stage using PIF-ELISA. Examine the inhibitory effects of anti-PIF-monoclonal antibody (mAb added to medium on cultured mouse embryos development. Test FITC-PIF uptake by cultured bovine blastocysts using fluorescent microscopy. Results PIF levels in mouse embryo culture medium significantly increased from the morula to the blastocyst stage (ANOVA, P = 0.01. In contrast, atretic embryos medium was similar to the medium only control. Detectable - though low - PIF levels were secreted already by 2-cell stage mouse embryos. In single bovine IVF-derived embryos, PIF levels in medium at day 3 of culture were higher than non-cleaving embryos (control (P = 0.01 and at day 7 were higher than day 3 (P = 0.03. In non-cleaving embryos culture medium was similar to medium alone (control. Anti-PIF-mAb added to mouse embryo cultures lowered blastocyst formation rate 3-fold in a dose-dependent manner (2-way contingency table, multiple groups, X2; P = 0.01 as compared with non-specific mouse mAb, and medium alone, control. FITC-PIF was taken-up by cultured bovine blastocysts, but not by scrambled FITC-PIF (control. Conclusions PIF is an early embryo viability marker that has a direct supportive role on embryo development in culture. PIF-ELISA use to assess IVF embryo quality prior to transfer is warranted. Overall, our data supports PIF's endogenous self sustaining role in embryo development and the

  5. The relationship between panoramic indices and dental implant failure

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Hyun Jung; Yi, Won Jin; Heo, Min Suk; Lee, Jin Koo; Lee, Sam Sun; Choi, Soon Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of); An, Chang Hyeon [Kyungpook National University College of Medicine, Taegu (Korea, Republic of)

    2004-03-15

    Several panoramic indices have been suggested to assess bone quality from the morphology and width of mandibular cortex on panoramic radiography. The purpose of this study was to compare dental implant failure group with control group in panoramic mandibular index (PMI), mandibular cortical index (MCI), and gonion index (GI) and to determine the effect of these panoramic indices on dental implant failure. A case-control study was designed. Test group (n = 42) consisted of the patients who had their implants extracted because of peri-implantitis. Control group (n = 139) consisted of the patients who retained their implants over one year without any pathologic changes and had been followed up periodically. They had dental implants installed in their mandibles without bone augmentation surgery from 1991 to 2001. The following measures were collected for each patients: 1) PMI, MCI, and GI were measured twice at one-week interval on preoperative panoramic views; and 2) age, sex, implant length, implant type, installed location, occluding dentition state, and complication were investigated from the chart record. The PMI showed moderate level of repeatability. The intra-observer agreement of MCI and GI were good. There was statistically significant difference in PMI between two groups. There were significant different patterns of distribution of MCI and GI between two groups. Among the panoramic indices, PMI and MCI showed significant correlation with dental implant failure. Panoramic indices can be used as reference data in estimating bone quality of edentulous patients who are to have implants installed in their mandibles.

  6. Cochlear implant failure: imaging evaluation of the electrode course

    Energy Technology Data Exchange (ETDEWEB)

    Jain, R.; Mukherji, S.K

    2003-04-01

    Cochlear implant (CI) is an electronic device used to rehabilitate patients with sensorineural hearing loss. The intent of this review is to demonstrate the normal position of the electrode on computed tomography (CT) and contrast this with various examples of the electrode malpositioning. Post-implantation CT is performed to localize the cause of implant failure in patients in which radiographs suggest an anomalous course of the electrode. A common cause of device failure is extrusion or malpositioning of the electrode. It is important for the radiologists to recognize this important aspect of device failure. Post-implant CT can help identify patients with malpositioned electrode in whom another attempt can be made by correctly re-implanting the electrode.

  7. Can intracytoplasmic sperm injection prevent total fertilization failure and enhance embryo quality in patients with non-male factor infertility?

    Science.gov (United States)

    Kim, Ju Yeong; Kim, Jee Hyun; Jee, Byung Chul; Lee, Jung Ryeol; Suh, Chang Suk; Kim, Seok Hyun

    2014-07-01

    To determine whether intracytoplasmic sperm injection (ICSI) could prevent total fertilization failure (TFF) and enhance the embryo quality in patients with non-male factor infertility. A total of 296 in vitro fertilization (IVF) cycles performed in patients with non-male factor infertility between April 2009 and March 2013 were included in this retrospective study. During the period, ICSI and conventional IVF were performed in 142 and 154 cycles, respectively. The usual indications for ICSI were in the cycles of patients with (1) known low fertilization rate, (2) repetitive implantation failure, (3) advanced maternal age, (4) presence of endometrioma, (5) low oocyte yield (number of oocytes ≤3), or (6) poor quality oocytes. The rate of TFF, normal fertilization, abnormal pronuclei (PN) formation, embryo quality, and pregnancy outcomes between the patients treated with ICSI and conventional IVF cycles were compared. The patients treated with ICSI (ICSI group, n=142) presented fewer number of oocytes than patients treated with conventional IVF cycles (n=154). The TFF rate was not different (4.2% vs. 0.6%, P=0.059), but the ICSI group presented a significantly higher rate of normal fertilization (83.4% vs. 79.1%, P=0.04) and lower rate of abnormal PN formation (3.9% vs. 13.3%, Pfertilization rate and the embryo quality. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. Intertrochanteric fracture non-unions with implant failure of the ...

    African Journals Online (AJOL)

    Failure of internal fixation of intertrochanteric fracture is associated with delayed union or malunion resulting in persistent pain and diminished function. We report a rare case of implant failure of the gamma nail with intertrochanteric fracture non union treated by DCS plate screw and bone graft. Pan African Medical Journal ...

  9. Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure

    DEFF Research Database (Denmark)

    Køber, Lars; Thune, Jens J; Nielsen, Jens C

    2016-01-01

    BACKGROUND: The benefit of an implantable cardioverter-defibrillator (ICD) in patients with symptomatic systolic heart failure caused by coronary artery disease has been well documented. However, the evidence for a benefit of prophylactic ICDs in patients with systolic heart failure that is not due...

  10. Appropriate Crypt Formation in the Uterus for Embryo Homing and Implantation Requires Wnt5a-ROR Signaling

    Directory of Open Access Journals (Sweden)

    Jeeyeon Cha

    2014-07-01

    Full Text Available Embryo homing and implantation occur within a crypt (implantation chamber at the antimesometrial (AM pole along the uterus. The mechanism by which this is achieved is not known. Here, we show that villi-like epithelial projections from the main uterine lumen toward the AM pole at regularly spaced intervals that form crypts for embryo implantation were disrupted in mice with uterine loss or gain of function of Wnt5a, or loss of function of both Ror1 and Ror2. This disruption of Wnt5a-ROR signaling resulted in disorderly epithelial projections, crypt formation, embryo spacing, and impaired implantation. These early disturbances under abnormal Wnt5a-ROR signaling were reflected in adverse late pregnancy events, including defective decidualization and placentation, ultimately leading to compromised pregnancy outcomes. This study presents deeper insight regarding the formation of organized epithelial projections for crypt formation and embryo implantation for pregnancy success.

  11. Protein Expression Landscape of Mouse Embryos during Pre-implantation Development

    Directory of Open Access Journals (Sweden)

    Yawei Gao

    2017-12-01

    Full Text Available Pre-implantation embryo development is an intricate and precisely regulated process orchestrated by maternally inherited proteins and newly synthesized proteins following zygotic genome activation. Although genomic and transcriptomic studies have enriched our understanding of the genetic programs underlying this process, the protein expression landscape remains unexplored. Using quantitative mass spectrometry, we identified nearly 5,000 proteins from 8,000 mouse embryos of each stage (zygote, 2-cell, 4-cell, 8-cell, morula, and blastocyst. We found that protein expression in zygotes, morulas, and blastocysts is distinct from 2- to 8-cell embryos. Analysis of protein phosphorylation identified critical kinases and signal transduction pathways. We highlight key factors and their important roles in embryo development. Combined analysis of transcriptomic and proteomic data reveals coordinated control of RNA degradation, transcription, and translation and identifies previously undefined exon-junction-derived peptides. Our study provides an invaluable resource for further mechanistic studies and suggests core factors regulating pre-implantation embryo development.

  12. Falha prematura em implantes orais = Early oral implant failures

    Directory of Open Access Journals (Sweden)

    Fadanelli, Alexandro Bianchi

    2005-01-01

    Full Text Available Atualmente, ainda há uma percentagem significativa de fracassos de implantes na prática clínica, causando transtorno para o profissional e para o paciente. O objetivo deste estudo foi avaliar a bibliografia disponível sobre o assunto, apresentar um caso clínico e discutir os aspectos relacionados aos insucessos na terapia com implantes ocorridos durante o período de osteointegração. A avaliação da literatura mostrou haverem múltiplos fatores possivelmente envolvidos nas falhas de implantes, sendo que através do estudo das falhas pode-se minimizar sua ocorrência

  13. A Legal Jurisprudential Deliberation on Lineage and Inheritance of the Pre-Implantation Embryo

    Directory of Open Access Journals (Sweden)

    Mohammad Taqi Rafiei

    2012-01-01

    Full Text Available Today, in vitro fertilization (IVF is not just a medical issue, but certainly also a complex legal issue, in which lawyers can play an important role by establishing the suitable legal conditions to regulate legal relations by introducing necessary theories. One of the important and controversial issues, which can be approached legally, is the study of the pre-implantation embryo with regard to property law, especially the inheritance of the pre-implantation embryo. Article 3 of the Conditions of Embryo Donation to Infertile Couples Act of the year 2003 only stipulates the responsibilities of the intended couple and born child in terms of support, upbringing, maintenance and respect; it does not specify any law regarding the other financial outcomes of lineage like "inheritance", which makes this law imperfect. Also, in view of the fact that lineage is one of the causes of inheritance; studying inheritance without analyzing lineage in the pre-implantation embryo is not possible. Therefore, it is recommended to study lineage and inheritance simultaneously. Some questions arise in this regard, including whether it is possible to prove lineage between the genetic father and mother with a laboratory child, and between the owner of the womb (that is intended wife and the child. Supposing the lineage is proved, what is the state of inheritance between them? Lawyers and Islamic jurists have different opinions regarding the lineage of the pre-implantation embryo and inheritance. The author believes that the owner of the sperm is regarded as the genetic father of the child and in terms of lineage between laboratory child and mother two genetic and carrying factors must be considered. Thereby, considering inheritance between the genetic father and the child is possible according to inheritance law. Regarding the inheritance state of a laboratory child from two mothers the problem can be solved by using the equality rule within the framework of inheritance

  14. Evidence For Hmgn2 Involvement in Mouse Embryo Implantation and Decidualization

    Directory of Open Access Journals (Sweden)

    Dang-Dang Li

    2017-12-01

    Full Text Available Background/Aims: Hmgn2 is involved in regulating embryonic development, but its physiological function during embryo implantation and decidualization remains unknown. Methods: In situ hybridization, real-time PCR, RNA interference, gene overexpression and MTS assay were used to examine the expression of Hmgn2 in mouse uterus during the pre-implantation period and explore its function and regulatory mechanisms in epithelial adhesion junction and stromal cell proliferation and differentiation. Results: Hmgn2 was primarily accumulated in uterine luminal epithelia on day 4 of pregnancy and subluminal stromal cells around the implanting blastocyst at implantation sites on day 5. Similar results were observed during delayed implantation and activation. Meanwhile, Hmgn2 expression was visualized in the decidua. In uterine epithelial cells, silencing of Hmgn2 by specific siRNA reduced the expression of adhesion molecules Cdh1, Cdh2 and Ctnnb1 and enhanced the expression of Muc1, whereas constitutive activation of Hmgn2 exhibited the opposite effects, suggesting a role for Hmgn2 in attachment reaction during embryo implantation. Estrogen stimulated the expression of Hmgn2 in uterine epithelia, but the stimulation was abrogated by ER antagonist ICI 182,780. Further analysis evidenced that attenuation of Hmgn2 might eliminate the regulation of estrogen on the expression of Cdh1, Cdh2 and Ctnnb1. In uterine stromal cells, progesterone induced the accumulation of Hmgn2 which advanced the expression of Prl8a2 and Prl3c1, two well-known differentiation markers for decidualization, but did not affect the proliferation of stromal cells. Knockdown of Hmgn2 blocked the progesterone-induced differentiation of uterine stromal cells. Moreover, Hmgn2 might serve as an intermediate to mediate the regulation of progesterone on Hand2. Conclusion: Hmgn2 may play an important role during embryo implantation and decidualization.

  15. Effect of antibiotics on implant failure and postoperative infection.

    Science.gov (United States)

    Bafail, Arwa S; Alamri, Ahmed M; Spivakovsky, Silvia

    2014-06-01

    Medline and hand search of the British Journal of Oral and Maxillofacial Surgery, Clinical Implant Dentistry and Related Research, Clinical Oral Investigations, Clinical Oral Implants Research, European Journal of Oral Implantology, Implant Dentistry, International Journal of Oral and Maxillofacial Implants, International Journal of Oral and Maxillofacial Surgery, Journal of Clinical Periodontology, Journal of Oral Implantology, Journal of Oral and Maxillofacial Surgery, Journal of Periodontology Medicina Oral, Patologa Oral y Cirugía Bucal, and Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. Search of the literature was made to identify randomised controlled trials (RCTs) on the efficacy of antibiotics compared with a control group (not receiving antibiotics or receiving placebo. All articles selected from the electronic and manual searches were independently assessed by the first and second authors of this study, in accordance with the established inclusion criteria. Two reviewers independently and in duplicate evaluated the quality of the included RCTs as part of the data extraction process. Four RCTs were included in the final review. These four RCTs grouped a total of 2063 implants and a total of 1002 patients. Antibiotic use significantly lowered the implant failure rate (P = 0.003), with an odds ratio of 0.331, implying that antibiotic treatment reduced the odds of failure by 66.9%. The number needed to treat (NNT) to prevent one patient from having an implant failure was 48 (95% confidence interval 31-109). In contrast, antibiotic use did not significantly reduce the incidence of postoperative infection (P = 0.754). Based on the results of this meta-analysis, and pending further research in the field, it can be concluded that there is evidence in favour of systematic antibiotic use in patients receiving dental implants, since such treatment significantly reduces implant failure. In contrast, antibiotic use does not exert a

  16. Tissue expression of EphB2 and RNA-seq analysis during embryo im-plantation in Meishan pigs.

    Science.gov (United States)

    Fu, Yanfeng; Zhou, Yanhong; Wang, Aiguo; Li, Lan; Liu, Honglin; Li, Bixia; Ren, Shouwen

    2014-12-01

    Embryo implantation is a key step affecting swine litter size, which is an important economic and reproduction trait in pigs. In order to investigate the effect of erythropoietin-producing hepatocellular receptor B2 (EphB2) on endometrium migration and attachment during swine embryo implantation, the mRNA and protein expression levels of EphB2 in endometrium implantation sites, endometrium non-implantation sites and ovary were detected in Meishan sows during pre-implantation, mid-implantation and post-implantation period using real-time quantitative PCR and Western blot. Differential expression genes were also analyzed in endometrium implantation sites and ovary during different implantation periods by RNA sequencing (RNA-seq) technology. The qRT-PCR and Western blot results showed that EphB2 mRNA and protein expression curve was the same in endomtrium implantation sites and endometrium non-implantation sites during pre-implantation, mid-implantation and post-implantation period, with a first increase followed by a decrease, and its expression level during mid-implantation was significantly higher than pre-implantation and post-implantation (Ppigs.

  17. Role of Serpine gene polymorphism in recurrent implantation failure and preeclampsia

    Directory of Open Access Journals (Sweden)

    Nidhi Sharma

    2017-01-01

    Full Text Available This is a rare case of serpine gene polymorphism causing thrombophilia and recurrent implantation failure following intrauterine insemination. SERPINE1 gene encodes plasminogen activator inhibitor type 1 and inhibits fibrinolysis, or clot dissolution. The 4G variant results in increased expression of SERPINE1 and consequently higher inhibition of fibrinolysis, thus leading to thrombophilia. The patient had unexplained primary infertility for 9 years. Ovulation induction was done with gonadotropin releasing hormone (GnRH agonist long protocol. Recombinant follicle stimulating hormone (FSH with step down protocol was used. Ovulation trigger was given with recombinant human chorionic gonadotrophin (HCG. Ovum pick up was done after 40 h of trigger. A total of 13 eggs were collected. Patient was put on Cabergoline to prevent ovarian hyperstimulation syndrome (OHSS. Four frozen embryos were transferred on day 14 after Laser-assisted hatching. EmbryoGlue was used to prevent implantation failure. Luteal phase support was given. She was put on enoxaparin and pregnancy has now been confirmed. The patient was on strict monitoring as this gene is also associated with preeclampsia during pregnancy.

  18. Implant complications and failures: the fixed prosthesis.

    Science.gov (United States)

    Tinsley, D; Watson, C J; Preston, A J

    2002-11-01

    The implant-retained fixed prosthesis has been advocated as an effective restoration offering significant benefits over conventional prosthetics. The success of treatment depends on careful pre-surgical planning and prosthesis design. This paper outlines some common complications encountered during the planning, fabrication and maintenance of both large and small fixed prostheses and suggests how these complications can be minimized.

  19. The role of matrix metalloproteinase-2 in the culture media in embryo implantation rate in normogonadotrophic cases undergoing ICSI

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    Yasser Ibrahim Orief

    2013-12-01

    Recommendations: Results of the present study suggest searching for other markers in the culture media for better embryo selection and for prediction of implantation in the normogonadotrophic cases undergoing ICSI.

  20. Specific gene-regulation networks during the pre-implantation development of the pig embryo as revealed by deep sequencing.

    Science.gov (United States)

    Cao, Suying; Han, Jianyong; Wu, Jun; Li, Qiuyan; Liu, Shichao; Zhang, Wei; Pei, Yangli; Ruan, Xiaoan; Liu, Zhonghua; Wang, Xumin; Lim, Bing; Li, Ning

    2014-01-03

    Because few studies exist to describe the unique molecular network regulation behind pig pre-implantation embryonic development (PED), genetic engineering in the pig embryo is limited. Also, this lack of research has hindered derivation and application of porcine embryonic stem cells and porcine induced pluripotent stem cells (iPSCs). We identified and analyzed the genome wide transcriptomes of pig in vivo-derived and somatic cell nuclear transferred (SCNT) as well as mouse in vivo-derived pre-implantation embryos at different stages using mRNA deep sequencing. Comparison of the pig embryonic transcriptomes with those of mouse and human pre-implantation embryos revealed unique gene expression patterns during pig PED. Pig zygotic genome activation was confirmed to occur at the 4-cell stage via genome-wide gene expression analysis. This activation was delayed to the 8-cell stage in SCNT embryos. Specific gene expression analysis of the putative inner cell mass (ICM) and the trophectoderm (TE) revealed that pig and mouse pre-implantation embryos share regulatory networks during the first lineage segregation and primitive endoderm differentiation, but not during ectoderm commitment. Also, fatty acid metabolism appears to be a unique characteristic of pig pre-implantation embryonic development. In addition, the global gene expression patterns in the pig SCNT embryos were different from those in in vivo-derived pig embryos. Our results provide a resource for pluripotent stem cell engineering and for understanding pig development.

  1. Pregnancy outcomes in women with repeated implantation failures after intracytoplasmic morphologically selected sperm injection (IMSI

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    Mauri Ana L

    2011-07-01

    Full Text Available Abstract Background The purpose of this study was to compare laboratory and clinical outcomes of intracytoplasmic morphologically selected sperm injection (IMSI and conventional intracytoplasmic sperm injection (ICSI in couples with repeated implantation failures. Methods A total of 200 couples with at least two prior unsuccessful ICSI cycles were enrolled: 100 couples were submitted to IMSI and 100 were submitted to routine ICSI. For IMSI, spermatozoa were selected at 8400× magnification using an inverted microscope equipped with Nomarski (differential interference contrast optics. For conventional ICSI, spermatozoa were selected at 400× magnification. Clinical outcomes were evaluated between the two groups. Results Study patients were comparable in age, number of treatment failures, aetiology of infertility, percentage of normal form assessed by MSOME (motile sperm organelle morphology examination, semen parameters, total number of oocytes collected, number of mature oocytes collected, total number of embryos transferred and number of high-quality embryos transferred. No statistically significant differences between the two groups were observed with regard to rates of fertilisation, implantation and pregnancy/cycle. Although not statistically significant, rates of miscarriage (IMSI:15.3% vs ICSI:31.7%, ongoing pregnancy (IMSI:22% vs ICSI:13% and live births (IMSI:21% vs ICSI:12% showed a trend towards better outcomes in the IMSI group. In addition, analysis of subpopulations with or without male factor showed similar results. Conclusions Our results suggest that IMSI does not provide a significant improvement in clinical outcome compared to ICSI, at least in couples with repeated implantation failures after conventional ICSI. However, it should be noted that there were clear trends for lower miscarriage rates (≈50% reduced and higher rates of ongoing pregnancy and live births (both nearly doubled within the IMSI group. Further confirmation

  2. Loss of Bmal1 decreases oocyte fertilization, early embryo development and implantation potential in female mice.

    Science.gov (United States)

    Xu, Jian; Li, Yan; Wang, Yizi; Xu, Yanwen; Zhou, Canquan

    2016-10-01

    Biological clock genes expressed in reproductive tissues play important roles in maintaining the normal functions of reproductive system. However, disruption of female circadian rhythm on oocyte fertilization, preimplantation embryo development and blastocyst implantation potential is still unclear. In this study, ovulation, in vivo and in vitro oocyte fertilization, embryo development, implantation and intracellular reactive oxygen species (ROS) levels in ovary and oviduct were studied in female Bmal1+/+ and Bmal1-/- mice. The number of naturally ovulated oocyte in Bmal1-/- mice decreased (5.2 ± 0.8 vs 7.8 ± 0.8, P fertilization rate and obtained blastocyst number were observed in Bmal1-/- female mice either mated with wild-type in vivo or fertilized by sperm from wild-type male mice in vitro (all P fertilization rate of oocytes derived from Bmal1-/- increased significantly compared with in vivo study (P fertilization rate, early embryo development and implantation potential in female mice, and these may be possibly caused by excess ROS levels generated in ovary and oviduct.

  3. Successful treatment of early implant failure: a case series.

    Science.gov (United States)

    AlGhamdi, Ali Saad Thafeed

    2012-06-01

    The aim of this longitudinal study was to evaluate the effect of combined treatment on early progressive bone loss around dental implants. The study sample consisted of 18 implants presenting at 4-6 weeks postplacement with early progressive bone loss. Clinical examination indicated the presence of a fistula in the soft tissue covering the implants in most cases. Defects around the implants were curetted, exposed implant surfaces were mechanically debrided and treated with tetracycline solution, and the defects were filled with bone graft and doxycycline powder. Bioabsorbable membranes were used. Final crowns were placed after 6 months. The patients were followed for an average of 30 months. The surgical sites healed without complication. At the time of loading, the defects were completely restored. At 12 months postloading, there was crestal bone loss to the level of the first thread (average, 1.3 mm). Pocket depths ranged from 3 to 5 mm (average, 3.6 mm) with no bleeding. No further changes were noticed throughout the remaining follow-up visits. All implants were successful according to the criteria proposed by Albrektsson and colleagues. Early detection and treatment of early progressive bone loss around dental implants are the key to saving early failing implants. The author recommends reevaluation visits 4-6 weeks postimplant placement to detect any signs of early failure so that immediate treatment can be undertaken if needed. © 2010 Wiley Periodicals, Inc.

  4. Early Diagnosis of Orthopedic Implant Failure Using Macromolecular Imaging Agents

    Science.gov (United States)

    Ren, Ke; Dusad, Anand; Zhang, Yijia; Purdue, P. Edward; Fehringer, Edward V.; Garvin, Kevin L.; Goldring, Steven R.; Wang, Dong

    2014-01-01

    Purpose To develop and evaluate diagnostic tools for early detection of wear particle-induced orthopaedic implant loosening. Methods N-(2-hydroxypropyl)methacrylamide (HPMA) copolymer was tagged with an near infrared dye and used to detect the inflammation induced by polymethylmethacrylate (PMMA) particles in a murine peri-implant osteolysis model. It was established by inserting implant into distal femur and with routine PMMA particles challenging. The osteolysis was evaluated by micro-CT and histological analysis at different time points. Results Significant peri-implant osteolysis was found three-month post PMMA particle challenge by micro-CT and histological analysis. At one-month time point, when there was no significant peri-implant bone loss, HPMA copolymer-near infrared dye conjugate was found to specifically target to the femur with PMMA particles deposition, but not the contralateral control femur with PBS infusion. Conclusion The results from this study demonstrated the feasibility of utilizing the macromolecular diagnostic agent to report particle-induced peri-implant inflammation prior to the development of detectable osteolysis. Recognition of this early pathological event would provide the window of opportunity for prevention of peri-implant osteolysis and subsequent orthopaedic implant failure. PMID:24590878

  5. Dysregulated LIF-STAT3 pathway is responsible for impaired embryo implantation in a Streptozotocin-induced diabetic mouse model

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    Tong-Song Wang

    2015-07-01

    Full Text Available The prevalence of diabetes is increasing worldwide with the trend of patients being young and creating a significant burden on health systems, including reproductive problems, but the effects of diabetes on embryo implantation are still poorly understood. Our study was to examine effects of diabetes on mouse embryo implantation, providing experimental basis for treating diabetes and its complications. Streptozotocin (STZ was applied to induce type 1 diabetes from day 2 of pregnancy or pseudopregnancy in mice. Embryo transfer was used to analyze effects of uterine environment on embryo implantation. Our results revealed that the implantation rate is significantly reduced in diabetic mice compared to controls, and the change of uterine environment is the main reason leading to the decreased implantation rate. Compared to control, the levels of LIF and p-STAT3 are significantly decreased in diabetic mice on day 4 of pregnancy, and serum estrogen level is significantly higher. Estrogen stimulates LIF expression under physiological level, but the excessive estrogen inhibits LIF expression. LIF, progesterone or insulin supplement can rescue embryo implantation in diabetic mice. Our data indicated that the dysregulated LIF-STAT3 pathway caused by the high level of estrogen results in the impaired implantation in diabetic mice, which can be rescued by LIF, progesterone or insulin supplement.

  6. Characteristics of implant failures in patients with a history of oral bisphosphonate therapy.

    Science.gov (United States)

    Martin, Daniel C; O'Ryan, Felice S; Indresano, A Thomas; Bogdanos, Pete; Wang, Benjamin; Hui, Rita L; Lo, Joan C

    2010-03-01

    This study examines the pattern of implant failures reported in a large cohort of patients who received oral bisphosphonate therapy. A total of 8,572 individuals who received oral bisphosphonate drugs returned a dental survey that obtained information pertaining to implant placement and related complications. Among the 589 individuals reporting dental implants, 16 reported implant failures that were verified by dental records. Implant placement, timing of failure, and bisphosphonate duration were ascertained to determine the characteristics of implant loss in the setting of oral bisphosphonate exposure. Among the 16 patients (all women, aged 70.2 +/- 7.6 yrs) there were 26 implant failures; 8 had failure of 12 implants in the maxilla and 9 had failure of 14 implants in the mandible. Early failure (failures (>1 yr after placement) occurred in 10 patients (18 implants); 2 patients had both early and late failures. Overall, few patients reported implant failures. However, among these, there were more late than early failures and a slightly higher proportion of failures in the mandible versus the maxilla. Further studies should investigate the role of chronic bisphosphonate therapy in implant survival and long-term implant osseointegration. Copyright (c) 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Prevalence and timing of individual cochlear implant electrode failures.

    Science.gov (United States)

    Carlson, Matthew L; Archibald, David J; Dabade, Tushar S; Gifford, Rene H; Neff, Brian A; Beatty, Charles W; Barrs, David M; Driscoll, Colin L W

    2010-08-01

    To identify the prevalence of individual electrode failures as a result of open and short circuits in the Nucleus N24 and Freedom series and the Advanced Bionics CII and HR90k (Helix and 1J) devices. Retrospective chart review. Tertiary referral center. Age at implantation, date of surgery, device type, and other relevant demographic data in addition to telemetry and impedance data were collected on 636 implants. Individual electrode circuit failures were identified using impedance testing performed intraoperatively and during subsequent programming sessions. Individual electrode failures were categorized as either "short" or "open" circuits as determined by manufacturer software algorithms. Combining all devices, the risk of 1 or more failures as determined by impedance telemetry is 9.0%. Three or more individual electrode circuit failures within an array may indicate impending deterioration of device performance and future need of reimplantation. Open and short circuits are routinely encountered. They can be managed by deactivating the affected electrode(s), and conventional wisdom states that this has little impact on performance. However, it is true that multiple failures are often associated with decreased performance and often lead to revision surgery. Certainly, every patient would prefer to have a fully functional device. Continued reporting of individual electrode circuit failures is critical to product development and improving overall device reliability.

  8. Intracavitary physiotherapy is not inferior to endometrial scratching in patients with recurrent implantation failure.

    Science.gov (United States)

    Zhang, Qian; Zhang, Bo; Yan, Junhao; Zhang, Chu; Tang, Rong; Sheng, Yan; Wang, Na; Chen, Zi-Jiang

    2015-01-01

    To investigate whether intracavitary physiotherapy is superior to endometrial scratching in patients with recurrent implantation failure (RIF) after in vitro fertilization/intracytoplasmic sperm injection- embryo transfer (IVF/ICSI-ET) cycles. According to the inclusion criteria defined by our hospital, 63 patients with RIF were included in the retrospective study. 20 patients who received intracavitary physiotherapy were classified into Group A, 8 patients with both intracavitary physiotherapy and endometrial scratching were into Group B, and 35 patients who underwent endometrial scratching were into Group C. The primary outcome measures were implantation and clinical pregnancy rates. The secondary outcome measure was pregnancy outcome. There were no statistical differences in implantation and clinical pregnancy rates between Groups A and C (29.41 vs 35.59 %, 45.00 vs 48.57 % respectively, P > 0.05), Groups B and C (36.36 vs 35.59 %, 50.00 vs 48.57 % respectively, P > 0.05). In addition, no statistical differences were discovered in pregnancy outcomes between Groups A and C (P > 0.05), Groups B and C (P > 0.05). Intracavitary physiotherapy is not inferior to endometrial scratching on improving implantation and clinical pregnancy rates in patients with RIF after IVF/ICSI cycles.

  9. Modulation of the maternal immune system by the pre-implantation embryo

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    Walker Caroline G

    2010-08-01

    Full Text Available Abstract Background A large proportion of pregnancy losses occur during the pre-implantation period, when the developing embryo is elongating rapidly and signalling its presence to the maternal system. The molecular mechanisms that prevent luteolysis and support embryo survival within the maternal environment are not well understood. To gain a more complete picture of these molecular events, genome-wide transcriptional profiles of reproductive day 17 endometrial tissue were determined in pregnant and cyclic Holstein-Friesian dairy cattle. Results Microarray analyses revealed 1,839 and 1,189 differentially expressed transcripts between pregnant and cyclic animals (with ≥ 1.5 fold change in expression; P-value Conclusion The maternal immune system actively surveys the uterine environment during early pregnancy. The embryo modulates this response inducing the expression of endometrial molecules that suppress the immune response and promote maternal tolerance to the embryo. During this period of local immune suppression, genes of the innate immune response (in particular, antimicrobial genes may function to protect the uterus against infection.

  10. Single vs 2 Implants on Peri-implant Marginal Bone Level and Implant Failures in Mandibular Implant Overdentures: A Systematic Review With Meta-analysis.

    Science.gov (United States)

    Ahmed Elawady, Dina Mohamed; Kaddah, Amal Fathy; Talaat Khalifa, Mohamed

    2017-09-01

    As a consensus, the 2-implant supported overdentures (ODs) are considered as the first choice of treatment for the edentulous mandible. In the same context, there is increased evidence supporting the use of single-implant OD. The aim of any design is to preserve the remaining structures and allow the longevity of the treatment. To evaluate the impact of single implant vs 2 implants on the peri-implant marginal bone loss (MBL) and number of implant failures in mandibular implant overdentures. A literature search of electronic databases (PubMed and Cochrane) was performed up to March 2016 and complemented by hand search. Randomized clinical trials (RCTs) that evaluated MBL and number of implant failures relative to single-implant mandibular overdenture (MOD) were selected. The review and meta-analysis were performed using meta-analytic statistical package and in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five RCTs met the inclusion criteria for systematic review and qualitative synthesis. The observation period ranged from 12 months to 5 years in the selected RCTs. The comparison included in the meta-analysis is single- vs 2-implant MODs. Pooled data revealed that single-implant MODs significantly decreased the MBL (mean difference: 0.27, 95% confidence interval: 0.20-0.34, P failures (risk ratio: 3.26, 95% confidence interval: 1.18-8.97), P = .02; I(2) = 0%). Single-implant MOD was found to be better than 2-implant MOD in terms of MBL and number of implant failures. However, this result should be interpreted with caution due to limited number of analyzed studies with different loading protocols and short follow-up period. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Experimental and failure analysis of the prosthetic finger joint implants

    Science.gov (United States)

    Naidu, Sanjiv H.

    Small joint replacement arthroplasty of the hand is a well accepted surgical procedure to restore function and cosmesis in an individual with a crippled hand. Silicone elastomers have been used as prosthetic material in various small hand joints for well over three decades. Although the clinical science aspects of silicone elastomer failure are well known, the physical science aspects of prosthetic failure are scant and vague. In the following thesis, using both an animal model, and actual retrieved specimens which have failed in human service, experimental and failure analysis of silicone finger joints are presented. Fractured surfaces of retrieved silicone trapezial implants, and silicone finger joint implants were studied with both FESEM and SEM; the mode of failure for silicone trapezium is by wear polishing, whereas the finger joint implants failed either by fatigue fracture or tearing of the elastomer, or a combination of both. Thermal analysis revealed that the retrieved elastomer implants maintained its viscoelastic properties throughout the service period. In order to provide for a more functional and physiologic arthroplasty a novel finger joint (Rolamite prosthesis) is proposed using more recently developed thermoplastic polymers. The following thesis also addresses the outcome of the experimental studies of the Rolamite prosthesis in a rabbit animal model, in addition to the failure analysis of the thermoplastic polymers while in service in an in vivo synovial environment. Results of retrieved Rolamite specimens suggest that the use for thermoplastic elastomers such as block copolymer based elastomers in a synovial environment such as a mammalian joint may very well be limited.

  12. Restraint stress alters immune parameters and induces oxidative stress in the mouse uterus during embryo implantation.

    Science.gov (United States)

    Liu, Guanhui; Dong, Yulan; Wang, Zixu; Cao, Jing; Chen, Yaoxing

    2014-12-01

    The influence of stress on embryo implantation is not well understood. Prior studies have focused on later gestational stages and the long-term impact of stress on immune function. The objective of this study is to investigate the effects of restraint stress on the immune parameters and the oxidative states of the uterus during implantation. In this study, pregnant CD1 mice were subjected to restraint stress (4 h/d) on embryonic day 1 (E1) and sacrificed on E3, E5, and E7. Maternal plasma corticosterone (CORT) secretion and implantation sites in the uterus were examined. The uterine (excluding embryos) homogenate and uterine lymphocytes were collected to examine oxidative stress states and associated immune parameters. The results demonstrated that restraint stress increased maternal plasma CORT secretion and reduced the number of implantation sites by 15.3% on E5 and by 26.1% on E7. Moreover, restraint stress decreased the density of uterine natural killer (uNK) cells in the endometrium by 22.1-47.9% and increased the density of mast cells in the myometrium by 55.6-76.9%. Restraint stress remarkably decreased the CD3(+)CD4(+) T/CD3(+)CD8(+) T cell ratio (by 26.2-28.9%) and attenuated uterine lymphocyte proliferation and secretion of cytokines. In addition, restraint stress threatened the intracellular equilibrium between oxidants and antioxidants, resulting in decreased glutathione peroxidase (GSH-PX) (32.2% and 45.7%), superoxide dismutase (SOD) (15.5% and 26.1%), and total antioxidant capacity (T-AOC) (18.4% and 18.2%) activities and increased malondialdehyde (MDA) (34.4% and 43.0%) contents on E5 and E7. In conclusion, these findings demonstrate that restraint stress causes abnormal implantation and negatively impacts immune parameters in association with oxidative stress in mice.

  13. Control of uterine microenvironment by Foxp3+ cells facilitates embryo implantation

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    Ana eTeles

    2013-06-01

    Full Text Available Implantation of the fertilized egg into the maternal uterus depends on the fine balance between inflammatory and anti-inflammatory processes. Whilst regulatory T cells (Tregs are reportedly involved in protection of allogeneic fetuses against rejection by the maternal immune system, their role for pregnancy to establish, e.g. blastocyst implantation, is not clear. By using 2-photon imaging we show that Foxp3+ cells accumulated in the mouse uterus during the receptive phase of the oestrus cycle. Seminal fluid further fostered Treg expansion. Depletion of Tregs in two Foxp3.DTR-based models prior to pairing drastically impaired implantation and resulted in infiltration of activated T effector cells as well as in uterine inflammation and fibrosis in both allogeneic and syngeneic mating combinations. Genetic deletion of the homing receptor CCR7 interfered with accumulation of Tregs in the uterus and implantation indicating that homing of Tregs to the uterus was mediated by CCR7. Our results demonstrate that Tregs play a critical role in embryo implantation by preventing the development of a hostile uterine microenvironment.

  14. Right heart failure post left ventricular assist device implantation.

    Science.gov (United States)

    Argiriou, Mihalis; Kolokotron, Styliani-Maria; Sakellaridis, Timothy; Argiriou, Orestis; Charitos, Christos; Zarogoulidis, Paul; Katsikogiannis, Nikolaos; Kougioumtzi, Ioanna; Machairiotis, Nikolaos; Tsiouda, Theodora; Tsakiridis, Kosmas; Zarogoulidis, Konstantinos

    2014-03-01

    Right heart failure (RHF) is a frequent complication following left ventricular assist device (LVAD) implantation. The incidence of RHF complicates 20-50% (range, 9-44%) of cases and is a major factor of postoperative morbidity and mortality. Unfortunately, despite the fact that many risk factors contributing to the development of RHF after LVAD implantation have been identified, it seems to be extremely difficult to avoid them. Prevention of RHF consists of the management of the preload and the afterload of the right ventricle with optimum inotropic support. The administration of vasodilators designed to reduce pulmonary vascular resistance is standard practice in most centers. The surgical attempt of implantation of a right ventricular assist device does not always resolve the problem and is not available in all cardiac surgery centers.

  15. Bacterial communities associated with apical periodontitis and dental implant failure

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    Simon Dingsdag

    2016-11-01

    Full Text Available Background: Previously, we demonstrated that bacteria reside in apparently healed alveolar bone, using culture and Sanger sequencing techniques. Bacteria in apparently healed alveolar bone may have a role in peri-implantitis and dental implant failure. Objective: To compare bacterial communities associated with apical periodontitis, those colonising a failed implant and alveolar bone with reference biofilm samples from healthy teeth. Methods and results: The study consisted of 196 samples collected from 40 patients undergoing routine dental implant insertion or rehabilitation. The bacterial 16S ribosomal DNA sequences were amplified. Samples yielding sufficient polymerase chain reaction product for further molecular analyses were subjected to terminal restriction fragment length polymorphism (T-RFLP; 31 samples and next generation DNA sequencing (454 GS FLX Titanium; 8 samples. T-RFLP analysis revealed that the bacterial communities in diseased tissues were more similar to each other (p<0.049 than those from the healthy reference samples. Next generation sequencing detected 13 bacterial phyla and 373 putative bacterial species, revealing an increased abundance of Gram-negative [Prevotella, Fusobacterium (p<0.004, Treponema, Veillonellaceae, TG5 (Synergistetes] bacteria and a decreased abundance of Gram-positive [(Actinomyces, Corynebacterium (p<0.008] bacteria in the diseased tissue samples (n=5 relative to reference supragingival healthy samples (n=3. Conclusion: Increased abundances of Prevotella, Fusobacterium and TG5 (Synergistetes were associated with apical periodontitis and a failed implant. A larger sample set is needed to confirm these trends and to better define the processes of bacterial pathogenesis in implant failure and apical periodontitis. The application of combined culture-based, microscopic and molecular technique-based approaches is suggested for future studies.

  16. Bacterial communities associated with apical periodontitis and dental implant failure

    Science.gov (United States)

    Dingsdag, Simon; Nelson, Stephen; Coleman, Nicholas V.

    2016-01-01

    Background Previously, we demonstrated that bacteria reside in apparently healed alveolar bone, using culture and Sanger sequencing techniques. Bacteria in apparently healed alveolar bone may have a role in peri-implantitis and dental implant failure. Objective To compare bacterial communities associated with apical periodontitis, those colonising a failed implant and alveolar bone with reference biofilm samples from healthy teeth. Methods and results The study consisted of 196 samples collected from 40 patients undergoing routine dental implant insertion or rehabilitation. The bacterial 16S ribosomal DNA sequences were amplified. Samples yielding sufficient polymerase chain reaction product for further molecular analyses were subjected to terminal restriction fragment length polymorphism (T-RFLP; 31 samples) and next generation DNA sequencing (454 GS FLX Titanium; 8 samples). T-RFLP analysis revealed that the bacterial communities in diseased tissues were more similar to each other (p<0.049) than those from the healthy reference samples. Next generation sequencing detected 13 bacterial phyla and 373 putative bacterial species, revealing an increased abundance of Gram-negative [Prevotella, Fusobacterium (p<0.004), Treponema, Veillonellaceae, TG5 (Synergistetes)] bacteria and a decreased abundance of Gram-positive [(Actinomyces, Corynebacterium (p<0.008)] bacteria in the diseased tissue samples (n=5) relative to reference supragingival healthy samples (n=3). Conclusion Increased abundances of Prevotella, Fusobacterium and TG5 (Synergistetes) were associated with apical periodontitis and a failed implant. A larger sample set is needed to confirm these trends and to better define the processes of bacterial pathogenesis in implant failure and apical periodontitis. The application of combined culture-based, microscopic and molecular technique-based approaches is suggested for future studies. PMID:27834171

  17. Culture media for human pre-implantation embryos in assisted reproductive technology cycles.

    Science.gov (United States)

    Youssef, Mohamed M A; Mantikou, Eleni; van Wely, Madelon; Van der Veen, Fulco; Al-Inany, Hesham G; Repping, Sjoerd; Mastenbroek, Sebastiaan

    2015-11-20

    Many media are commercially available for culturing pre-implantation human embryos in assisted reproductive technology (ART) cycles. It is unknown which culture medium leads to the best success rates after ART. To evaluate the safety and effectiveness of different human pre-implantation embryo culture media in used for in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) cycles. We searched the Cochrane Menstrual Disorders and Subfertility Group's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the National Research Register, the Medical Research Council's Clinical Trials Register and the NHS Center for Reviews and Dissemination databases from January 1985 to March 2015. We also examined the reference lists of all known primary studies, review articles, citation lists of relevant publications and abstracts of major scientific meetings. We included all randomised controlled trials which randomised women, oocytes or embryos and compared any two commercially available culture media for human pre-implantation embryos in an IVF or ICSI programme. Two review authors independently selected the studies, assessed their risk of bias and extracted data. We sought additional information from the authors if necessary. We assessed the quality of the evidence using Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methods. The primary review outcome was live birth or ongoing pregnancy. We included 32 studies in this review. Seventeen studies randomised women (total 3666), three randomised cycles (total 1018) and twelve randomised oocytes (over 15,230). It was not possible to pool any of the data because each study compared different culture media.Only seven studies reported live birth or ongoing pregnancy. Four of these studies found no evidence of a difference between the media compared, for either day three or day five embryo transfer. The data from the fifth study did not appear reliable

  18. Failure rates of mini-implants placed in the infrazygomatic region.

    Science.gov (United States)

    Uribe, Flavio; Mehr, Rana; Mathur, Ajay; Janakiraman, Nandakumar; Allareddy, Veerasathpurush

    2015-01-01

    The purpose of this pilot study was to evaluate the failure rates of mini-implants placed in the infrazygomatic region and to evaluate factors that affect their stability. A retrospective cohort study of 30 consecutive patients (55 mini-implants) who had infrazygomatic mini-implants at a University Clinic were evaluated for failure rates. Patient, mini-implant, orthodontic, surgical, and mini-implant maintenance factors were evaluated by univariate logistic regression models for association to failure rates. A 21.8 % failure rate of mini-implants placed in the infazygomatic region was observed. None of the predictor variables were significantly associated with higher or lower odds for failed implants. Failure rates for infrazygomatic mini-implants were slightly higher than those reported in other maxilla-mandibular osseous locations. No predictor variables were found to be associated to the failure rates.

  19. Optimized protocol for cryopreservation of human eggs improves developmental competence and implantation of resulting embryos.

    Science.gov (United States)

    Wang, Cassie T; Liang, Lifeng; Witz, Craig; Williams, Dan; Griffith, Jason; Skorupski, Josh; Haddad, Ghassan; Gill, Jimmy; Wang, Weihua

    2013-02-13

    Successful egg cryopreservation has many potential benefits to a variety of patients. However, a superior standard protocol describing all aspects of oocyte cryopreservation has not yet been identified. Oocyte cryopreservation is still a technical challenge for many infertility clinics. To maintain satisfactory clinical outcomes, there is a need to develop an easy to use, yet efficient laboratory protocol. The present study was designed to examine if human embryos resulting from eggs frozen with an optimized vitrification protocol have similar developmental competence as those from fresh eggs. Twenty recipients received donated eggs vitrified with a protocol in which short exposure time to the vitrification solution was used and 23 recipients received donated eggs and 6 patients had their own eggs vitrified with a modified protocol in which long exposure time to the vitrification solution was used. After warming, egg survival, fertilization, cleavage, blastocyst formation, clinical pregnancy and implantation rates were compared. The developmental competence of eggs vitrified with the optimized protocol was further compared with fresh eggs donated from the same donors. There was no difference in the oocyte survival, fertilization, cleavage, clinical pregnancy or implantation rates between the short and long protocol groups. However, blastocyst formation rate was significantly (P eggs vitrified with long protocol and fresh eggs from the same donors (12) were compared in 39 recipients, no differences were observed in terms of fertilization (86.4 vs 80.1%), blastocyst formation (50.0 vs 59.2%), clinical pregnancy (63.2 vs 60.0%) and implantation (41.7 vs 44.7%) rates. Four out of 6 patients had ongoing pregnancy after transfer of embryos from their own frozen eggs with a 46.2% implantation rate. These results indicate that blastocyst development is an appropriate measure for egg survival after cryopreservation and frozen eggs have similar developmental potential as

  20. Failure rates of mini-implants placed in the infrazygomatic region

    OpenAIRE

    Uribe, Flavio; Mehr, Rana; Mathur, Ajay; Janakiraman, Nandakumar; Allareddy, Veerasathpurush

    2015-01-01

    Background The purpose of this pilot study was to evaluate the failure rates of mini-implants placed in the infrazygomatic region and to evaluate factors that affect their stability. Methods A retrospective cohort study of 30 consecutive patients (55 mini-implants) who had infrazygomatic mini-implants at a University Clinic were evaluated for failure rates. Patient, mini-implant, orthodontic, surgical, and mini-implant maintenance factors were evaluated by univariate logistic regression model...

  1. Functional studies of signaling pathways in peri-implantation development of the mouse embryo by RNAi

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    Bell Graham

    2005-12-01

    Full Text Available Abstract Background Studies of gene function in the mouse have relied mainly on gene targeting via homologous recombination. However, this approach is difficult to apply in specific windows of time, and to simultaneously knock-down multiple genes. Here we report an efficient method for dsRNA-mediated gene silencing in late cleavage-stage mouse embryos that permits examination of phenotypes at post-implantation stages. Results We show that introduction of Bmp4 dsRNA into intact blastocysts by electroporation recapitulates the genetic Bmp4 null phenotype at gastrulation. It also reveals a novel role for Bmp4 in the regulation the anterior visceral endoderm specific gene expression and its positioning. We also show that RNAi can be used to simultaneously target several genes. When applied to the three murine isoforms of Dishevelled, it leads to earlier defects than previously observed in double knock-outs. These include severe delays in post-implantation development and defects in the anterior midline and neural folds at headfold stages. Conclusion Our results indicate that the BMP4 signalling pathway contributes to the development of the anterior visceral endoderm, and reveal an early functional redundancy between the products of the murine Dishevelled genes. The proposed approach constitutes a powerful tool to screen the functions of genes that govern the development of the mouse embryo.

  2. Increased expression of heat shock protein 105 in rat uterus of early pregnancy and its significance in embryo implantation

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    Hu Zhao-Yuan

    2009-03-01

    Full Text Available Abstract Background Heat shock proteins (Hsps are a set of highly conserved proteins, Hsp105, has been suggested to play a role in reproduction. Methods Spatio-temporal expression of Hsp105 in rat uterus during peri-implantation period was examined by immunohistochemistry and Western blot, pseudopregnant uterus was used as control. Injection of antisense oligodeoxynucleotides to Hsp105 into pregnant rat uteri was carried out to look at effect of Hsp105 on embryo implantation. Results Expression of Hsp105 was mainly in the luminal epithelium on day 1 of pregnancy, and reached a peak level on day 5, whereas in stroma cells, adjacent to the implanting embryo, the strongest expression of Hsp105 was observed on day 6. The immunostaining profile in the uterus was consistent with that obtained by Western blot in the early pregnancy. In contrast, no obvious peak level of Hsp105 was observed in the uterus of pseudopregnant rat on day 5 or day 6. Furthermore, injection of antisense oligodeoxynucleotides to Hsp105 into the rat uterine horn on day 3 of pregnancy obviously suppressed the protein expression as expected and reduced number of the implanted embryos as compared with the control. Conclusion Temporal and spatial changes in Hsp105 expression in pregnant rat uterus may play a physiological role in regulating embryo implantation.

  3. Appropriate crypt formation in the uterus for embryo homing and implantation requires Wnt5a-ROR signaling.

    Science.gov (United States)

    Cha, Jeeyeon; Bartos, Amanda; Park, Craig; Sun, Xiaofei; Li, Yingju; Cha, Sang-Wook; Ajima, Rieko; Ho, Hsin-Yi Henry; Yamaguchi, Terry P; Dey, Sudhansu K

    2014-07-24

    Embryo homing and implantation occur within a crypt (implantation chamber) at the antimesometrial (AM) pole along the uterus. The mechanism by which this is achieved is not known. Here, we show that villi-like epithelial projections from the main uterine lumen toward the AM pole at regularly spaced intervals that form crypts for embryo implantation were disrupted in mice with uterine loss or gain of function of Wnt5a, or loss of function of both Ror1 and Ror2. This disruption of Wnt5a-ROR signaling resulted in disorderly epithelial projections, crypt formation, embryo spacing, and impaired implantation. These early disturbances under abnormal Wnt5a-ROR signaling were reflected in adverse late pregnancy events, including defective decidualization and placentation, ultimately leading to compromised pregnancy outcomes. This study presents deeper insight regarding the formation of organized epithelial projections for crypt formation and embryo implantation for pregnancy success. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Number of supernumerary vitrified blastocysts is positively correlated with implantation and live birth in single-blastocyst embryo transfers.

    Science.gov (United States)

    Hill, Micah J; Richter, Kevin S; Heitmann, Ryan J; Lewis, Terrance D; DeCherney, Alan H; Graham, James R; Widra, Eric; Levy, Michael J

    2013-05-01

    To estimate whether live birth in single-blastocyst transfers is correlated with the number of sibling supernumerary vitrified blastocysts (embryos not transferred) generated from that same cycle. Retrospective cohort study. A large academic assisted reproduction clinic. All single-blastocyst transfers in 2010 graded as "good" embryos by Society for Assisted Reproductive Technologies (SART) criteria. None. Implantation and live birth. Of the 655 single-blastocyst transfers that met inclusion criteria, implantation occurred in 65% and live birth in 54% of cycles. In chi-square analysis, patients with supernumerary vitrified blastocysts had a statistically higher implantation rate (65% versus 50%) and live-birth rate (56% versus 41%) when compared with patients without supernumerary blastocysts. Univariate logistic regression demonstrated an increase in implantation (OR 1.09; 95% CI, 1.03-1.15) and live birth (OR 1.06; 95% CI, 1.02-1.09) with increasing number of supernumerary blastocysts. Multivariate logistic regression analysis demonstrated that patient age and the number of supernumerary blastocysts were statistically significantly associated with implantation and live birth. The number of supernumerary vitrified blastocysts correlated positively with the odds of implantation and live birth in good quality single-blastocyst transfers. Patients with supernumerary blastocysts are good candidates for single-embryo transfer. Published by Elsevier Inc.

  5. Analysis of risk factors for cluster behavior of dental implant failures.

    Science.gov (United States)

    Chrcanovic, Bruno Ramos; Kisch, Jenö; Albrektsson, Tomas; Wennerberg, Ann

    2017-08-01

    Some studies indicated that implant failures are commonly concentrated in few patients. To identify and analyze cluster behavior of dental implant failures among subjects of a retrospective study. This retrospective study included patients receiving at least three implants only. Patients presenting at least three implant failures were classified as presenting a cluster behavior. Univariate and multivariate logistic regression models and generalized estimating equations analysis evaluated the effect of explanatory variables on the cluster behavior. There were 1406 patients with three or more implants (8337 implants, 592 failures). Sixty-seven (4.77%) patients presented cluster behavior, with 56.8% of all implant failures. The intake of antidepressants and bruxism were identified as potential negative factors exerting a statistically significant influence on a cluster behavior at the patient-level. The negative factors at the implant-level were turned implants, short implants, poor bone quality, age of the patient, the intake of medicaments to reduce the acid gastric production, smoking, and bruxism. A cluster pattern among patients with implant failure is highly probable. Factors of interest as predictors for implant failures could be a number of systemic and local factors, although a direct causal relationship cannot be ascertained. © 2017 Wiley Periodicals, Inc.

  6. School failure in students who are normal-hearing or deaf: with or without cochlear implants

    National Research Council Canada - National Science Library

    Duarte, Ivone; Santos, Cristina Costa; Rego, Guilhermina; Nunes, Rui

    2016-01-01

    To evaluate the impact of cochlear implants on the school failure of deaf who attend mainstream classes by comparing them to their normal-hearing peers as well as deaf without cochlear implants. This case...

  7. Does antibiotic prophylaxis at implant placement decrease early implant failures? A Cochrane systematic review.

    Science.gov (United States)

    Esposito, Marco; Grusovin, Maria Gabriella; Loli, Vasiliki; Coulthard, Paul; Worthington, Helen V

    2010-01-01

    Marco Esposito is the first author of two of the included studies; however, he was not involved in the quality assessment of these trials. This review is based on a Cochrane systematic review entitled 'Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications' published in The Cochrane Library (see http://www.cochrane.org for more information). Cochrane systematic reviews are regularly updated to include new research, and in response to comments and criticisms from readers. If you wish to comment on this review, please send your comments to the Cochrane website or to Marco Esposito. The Cochrane Library should be consulted for the most recent version of the review. The results of a Cochrane Review can be interpreted differently, depending on people's perspectives and circumstances. Please consider the conclusions presented carefully. They are the opinions of the review authors, and are not necessarily shared by the Cochrane Collaboration. To assess the beneficial or harmful effects of systemic prophylactic antibiotics at dental implant placement versus no antibiotic/placebo administration and, if antibiotics are of benefit, to find which type, dosage and duration is the most effective. The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched up to 2 June 2010 for randomised controlled clinical trials (RCTs) with a follow-up of at least 3 months comparing the administration of various prophylactic antibiotic regimens versus no antibiotics to patients undergoing dental implant placement. Outcome measures were prosthesis failures, implant failures, postoperative infections and adverse events (gastrointestinal, hypersensitivity, etc.). Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. Meta-analyses were

  8. Embryo implantation is closely associated with dynamic expression of proprotein convertase 5/6 in the rabbit uterus

    Directory of Open Access Journals (Sweden)

    Li Ying

    2011-04-01

    Full Text Available Abstract Background Proprotein convertase 5/6 (PC5/6 is critical for embryo implantation in women, regulating both uterine epithelial receptivity and stromal cell decidualization. PC5/6 is likewise essential for implantation in mice, but involved only in decidualization. An alternative animal model is required to address the function of PC5/6 in the uterine epithelium. This study aimed to establish whether PC5/6 is associated with embryo implantation in rabbits. Methods Virgin New-Zealand white rabbits aged 3-4 moths were mated with males of the same strain, or pseudo-pregnancy induced. After mating, uterine tissues were collected over a 10 day (d period (n = 3 per time point for RNA, protein and histological analyses to determine the temporal and spatial uterine expression pattern of PC5/6 during the initial stages of pregnancy or induced pseudo-pregnancy. Results PC5/6 mRNA was up-regulated just prior to embryo attachment on d6, and the elevated expression was maintained throughout implantation on d6.5-10. Western analysis revealed a preferential up-regulation of PC5/6 in the implantation sites. Immunohistochemical analysis identified that both the amount and cellular localization of PC5/6 changed with increasing pregnancy stages. Before embryo attachment, PC5/6 was low and localised in the luminal and glandular epithelium. It increased on d6.5 in the basal glands and mucosal folds, and then strongly intensified on d7-10 in the multinucleated luminal symplasma and decidual cells at the site of embryo implantation. In contrast, the pseudo-pregnant uterus displayed relatively low and static PC6 mRNA expression throughout the 10 days, with no obvious changes in either PC5/6 level or cellular localization. Conclusions These findings demonstrate that embryo implantation in the rabbit is closely associated with dynamic expression of uterine PC5/6, and that the rabbit may be an appropriate model to investigate the function of PC5/6 in the uterine

  9. Remote management of heart failure using implantable electronic devices.

    Science.gov (United States)

    Morgan, John M; Kitt, Sue; Gill, Jas; McComb, Janet M; Ng, Ghulam Andre; Raftery, James; Roderick, Paul; Seed, Alison; Williams, Simon G; Witte, Klaus K; Wright, David Jay; Harris, Scott; Cowie, Martin R

    2017-08-07

    Remote management of heart failure using implantable electronic devices (REM-HF) aimed to assess the clinical and cost-effectiveness of remote monitoring (RM) of heart failure in patients with cardiac implanted electronic devices (CIEDs). Between 29 September 2011 and 31 March 2014, we randomly assigned 1650 patients with heart failure and a CIED to active RM or usual care (UC). The active RM pathway included formalized remote follow-up protocols, and UC was standard practice in nine recruiting centres in England. The primary endpoint in the time to event analysis was the 1st event of death from any cause or unplanned hospitalization for cardiovascular reasons. Secondary endpoints included death from any cause, death from cardiovascular reasons, death from cardiovascular reasons and unplanned cardiovascular hospitalization, unplanned cardiovascular hospitalization, and unplanned hospitalization. REM-HF is registered with ISRCTN (96536028). The mean age of the population was 70 years (range 23-98); 86% were male. Patients were followed for a median of 2.8 years (range 0-4.3 years) completing on 31 January 2016. Patient adherence was high with a drop out of 4.3% over the course of the study. The incidence of the primary endpoint did not differ significantly between active RM and UC groups, which occurred in 42.4 and 40.8% of patients, respectively [hazard ratio 1.01; 95% confidence interval (CI) 0.87-1.18; P = 0.87]. There were no significant differences between the two groups with respect to any of the secondary endpoints or the time to the primary endpoint components. Among patients with heart failure and a CIED, RM using weekly downloads and a formalized follow up approach does not improve outcomes.

  10. Effects of embryo culture media do not persist after implantation: a histological study in mice.

    Science.gov (United States)

    Hemkemeyer, Sandra A; Schwarzer, Caroline; Boiani, Michele; Ehmcke, Jens; Le Gac, Séverine; Schlatt, Stefan; Nordhoff, Verena

    2014-02-01

    Is post-implantation embryonic development after blastocyst transfer affected by exposure to different assisted reproduction technology (ART) culture media? Fetal development and placental histology of ART embryos cultured in vitro in different ART media was not impaired compared with embryos grown in vivo. The application of different in vitro culture (IVC) media for human ART has an effect on birthweight of newborns. In the mouse model, differences in blastocyst formation were reported after culture in different ART media. Moreover, abnormalities in the liver and heart have been detected as a result of suboptimal IVC conditions. Fertilized oocytes from inbred and outbred breeding schemes were retrieved and either immediately transferred to foster mothers or incubated in control or human ART culture media up to the blastocyst stage prior to transfer. Placental and fetal anatomy and particularly bone development were evaluated. B6C3F1 female mice were used as oocyte donors after ovulation induction. C57Bl/6 and CD1 males were used for mating and CD1 females as foster mothers for embryo transfer. Fertilized oocytes were recovered from mated females and incubated in sequential human ART media (ISM1/ISM2 and HTF/Multiblast), in control media [KSOM(aa) and Whitten's medium] or grown in utero without IVC (zygote control). As in vivo, control B6C3F1 females were superovulated and left untreated. Fetuses and placentae were isolated by Caesarean section and analysed at 18.5 days post-coitum (dpc) for placenta composition and at 15.5 dpc for body weight, crown-rump length (CRL), fetal organ development, morphological development, total bone length and extent of bone ossification. No major differences in the number of implantation sites or in histological appearance of the placentae were detected. CRL of KSOM(aa) fetuses was higher compared with zygote control and Whitten's medium. Histological analysis of tissue sections revealed no gross morphological differences compared

  11. Risk factors associated with early implant failure: A 5-year retrospective clinical study.

    Science.gov (United States)

    Olmedo-Gaya, Maris Victoria; Manzano-Moreno, Francisco J; Cañaveral-Cavero, Esther; de Dios Luna-del Castillo, Juan; Vallecillo-Capilla, Manuel

    2016-02-01

    The replacement of lost teeth with dental implants is a widespread treatment whose associated problems are also frequently encountered. Nevertheless, the factors associated with early implant failure have not been well documented. Further analyses of the factors influencing osseointegration establishment are required to maximize the predictability of the procedure and minimize implant failures. The purpose of this retrospective clinical study was to explore the association between possible risk factors and early implant failure. This retrospective clinical study evaluated 142 participants who received 276 external connection BTI implants between 2007 and 2011. Participant variables (age, sex, systemic disease, tobacco use, alcohol consumption, bruxism, and degree of periodontal disease), implant variables (type of edentulism, localization, area, diameter, length, and bone quality), intervention variables (expansion mechanisms, sinus augmentation techniques, bone regeneration, and implant insertion), and postoperative variables (presence of pain/inflammation at 1 week postsurgery) were studied. A multilevel logistic regression model (mixed effects-type model) was used to determine the influence of variables on early implant failure. Early implant failure was significantly associated with the male sex (P=.001), severe periodontal disease (P=.005), short implants (P=.001), expansion technique (P=.002), and postoperative pain/inflammation at 1 week postsurgery (Pdental implant failure is more frequent in men and in individuals with severe periodontal disease, short implants, pain/inflammation at 1 week postsurgery, or bone expansion treatment. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  12. Sperm DNA fragmentation, recurrent implantation failure and recurrent miscarriage

    Directory of Open Access Journals (Sweden)

    Carol Coughlan

    2015-01-01

    Full Text Available Evidence is increasing that the integrity of sperm DNA may also be related to implantation failure and recurrent miscarriage (RM. To investigate this, the sperm DNA fragmentation in partners of 35 women with recurrent implantation failure (RIF following in vitro fertilization, 16 women diagnosed with RM and seven recent fathers (control were examined. Sperm were examined pre- and post-density centrifugation by the sperm chromatin dispersion (SCD test and the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL assay. There were no significant differences in the age of either partner or sperm concentration, motility or morphology between three groups. Moreover, there were no obvious differences in sperm DNA fragmentation measured by either test. However, whilst on average sperm DNA fragmentation in all groups was statistically lower in prepared sperm when measured by the SCD test, this was not seen with the results from the TUNEL assay. These results do not support the hypothesis that sperm DNA fragmentation is an important cause of RIF or RM, or that sperm DNA integrity testing has value in such patients. It also highlights significant differences between test methodologies and sperm preparation methods in interpreting the data from sperm DNA fragmentation tests.

  13. Intake of Proton Pump Inhibitors Is Associated with an Increased Risk of Dental Implant Failure.

    Science.gov (United States)

    Chrcanovic, Bruno Ramos; Kisch, Jenö; Albrektsson, Tomas; Wennerberg, Ann

    To investigate the association between the intake of proton pump inhibitors (PPIs) and the risk of dental implant failure. The present retrospective cohort study is based on patients consecutively treated between 1980 and 2014 with implant-supported/retained prostheses at one specialist clinic. Modern endosseous dental implants with cylindrical or conical design were included, and only complete cases were considered; ie, only those implants with information available for all variables measured were included in the regression model analysis. Zygomatic implants and implants detected in radiographies but without basic information about them in the patients' files were excluded from the study. Implant- and patient-related data were collected. Multilevel mixed-effects parametric survival analysis was used to test the association between PPI exposure (predictor variable) and risk of implant failure (outcome variable), adjusting for several potential confounders. A total of 3,559 implants were placed in 999 patients, with 178 implants reported as failures. The implant failure rates were 12.0% (30/250) for PPI users and 4.5% (148/3,309) for nonusers. A total of 45 out of 178 (25.3%) failed implants were lost up to abutment connection (6 in PPI users, 39 in nonusers), with an early-to-late failure ratio of 0.34:1. The intake of PPIs was shown to have a statistically significant negative effect for implant survival rate (HR 2.811; 95% CI: 1.139 to 6.937; P = .025). Bruxism, smoking, implant length, prophylactic antibiotic regimen, and implant location were also identified as factors with a statistically significant effect on the implant survival rate. This study suggests that the intake of PPIs may be associated with an increased risk of dental implant failure.

  14. Possible role of natural killer and natural killer T-like cells in implantation failure after IVF.

    Science.gov (United States)

    Miko, Eva; Manfai, Zoltan; Meggyes, Matyas; Barakonyi, Aliz; Wilhelm, Ferenc; Varnagy, Akos; Bodis, Jozsef; Illes, Zsolt; Szekeres-Bartho, Julia; Szereday, Laszlo

    2010-12-01

    During implantation, maternal immunoactivation and tolerance are not only limited to the decidua but are also observed in the periphery, predominantly affecting the innate immune system. Since unexplained female infertility, as well as recurrent spontaneous abortion and implantation failure, are thought to be associated with pathological maternal immunotolerance mechanisms, this study focused on immune profile analysis of IVF candidates. Previous studies on peripheral natural killer (NK) cell characteristics of IVF patients have been limited to the comparison of blood samples taken prior to the IVF procedure. This study performed a follow-up study and compared patient's data obtained on the day of oocyte collection with the data 1 week after embryo transfer. The aim was to investigate phenotypic (subpopulations, CD69, T-cell immunoglobulin mucin 3 and NK-activating receptor expression) and functional (perforin and CD107a expression) changes in the peripheral NK and NK T (NKT)-like cell populations. During this short period of time around the IVF procedure, women with failed IVF reflected unfavourable Th1-oriented changes of NK and NKT-like cells. In comparison the follow-up data for women with successful conception remained principally constant. The observed peripheral changes during early pregnancy in the same individual may also have importance in successful embryo implantation. Copyright © 2010 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  15. Optimized protocol for cryopreservation of human eggs improves developmental competence and implantation of resulting embryos

    Directory of Open Access Journals (Sweden)

    Wang Cassie T

    2013-02-01

    Full Text Available Abstract Background Successful egg cryopreservation has many potential benefits to a variety of patients. However, a superior standard protocol describing all aspects of oocyte cryopreservation has not yet been identified. Oocyte cryopreservation is still a technical challenge for many infertility clinics. To maintain satisfactory clinical outcomes, there is a need to develop an easy to use, yet efficient laboratory protocol. The present study was designed to examine if human embryos resulting from eggs frozen with an optimized vitrification protocol have similar developmental competence as those from fresh eggs. Methods Twenty recipients received donated eggs vitrified with a protocol in which short exposure time to the vitrification solution was used and 23 recipients received donated eggs and 6 patients had their own eggs vitrified with a modified protocol in which long exposure time to the vitrification solution was used. After warming, egg survival, fertilization, cleavage, blastocyst formation, clinical pregnancy and implantation rates were compared. The developmental competence of eggs vitrified with the optimized protocol was further compared with fresh eggs donated from the same donors. Results There was no difference in the oocyte survival, fertilization, cleavage, clinical pregnancy or implantation rates between the short and long protocol groups. However, blastocyst formation rate was significantly (P Conclusions These results indicate that blastocyst development is an appropriate measure for egg survival after cryopreservation and frozen eggs have similar developmental potential as fresh eggs if they are frozen with an optimized method.

  16. Bruxism and dental implant failures: a multilevel mixed effects parametric survival analysis approach.

    Science.gov (United States)

    Chrcanovic, B R; Kisch, J; Albrektsson, T; Wennerberg, A

    2016-11-01

    Recent studies have suggested that the insertion of dental implants in patients being diagnosed with bruxism negatively affected the implant failure rates. The aim of the present study was to investigate the association between the bruxism and the risk of dental implant failure. This retrospective study is based on 2670 patients who received 10 096 implants at one specialist clinic. Implant- and patient-related data were collected. Descriptive statistics were used to describe the patients and implants. Multilevel mixed effects parametric survival analysis was used to test the association between bruxism and risk of implant failure adjusting for several potential confounders. Criteria from a recent international consensus (Lobbezoo et al., J Oral Rehabil, 40, 2013, 2) and from the International Classification of Sleep Disorders (International classification of sleep disorders, revised: diagnostic and coding manual, American Academy of Sleep Medicine, Chicago, 2014) were used to define and diagnose the condition. The number of implants with information available for all variables totalled 3549, placed in 994 patients, with 179 implants reported as failures. The implant failure rates were 13·0% (24/185) for bruxers and 4·6% (155/3364) for non-bruxers (P bruxism was a statistically significantly risk factor to implant failure (HR 3·396; 95% CI 1·314, 8·777; P = 0·012), as well as implant length, implant diameter, implant surface, bone quantity D in relation to quantity A, bone quality 4 in relation to quality 1 (Lekholm and Zarb classification), smoking and the intake of proton pump inhibitors. It is suggested that the bruxism may be associated with an increased risk of dental implant failure. © 2016 John Wiley & Sons Ltd.

  17. The Risk Factors in Early Failure of Dental Implants: a Retrospective Study

    Science.gov (United States)

    Mohajerani, Hassan; Roozbayani, Roozbeh; Taherian, Shahram; Tabrizi, Reza

    2017-01-01

    Statement of the Problem: Despite the low failure rate of dental implants, recognition of the risk factors can enhance the predictability of failure. Purpose: The aim of this study was to evaluate the risk factors for early implant failure. Materials and Method: This retrospective cohort study was conducted on two groups of patients, the patients with a failed implant before loading and those without a failed implant. Age, gender, implant type, implant surface, implant length, bone type, type of surgery (one- or two-stage) and immediate (fresh socket) or delayed placement of implant were the variables to be assessed in this study. Results: Out of the 1,093 evaluated implants, 73 cases (6.68%) failed in early stages. The two groups were significantly different in terms of implant surface, fresh socket placement, prophylactic use of antibiotics, and bone density (pimplant height, implant type (cylindrical or tapered) and one-stage or two-stage placement were not significantly different between the two groups (p> 0.05). Conclusion: It seems that prophylactic antibiotic therapy, implant surface, bone density and placement in fresh extraction socket may contribute to dental implant failure. PMID:29201974

  18. Analysis of time to failure of orthodontic mini-implants after insertion or loading

    Science.gov (United States)

    Jeong, Jong-Wha; Lee, Nam-Ki; Kim, Young-Kyun; Lee, Jong-Ho; Kim, Tae-Woo

    2015-01-01

    Objectives This study was performed to evaluate patterns of failure time after insertion, failure rate according to loading time after insertion, and the patterns of failure after loading. Materials and Methods A total of 331 mini-implants were classified into the non-failure group (NFG) and failure group (FG), which was divided into failed group before loading (FGB) and failed group after loading (FGA). Orthodontic force was applied to both the NFG and FGA. Failed mini-implants after insertion, ratio of FGA to NFG according to loading time after insertion, and failed mini-implants according to failed time after loading were analyzed. Results Percentages of failed mini-implants after insertion were 15.79%, 36.84%, 12.28%, and 10.53% at 4, 8, 12, and 16 weeks, respectively. Mini-implant failure demonstrated a peak from 4 to 5 weeks after insertion. The failure rates according to loading time after insertion were 13.56%, 8.97%, 11.32%, and 5.00% at 4, 8, 12, and 16 weeks, respectively. Percentages of failed mini-implants after loading were 13.79%, 24.14%, 20.69%, and 6.9% at 4, 8, 12, and 16 weeks, respectively. Conclusion Mini-implant stability is typically acquired 12 to 16 weeks after insertion, and immediate loading can cause failure of the mini-implant. Failure after loading was observed during the first 12 weeks. PMID:26568925

  19. Three-Dimensional High-Frequency Ultrasonography for Early Detection and Characterization of Embryo Implantation Site Development in the Mouse.

    Directory of Open Access Journals (Sweden)

    Mary C Peavey

    Full Text Available Ultrasonography is a powerful tool to non-invasively monitor in real time the development of the human fetus in utero. Although genetically engineered mice have served as valuable in vivo models to study both embryo implantation and pregnancy progression, such studies usually require sacrifice of parous mice for subsequent phenotypic analysis. To address this issue, we used three-dimensional (3-D reconstruction in silico of high-frequency ultrasound (HFUS imaging data for early detection and characterization of murine embryo implantation sites and their development in utero. With HFUS imaging followed by 3-D reconstruction, we were able to precisely quantify embryo implantation site number and embryonic developmental progression in pregnant C57BL6J/129S mice from as early as 5.5 days post coitus (d.p.c. through to 9.5 d.p.c. using a VisualSonics Vevo 2100 (MS550S transducer. In addition to measurements of implantation site number, location, volume and spacing, embryo viability via cardiac activity monitoring was also achieved. A total of 12 dams were imaged with HFUS with approximately 100 embryos examined per embryonic day. For the post-implantation period (5.5 to 8.5 d.p.c., 3-D reconstruction of the gravid uterus in mesh or solid overlay format enabled visual representation in silico of implantation site location, number, spacing distances, and site volume within each uterine horn. Therefore, this short technical report describes the feasibility of using 3-D HFUS imaging for early detection and analysis of post-implantation events in the pregnant mouse with the ability to longitudinally monitor the development of these early pregnancy events in a non-invasive manner. As genetically engineered mice continue to be used to characterize female reproductive phenotypes, we believe this reliable and non-invasive method to detect, quantify, and characterize early implantation events will prove to be an invaluable investigative tool for the study of

  20. Embryo selection in IVF

    National Research Council Canada - National Science Library

    Mastenbroek, Sebastiaan; van der Veen, Fulco; Aflatoonian, Abbas; Shapiro, Bruce; Bossuyt, Patrick; Repping, Sjoerd

    2011-01-01

    To optimize success rates of IVF, selection of the most viable embryo(s) for transfer has always been essential, as embryos that are cryopreserved are thought to have a reduced chance of implanting after thawing...

  1. Risk Factors associated with Dental Implant Failure: A Study of 302 Implants placed in a Regional Center.

    Science.gov (United States)

    Oztel, Mehmet; Bilski, Wojciech M; Bilski, Arthur

    2017-08-01

    The aim of this research is to determine which risk factors are associated with dental implant failure and survival. Data pertaining to patients who received one or more dental implants from 2011 to 2013 in a regional center were retrospectively reviewed. This included a total of 302 Biomet 3i NanoTite Tapered Certain implants placed in 177 patients. All patients were followed up until the end of 2015. This study found an overall success rate of 95%. Statistically significant factors that were found to affect implant survival were implant length, surgical technique, and presence of diabetes mellitus DM. Age, gender, body mass index (BMI), implant site, smoking, and variable operators were not found to have any significant implant on implant survival. This study has demonstrated that the incidence of implant failure and its complications is affected by a number of important factors that clinicians should consider when assessing patients. A follow-up study with a larger sample size, longer follow-up period, and details of the type of prosthetic rehabilitation would be beneficial in producing more definitive conclusions which may improve clinical practice. Dental implants play an important role in modern-day dental rehabilitation. It is vital that clinicians understand the impact of variable risk factors on implant survival. This study will add to the growing literature on the subject.

  2. Clinical retrospective study of self-reported penicillin allergy on dental implant failures and infections.

    Science.gov (United States)

    French, David; Noroozi, Mehdi; Shariati, Batoul; Larjava, Hannu

    2016-01-01

    The aim of this retrospective study was to investigate whether self-reported allergy to penicillin may contribute to a higher rate of postsurgical infection and implant failure. This retrospective, non-interventional, open cohort study reports on implant survival and infection complications of 5,576 implants placed in private practice by one periodontist, and includes 4,132 implants that were followed for at least 1 year. Logistic regression was applied to examine the relationship between self-reported allergy to penicillin and implant survival, while controlling for potential confounders such as smoking, implant site, bone augmentation, loading protocol, immediate implantation, and bone level at baseline. The cumulative survival rate (CSR) was calculated according to the life table method and the Cox proportional hazard model was fitted to data. Out of 5,106 implants placed in patients taking penicillin it was found that 0.8% failed, while 2.1% failed of the 470 implants placed for patients with self-reported allergy to penicillin (P = .002). Odds of failure for implants placed in penicillin-allergic patients were 3.1 times higher than in non-allergic patients. For immediate implant placement, penicillin-allergic patients had a failure rate 10-times higher than the non-allergic cohort. Timing of implant failure occurring within 6 months following implantation was 80% in the penicillin-allergic group versus 54% in the non-allergic group. From the 48 implant sites showing postoperative infection: penicillin-allergic patients had an infection rate of 3.4% (n = 16/470) versus 0.6% in the non-allergic group (n = 32/5,106) (P penicillin allergy was associated with a higher rate of infection, and primarily affected early implant failure.

  3. Specific gene-regulation networks during the pre-implantation development of the pig embryo as revealed by deep sequencing

    OpenAIRE

    Cao, Suying; Han, Jianyong; Wu, Jun; Li, Qiuyan; Liu, Shichao; Zhang, Wei; Pei, Yangli; Ruan, Xiaoan; Liu, Zhonghua; Wang, Xumin; Lim, Bing; Li, Ning

    2014-01-01

    Background Because few studies exist to describe the unique molecular network regulation behind pig pre-implantation embryonic development (PED), genetic engineering in the pig embryo is limited. Also, this lack of research has hindered derivation and application of porcine embryonic stem cells and porcine induced pluripotent stem cells (iPSCs). Results We identified and analyzed the genome wide transcriptomes of pig in vivo-derived and somatic cell nuclear transferred (SCNT) as well as mouse...

  4. The developmental transcriptome landscape of receptive endometrium during embryo implantation in dairy goats.

    Science.gov (United States)

    Zhang, Lei; Liu, XiaoRui; Liu, JunZe; Ma, Li; Zhou, ZhanQin; Song, YuXuan; Cao, BinYun

    2017-10-30

    Under natural conditions, some embryos cannot implant successfully because of the dysfunction of receptive endometrium (RE). Thus, it is imperative for us to study the molecular mechanisms involved in the formation of the RE from pre-receptive endometrium (PE). In this study, the endometrium from gestational day 5 (D5, PE) and gestational day 15 (D15, RE) dairy goats were selected to systematically analyze the transcriptome using strand-specific Ribo-Zero RNA-Seq, >120 million high-quality paired-end reads were generated and 47,616 transcripts were identified in the endometrium of dairy goats. A total of 810 mRNAs were differentially expressed genes (DEGs) between the RE and PE meeting the criteria of P-values<0.05. Bioinformatics analysis of the DEGs revealed that a number of biological processes and pathways were potentially involved in the establishment of the RE, notably energy metabolism and amino acid metabolism. Furthermore, we speculated that CXCL14, IGFBP3, and LGALS15 potentially participated in the development of endometrium. What's more, putative SNPs, InDels and AS events were identified and analyzed in the endometrium. In a word, this resulting view of the transcriptome greatly enhances the comprehensive transcript catalog and uncovers the global trends in gene expression during the formation of receptive endometrium in dairy goats. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Filariasis infection is a probable cause of implantation failure in in vitro fertilization cycles.

    Science.gov (United States)

    Bazi, Tony; Finan, Ramzi; Zourob, Dani; Sabbagh, Amira S; Nasnas, Roy; Zreik, Tony G

    2006-06-01

    To describe a parasitic infection that probably affected the implantation of good-quality embryos in an in vitro fertilization (IVF) cycle. Case report. Tertiary care center in a university hospital. A 36-year-old Caucasian female with primary unexplained infertility. The patient underwent two cycles of IVF with good-quality embryos transferred; however, no pregnancy ensued despite adequate luteal support. In vitro fertilization cycles, CBC, blood smear, evaluation for eosinophilia including serological evaluation for parasitic infections. Pregnancy. Following treatment for filariasis, a repeat IVF cycle using the same stimulation protocol yielded a full-term pregnancy. This case is of particular importance because, to our knowledge, it is the first to describe a parasitic infection that probably affected the implantation of good-quality embryos in IVF cycles.

  6. Impact of dental implant length on early failure rates: a meta-analysis of observational studies.

    Science.gov (United States)

    Pommer, Bernhard; Frantal, Sophie; Willer, Jürgen; Posch, Martin; Watzek, Georg; Tepper, Gabor

    2011-09-01

    To test the null hypothesis of no difference in failure rates of short (minimum length: 7 mm) and longer dental implants (≥ 10 mm), a meta-analysis was performed on prospective observational trials. A systematic electronic and hand search was performed to identify eligible studies. Having additional data supplied by the authors, 54 publications were included (19,083 implants). In case of mandibular implants, the null hypothesis of no impact of reduced implant length on failure within the first year of prosthetic loading could not be rejected. A significant impact of implant length could be substantiated for short machined implants in the anterior [odds ratio (OR) 5.4] and posterior maxilla (OR 3.4), while short rough-surfaced implants demonstrated increased failure rates in the anterior maxillary sites. No influence of implant diameter and denture type on the failure rate of short implants could be revealed. In areas of reduced alveolar bone height the use of short dental implants may reduce the need for invasive bone augmentation procedures. © 2011 John Wiley & Sons A/S.

  7. The Relationship between Vascular Endothelial Growth Factor 1154G/A Polymorphism and Recurrent Implantation Failure

    Science.gov (United States)

    Vagnini, Laura D.; Nascimento, Adriana M.; Canas, Maria do Carmo T.; Renzi, Adriana; Oliveira-Pelegrin, Gabriela R.; Petersen, Claudia G.; Mauri, Ana L.; Oliveira, João Batista A.; Baruffi, Ricardo L.R.; Cavagna, Mario; Franco, José G.

    2015-01-01

    Objective The aim of this study was to investigate the relationship between herpesvirus-associated ubiquitin-specific protease (HAUSP A/G, rs1529916), tumor protein p53 (TP53 Arg/Pro, rs1042522), leukemia inhibitory factor (LIF G/T, rs929271), glycoprotein 130 (gp130 A/T, rs1900173) and vascular endothelial growth factor (VEGF G/A, rs1570360) polymorphisms and recurrent implantation failure (RIF) in Brazilian women. Subjects and Methods A total of 120 women with RIF (i.e. those with ≥5 cleaved embryos transferred and a minimum of 2 failed in vitro fertilization/intracytoplasmic sperm injection attempts) were included. The control group involved 89 women who had experienced at least 1 live birth (without any infertility treatment). DNA was extracted from the peripheral blood of all participants, and the abovementioned single-nucleotide polymorphisms (SNPs) were genotyped by real-time polymerase chain reaction. The data were evaluated using Fisher's test. Results A significant difference between the RIF and control groups was found in the VEGF gene where the GG genotype showed a 2.1-fold increased chance of not being included in the RIF group, while the presence of an A allele increased this risk 1.6-fold. No significant differences were found for the other polymorphisms. Conclusion This study showed an association between the VEGF -1154G/A polymorphism and RIF in Brazilian women. PMID:26305668

  8. Active caspase-3 and ultrastructural evidence of apoptosis in spontaneous and induced cell death in bovine in vitro produced pre-implantation embryos

    DEFF Research Database (Denmark)

    Gjørret, Jakob O.; Fabian, Dusan; Avery, Birthe

    2007-01-01

    In this study we investigated chronological onset and involvement of active caspase-3, apoptotic nuclear morphology, and TUNEL-labeling, as well as ultrastructural evidence of apoptosis, in both spontaneous and induced cell death during pre-implantation development of bovine in vitro produced...... embryos. Pre-implantation embryos (2-cell to Day 8 blastocysts) were cultured with either no supplementation (untreated) or with 10 µM staurosporine for 24 hr (treated). Embryos were subjected to immunohistochemical staining of active caspase-3, TUNEL-reaction for detection of DNA degradation and DAPI...

  9. Investigation of Pathogenic Genes in Peri-Implantitis from Implant Clustering Failure Patients: A Whole-Exome Sequencing Pilot Study

    Science.gov (United States)

    Lee, Soohyung; Kim, Ji-Young; Hwang, Jihye; Kim, Sanguk; Lee, Jae-Hoon; Han, Dong-Hoo

    2014-01-01

    Peri-implantitis is a frequently occurring gum disease linked to multi-factorial traits with various environmental and genetic causalities and no known concrete pathogenesis. The varying severity of peri-implantitis among patients with relatively similar environments suggests a genetic aspect which needs to be investigated to understand and regulate the pathogenesis of the disease. Six unrelated individuals with multiple clusterization implant failure due to severe peri-implantitis were chosen for this study. These six individuals had relatively healthy lifestyles, with minimal environmental causalities affecting peri-implantitis. Research was undertaken to investigate pathogenic genes in peri-implantitis albeit with a small number of subjects and incomplete elimination of environmental causalities. Whole-exome sequencing was performed on collected saliva samples via self DNA collection kit. Common variants with minor allele frequencies (MAF) > = 0.05 from all control datasets were eliminated and variants having high and moderate impact and loss of function were used for comparison. Gene set enrichment analysis was performed to reveal functional groups associated with the genetic variants. 2,022 genes were left after filtering against dbSNP, the 1000 Genomes East Asian population, and healthy Korean randomized subsample data (GSK project). 175 (p-value implant failure. This result may demonstrate the feasibility of and provide pilot data for a larger research project aimed at discovering biomarkers for early diagnosis of peri-implantitis. PMID:24921256

  10. Estimates of Hospital Based Emergency Department Visits due to Dental Implant Failures in the United States.

    Science.gov (United States)

    Elangovan, Satheesh; Allareddy, Veerasathpurush

    2016-06-01

    Objective of the current study is to provide nationally representative estimates of hospital based emergency department (ED) visits attributed to dental implant failures in the United States. The Nationwide Emergency Department sample for the years 2008-2010 was used. All ED visits with a diagnosis of "dental implant failures" were selected for analysis. Patient demographics were examined. Outcomes of interest included disposition status following the ED visit and ED charges. During the study period, a total of 1200 ED visits were due to dental implant failures. Most ED visits with dental implant failures occurred among those aged dental implant occurred in 31.7% of patients while post-osseointegration mechanical failure of dental implant occurred in 30.4% of patients. Following an ED visit, 82.8% were discharged routinely and 13.3% of patients were admitted as in-patients into the same hospital following the ED visit. The mean ED charge per visit was $1167. Highest proportions of these ED visits were comprised of those aged implant failures. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Perkembangan Praimplantasi Embrio Mencit dengan Materi Genetik yang Berasal dari Parental, Maternal, dan Inti Sel Somatik (PRE-IMPLANTATION DEVELOPMENT OF MOUSE EMBRYO WITH GENETIC MATERIAL DERIVED FROM PARENTAL, MATERNAL AND SOMATIC CELL NUCLEUS

    Directory of Open Access Journals (Sweden)

    Harry Murti

    2014-05-01

    Full Text Available Cloned embryo and parthenogenetic embryo are a potential source of stem cells for regenerativemedicine. Stem cells derived from those embryos are expected to overcome the ethical issues to the use offertilization embryos for therapeutic purposes. The pre-implantation development is a critical step fordeveloping embryos reach the blastocyst stage. The objectives in vivo of this research are to produce mousecloned embryo, parthenogenetic embryo, and fertilized embryo and to study stages of  in vitro pre-implantation development culture. In vivo fertilized embryos, mouse oocytes, and cumulus cells were usedin this study. Treatment was performed on female mice superovulated with PMSG and hCG injections.Two-cell stage of in vivo fertilized embryos were collected on the second day post hCG injection. Clonedembryos were produced through Somatic Cell Nuclear Transfer (SCNT, which included enucleation, nucleartransfer and artificial activation. Parthenogenetic embryos were produced with artificial activationtechnique. The result of the research indicated that SCNT application was able to produce cloned embryos which could develop to blastocyst stage (3,2%. In addition, artificial activation of oocytes could produceparthenogenetic embryos which were able to develop up to the blastocyst stage (8,6%. In conclusion,efficiency level of parthenogenetic embryos that is able to reach the blastocyst stage was higher than in thecloned embryos. Fertilized embryos shows a better development and more efficient compared to in vitrocloned embryos and parthenogenetic embryos cultures.

  12. Use of imaging software for assessment of the associations among zona pellucida thickness variation, assisted hatching, and implantation of day 3 embryos.

    Science.gov (United States)

    Lewis, Erin I; Farhadifar, Reza; Farland, Leslie V; J Needleman, Daniel; Missmer, Stacey A; Racowsky, Catherine

    2017-10-01

    The aim of this study was to determine if zona pellucida thickness variation (ZPTV) is associated with implantation and if this relationship changes with use of assisted hatching (AH). Day 3 embryos from single or double embryo transfers (DETs) performed between 2014 and 2016 were included. ZPTV was assessed by examining photographs taken before transfer using an automated image processing platform to segment the zona pellucida (ZP) with an active contour technique. One hundred points were obtained of ZP thickness (ZPT) of each embryo to calculate ZPTV ([maximum ZPT-mean ZPT]/mean ZPT). Logistic regression was used to calculate the odds ratio (OR) and 95% confidence intervals (CI) of implantation by tertile of ZPTV. Maternal age and AH were adjusted for a priori. Other cycle and embryo characteristics were adjusted for if they altered the continuous effect estimate by >10%. There was no statistically significant association between ZPTV and implantation across tertiles although embryos with greater ZPTV showed a trend of decreased implantation (Tertile 2 (T2) versus Tertile 1 (T1), OR = 0.80, CI = 0.50-1.28; Tertile 3 (T3) versus Tertile 1 (T3), OR = 0.75, CI = 0.47-1.20). While similar nonsignificant trends for the association between ZPTV and implantation were observed across tertiles after stratification of embryos hatched or not, embryos with the greatest ZPTV had slightly higher odds for implantation when AH was utilized (T3 vs. T1: with AH, OR = 0.89, CI = 0.49-1.62; without AH, OR = 0.61, 0.29-1.27). ZPTV was not associated with implantation after day 3 transfer. This finding did not vary by use of AH.

  13. A retrospective study on 1592 consecutively performed operations in one private referral clinic. Part II: Peri-implantitis and implant failures.

    Science.gov (United States)

    Jemt, Torsten; Karouni, Michel; Abitbol, Jérémy; Zouiten, Ons; Antoun, Hadi

    2017-06-01

    Few large-scale follow-up studies are reported on routine implant treatment. To report retrospective data on peri-implantitis and overall implant failures at one private referral clinic (effectiveness study). A total of 1017 patients were consecutively provided with 3082 implants with an anodized surface during 1592 operations between 2000 and 2011. All patients with any of four events of problems were identified; "peri-implantitis," "surgery related to peri-implantitis," "overall implant failure," and "late implant failures." A logistic multivariate analysis was performed to identify possible factors with association to the four events. "Lower jaw surgery" (HR = 3.03) and "immediate gingival grafting" at implant surgery (HR = 3.34) were factors with the highest risk associated to the two peri-implantitis events, respectively. Risk of peri-implantitis increased by year of inclusion from year 2000 (HR = 1.28). "Overall implant failures" were associated to "smoking" (HR = 2.11), "surgical technique" (highest for direct placement; HR = 1.67), and "type of implant" (NobelActive CC; HR = 2.48). NobelActive CC was more used in upper jaws, using immediate or one-stage surgery with bone and mucosa grafting procedures than other implants (P failures were shown to be associated to earlier inflammatory problems, smoking habits, surgical technique, and treatment in the posterior lower jaw. © 2017 Wiley Periodicals, Inc.

  14. Three-dimensional localisation of NANOG, OCT4, and E-CADHERIN in porcine pre- and peri-implantation embryos

    DEFF Research Database (Denmark)

    Wolf, Xenia Asbæk; Serup, Palle; Hyttel, Poul

    2011-01-01

    The expression patterns of NANOG and OCT4 have previously been reported to differ markedly between mammalian species indicating distinct species-specific roles during development. We investigate the three-dimensional expression pattern of NANOG and OCT4 in porcine pre- and peri-implantation embryos...... NANOG was localised to nuclei in a minor portion of the epiblast cells in which E-CADHERIN seemed to be up-regulated and OCT4 down-regulated. Later NANOG was restricted to the potential PGCs. OCT4 was detected in inner cell mass, epiblast, and mesoderm, and we found that OCT4 expression, in contrast...

  15. Early Implant Failures Related to Individual Surgeons: An Analysis Covering 11,074 Operations Performed during 28 Years.

    Science.gov (United States)

    Jemt, Torsten; Olsson, Malin; Renouard, Franck; Stenport, Victoria; Friberg, Bertil

    2016-10-01

    Compared with knowledge on patient and implant component factors, little knowledge is available on surgeons' role in early implant failures. To report incidence of early implant failures related to total number of operations performed by individual surgeons. Early implant failures (≤1 year of implant prosthesis function) were reported after a total of 11,074 implant operations at one specialist clinic during 28 years of surgery. Altogether, 8,808 individual patients were treated by 23 different dentists, of whom 21 surgeons were specialists in oral surgery or periodontology. Recorded failures were related to total numbers of performed operations per surgeon, followed by statistical comparisons (χ(2) ) between surgeons with regard to type of treated jaw and implant surface. Altogether, 616 operations were recorded with early implant failures (5.6%), most often observed in edentulous upper jaws after placing implants with a turned surface (p failures are complex, multifactorial problems associated with many aspects in the surgical procedure. A stochastic variation of failures for individual surgeons could be observed over the years. Different levels of failure rate could be observed between the surgeons, occasionally reaching significant levels as a total or for different jaw situations (p failure rates when using implants with moderately rough surfaces (p failure rate between the surgeons was maintained. © 2015 Wiley Periodicals, Inc.

  16. Retrospective analysis of 56 edentulous dental arches restored with 344 single-stage implants using an immediate loading fixed provisional protocol: statistical predictors of implant failure.

    Science.gov (United States)

    Kinsel, Richard P; Liss, Mindy

    2007-01-01

    The purpose of this retrospective study was to evaluate the effects of implant dimensions, surface treatment, location in the dental arch, numbers of supporting implant abutments, surgical technique, and generally recognized risk factors on the survival of a series of single-stage Straumann dental implants placed into edentulous arches using an immediate loading protocol. Each patient received between 4 and 18 implants in one or both dental arches. Periapical radiographs were obtained over a 2- to 10-year follow-up period to evaluate crestal bone loss following insertion of the definitive metal-ceramic fixed prostheses. Univariate tests for failure rates as a function of age ( or = 60 years), gender, smoking, bone grafting, dental arch, surface type, anterior versus posterior, number of implants per arch, and surgical technique were made using Fisher exact tests. The Cochran-Armitage test for trend was used to evaluate the presence of a linear trend in failure rates regarding implant length and implant diameter. Logistic regression modeling was used to determine which, if any, of the aforementioned factors would predict patient and implant failure. A significance criterion of P = .05 was utilized. Data were collected for 344 single-stage implants placed into 56 edentulous arches (39 maxillae and 17 mandibles) of 43 patients and immediately loaded with a 1-piece provisional fixed prosthesis. A total of 16 implants failed to successfully integrate, for a survival rate of 95.3%. Increased rates of failure were associated with reduced implant length, placement in the posterior region of the jaw, increased implant diameter, and surface treatment. Implant length emerged as the sole significant predictor of implant failure. In this retrospective analysis of 56 consecutively treated edentulous arches with multiple single-stage dental implants loaded immediately, reduced implant length was the sole significant predictor of failure.

  17. Recurrent implantation failure in IVF: features of cycles that eventually ended in conception.

    Science.gov (United States)

    Bord, Ilia; Tamir, Belle; Harlev, Avraham; Har-Vardi, Iris; Lunenfeld, Eitan; Friger, Michael; Levitas, Eliahu

    2016-04-01

    To evaluate the characteristics of patients and IVF cycles with recurrent implantation failure who eventually succeeded to conceive compared to those who failed to do so. In a retrospective study, we explored our database for patients younger than 35 years old who underwent at least three unsuccessful fresh IVF cycles. The following parameters were analyzed: cause of infertility, FSH level, stimulation cycle characteristics, fertilization rate, the type of luteal support, and cycle outcome. Uterine cavity assessment was also included. The relationship between endometrial scratching and the outcome of the following IVF cycle was assessed for the subsequent pregnancy rate. The study included 184 patients who underwent 854 IVF cycles. There were no statistically significant differences between patients who eventually conceived and those who did not in terms of ovarian reserve and response to gonadotropin treatment. IVF cycles that eventually ended with conception were characterized by shorter stimulation (10.87 ± 2.17 versus 11.34 ± 2.33 days, p < 0.05), higher estrogen level on the day of hCG administration (1661 ± 667 versus 1472 ± 633 pg/ml, p = 0.009), more fertilized oocytes via ICSI (5.04 ± 4.29 versus 3.85 ± 3.45, p = 0.002), and more embryos available for transfer (5.98 ± 3.89 versus 5.12 ± 3.31, p = 0.002). Combined estrogen and progesterone luteal support combined with endometrial scratching prior to the subsequent IVF cycle has been positively related to increased pregnancy rates. Young patients with RIF having a normal ovarian reserve and satisfactory ovarian response to superovulation should be encouraged to pursue IVF, even though the probability to conceive is relatively low compared to the general IVF population.

  18. Near-infrared laser irradiation improves the development of mouse pre-implantation embryos.

    Science.gov (United States)

    Yokoo, Masaki; Mori, Miho

    2017-05-27

    The aim of the present study was to assess the effects of near-infrared laser irradiation on the in vitro development of mouse embryos. Female ICR mice were superovulated with pregnant mare serum gonadotropin and human chorionic gonadotropin (hCG), and mated with male mice. Two-cell stage embryos were collected 40 h after administering hCG and cultured in M16 medium. Two-cell embryos (0 h after culture), 8-cell embryos (approx. 30 h after culture), morula (approx. 48 h after culture), and blastocysts (approx. 73 h after culture) were irradiated at 904 nm for 60 s. These embryos were cultured in a time-lapse monitoring system and the timing of blastocyst hatching was evaluated. Some of the irradiated blastocysts were transferred to the uterine horns of pseudopregnant recipients immediately after irradiation. Pregnancy rates, and offspring growth and fertility, were evaluated. Near-infrared laser irradiation increased the speed of in vitro mouse embryo development. In irradiated blastocysts, hatching was faster than in control (non-irradiated) blastocysts (18.4 vs. 28.2 h, P infrared laser irradiation improves the quality of mouse embryo development in vitro, and increases the live birth rate without affecting the normality of the offspring. Thus, the near-infrared laser method may enhance the quality of embryos and contribute to improvements in reproductive technologies in mammals. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Investigation of pathogenic genes in peri-implantitis from implant clustering failure patients: a whole-exome sequencing pilot study.

    Directory of Open Access Journals (Sweden)

    Soohyung Lee

    Full Text Available Peri-implantitis is a frequently occurring gum disease linked to multi-factorial traits with various environmental and genetic causalities and no known concrete pathogenesis. The varying severity of peri-implantitis among patients with relatively similar environments suggests a genetic aspect which needs to be investigated to understand and regulate the pathogenesis of the disease. Six unrelated individuals with multiple clusterization implant failure due to severe peri-implantitis were chosen for this study. These six individuals had relatively healthy lifestyles, with minimal environmental causalities affecting peri-implantitis. Research was undertaken to investigate pathogenic genes in peri-implantitis albeit with a small number of subjects and incomplete elimination of environmental causalities. Whole-exome sequencing was performed on collected saliva samples via self DNA collection kit. Common variants with minor allele frequencies (MAF > = 0.05 from all control datasets were eliminated and variants having high and moderate impact and loss of function were used for comparison. Gene set enrichment analysis was performed to reveal functional groups associated with the genetic variants. 2,022 genes were left after filtering against dbSNP, the 1000 Genomes East Asian population, and healthy Korean randomized subsample data (GSK project. 175 (p-value <0.05 out of 927 gene sets were obtained via GSEA (DAVID. The top 10 was chosen (p-value <0.05 from cluster enrichment showing significance of cytoskeleton, cell adhesion, and metal ion binding. Network analysis was applied to find relationships between functional clusters. Among the functional groups, ion metal binding was located in the center of all clusters, indicating dysfunction of regulation in metal ion concentration might affect cell morphology or cell adhesion, resulting in implant failure. This result may demonstrate the feasibility of and provide pilot data for a larger research

  20. Fatigue failure of dental implants in simulated intraoral media.

    Science.gov (United States)

    Shemtov-Yona, K; Rittel, D

    2016-09-01

    Metallic dental implants are exposed to various intraoral environments and repetitive loads during service. Relatively few studies have systematically addressed the potential influence of the environment on the mechanical integrity of the implants, which is therefore the subject of this study. Four media (groups) were selected for room temperature testing, namely dry air, saliva substitute, same with 250ppm of fluoride, and saline solution (0.9%). Monolithic Ti-6Al-4V implants were loaded until fracture, using random spectrum loading. The study reveals that the only aggressive medium of all is the saline solution, as it shortens significantly the spectrum fatigue life of the implants. The quantitative scanning electron fractographic analysis indicates that all the tested implants grew fatigue cracks of similar lengths prior to catastrophic fracture. However, the average crack growth rate in the saline medium was found to largely exceed that in other media, suggesting a decreased fracture toughness. The notion of a characteristic timescale for environmental degradation was proposed to explain the results of our spectrum tests that blend randomly low and high cycle fatigue. Random spectrum fatigue testing is powerful technique to assess and compare the mechanical performance of dental implants for various designs and/or environments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Detecting soft failures in pediatric cochlear implants: relating behavior to language outcomes

    Science.gov (United States)

    Moberly, Aaron C.; Welling, D. Bradley; Nittrouer, Susan

    2013-01-01

    Hypothesis Undesirable behaviors in young children with cochlear implants suggest device soft failure. Background Cochlear implant soft failure refers to non-optimal performance not detectable with routine hardware checks. Pediatric failures may delay language development, but failure detection is difficult. A 2005 soft failure consensus statement recommended a checklist for suspected device malfunctions. That checklist included the appearance of "bad" behaviors and aggression (externalizing behaviors) or self injury and inattentiveness (internalizing behaviors) as indicators of soft failure. Accordingly, these behaviors should predict slowed language growth, and the analyses reported here sought evidence of that predictive power. Methods Data from a longitudinal study of 80 children with cochlear implants collected at six times between 18 and 48 months were re-examined. Language measures included auditory comprehension, expressive vocabulary, and unstructured language. A parent questionnaire, the Child Behavior Checklist, examined externalizing and internalizing behaviors. Behavior measures were correlated with language measures in a series of analyses. Results Externalizing and internalizing behaviors did not consistently correlate with language at the ages tested. Additionally, early behaviors did not predict later language abilities. Individual language measures correlated best with overall language development 12 months later. Conclusions This study fails to support the hypothesis that externalizing and internalizing behaviors in pediatric cochlear implant users correlate with slowed language advance. These behaviors should not be seen as evidence of declining language performance as may be seen with device soft failure. Instead clinical assessments of language abilities are necessary. PMID:24136308

  2. A retro-prospective effectiveness study on 3448 implant operations at one referral clinic: A multifactorial analysis. Part I: Clinical factors associated to early implant failures.

    Science.gov (United States)

    Jemt, Torsten

    2017-09-08

    Limited numbers of large effectiveness studies on routine dental implant treatment are available in the literature. To report retro-prospective data on prevalence of early implant failures in a large number of routine patients/operations at 1 referral clinic. A total of 2848 patients were consecutively provided with 9582 implants with an anodized surface (Nobel Biocare AB) during 3448 implant operations between 2003 and 2011. All patients were invited to a follow-up program and early implant failures up to first annual examination were consecutively identified. A logistic multivariate data analysis was performed to identify possible factors with an association to early implant failures. A total of 43, 73, and 81 implant operations were denoted as early failures depending on when cut-off time was defined, using: abutment connection, prosthesis placement, or at first year of follow-up, respectively. Five factors showed significant association to "early implant failures," where the highest risk for a failure was associated to "surgeon" (hazard ratio [HR] 5.13), followed by "not prosthetic treatment at the referral clinic" (HR 2.71). When all 5 significant factors were present, the risk for an early failure after an operation was 7.0%, and the risk decreased to 0.1% when none/lowest risk factors were present. The role of the surgeons/dentists involved in the rehabilitation of the implant patients and numbers of placed implants (degree of tooth loss) showed the strongest associations to early implant failures in the present clinic. Also increased bone resorption was associated to increased risk for implant failure. © 2017 Wiley Periodicals, Inc.

  3. Associations between Individual and Combined Polymorphisms of the TNF and VEGF Genes and the Embryo Implantation Rate in Patients Undergoing In Vitro Fertilization (IVF Programs.

    Directory of Open Access Journals (Sweden)

    Radia Boudjenah

    Full Text Available A multiple pregnancy is now considered to be the most common adverse outcome associated with in vitro fertilization (IVF. As a consequence, the identification of women with the best chances of embryo implantation is a challenge in IVF program, in which the objective is to offer elective single-embryo transfer (eSET without decreasing the pregnancy rate. To date, a range of hormonal and clinical parameters have been used to optimize eSET but none have significant predictive value. This variability could be due to genetic predispositions related to single-nucleotide polymorphisms (SNPs. Here, we assessed the individual and combined impacts of thirteen SNPs that reportedly influence the outcome of in vitro fertilisation (IVF on the embryo implantation rate for patients undergoing intracytoplasmic sperm injection program (ICSI.A 13 gene polymorphisms: FSHR(Asn680Ser, p53(Arg72Pro, AMH(Ile49Ser, ESR2(+1730G>A, ESR1(-397T>C, BMP15(-9C>G, MTHFR1(677C>T, MTHFR2(1298A>C, HLA-G(-725C>G, VEGF(+405G>C, TNFα(-308A>G, AMHR(-482A>G, PAI-1(4G/5G, multiplex PCR assay was designed to genotype women undergoing ICSI program. We analyzed the total patients population (n = 428 and a subgroup with homogeneous characteristics (n = 112.Only the VEGF(+405G>C and TNFα(-308A>G polymorphisms impacted fertilization, embryo implantation and pregnancy rates. Moreover, the combined VEGF+405.GG and TNFα-308.AG or AA genotype occurred significantly more frequently in women with high implantation potential. In contrast, the VEGF+405.CC and TNFα-308.GG combination was associated with a low implantation rate.We identified associations between VEGF(+405G>C and TNFα(-308A>G polymorphisms (when considered singly or as combinations and the embryo implantation rate. These associations may be predictive of embryo implantation and could help to define populations in which elective single-embryo transfer should be recommended (or, conversely, ruled out. However, the mechanism

  4. A retrospective analysis of factors associated with multiple implant failures in maxillae.

    Science.gov (United States)

    Ekfeldt, A; Christiansson, U; Eriksson, T; Lindén, U; Lundqvist, S; Rundcrantz, T; Johansson, L A; Nilner, K; Billström, C

    2001-10-01

    This retrospective study was designed to verify the factors that influence implant failures. Six prosthodontic clinics in Sweden participated in the study, and together they included a total of 54 patients treated between January 1988 and December 1996. All patients were completely edentulous in the maxilla, and received either a fixed prosthesis or an overdenture supported by at least 4 implants (Brånemark System). Half of the patients belonged to the study group, and an inclusion criterion for this group was that they had lost at least half of their implants. To reduce bias, the patients in the control group were matched to the study group, i.e. they were selected so that both groups were as identical as possible. The results of the study indicate that the control group had a better initial bone support than the study group. Furthermore, the patients in the study group suffered from circumstances that could induce implant failure, such as bruxism, personal grief, depression, as well as addictions to cigarettes, alcohol and/or narcotics. On the study form the clinicians were asked to give their own opinion of the reason for implant failure. The answers given could easily be grouped into 5 different topics, and this experience can be useful to improve patient selection. This study suggests that there are certain factors of importance to consider to prevent a cluster phenomenon of implant failures i.e. lack of bone support, heavy smoking habits and bruxism.

  5. Implant failure and history of failed endodontic treatment: A retrospective case-control study.

    Science.gov (United States)

    Chatzopoulos, Georgios S; Wolff, Larry F

    2017-11-01

    Residual bacterial biofilm and/or bacteria in planktonic form may be survived in the bone following an extraction of an infected tooth that was endodontically treated unsuccessfully Failed endodontic treatment may be associated with failure of implants to osseointegrate in the same sites. Therefore, the aim of this retrospective case-control study is to examine the risk of implant failure in previous failed endodontic sites. This retrospective case-control study is based on 94 dental records of implants placed at the University of Minnesota School of Dentistry. Dental records of patients who received an implant in sites with previously failed endodontic therapy in the dental school were identified from the electronic database, while control subjects were obtained from the same pool of patients with the requirement to have received an implant in a site that was not endodontically treated. The mean age of the population was 62.89±14.17 years with 57.4% of the sample being females and 42.6% of them being males. In regards to the socio-economic status and dental insurance, 84.0% of this population was classified as low socio-economic status and 68.1% had dental insurance. Tobacco use was self-reported by 9.6% and hypercholesterolemia was the most prevalent systemic medical condition. Dental implant failure was identified in two of the included records (2.1%), both of which were placed in sites with a history of failed endodontic treatment. Within the limitations of this retrospective case-control study, further investigation with a larger population group into implant failure of sites that previously had unsuccessful endodontic treatment would be warranted. Implant failure may be associated with a history of failed endodontic treatment. Key words:Implantology, endodontics, osseointegration, treatment outcome, case-control study.

  6. Kisspeptin: A Potential Factor for Unexplained Infertility and Impaired Embryo Implantation.

    Science.gov (United States)

    Mumtaz, Aaida; Khalid, Aqsa; Jamil, Zehra; Fatima, Syeda Sadia; Arif, Sara; Rehman, Rehana

    2017-01-01

    Kisspeptin (KP) is a neuropeptide that causes the release of the gonadotropin releasing hormone, which controls hypothalamo pituitary ovarian axis and exerts a number of peripheral effects on reproductive organs. The primary objective of this study was to compare baseline KP levels in females with different types of infertility and identify possible correlations with risk of failure to conceive, preclinical abortion and pregnancy after intracytoplasmic sperm injection (ICSI). A longitudinal cohort study was carried out from August 2014 until May 2015 by recruiting 124 female patients undergoing ICSI, after obtaining ethical approval from the Australian Concept Infertility Medical Center. Cause of infertility due to male, female and unexplained factors was at a frequency of 32 (24%), 33 (31%) and 59 (45%) among the individuals respectively. KP levels were measured by ELISA assay before the initiation of the ICSI treatment protocol. Outcome of ICSI was categorized into three groups of non-pregnant with beta-human chorionic gonadotropin (β-hCG)25 mIU/ml and no cardiac activity, and clinical pregnancy declared upon confirmation of cardiac activity. Results based on cause of infertility and outcome groups were analyzed by one-way ANOVA. Females with unexplained infertility had significantly lower levels of KP when compared with those with male factor infertility (176.69 ± 5.03 vs. 397.6 ± 58.2, P=0.001). Clinical pregnancy was observed in 28 (23%) females of which 17 (71%) had a female cause of infertility. In the non-pregnant group of 66 (53%) females, common cause of infertility was unexplained 56(85%). A weak positive correlation of KP levels with fertilized oocytes and endometrial thickness was observed (P=0.04 and 0.01 respectively). Deficiency of KP in females with unexplained infertility was associated with reduced chances of implantation after ICSI.

  7. Is Low Serum Vitamin D Associated with Early Dental Implant Failure? A Retrospective Evaluation on 1625 Implants Placed in 822 Patients

    Directory of Open Access Journals (Sweden)

    Francesco Mangano

    2016-01-01

    Full Text Available Aim. To investigate whether there is a correlation between early dental implant failure and low serum levels of vitamin D. Methods. All patients treated with dental implants in a single centre, in the period 2003–2015, were considered for enrollment in this study. The main outcome was early implant failure. The influence of patient-related variables on implant survival was calculated using the Chi-square test. Results. 822 patients treated with 1625 implants were selected for this study; 27 early failures (3.2% were recorded. There was no link between gender, age, smoking, history of periodontitis, and an increased incidence of early failures. Statistical analysis reported 9 early failures (2.2% in patients with serum levels of vitamin D > 30 ng/mL, 16 early failures (3.9% in patients with levels between 10 and 30 ng/mL, and 2 early failures (9.0% in patients with levels <10 ng/mL. Although there was an increasing trend in the incidence of early implant failures with the worsening of vitamin D deficiency, the difference between these 3 groups was not statistically significant (P=0.15. Conclusions. This study failed in proving an effective link between low serum levels of vitamin D and an increased risk of early implant failure. Further studies are needed to investigate this topic.

  8. Effect of 935-MHz phone-simulating electromagnetic radiation on endometrial glandular cells during mouse embryo implantation.

    Science.gov (United States)

    Liu, Wenhui; Zheng, Xinmin; Qu, Zaiqing; Zhang, Ming; Zhou, Chun; Ma, Ling; Zhang, Yuanzhen

    2012-10-01

    This study examined the impact of 935MHz phone-simulating electromagnetic radiation on embryo implantation of pregnant mice. Each 7-week-old Kunming (KM) female white mouse was set up with a KM male mouse in a single cage for mating overnight after induction of ovulation. In the first three days of pregnancy, the pregnant mice was exposed to electromagnetic radiation at low-intensity (150 μW/cm(2), ranging from 130 to 200 μW/cm(2), for 2- or 4-h exposure every day), mid-intensity (570 μW/cm(2), ranging from 400 to 700 μW/cm(2), for 2- or 4-h exposure every day) or high-intensity (1400 μW/cm(2), ranging from 1200 to 1500 μW/cm(2), for 2- or 4-h exposure every day), respectively. On the day 4 after gestation (known as the window of murine embryo implantation), the endometrium was collected and the suspension of endometrial glandular cells was made. Laser scanning microscopy was employed to detect the mitochondrial membrane potential and intracellular calcium ion concentration. In high-intensity, 2- and 4-h groups, mitochondrial membrane potential of endometrial glandular cells was significantly lower than that in the normal control group (Pelectromagnetic radiation and longer length of the radiation are required to inflict a remarkable functional and structural damage to mitochondrial membrane. Our data demonstrated that electromagnetic radiation with a 935-MHz phone for 4 h conspicuously decreased mitochondrial membrane potential and lowered the calcium ion concentration of endometrial glandular cells. It is suggested that high-intensity electromagnetic radiation is very likely to induce the death of embryonic cells and decrease the chance of their implantation, thereby posing a high risk to pregnancy.

  9. Revision of unicompartmental knee arthroplasty: implants used and causes of failure.

    Science.gov (United States)

    Mozella, Alan de Paula; Borges Gonçalves, Felipe; Osterno Vasconcelos, Jansen; de Araújo Barros Cobra, Hugo Alexandre

    2014-01-01

    to determine the causes of unicondylar knee arthroplasty failures, as well as identify the implants used and the need of bone grafting in patients undergoing revision UKA in Center of Knee Surgery at the Instituto Nacional de Traumatologia e Ortopedia (INTO) in the period between January 1990 and January 2013. a retrospective analysis of the medical documentation and imaging, determining the cause of failure of UKA and the time of its occurrence, as well as prosthetic components implanted during the review and the need for bone grafting. in this study, 27 UKA failures in 26 patients were included. Collapse of one or more components was the main cause of failure, occurring in 33% of patients. Aseptic failure was identified in 30% of cases, progression of osteoarthrosis in 15%, infection and pain 7% each, and osteolysis and polyethylene failure in 4% each. Early failure occurred in 41% of all revisions of UKA and late failure in 59%. 23 patients have undergone revision of UK. in 35% of revisions the use of bone grafting was needed in tibial area; in 3 cases we needed allograft from Tissue Bank. We did not use metal increase in any of the revision. In one patient we used implant constraint for instability.

  10. Revision of unicompartmental knee arthroplasty: implants used and causes of failure

    Directory of Open Access Journals (Sweden)

    Alan de Paula Mozella

    2014-04-01

    Full Text Available OBJECTIVE: to determine the causes of unicondylar knee arthroplasty failures, as well as identify the implants used and the need of bone grafting in patients undergoing revision UKA in Center of Knee Surgery at the Instituto Nacional de Traumatologia e Ortopedia (INTO in the period between January 1990 and January 2013.METHODS: a retrospective analysis of the medical documentation and imaging, determining the cause of failure of UKA and the time of its occurrence, as well as prosthetic components implanted during the review and the need for bone grafting.RESULTS: in this study, 27 UKA failures in 26 patients were included. Collapse of one or more components was the main cause of failure, occurring in 33% of patients. Aseptic failure was identified in 30% of cases, progression of osteoarthrosis in 15%, infection and pain 7% each, and osteolysis and polyethylene failure in 4% each. Early failure occurred in 41% of all revisions of UKA and late failure in 59%. 23 patients have undergone revision of UK.CONCLUSION: in 35% of revisions the use of bone grafting was needed in tibial area; in 3 cases we needed allograft from Tissue Bank. We did not use metal increase in any of the revision. In one patient we used implant constraint for instability.

  11. Biodegradable Magnesium (Mg) Implantation Does Not Impose Related Metabolic Disorders in Rats with Chronic Renal Failure

    Science.gov (United States)

    Wang, Jiali; Xu, Jiankun; Liu, Waiching; Li, Yangde; Qin, Ling

    2016-05-01

    Mg and its alloys have been considered as one of the most promising biodegradable medical devices, but it was still unclear whether hypermagnesemia involved health risks would occur in persons with kidney disease due to their deteriorated kidney function for Mg ions excretion from their body. In this study, we established a chronic renal failure (CRF) model in rats induced by adenine administration prior to Mg implantation, aiming to predict if CRF patients are suitable for the use of Mg implants. The results showed that Mg levels in serum, urine, feces and internal organs had no significant changes after Mg implantation for both normal and CRF rats. Biochemical indices detection and histopathological analysis in kidney, liver and heart tissue confirmed that Mg implants did not induce any extra damage in animals even with renal failure. Our study indicates that Mg based orthopaedic medical device may be considered for use in CRF patients without biosafety concerns.

  12. Modular titanium alloy neck adapter failures in hip replacement--failure mode analysis and influence of implant material.

    Science.gov (United States)

    Grupp, Thomas M; Weik, Thomas; Bloemer, Wilhelm; Knaebel, Hanns-Peter

    2010-01-04

    Modular neck adapters for hip arthroplasty stems allow the surgeon to modify CCD angle, offset and femoral anteversion intraoperatively. Fretting or crevice corrosion may lead to failure of such a modular device due to high loads or surface contamination inside the modular coupling. Unfortunately we have experienced such a failure of implants and now report our clinical experience with the failures in order to advance orthopaedic material research and joint replacement surgery.The failed neck adapters were implanted between August 2004 and November 2006 a total of about 5000 devices. After this period, the titanium neck adapters were replaced by adapters out of cobalt-chromium. Until the end of 2008 in total 1.4% (n = 68) of the implanted titanium alloy neck adapters failed with an average time of 2.0 years (0.7 to 4.0 years) postoperatively. All, but one, patients were male, their average age being 57.4 years (36 to 75 years) and the average weight 102.3 kg (75 to 130 kg). The failures of neck adapters were divided into 66% with small CCD of 130 degrees and 60% with head lengths of L or larger. Assuming an average time to failure of 2.8 years, the cumulative failure rate was calculated with 2.4%. A series of adapter failures of titanium alloy modular neck adapters in combination with a titanium alloy modular short hip stem was investigated. For patients having received this particular implant combination risk factors were identified which were associated with the occurRence of implant failure. A Kaplan-Meier survival-failure-analysis was conducted. The retrieved implants were analysed using microscopic and chemical methods. Modes of failure were simulated in biomechanical tests. Comparative tests included modular neck adapters made of titanium alloy and cobalt chrome alloy material. Retrieval examinations and biomechanical simulation revealed that primary micromotions initiated fretting within the modular tapered neck connection. A continuous abrasion and

  13. Modular titanium alloy neck adapter failures in hip replacement - failure mode analysis and influence of implant material

    Directory of Open Access Journals (Sweden)

    Bloemer Wilhelm

    2010-01-01

    Full Text Available Abstract Background Modular neck adapters for hip arthroplasty stems allow the surgeon to modify CCD angle, offset and femoral anteversion intraoperatively. Fretting or crevice corrosion may lead to failure of such a modular device due to high loads or surface contamination inside the modular coupling. Unfortunately we have experienced such a failure of implants and now report our clinical experience with the failures in order to advance orthopaedic material research and joint replacement surgery. The failed neck adapters were implanted between August 2004 and November 2006 a total of about 5000 devices. After this period, the titanium neck adapters were replaced by adapters out of cobalt-chromium. Until the end of 2008 in total 1.4% (n = 68 of the implanted titanium alloy neck adapters failed with an average time of 2.0 years (0.7 to 4.0 years postoperatively. All, but one, patients were male, their average age being 57.4 years (36 to 75 years and the average weight 102.3 kg (75 to 130 kg. The failures of neck adapters were divided into 66% with small CCD of 130° and 60% with head lengths of L or larger. Assuming an average time to failure of 2.8 years, the cumulative failure rate was calculated with 2.4%. Methods A series of adapter failures of titanium alloy modular neck adapters in combination with a titanium alloy modular short hip stem was investigated. For patients having received this particular implant combination risk factors were identified which were associated with the occurence of implant failure. A Kaplan-Meier survival-failure-analysis was conducted. The retrieved implants were analysed using microscopic and chemical methods. Modes of failure were simulated in biomechanical tests. Comparative tests included modular neck adapters made of titanium alloy and cobalt chrome alloy material. Results Retrieval examinations and biomechanical simulation revealed that primary micromotions initiated fretting within the modular tapered neck

  14. Developmental stage on day-5 and fragmentation rate on day-3 can influence the implantation potential of top-quality blastocysts in IVF cycles with single embryo transfer

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    Devroey Paul

    2007-01-01

    Full Text Available Abstract Background In IVF-ICSI cycles with single embryo transfer (SET, embryo selection for transfer is of crucial importance. The present study aimed to define which embryo parameters might be related to the implantation potential of advanced blastocysts. Methods Overall, in 203 cycles with SET, developmental characteristics of 93 implanted (group A and 110 non-implanted (group B advanced blastocysts of good quality were compared. The following developmental parameters were assessed in the two groups: normal fertilization, developmental stage on day 5, number of blastomeres on day 2 and on day 3, fragmentation rate on day 3, compaction on day 4 and cleavage pattern on day 2 and day 3. Results Expanded blastocysts compared to full blastocysts have higher implantation potential (56.5% vs. 29.3%, p 10–50% fragments on day 3 showed a significant lower implantation (29.7% than those with ≤ 10%fragments (49.4%, P = 0.03. All the other parameters analysed were comparable for the two groups. Conclusion Developmental stage on day 5 and fragmentation rate on day 3 were related to the implantation potential of advanced blastocysts and should also be taken into account in the selection of the best advanced blastocyst for transfer.

  15. Trp53 deficient mice predisposed to preterm birth display region-specific lipid alterations at the embryo implantation site

    Energy Technology Data Exchange (ETDEWEB)

    Lanekoff, Ingela; Cha, Jeeyeon; Kyle, Jennifer E.; Dey, Sudhansu K.; Laskin, Julia; Burnum-Johnson, Kristin E.

    2016-09-13

    Here we demonstrate that conditional deletion of mouse uterine Trp53 (p53d/d), molecularly linked to mTORC1 activation and causally linked to premature uterine senescence and preterm birth, results in aberrant lipid signatures within the heterogeneous cell types of embryo implantation sites on day 8 of pregnancy. In situ nanospray desorption electrospray ionization mass spectrometry imaging (nano-DESI MSI) was used to characterize the molecular speciation of free fatty acids, monoacylglycerols, unmodified and oxidized phosphatidylcholine (PC/Ox-PC), and diacylglycerol (DG) species within implantation sites of p53d/d mice and floxed littermates. Implantation sites from p53d/d mice exhibited distinct spatially resolved changes demonstrating accumulation of DG species, depletion of Ox-PC species, and increase in species with more unsaturated acyl chains, including arachidonic and docosahexaenoic acid. Understanding abnormal changes in the abundance and localization of individual lipid species early in the progression to premature birth is important for discovering novel targets for treatments and diagnosis.

  16. Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicity.

    Science.gov (United States)

    Green, Ben; Griffiths, Emily; Almond, Solomon

    2017-01-24

    There were at least 31,171 metal-on-metal (MoM) hip implants in the UK between 2003 and 2011. Some of these were subject to failure and widescale recalls and revisions followed. This is a presentation of ten cases (mean age 60 years) where we evaluated neuropsychiatric morbidity following metal-on-metal hip implant failure and revision. Implants were ASR total hip replacement (acetabular implant, taper sleeve adaptor and unipolar femoral implants) performed between 2005 and 2009. This case series describes, for the first time, neuropsychiatric complications after revision where there has been cobalt and chromium toxicity. Pre-revision surgery, nine patients had toxic levels of chromium and cobalt (mean level chromium 338 nmol/l, mean cobalt 669.4 nmol/l). Depression assessment showed 9 of 9 respondents fulfilled the BDI criteria for depression and 3 of these were being treated. 7 of 9 patients showing short term memory deficit with mean mini mental state examination score of 24.2. The normal population mean MMSE for this group would be expected to be 28 with chromium metallosis following MoM implant failure. Larger studies of neurocognitive effects are indicated in this group. There may be implications for public health.

  17. Influence of platform diameter in the reliability and failure mode of extra-short dental implants.

    Science.gov (United States)

    Bordin, Dimorvan; Bergamo, Edmara T P; Bonfante, Estevam A; Fardin, Vinicius P; Coelho, Paulo G

    2018-01-01

    To evaluate the influence of implant diameter in the reliability and failure mode of extra-short dental implants. Sixty-three extra-short implants (5mm-length) were allocated into three groups according to platform diameter: Ø4.0-mm, Ø5.0-mm, and Ø6.0-mm (21 per group). Identical abutments were torqued to the implants and standardized crowns cemented. Three samples of each group were subjected to single-load to failure (SLF) to allow the design of the step-stress profiles, and the remaining 18 were subjected to step-stress accelerated life-testing (SSALT) in water. The use level probability Weibull curves, and the reliability (probability of survival) for a mission of 100,000 cycles at 100MPa, 200MPa, and 300MPa were calculated. Failed samples were characterized in scanning electron microscopy for fractographic inspection. No significant difference was observed for reliability regarding implant diameter for all loading missions. At 100MPa load, all groups showed reliability higher than 99%. A significant decreased reliability was observed for all groups when 200 and 300MPa missions were simulated, regardless of implant diameter. At 300MPa load, the reliability was 0%, 0%, and 5.24%, for Ø4.0mm, Ø5.0mm, and Ø6.0mm, respectively. The mean beta (β) values were lower than 0.55 indicating that failures were most likely influenced by materials strength, rather than damage accumulation. The Ø6.0mm implant showed significantly higher characteristic stress (η = 1,100.91MPa) than Ø4.0mm (1,030.25MPa) and Ø5.0mm implant (η = 1,012.97MPa). Weibull modulus for Ø6.0-mm implant was m = 7.41, m = 14.65 for Ø4.0mm, and m = 11.64 for Ø5.0mm. The chief failure mode was abutment fracture in all groups. The implant diameter did not influence the reliability and failure mode of 5mm extra-short implants. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. School failure in students who are normal-hearing or deaf: with or without cochlear implants.

    Science.gov (United States)

    Duarte, Ivone; Santos, Cristina Costa; Rego, Guilhermina; Nunes, Rui

    2016-01-01

    To evaluate the impact of cochlear implants on the school failure of deaf who attend mainstream classes by comparing them to their normal-hearing peers as well as deaf without cochlear implants. This case-control study included participants aged 8-18 years. The number of school years failed was obtained from school records. The greatest differences in achievement levels were found between hearing students and those who were deaf without cochlear implants. Cochlear implants provide educational opportunities for hearing-impaired students, yet those without cochlear implants remain at a great disadvantage. These findings suggest that measures promoting greater equity and quality for all deaf students allow achievement levels closer to those of the not impaired.

  19. Estimating changes in cardiac output using an implanted hemodynamic monitor in heart failure patients

    DEFF Research Database (Denmark)

    Ståhlberg, Marcus; Damgaard, Morten; Ersgård, David

    2010-01-01

    OBJECTIVES: The aim of this study was to evaluate an algorithm that estimates changes in cardiac output (CO) from right ventricular (RV) pressure waveforms derived from an implantable hemodynamic monitor (IHM) in heart failure patients. DESIGN: Twelve heart failure patients (NYHA II-III, EF 32......%) with an implantable hemodynamic monitor (Chronicle) were included in this study. Changes in cardiac output were provoked by body position change at rest (left lateral supine, horizontal supine, sitting, and standing) and a steady state bicycle exercise at 20 watts. Estimated CO derived from the IHM (CO...

  20. Human embryos secrete microRNAs into culture media--a potential biomarker for implantation.

    Science.gov (United States)

    Rosenbluth, Evan M; Shelton, Dawne N; Wells, Lindsay M; Sparks, Amy E T; Van Voorhis, Bradley J

    2014-05-01

    To determine whether human blastocysts secrete microRNA (miRNAs) into culture media and whether these reflect embryonic ploidy status and can predict in vitro fertilization (IVF) outcomes. Experimental study of human embryos and IVF culture media. Academic IVF program. 91 donated, cryopreserved embryos that developed into 28 tested blastocysts, from 13 couples who had previously completed IVF cycles. None. Relative miRNA expression in IVF culture media. Blastocysts were assessed by chromosomal comparative genomic hybridization analysis, and the culture media from 55 single-embryo transfer cycles was tested for miRNA expression using an array-based quantitative real-time polymerase chain reaction analysis. The expression of the identified miRNA was correlated with pregnancy outcomes. Ten miRNA were identified in the culture media; two were specific to spent media (miR-191 and miR-372), and one was only present in media before the embryos had been cultured (miR-645). MicroRNA-191 was more highly concentrated in media from aneuploid embryos, and miR-191, miR-372, and miR-645 were more highly concentrated in media from failed IVF/non-intracytoplasmic sperm injection cycles. Additionally, miRNA were found to be more highly concentrated in ICSI and day-5 media samples when compared with regularly inseminated and day-4 samples, respectively. MicroRNA can be detected in IVF culture media. Some of these miRNA are differentially expressed according to the fertilization method, chromosomal status, and pregnancy outcome, which makes them potential biomarkers for predicting IVF success. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Expression of proposed implantation marker genes CDX2 and HOXB7 in the blastocyst does not distinguish viable from non-viable human embryos

    DEFF Research Database (Denmark)

    Kirkegaard, Kirstine; Hindkjær, Johnny Juhl; Ingerslev, Hans Jakob

    2012-01-01

    Introduction: Selection of the most competent embryo challenges the credo of promoting single embryo transfer (SET) while maintaining high pregnancy rates, thus intensifying the need to introduce techniques that can improve embryo selection. Recent studies have demonstrated that blastocyst gene...... after oocyte retrieval. Immediately following biopsy, cells were lysed and reverse transcriptase PCR (RT-PCR) was carried out directly on the cell lysate using Superscript® III First Strand Synthesis kit (Invitrogen) thus avoiding introducing RNA amplification steps. As part of the study, the expression...... of 15 key genes associated with developmental competence in animals were evaluated in high quality human embryos with monogenic or chromosomal disorders from a pre-implantation genetic disorder program. Triplicate cDNA amplifications for quantitative (q) RT-PCR were performed using pre-designed gene...

  2. Does Bruxism Contribute to Dental Implant Failure? A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Zhou, Yi; Gao, Jinxia; Luo, Le; Wang, Yining

    2016-04-01

    Bruxism was usually considered as a contraindication for oral implanting. The causal relationship between bruxism and dental implant failure was remained controversial in existing literatures. This meta-analysis was performed to investigate the relationship between them. This review conducted an electronic systematic literature search in MEDLINE (PubMed) and EmBase in November 2013 without time and language restrictions. Meanwhile, a hand searching for all the relevant references of included studies was also conducted. Study information extraction and methodological quality assessments were accomplished by two reviewers independently. A discussion ensued if any disagreement occurred, and unresolved issues were solved by consulting a third reviewer. Methodological quality was assessed by using the Newcastle-Ottawa Scale tool. Odds ratio (OR) with 95% confidence interval (CI) was pooled to estimate the relative effect of bruxism on dental implant failures. Fixed effects model was used initially; if the heterogeneity was high, random effects model was chosen for meta-analysis. Statistical analyses were carried out by using Review Manager 5.1. In this meta-analysis review, extracted data were classified into two groups based on different units. Units were based on the number of prostheses (group A) and the number of patients (group B). In group A, the total pooled OR of bruxers versus nonbruxers for all subgroups was 4.72 (95% CI: 2.66-8.36, p = .07). In group B, the total pooled OR of bruxers versus nonbruxers for all subgroups was 3.83 (95% CI: 2.12-6.94, p = .22). This meta-analysis was performed to evaluate the relationship between bruxism and dental implant failure. In contrast to nonbruxers, prostheses in bruxers had a higher failure rate. It suggests that bruxism is a contributing factor of causing the occurrence of dental implant technical/biological complications and plays a role in dental implant failure. © 2015 Wiley Periodicals, Inc.

  3. The Lc3-synthase gene B3gnt5 is essential to pre-implantation development of the murine embryo

    Directory of Open Access Journals (Sweden)

    Cinelli Paolo

    2008-11-01

    Full Text Available Abstract Background Glycosphingolipids (GSL are integral components of mammalian cell membranes that are involved in cell adhesion and cell signaling processes. GSL are subdivided into structural series, like ganglio-, lacto/neolacto-, globo- and isoglo-series, which are defined by distinct trisaccharide cores. The β1,3 N-acetylglucosaminyltransferase-V (B3gnt5 enzyme catalyzes the formation of the Lc3 structure, which is the core of lactoseries derived GSL. Results The biological significance of the glycoconjugates produced by the B3gnt5 enzyme was investigated by inactivating the B3gnt5 gene in the mouse germline. The disruption of the B3gnt5 protein-coding region in mouse embryonic stem cells resulted in reduced Lc3-synthase activity, supporting its specific contribution to lactoseries derived GSL synthesis. Breeding of heterozygous mutant mice failed to produce any viable progeny homozygous for the B3gnt5-null allele. The genotypic examination of embryos from heterozygous crosses showed that the disruption of the B3gnt5 gene leads to pre-implantation lethality. This finding was compatible with the expression pattern of the B3gnt5 gene in the pre-implantation embryo as shown by in situ hybridization. The analysis of GSL profiles in embryonic stem cells heterozygous for the B3gnt5-null allele confirmed the reduced levels of lactoseries derived GSL levels and of other GSL species. Conclusion The disruption of the B3gnt5 gene in mice affected the expression of lactoseries derived GLS and possibly of protein-bound β3GlcNAc-linked glycans, thereby demonstrating an essential contribution of these glycoconjugates in early embryonic development, and supporting the importance of these glycoconjugates in cell differentiation and adhesion processes.

  4. The effect of estrogen administration during early pregnancy upon the survival of single implanted pig embryos.

    Science.gov (United States)

    Kawarasaki, T; Enya, S; Otsu, Y

    2012-12-01

    In the present study, we investigated the influence of exogenous estrogen on embryo survival after transfer into prepubertal gilts in which estrus had been induced. In the first experiment, estrus was induced in prepubertal gilts by the administration of 1,000 IU of eCG and 750 IU of hCG every 72 h. Several blastocysts were recovered on d 6 (d 0 is the day of hCG administration), and 1 embryo was transferred to the tip of 1 side of the uterine horn on d 6 (Control). In treated groups, after embryo transfer, 5 mg of estradiol benzoate (EB) was administered on d 11 (EB5mg-1) or d 11, d 13, and d 15 (EB5mg-3) or d 11, 12, 13, 14, and 15 (EB5mg-5) or 20 mg of estradiol dipropionate (EDP) was administered on d 11 (EDP20mg-1) or d 11 and d 14 (EDP20mg-2). Autopsy examinations were performed on d 53 to 60. Although nontreated gilts did not become pregnant, gilts in each of the estradiol-treated groups became pregnant. The greatest pregnancy rate (77.8%, 7/9) was obtained with EDP20mg-2 (EDP20mg-2 > control: P piglet died from dystocia, and 1 suffered from deformity involving double-breasted hooves and died 6 d after birth. There was no difference (P > 0.05) in survival rate on d 30 of pregnancy and weaning (50%, 6/12). Body weight at birth and at weaning did not differ from that reported in previous studies. In conclusion, this study showed that EDP5mg-2 treatment during early pregnancy leads to full-term development of a single embryo.

  5. Endometrial injury prior to assisted reproductive techniques for recurrent implantation failure: a systematic literature review.

    Science.gov (United States)

    Panagiotopoulou, Nikoletta; Karavolos, Stamatios; Choudhary, Meenakshi

    2015-10-01

    Endometrial injury to improve implantation for women undergoing assisted reproductive techniques has attracted a lot of attention recently and has rapidly become incorporated into clinical practice. The aim of this study is, thus, to assess the effectiveness and safety of endometrial injury performed in the cycle preceding assisted reproductive techniques in women with recurrent implantation failure. Electronic database searches, including MEDLINE, EMBASE, CENTRAL and grey literature, up to 30th May 2015 were conducted with no restrictions. Randomized controlled trials comparing endometrial injury versus placebo or no treatment in the cycle preceding assisted reproductive techniques in women with recurrent implantation failure were selected. The primary outcome was live birth rate. Secondary outcomes were clinical pregnancy, implantation, miscarriage and procedure-related complication rates. Of the 1115 publications identified, 4 met the inclusion criteria. Meta-analysis was not possible due to significant clinical heterogeneity among the included studies. Patients' characteristics differed, as did the intervention used with endometrial injury being performed at different phases of the preceding menstrual cycle. Moreover, the effect of endometrial injury on live birth and clinical pregnancy rates were inconsistent among the included studies. In summary, there is currently insufficient evidence to support the use of endometrial injury in women with recurrent implantation failure undergoing assisted reproductive techniques while the procedure-associated complication rate has not been assessed. Clinical implementation should, thus, be deferred until robust evidence becomes available. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Long-Term Fatigue and Its Probability of Failure Applied to Dental Implants

    Directory of Open Access Journals (Sweden)

    María Prados-Privado

    2016-01-01

    Full Text Available It is well known that dental implants have a high success rate but even so, there are a lot of factors that can cause dental implants failure. Fatigue is very sensitive to many variables involved in this phenomenon. This paper takes a close look at fatigue analysis and explains a new method to study fatigue from a probabilistic point of view, based on a cumulative damage model and probabilistic finite elements, with the goal of obtaining the expected life and the probability of failure. Two different dental implants were analysed. The model simulated a load of 178 N applied with an angle of 0°, 15°, and 20° and a force of 489 N with the same angles. Von Mises stress distribution was evaluated and once the methodology proposed here was used, the statistic of the fatigue life and the probability cumulative function were obtained. This function allows us to relate each cycle life with its probability of failure. Cylindrical implant has a worst behaviour under the same loading force compared to the conical implant analysed here. Methodology employed in the present study provides very accuracy results because all possible uncertainties have been taken in mind from the beginning.

  7. Implant failure caused by non-union of bisphosphonate-associated subtrochanteric femur fracture.

    LENUS (Irish Health Repository)

    O'Neill, Barry James

    2014-04-03

    Bisphosphonate use has been identified as a contributory factor in atypical subtrochanteric fracture of the femur. These fractures are commonly treated with an intramedullary device. We present a case of implant failure of an intrameduallary device caused by non-union of an atypical subtrochanteric fracture.

  8. Incidence and Determinants of Dental Implant Failure: A Review of Electronic Health Records in a U.S. Dental School.

    Science.gov (United States)

    Hickin, Matthew Parker; Shariff, Jaffer A; Jennette, Philip J; Finkelstein, Joseph; Papapanou, Panos N

    2017-10-01

    The aim of this study was to use electronic health care records (EHRs) to examine retrospectively the incidence of and attributes associated with dental implant failures necessitating implant removal in a large cohort of patients treated in the student clinics of a U.S. dental school over three and a half years. EHRs were searched for all patients who received dental implants between July 1, 2011, and December 31, 2014. Characteristics of patients and implants that were actively removed due to irrevocable failure of any etiology ("failure cohort") during this period were compared to those of all other patients who received dental implants during the same time frame ("reference cohort"). Differences in the frequency distribution of various characteristics between the failure and reference cohorts were compared. Of a total 6,129 implants placed in 2,127 patients during the study period, 179 implants (2.9%) in 120 patients (5.6%) were removed. In the multivariate analysis, presence of a removable (OR=2.86) or fixed temporary prosthesis (OR=3.71) was statistically significantly associated with increased risk for implant failure. In contrast, antibiotic coverage (pre- and post-surgery OR=0.16; post-surgery only OR=0.38) and implants of certain manufacturers were associated with lower risk of implant failure. In this sizeable cohort of patients receiving care in dental student clinics, the review of EHRs facilitated identification of multiple variables associated with implant failure resulting in removal; however, these findings do not suggest causative relationships. The adopted analytical approach can enhance quality assurance measures and may contribute to the identification of true risk factors for dental implant failure.

  9. [The Development and Application of the Orthopaedics Implants Failure Database Software Based on WEB].

    Science.gov (United States)

    Huang, Jiahua; Zhou, Hai; Zhang, Binbin; Ding, Biao

    2015-09-01

    This article develops a new failure database software for orthopaedics implants based on WEB. The software is based on B/S mode, ASP dynamic web technology is used as its main development language to achieve data interactivity, Microsoft Access is used to create a database, these mature technologies make the software extend function or upgrade easily. In this article, the design and development idea of the software, the software working process and functions as well as relative technical features are presented. With this software, we can store many different types of the fault events of orthopaedics implants, the failure data can be statistically analyzed, and in the macroscopic view, it can be used to evaluate the reliability of orthopaedics implants and operations, it also can ultimately guide the doctors to improve the clinical treatment level.

  10. The association between three attitude-related indexes of oral hygiene and secondary implant failures: A retrospective longitudinal study.

    Science.gov (United States)

    Tecco, S; Grusovin, M G; Sciara, S; Bova, F; Pantaleo, G; Capparé, P

    2017-07-11

    This study evaluated the strength of the association between three widely used clinical indexes considered as distal behavioural indicators of attitude-related oral status (an index of oral hygiene, the plaque index [PI] and two periodontal indexes, that is the presence of bleeding on probing [BOP] and of pockets probing depth [PPD]) and secondary implant failure due to peri-implantitis in patients rehabilitated with cemented prosthesis. The study included patients who underwent implant-prosthetic rehabilitation and had joined the programme of maintenance of the same hospital. Implant failures, number of months between implant insertion and implant loading, and patients' surgical protocol were monitored and recorded. Further, PI, BOP and PPD-all attitude-related indicators of oral hygiene and periodontal inflammation-were recorded and related, in terms of odds ratios (ORs ) and corresponding risk factors, to secondary implant failures. A total of 1427 patients (2673 implants) were enrolled. The follow-up ranged from 1.5 to 9 years (mean 5.3 years±1.3). The cumulative survival rate was 98.01%. Thirty-two patients (36 implants, 1.36% of all implants) had implant failure. A statistically significant association between PI, BOP, PPD and secondary failures due to peri-implantitis was observed. Within the limitations of this study, all three attitude-related behavioural indicators-the plaque index (PI), bleeding on probing (BOP) and abnormal probing pocket depth (PPD)-proved to be significant risk indicators for secondary implant failure due to peri-implantitis, both from a clinical and from a socio-psychological attitude-related perspective. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Occlusal concepts application in resolving implant prosthetic failure: case report.

    Science.gov (United States)

    Jamcoski, Vanessa Helena; Faot, Fernanda; de Mattias Sartori, Ivete Aparecida; Vieira, Rogéria Acedo; Tiossi, Rodrigo

    2014-04-01

    The prosthetic management of a poor implant treatment is presented in this case report. The recommended occlusion concepts for implant-supported prostheses were applied for the resolution of the case. The rehabilitation of the posterior segments provided a mutually protected occlusion with adequate distribution of the axial and lateral bite forces with stable posterior occlusion. The clinical exam indicated the need for modification in the vertical dimension of occlusion. Sufficient interocclusal rest space was present to test the alteration in the vertical dimension. The aim was to achieve an occlusion scheme that followed four specific criteria: (1) centric contacts and centric relation of the jaw-to-jaw position; (2) anterior guidance only; (3) shallow anterior angle of tooth contact; and (4) vertical dimension of occlusion with acceptable tooth form and guidance. The success of an oral rehabilitation relies in following the aforementioned criteria, appropriate interaction between the dental laboratory technician and the clinician, careful elaboration of the provisional rehabilitation with all the desired details to be reproduced in the final prosthetic restoration and sufficient follow-up time of the provisional prostheses before placing the final restoration.

  12. Total artificial heart implantation for biventricular failure due to eosinophilic myocarditis.

    Science.gov (United States)

    Kawabori, Masashi; Kurihara, Chitaru; Miller, Yair; Heck, Kent A; Bogaev, Roberta C; Civitello, Andrew B; Cohn, William E; Frazier, O H; Morgan, Jeffrey A

    2017-09-01

    Idiopathic hypereosinophilic syndrome is a condition of unknown etiology characterized by proliferation of eosinophils and their infiltration into tissues. Although cardiac involvement is rare, eosinophilic myocarditis can lead to life-threating fulminant congestive heart failure. Treatment of patients with eosinophilic myocarditis is challenging as heart failure can be caused by biventricular dysfunction. To our knowledge, this is the first case reported in the literature describing a patient with acute severe biventricular heart failure caused by eosinophilic myocarditis with mural left ventricular apical thrombus who was successfully treated with implantation of a total artificial heart as a bridge to heart transplant.

  13. Evaluation of the effect of oral ritodrine on implantation rate in in-vitro fertilization-embryo transfer cycles

    Directory of Open Access Journals (Sweden)

    Maryam Ahmadi

    2011-01-01

    Full Text Available Background: Pregnancy rate with IVF cycle is almost 22%. Many investigations perform to increase this rate in IVF. Various factors affect the result of IVF cycles. One of these factors could be uterine contractions that expel transferred embryo. Ritodrine is a beta mimetic agent that can block and decrease uterine contractions.Objective: The objective of this study was to determine ritodrine effectiveness for increasing the implantation rate in IVF cycles, and its probable mechanisms in decreasing uterine contractions as well.Materials and Methods: A total of 100 patients of IVF-ET cycles were divided randomly in two groups in a university hospital, Hamadan, Iran. The case group were prescribed ritodrine 10 mg / bid orally after oocyte retrieval until 10 days. The control group didn’t received ridotrine.Results: In ritodrine group 14% of patients and in control group 16% had positive β-hCG test (p-value>0.5.Conclusion: Ritodrine did not improve the implantation rate in IVF-ET cycles

  14. Patient barriers to implantable cardioverter defibrillator implantation for the primary prevention of sudden cardiac death in patients with heart failure and reduced ejection fraction.

    Science.gov (United States)

    Chan, Laura Lihua; Lim, Choon Pin; Aung, Soe Tin; Quetua, Paul; Ho, Kah Leng; Chong, Daniel; Teo, Wee Siong; Sim, David; Ching, Chi Keong

    2016-04-01

    Device therapy is efficacious in preventing sudden cardiac death (SCD) in patients with reduced ejection fraction. However, few who need the device eventually opt to undergo implantation and even fewer reconsider their decisions after deliberation. This is due to many factors, including unresolved patient barriers. This study identified the factors that influenced patients' decision to decline implantable cardioverter defibrillator (ICD) implantation, and those that influenced patients who initially declined an implant to reconsider having one. A single-centre survey was conducted among 240 patients who had heart failure with reduced ejection fraction and met the ICD implantation criteria, but had declined ICD implantation. Participants who refused ICD implantation were mostly male (84%), Chinese (71%), married (72%), currently employed (54%), and had up to primary or secondary education (78%) and monthly income of gap may lead to higher rates of ICD implantation. Copyright: © Singapore Medical Association.

  15. Acute endothelial failure after cosmetic iris implants (NewIris®).

    Science.gov (United States)

    Garcia-Pous, Maria; Udaondo, Patricia; Garcia-Delpech, Salvador; Salom, David; Díaz-Llopis, Manuel

    2011-01-01

    We report a case of an acute endothelial failure after the implantation of a new cosmetic, colored, artificial iris diaphragm implant called NewIris(®). A 21-year-old woman came to us complaining of progressive loss of vision and pain after NewIris lenses had been implanted. Decreased visual acuity, corneal edema, and increased intraocular pressure in both eyes appeared only 3 weeks after the surgery. The lenses were removed as soon as possible but had already severely affected the endothelial cell count. NewIris implants are an alternative to cosmetic contact lenses, but they are not as safe as other phakic anterior chamber intraocular lenses, nor are they a good option for the patient.

  16. Influence of acupuncture on the outcomes of in vitro fertilisation when embryo implantation has failed: a prospective randomised controlled clinical trial.

    Science.gov (United States)

    Villahermosa, Daniela Isoyama Manca di; Santos, Lara Guercio dos; Nogueira, Mariana Balthazar; Vilarino, Fabia Lima; Barbosa, Caio Parente

    2013-06-01

    To evaluate the effectiveness of acupuncture and moxibustion as an adjuvant treatment in women undergoing in vitro fertilisation (IVF) when embryo implantation has failed. A prospective, randomised controlled clinical trial was conducted with 84 infertile patients who had had at least two unsuccessful attempts of IVF. The patients were randomised in three groups: control (n=28), sham (n=28) and acupuncture (n=28). The sample size was calculated by assuming a pregnancy rate of 10% when embryo implantation had failed. The pregnancy rates of the current IVF cycle were evaluated by measurement of blood β human chorionic gonadotrophin (βhCG) and subsequent transvaginal ultrasound. Acupuncture was performed on the first and seventh day of ovulation induction, on the day before ovarian puncture and on the day after embryo transfer. In the acupuncture group, patients were treated with moxibustion at nine acupuncture points (BL18, BL22, BL23, BL52, CV3, CV4, CV5, CV7, GV4) and needling at 12 points. In the sham group needles were inserted in eight areas that did not correspond to known acupuncture points. The clinical pregnancy rate in the acupuncture group was significantly higher than that in the control and sham groups (35.7% vs 7.1% vs 10.7%; p=0.0169). In this study, acupuncture and moxibustion increased pregnancy rates when used as an adjuvant treatment in women undergoing IVF, when embryo implantation had failed.

  17. Potential hazards to embryo implantation: A human endometrial in vitro model to identify unwanted antigestagenic actions of chemicals

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, L.; Deppert, W.R. [Department of Obstetrics and Gynecology, University Hospital Freiburg (Germany); Pfeifer, D. [Department of Hematology and Oncology, University Hospital Freiburg (Germany); Stanzel, S.; Weimer, M. [Department of Biostatistics, German Cancer Research Center, Heidelberg (Germany); Hanjalic-Beck, A.; Stein, A.; Straßer, M.; Zahradnik, H.P. [Department of Obstetrics and Gynecology, University Hospital Freiburg (Germany); Schaefer, W.R., E-mail: wolfgang.schaefer@uniklinik-freiburg.de [Department of Obstetrics and Gynecology, University Hospital Freiburg (Germany)

    2012-05-01

    Embryo implantation is a crucial step in human reproduction and depends on the timely development of a receptive endometrium. The human endometrium is unique among adult tissues due to its dynamic alterations during each menstrual cycle. It hosts the implantation process which is governed by progesterone, whereas 17β-estradiol regulates the preceding proliferation of the endometrium. The receptors for both steroids are targets for drugs and endocrine disrupting chemicals. Chemicals with unwanted antigestagenic actions are potentially hazardous to embryo implantation since many pharmaceutical antiprogestins adversely affect endometrial receptivity. This risk can be addressed by human tissue-specific in vitro assays. As working basis we compiled data on chemicals interacting with the PR. In our experimental work, we developed a flexible in vitro model based on human endometrial Ishikawa cells. Effects of antiprogestin compounds on pre-selected target genes were characterized by sigmoidal concentration–response curves obtained by RT-qPCR. The estrogen sulfotransferase (SULT1E1) was identified as the most responsive target gene by microarray analysis. The agonistic effect of progesterone on SULT1E1 mRNA was concentration-dependently antagonized by RU486 (mifepristone) and ZK137316 and, with lower potency, by 4-nonylphenol, bisphenol A and apigenin. The negative control methyl acetoacetate showed no effect. The effects of progesterone and RU486 were confirmed on the protein level by Western blotting. We demonstrated proof of principle that our Ishikawa model is suitable to study quantitatively effects of antiprogestin-like chemicals on endometrial target genes in comparison to pharmaceutical reference compounds. This test is useful for hazard identification and may contribute to reduce animal studies. -- Highlights: ► We compare progesterone receptor-mediated endometrial effects of chemicals and drugs. ► 4-Nonylphenol, bisphenol A and apigenin exert weak

  18. Failure of implantable cardioverter-defibrillator leads: a matter of lead size?

    Science.gov (United States)

    Rordorf, Roberto; Poggio, Luca; Savastano, Simone; Vicentini, Alessandro; Petracci, Barbara; Chieffo, Enrico; Klersy, Catherine; Landolina, Maurizio

    2013-02-01

    Small-diameter implantable cardioverter-defibrillator (ICD) Sprint Fidelis and Riata leads have been recalled owing to an increased risk of lead failure, thus arousing the suspicion that lead size might be a critical issue. To compare the incidence of failure of small-diameter (≤8 F) and standard-diameter (>8 F) ICD leads implanted in a single center. From January 2003 to December 2010, 190 Sprint Fidelis, 182 Riata/Riata ST, 99 Optim (Riata Optim/Durata), and 419 standard-diameter leads were implanted in our center. During a median follow-up of 33 months, the overall failure rate was 6.3%. Follow-up duration was similar for Sprint Fidelis, Riata, and standard-diameter leads but shorter for the Optim group. The failure rate was significantly higher in Sprint Fidelis leads than in both standard-diameter (4.8%/year vs 0.8%/year; Pleads. The incidence of lead failure in Riata/Riata ST leads proved significantly higher than in standard-diameter leads (2.6%/year vs 0.8%/year; P = .001). No cases of lead failure were recorded in the Optim group. On multivariable analyses, small-diameter (hazard ratio [HR] 5.03, 2.53-10.01, Pleads and agelead failure. Compared with standard-diameter leads, both Sprint Fidelis and Riata/Riata ST small-diameter ICD leads are at an increased risk of failure, although the incidence of events is significantly lower in the Riata than in the Sprint Fidelis group. Copyright © 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  19. Cost-Effectiveness of Adding Cardiac Resynchronization Therapy to an Implantable Cardioverter-Defibrillator Among Patients With Mild Heart Failure

    DEFF Research Database (Denmark)

    Woo, Christopher Y; Strandberg, Erika J; Schmiegelow, Michelle D

    2015-01-01

    -defibrillator (ICD) alone among patients with left ventricular systolic dysfunction, prolonged intraventricular conduction, and mild heart failure. DESIGN: Markov decision model. DATA SOURCES: Clinical trials, clinical registries, claims data from Centers for Medicare & Medicaid Services, and Centers for Disease......BACKGROUND: Cardiac resynchronization therapy (CRT) reduces mortality and heart failure hospitalizations in patients with mild heart failure. OBJECTIVE: To estimate the cost-effectiveness of adding CRT to an implantable cardioverter-defibrillator (CRT-D) compared with implantable cardioverter...

  20. Relationship between Sponsorship and Failure Rate of Dental Implants: A Systematic Approach

    Science.gov (United States)

    Popelut, Antoine; Valet, Fabien; Fromentin, Olivier; Thomas, Aurélie; Bouchard, Philippe

    2010-01-01

    Background The number of dental implant treatments increases annually. Dental implants are manufactured by competing companies. Systematic reviews and meta-analysis have shown a clear association between pharmaceutical industry funding of clinical trials and pro-industry results. So far, the impact of industry sponsorship on the outcomes and conclusions of dental implant clinical trials has never been explored. The aim of the present study was to examine financial sponsorship of dental implant trials, and to evaluate whether research funding sources may affect the annual failure rate. Methods and Findings A systematic approach was used to identify systematic reviews published between January 1993 and December 2008 that specifically deal with the length of survival of dental implants. Primary articles were extracted from these reviews. The failure rate of the dental implants included in the trials was calculated. Data on publication year, Impact Factor, prosthetic design, periodontal status reporting, number of dental implants included in the trials, methodological quality of the studies, presence of a statistical advisor, and financial sponsorship were extracted by two independent reviewers (kappa  = 0.90; CI95% [0.77–1.00]). Univariate quasi-Poisson regression models and multivariate analysis were used to identify variables that were significantly associated with failure rates. Five systematic reviews were identified from which 41 analyzable trials were extracted. The mean annual failure rate estimate was 1.09%.(CI95% [0.84–1.42]). The funding source was not reported in 63% of the trials (26/41). Sixty-six percent of the trials were considered as having a risk of bias (27/41). Given study age, both industry associated (OR = 0.21; CI95% [0.12–0.38]) and unknown funding source trials (OR = 0.33; (CI95% [0.21–0.51]) had a lower annual failure rates compared with non-industry associated trials. A conflict of interest statement was disclosed in 2

  1. Relationship between sponsorship and failure rate of dental implants: a systematic approach.

    Directory of Open Access Journals (Sweden)

    Antoine Popelut

    Full Text Available BACKGROUND: The number of dental implant treatments increases annually. Dental implants are manufactured by competing companies. Systematic reviews and meta-analysis have shown a clear association between pharmaceutical industry funding of clinical trials and pro-industry results. So far, the impact of industry sponsorship on the outcomes and conclusions of dental implant clinical trials has never been explored. The aim of the present study was to examine financial sponsorship of dental implant trials, and to evaluate whether research funding sources may affect the annual failure rate. METHODS AND FINDINGS: A systematic approach was used to identify systematic reviews published between January 1993 and December 2008 that specifically deal with the length of survival of dental implants. Primary articles were extracted from these reviews. The failure rate of the dental implants included in the trials was calculated. Data on publication year, Impact Factor, prosthetic design, periodontal status reporting, number of dental implants included in the trials, methodological quality of the studies, presence of a statistical advisor, and financial sponsorship were extracted by two independent reviewers (kappa = 0.90; CI(95% [0.77-1.00]. Univariate quasi-Poisson regression models and multivariate analysis were used to identify variables that were significantly associated with failure rates. Five systematic reviews were identified from which 41 analyzable trials were extracted. The mean annual failure rate estimate was 1.09%.(CI(95% [0.84-1.42]. The funding source was not reported in 63% of the trials (26/41. Sixty-six percent of the trials were considered as having a risk of bias (27/41. Given study age, both industry associated (OR = 0.21; CI(95% [0.12-0.38] and unknown funding source trials (OR = 0.33; (CI(95% [0.21-0.51] had a lower annual failure rates compared with non-industry associated trials. A conflict of interest statement was disclosed in 2

  2. A retro-prospective effectiveness study on 3448 implant operations at one referral clinic: A multifactorial analysis. Part II: Clinical factors associated to peri-implantitis surgery and late implant failures.

    Science.gov (United States)

    Jemt, Torsten

    2017-09-08

    Little knowledge is available on implant treatment in large effectiveness studies in routine practice. To report retro-prospective data on prevalence of peri-implantitis surgery and late implant failures in a large number of routine patients at 1 referral clinic. Altogether 9582 implants with an anodized surface (Nobel Biocare AB) were consecutively placed between 2003 and 2011 and followed-up to end of 2015. All peri-implantitis operations and late implant failures were consecutively identified. A logistic multivariate data analysis was performed to identify association between the complications and different clinical factors. Furthermore, data on prevalence on risk for inflammation and bone loss at implants ("peri-implantitis") and surgery related to peri-implantitis was collected for another reference group of about 10 000 implant patients during 3 consecutive years (2013-2015). Cumulative survival rates for implant operations without peri-implantitis surgery or implant failures were calculated to 96.4% (95% CI: 97.3-95.4) and 95.0% (95% CI: 96.0-94.1) after 10 years, respectively. Risk for "peri-implantitis surgery" showed a significant association (P failures," where "treatment in lower jaw" had the highest risk; HR 2.03. "Overall implant failures" were associated to 4 significant factors where "surgeon" (HR 2.50) showed highest impact on risk. "Numbers of implants" and "bone resorption" at surgery were the 2 significant factors that were consistent for all the time periods of failures during follow-up (early/late/total). On an average 7.4% of examined patients in the reference group were denoted with highest risk group ("peri-implantitis") of which on an average 12.7% of these patients had surgery related to peri-implantitis. "The dentist" involved in the surgical and prosthetic rehabilitation of the implant patients, "number of implants" and degree of "bone resorption" seem to have most impact on overall implant complications and failures in the present

  3. Acute endothelial failure after cosmetic iris implants (NewIris®

    Directory of Open Access Journals (Sweden)

    Garcia-Pous M

    2011-05-01

    Full Text Available Maria Garcia-Pous1, Patricia Udaondo2, Salvador Garcia-Delpech2, David Salom1, Manuel Díaz-Llopis21Faculty of Medicine, University of Valencia, Valencia, Spain; 2Ophthalmology Department, Hospital Universitario La Fe, Valencia, SpainAbstract: We report a case of an acute endothelial failure after the implantation of a new cosmetic, colored, artificial iris diaphragm implant called NewIris®. A 21-year-old woman came to us complaining of progressive loss of vision and pain after NewIris lenses had been implanted. Decreased visual acuity, corneal edema, and increased intraocular pressure in both eyes appeared only 3 weeks after the surgery. The lenses were removed as soon as possible but had already severely affected the endothelial cell count. NewIris implants are an alternative to cosmetic contact lenses, but they are not as safe as other phakic anterior chamber intraocular lenses, nor are they a good option for the patient.Keywords: NewIris, endothelial failure, cosmetic iris implants

  4. Percutaneous Implantation of A Parachute Device For Treatment of Ischemic Heart Failure

    Energy Technology Data Exchange (ETDEWEB)

    Cilingiroglu, Mehmet, E-mail: mcilingiroglu@yahoo.com; Rollefson, William A.; Mego, David

    2013-07-15

    Congestive heart failure (CHF) secondary to ischemic cardiomyopathy is associated with significant morbidity and mortality despite currently available medical therapy. The Parachute{sup TM} device is a novel left ventricular partitioning device that is delivered percutaneously in the left ventricle (LV) in patients with anteroapical regional wall motion abnormalities, dilated LV and systolic dysfunction after anterior myocardial infarction with favorable clinical and LV hemodynamic improvements post-implantation. Here, we do review the current literature and present a case of the Parachute device implantation.

  5. Percutaneous implantation of a parachute device for treatment of ischemic heart failure.

    Science.gov (United States)

    Cilingiroglu, Mehmet; Rollefson, William A; Mego, David

    2013-01-01

    Congestive heart failure (CHF) secondary to ischemic cardiomyopathy is associated with significant morbidity and mortality despite currently available medical therapy. The Parachute(TM) device is a novel left ventricular partitioning device that is delivered percutaneously in the left ventricle (LV) in patients with anteroapical regional wall motion abnormalities, dilated LV and systolic dysfunction after anterior myocardial infarction with favorable clinical and LV hemodynamic improvements post-implantation. Here, we do review the current literature and present a case of the Parachute device implantation. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Acute endothelial failure after cosmetic iris implants (NewIris®)

    OpenAIRE

    Garcia-Pous M; Udaondo P; Garcia-Delpech S; Salom D; Díaz-Llopis M

    2011-01-01

    Maria Garcia-Pous1, Patricia Udaondo2, Salvador Garcia-Delpech2, David Salom1, Manuel Díaz-Llopis21Faculty of Medicine, University of Valencia, Valencia, Spain; 2Ophthalmology Department, Hospital Universitario La Fe, Valencia, SpainAbstract: We report a case of an acute endothelial failure after the implantation of a new cosmetic, colored, artificial iris diaphragm implant called NewIris®. A 21-year-old woman came to us complaining of progressive loss of vision and pain af...

  7. Selective serotonin reuptake inhibitors and dental implant failure-A significant concern in elders?

    Science.gov (United States)

    Gupta, Bhumija; Acharya, Aneesha; Pelekos, Georgios; Gopalakrishnan, Dharmarajan; Kolokythas, Antonia

    2017-12-01

    Depression is a significantly prevalent health concern in geriatric populations. Selective serotonin reuptake inhibitor drugs (SSRI) are the most commonly prescribed antidepressant agents, with increasing rates of prescription. The present report aimed to present a concise review of the current understanding regarding SSRI effects on bone and dental implant outcomes. A broad-based review and summary of literature pertaining to the effects of SSRI on bone metabolism and on dental implant survival was performed. The available literature indicates that serotonin plays a significant role in bone metabolism and experimental reports demonstrate adverse impacts of SSRI on multiple pathways of bone metabolism. Early clinical reports suggest detrimental effects of SSRI on dental implant survival. The type of SSRI drug, dosage and host-related genetic and metabolic factors could be potential modulating factors. There is a paucity of data regarding SSRI usage and dental implant survival specific to geriatric cohorts. As older individuals comprise a high-risk group for both high oral rehabilitation and SSRI use, clinicians should be aware the potential association between SSRI and dental implant failures. Well-designed investigations specific to geriatric cohorts are essential to understand the implications of SSRI use on dental implant prognosis. © 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  8. An increase in IL-1β concentrations in embryo culture-conditioned media obtained by in vitro fertilization on day 3 is related to successful implantation.

    Science.gov (United States)

    Sequeira, Karina; Espejel-Núñez, Aurora; Vega-Hernández, Eva; Molina-Hernández, Anayansi; Grether-González, Patricia

    2015-11-01

    This study aimed to evaluate interleukin (IL)-1β concentrations in maternal serum and in embryo-cultured conditioned media and to correlate these findings with success of implantation. A total of 70 infertile women who underwent in vitro fertilization treatment were studied. IL-1β concentrations were quantified in maternal serum and in embryo culture-conditioned media on days 1 and 3. The findings were compared between those who achieved pregnancy and those who did not. No significant differences were found in IL-1β serum concentrations between the groups. IL-1β was not detected in day 1 culture-conditioned medium. On day 3, IL-1β was quantified in 27 patients, and IL-1β concentrations were significantly higher in women who achieved pregnancy than in those who did not (p culture-conditioned medium in patients who achieve pregnancy after in vitro fertilization treatment indicate a possible role of embryonic IL-1β in the implantation process.

  9. Isolation of primary osteoblast cell lines from adult rat and rat embryos and their use as models for in vitro biocompatibility tests of nanostructured titanium-based implants.

    Science.gov (United States)

    Khrunyk, Y Y; Vyalykh, I V; Korelin, A V; Belikov, S V; Karabanalov, M S; Rakitin, S B; Kamalov, R V; Popov, A A

    2017-07-01

    Methods for obtaining osteoblast cultures from the calvaria of adult Wistar rats and 12-day-old embryos of these rats have been adapted for studying the biocompatibility and ossointegration of titanium-based implants. The osteoblast morphology and their differentiation into osteocytes on a titanium matrix with specially treated surface have been studied. It has been confirmed that two cultures of diploid rat cells obtained in the study can serve as efficient models for preclinical in vitro testing of nanostructured titanium implants for biocompatibility and osseointegration.

  10. Load to failure of different titanium abutments for an internal hexagon implant.

    Science.gov (United States)

    Yilmaz, Burak; Salaita, Louai G; Seidt, Jeremy D; Clelland, Nancy L; McGlumphy, Edwin A

    2015-10-01

    Several aftermarket abutments are available for a commonly used internal hexagonal connection implant. However, their load to failure performance is unknown when compared with the manufacturer's abutment. The purpose of this in vitro study was to conduct a load to failure comparison of 5 different titanium abutments (manufacturer's and aftermarket) for cement-retained restorations used on an implant with an internal hexagon connection. Five implants (Tapered Screw-Vent, 4.1×11.5 mm; Zimmer Dental) were individually secured in a loading apparatus, and 3 abutment specimens of each of the 5 different titanium abutments (Atlantis, AstraTech TiDesign, Legacy Straight Contoured, Inclusive Custom, and Zimmer PSA) (n=15 total) were loaded at a 30-degree angle until fracture of the implant abutment complex. Data for load to fracture were compared with analysis of variance and a Tukey-Kramer post hoc test (α=.05). Significant differences were noted between the fracture loads of some abutment pairs; Atlantis-AstraTech TiDesign, Atlantis-Legacy Straight Contoured, AstraTech TiDesign-Legacy Straight Contoured, Inclusive Custom-AstraTech TiDesign, and Inclusive Custom-Legacy Straight Contoured (P<.05). The highest overall resistance to fracture was achieved by the Legacy Straight Contoured Abutment, which was significantly greater than all other aftermarket abutments (P<.05). Tested abutments fractured at an average of 649.17 N. The Zimmer PSA abutment was the only abutment that showed no fracture of any of the components before implant failure. When comparing manufacturer's versus aftermarket brands, the manufacturer's abutment (Zimmer PSA) was the only abutment without fracture of any of the components. Aftermarket brands experienced screw fractures, which could result in further clinical prosthetic complications. The clinical implications of these findings need further investigation. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by

  11. Remote monitoring reduces healthcare use and improves quality of care in heart failure patients with implantable defibrillators: the evolution of management strategies of heart failure patients with implantable defibrillators (EVOLVO) study

    National Research Council Canada - National Science Library

    Landolina, Maurizio; Perego, Giovanni B; Lunati, Maurizio; Curnis, Antonio; Guenzati, Giuseppe; Vicentini, Alessandro; Parati, Gianfranco; Borghi, Gabriella; Zanaboni, Paolo; Valsecchi, Sergio; Marzegalli, Maurizio

    2012-01-01

    Heart failure patients with implantable cardioverter-defibrillators (ICDs) or an ICD for resynchronization therapy often visit the hospital for unscheduled examinations, placing a great burden on healthcare providers...

  12. HSPC117 deficiency in cloned embryos causes placental abnormality and fetal death

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yingying [Department of Reproduction and Development, Kunming Institute of Zoology and Kunming Primate Research Center, Chinese Academy of Sciences, Kunming 650223 (China); State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100080 (China); Graduate University of Chinese Academy of Sciences, Beijing 100049 (China); Hai, Tang; Liu, Zichuan; Zhou, Shuya; Lv, Zhuo [State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100080 (China); Graduate University of Chinese Academy of Sciences, Beijing 100049 (China); Ding, Chenhui; Liu, Lei [State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100080 (China); Niu, Yuyu [Department of Reproduction and Development, Kunming Institute of Zoology and Kunming Primate Research Center, Chinese Academy of Sciences, Kunming 650223 (China); Zhao, Xiaoyang; Tong, Man [State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100080 (China); Graduate University of Chinese Academy of Sciences, Beijing 100049 (China); Wang, Liu [State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100080 (China); Jouneau, Alice [INRA, UMR 1198, ENVA, CNRS, FRE 2857, Biologie du Developpement et Reproduction, Jouy en Josas F-78350 (France); Zhang, Xun [Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114 (United States); Ji, Weizhi, E-mail: wji@mail.kiz.ac.cn [Department of Reproduction and Development, Kunming Institute of Zoology and Kunming Primate Research Center, Chinese Academy of Sciences, Kunming 650223 (China); Zhou, Qi, E-mail: qzhou@ioz.ac.cn [State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100080 (China)

    2010-07-02

    Somatic cell nuclear transfer (SCNT) has been successfully used in many species to produce live cloned offspring, albeit with low efficiency. The low frequency of successful development has usually been ascribed to incomplete or inappropriate reprogramming of the transferred nuclear genome. Elucidating the genetic differences between normal fertilized and cloned embryos is key to understand the low efficiency of SCNT. Here, we show that expression of HSPC117, which encodes a hypothetical protein of unknown function, was absent or very low in cloned mouse blastocysts. To investigate the role of HSPC117 in embryo development, we knocked-down this gene in normal fertilized embryos using RNA interference. We assessed the post-implantation survival of HSPC117 knock-down embryos at 3 stages: E9 (prior to placenta formation); E12 (after the placenta was fully functional) and E19 (post-natal). Our results show that, although siRNA-treated in vivo fertilized/produced (IVP) embryos could develop to the blastocyst stage and implanted without any difference from control embryos, the knock-down embryos showed substantial fetal death, accompanied by placental blood clotting, at E12. Furthermore, comparison of HSPC117 expression in placentas of nuclear transfer (NT), intracytoplasmic sperm injection (ICSI) and IVP embryos confirmed that HSPC117 deficiency correlates well with failures in embryo development: all NT embryos with a fetus, as well as IVP and ICSI embryos, had normal placental HSPC117 expression while those NT embryos showing reduced or no expression of HSPC117 failed to form a fetus. In conclusion, we show that HSPC117 is an important gene for post-implantation development of embryos, and that HSPC117 deficiency leads to fetal abnormalities after implantation, especially following placental formation. We suggest that defects in HSPC117 expression may be an important contributing factor to loss of cloned NT embryos in vivo.

  13. Allergic reaction to vanadium causes a diffuse eczematous eruption and titanium alloy orthopedic implant failure.

    Science.gov (United States)

    Engelhart, Sally; Segal, Robert J

    2017-04-01

    Allergy as a cause of adverse outcomes in patients with implanted orthopedic hardware is controversial. Allergy to titanium-based implants has not been well researched, as titanium is traditionally thought to be inert. We highlight the case of a patient who developed systemic dermatitis and implant failure after surgical placement of a titanium alloy (Ti6Al4V) plate in the left foot. The hardware was removed and the eruption cleared in the following weeks. The plate and screws were submitted for metal analysis. The elemental composition of both the plate and screws included 3 major elements-titanium, aluminum, and vanadium-as well as trace elements. Metal analysis revealed that the plate and screws had different microstructures, and electrochemical studies demonstrated that galvanic corrosion could have occurred between the plate and screws due to their different microstructures, contributing to the release of vanadium in vivo. The patient was patch tested with several metals including components of the implant and had a positive patch test reaction only to vanadium trichloride. These findings support a diagnosis of vanadium allergy and suggests that clinicians should consider including vanadium when patch testing patients with a suspected allergic reaction to vanadium-containing implants.

  14. Failure of a carbon fiber-reinforced polymer implant used for transforaminal lumbar interbody fusion.

    Science.gov (United States)

    Sardar, Zeeshan; Jarzem, Peter

    2013-12-01

    Lumbar interbody fusion is a common procedure owing to the high prevalence of degenerative spinal disorders. During such procedures, carbon fiber-reinforced polymer (CFRP) cages are frequently utilized to fill the void created between adjacent vertebral bodies, to provide mechanical stability, and to carry graft material. Failure of such implants can lead to significant morbidity. We discuss the possible causes leading to the failure of a CFRP cage in a patient with rheumatoid arthritis. Review of a 49-year-old woman who underwent revision anterior lumbar interbody fusion 2 years after posterior instrumentation and transforaminal lumbar interbody fusion at L4-L5 and L5-S1. The patient developed pseudarthrosis at the two previously fused levels with failure of the posterior instrumentation. Revision surgery reveled failure with fragmentation of the CFRP cage at the L5-S1 level. CFRP implants can break if mechanical instability or nonunion occurs in the spinal segments, thus emphasizing the need for optimizing medical management and meticulous surgical technique in achieving stability.

  15. Is the intake of selective serotonin reuptake inhibitors associated with an increased risk of dental implant failure?

    Science.gov (United States)

    Chrcanovic, B R; Kisch, J; Albrektsson, T; Wennerberg, A

    2017-06-01

    The aim of this retrospective study was to investigate the association between the intake of selective serotonin reuptake inhibitors (SSRIs) and the risk of dental implant failure. Patients were included if they were taking SSRIs only and no other medication, did not present any other systemic condition or compromising habits (bruxism, smoking, snuff), and complied with the use of prophylactic antibiotics for implant surgery. The multivariate generalized estimating equation (GEE) method and multilevel mixed-effects parametric survival analysis were used to test the association between SSRI exposure (predictor variable) and the risk of implant failure (outcome variable), adjusting for several potential confounders (other variables). The total number of implants with information available and meeting the necessary eligibility criteria was 931 (35 failures). These were placed in 300 patients. The implant failure rate was 12.5% for SSRI users and 3.3% for non-users (P=0.007). Kaplan-Meier analysis showed a statistically significant difference in the cumulative survival rate (Pimplant failure (P=0.530), nor did the multilevel model (P=0.125). It is suggested that the intake of SSRIs may not be associated with an increased risk of dental implant failure. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Fatigue resistance and failure mode of adhesively restored custom metal-composite resin premolar implant abutments.

    Science.gov (United States)

    Boff, Luís Leonildo; Oderich, Elisa; Cardoso, Antônio Carlos; Magne, Pascal

    2014-01-01

    To evaluate the fatigue resistance and failure mode of composite resin and porcelain onlays and crowns bonded to premolar custom metal-composite resin premolar implant abutments. Sixty composite resin mesostructures were fabricated with computer assistance with two preparation designs (crown vs onlay) and bonded to a metal implant abutment. Following insertion into an implant with a tapered abutment interface (Titamax CM), each metal-composite resin abutment was restored with either composite resin (Paradigm MZ100) or ceramic (Paradigm C) (n = 15) and attached with adhesive resin (Optibond FL) and a preheated light-curing composite resin (Filtek Z100). Cyclic isometric chewing (5 Hz) was then simulated, starting with 5,000 cycles at a load of 50 N, followed by stages of 200, 400, 600, 800, 1,000, 1,200, and 1,400 N (25,000 cycles each). Samples were loaded until fracture or to a maximum of 180,000 cycles. The four groups were compared using life table survival analysis (log-rank test). Previously published data using zirconia abutments of the same design were included for comparison. Paradigm C and MZ100 specimens fractured at average loads of 1,133 N and 1,266 N, respectively. Survival rates ranged from 20% to 33.3% (ceramic crowns and onlays) to 60% (composite resin crowns and onlays) and were significantly different (pooled data for restorative material). There were no restoration failures, but there were adhesive failures at the connection between the abutment and the mesostructure. The survival of the metal-composite resin premolar abutments was inferior to that of identical zirconia abutments from a previous study (pooled data for abutment material). Composite resin onlays/crowns bonded to metal-composite resin premolar implant abutments presented higher survival rates than comparable ceramic onlays/crowns. Zirconia abutments outperformed the metal-composite resin premolar abutments.

  17. Comparative study of the failure rates among 3 implantable defibrillator leads.

    Science.gov (United States)

    van Malderen, Sophie C H; Szili-Torok, Tamas; Yap, Sing C; Hoeks, Sanne E; Zijlstra, Felix; Theuns, Dominic A M J

    2016-12-01

    After the introduction of the Biotronik Linox S/SD high-voltage lead, several cases of early failure have been observed. The purpose of this article was to assess the performance of the Linox S/SD lead in comparison to 2 other contemporary leads. We used the prospective Erasmus MC ICD registry to identify all implanted Linox S/SD (n = 408), Durata (St. Jude Medical, model 7122) (n = 340), and Endotak Reliance (Boston Scientific, models 0155, 0138, and 0158) (n = 343) leads. Lead failure was defined by low- or high-voltage impedance, failure to capture, sense or defibrillate, or the presence of nonphysiological signals not due to external interference. During a median follow-up of 5.1 years, 24 Linox (5.9%), 5 Endotak (1.5%), and 5 Durata (1.5%) leads failed. At 5-year follow-up, the cumulative failure rate of Linox leads (6.4%) was higher than that of Endotak (0.4%; P leads. The incidence rate was higher in Linox leads (1.3 per 100 patient-years) than in Endotak and Durata leads (0.2 and 0.3 per 100 patient-years, respectively; P leads functioning at 3-year follow-up revealed a stable failure rate of 3% per year. The majority of failures consisted of noise (62.5%) and abnormal impedance (33.3%). This study demonstrates a higher failure rate of Linox S/SD high-voltage leads compared to contemporary leads. Although the mechanism of lead failure is unclear, the majority presents with abnormal electrical parameters. Comprehensive monitoring of Linox S/SD high-voltage leads includes remote monitoring to facilitate early detection of lead failure. Copyright © 2016. Published by Elsevier Inc.

  18. SU-E-I-42: Normalized Embryo/fetus Doses for Fluoroscopically Guided Pacemaker Implantation Procedures Calculated Using a Monte Carlo Technique

    Energy Technology Data Exchange (ETDEWEB)

    Damilakis, J; Stratakis, J; Solomou, G [University of Crete, Heraklion (Greece)

    2014-06-01

    Purpose: It is well known that pacemaker implantation is sometimes needed in pregnant patients with symptomatic bradycardia. To our knowledge, there is no reported experience regarding radiation doses to the unborn child resulting from fluoroscopy during pacemaker implantation. The purpose of the current study was to develop a method for estimating embryo/fetus dose from fluoroscopically guided pacemaker implantation procedures performed on pregnant patients during all trimesters of gestation. Methods: The Monte Carlo N-Particle (MCNP) radiation transport code was employed in this study. Three mathematical anthropomorphic phantoms representing the average pregnant patient at the first, second and third trimesters of gestation were generated using Bodybuilder software (White Rock science, White Rock, NM). The normalized embryo/fetus dose from the posteroanterior (PA), the 30° left-anterior oblique (LAO) and the 30° right-anterior oblique (RAO) projections were calculated for a wide range of kVp (50–120 kVp) and total filtration values (2.5–9.0 mm Al). Results: The results consist of radiation doses normalized to a) entrance skin dose (ESD) and b) dose area product (DAP) so that the dose to the unborn child from any fluoroscopic technique and x-ray device used can be calculated. ESD normalized doses ranged from 0.008 (PA, first trimester) to 2.519 μGy/mGy (RAO, third trimester). DAP normalized doses ranged from 0.051 (PA, first trimester) to 12.852 μGy/Gycm2 (RAO, third trimester). Conclusion: Embryo/fetus doses from fluoroscopically guided pacemaker implantation procedures performed on pregnant patients during all stages of gestation can be estimated using the method developed in this study. This study was supported by the Greek Ministry of Education and Religious Affairs, General Secretariat for Research and Technology, Operational Program ‘Education and Lifelong Learning’, ARISTIA (Research project: CONCERT)

  19. MicroRNA Profiles in Spontaneous Decidualized Menstrual Endometrium and Early Pregnancy Decidua with Successfully Implanted Embryos.

    Directory of Open Access Journals (Sweden)

    Yu Wang

    Full Text Available To comparatively analyze the human microRNA (miRNA profiles between spontaneous decidualized menstrual endometrium and early pregnancy decidua by an in-depth sequencing of miRNAs. The specific miRNAs expressed at conception might be involved in pregnancy establishment and expression of let-7f-5p and let-7g-5p was experimentally up-regulated or inhibited to assess the effect on the expression of IGF2BP-1 and IGF2R in vitro, respectively. Samples of endometria and deciduas were obtained from 25 women who suffered from tubal or male factor subfertility and from 35 early pregnant women who underwent pregnancy termination at 6-8 weeks gestation were irrespectively collected and comparatively analyzed by miRNA sequencing and differential expression of known and novel miRNAs was analyzed using bioinformatics. The 2042 miRNA expression was analyzed in the study and the differential expression of six miRNAs was validated by qRT-PCR. The expression of four miRNAs in decidua samples was down-regulated (miR-34c, miR-92a, miR-181a-5p, and miR-191, whereas the expression of miR-10a-5p and let-7f-5p was significantly up-regulated. The expression of IGF2BP-1 and IGF2R declined and increased with overexpression and inhibition of let-7f-5p and let-7g-5p, respectively. Changes in the expression of particular miRNAs might play a role in the physiology of decidualization following successful embryo implantation, ultimately resulting in continuous decidualization.

  20. Does a higher glycemic level lead to a higher rate of dental implant failure?: A meta-analysis.

    Science.gov (United States)

    Shi, Quan; Xu, Juan; Huo, Na; Cai, Chuan; Liu, Hongchen

    2016-11-01

    Owing to limited evidence, it is unclear whether diabetes that is not well controlled would lead to a higher rate of dental implant failure. The authors of this meta-analysis evaluated whether the failure rate for patients with diabetes that was not well controlled was higher than the failure rate for patients with well-controlled diabetes. The authors searched PubMed, the Cochrane Library, and ClinicalTrials.gov without limitations for studies whose investigators compared the dental implant failure rates between patients with well-controlled diabetes and diabetes that was not well controlled. The authors pooled the relative risk (RR) and 95% confidence interval (CI) values to estimate the relative effect of the glycemic level on dental implant failures. The authors used a subgroup analysis to identify the association between the implant failure rate and the stage at which the failure occurred. The authors included 7 studies in this meta-analysis, including a total of 252 patients and 587 dental implants. The results of the pooled analysis did not indicate a direct association between the glycemic level in patients with diabetes and the dental implant failure rate (RR, 0.620; 95% CI, 0.225-1.705). The pooled RR in the subgroup of patients who experienced early implant failure was 0.817 (95% CI, 0.096-6.927), whereas in the subgroup of patients who experienced late implant failure, the pooled RR was 0.572 (95% CI, 0.206-1.586). On the basis of the evidence, the results of this meta-analysis failed to show a difference in the failure rates for dental implants between patients with well-controlled diabetes and patients with diabetes that was not well controlled. However, considering the limitations associated with this meta-analysis, the authors determined that future studies that are well designed and provide adequate controls for confounding factors are required. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  1. Clinical and psychological impact of prophylactic implantable cardioverter-defibrillators in a community heart failure population.

    LENUS (Irish Health Repository)

    Arnous, S

    2012-02-01

    AIMS: ICD implantation for primary prevention of sudden cardiac death in patients with left ventricular systolic dysfunction (ejection fraction <\\/= 35%) has increased since the publication of the SCD-HEFT and MADIT-II data. The aim of this study is to examine the effectiveness and safety of prophylactic ICD use in a community heart failure population and to assess the impact on patient\\'s quality of life. METHODS AND RESULTS: Seventy-one ICDs were inserted between the years 2002 and 2006. The mean follow-up from time of insertion was 24 +\\/- 11 months. Eighteen patients (25%) had potentially life-saving therapy. Seven (10%) patients received inappropriate shocks. Complications were encountered in five patients (7%). CONCLUSION: In a community heart failure population, prophylactic ICD implantation is associated with a high incidence of life-saving therapy, a low complication rate and a high level of tolerability. These data indicate translation of clinical trial benefits to the general heart failure population.

  2. Load to failure of different zirconia abutments for an internal hexagon implant.

    Science.gov (United States)

    Yilmaz, Burak; Salaita, Louai G; Seidt, Jeremy D; McGlumphy, Edwin A; Clelland, Nancy L

    2015-09-01

    Various zirconia abutment designs are available to restore implant systems. Fracture resistance is one of the criteria involved in selecting among these options. The purpose of this in vitro study was to measure and compare load to failure for 5 zirconia abutments for an internally hexagon implant. Five 4.1×11.5-mm Zimmer tapered screw-vent implants were individually secured in a loading apparatus, and 3 specimens of each of the 5 different abutments (Zimmer Contour with a Ti ring, anatomic-contour Atlantis-Zr, anatomic-contour Inclusive-Zr, anatomic-contour Astra Tech ZirDesign, Legacy Straight Contoured abutment with Ti core) (N=15) were loaded at a 30-degree angle until the implant abutment complex failed. Data for load to failure were compared with analysis of variance and a Tukey-Kramer post hoc test (α=.05). The custom anatomic-contour abutment (Inclusive) showed the lowest load to fracture, and the stock anatomic-contour (AstraTech ZirDesign) the second lowest load to fracture. These were significantly lower than all other abutments (Pload of 842 N for zirconia abutments with titanium component (P<.05). The stock zirconia abutment with a titanium ring and the zirconia abutment with a titanium core-hexagon (Legacy Straight Contoured) had significantly greater fracture resistance than that of any of the 1-piece anatomic-contour zirconia abutments tested. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  3. Effect of implant loading protocols on failure and marginal bone loss with unsplinted two-implant-supported mandibular overdentures: systematic review and meta-analysis.

    Science.gov (United States)

    Helmy, M H E-D; Alqutaibi, A Y; El-Ella, A A; Shawky, A F

    2017-11-13

    The aim of this study was to compare implant failure and radiographic bone level changes with different loading protocols for unsplinted two-implant-supported mandibular overdentures. An electronic search of two databases (PubMed, Cochrane Library) was performed, without language restriction, to identify randomized controlled trials (RCTs) comparing immediate or early versus conventional dental implant loading protocols for unsplinted two-implant-supported mandibular overdentures. Data were extracted independently by two reviewers. The Cochrane tool was used to assess the quality of included studies. A meta-analysis was performed. Eight RCTs were identified, seven of which were included; one trial was excluded because related outcomes were not measured. Four of the seven studies were considered to have a high risk of bias and three an unclear risk. Meta-analysis revealed no difference between immediate versus conventional or early versus conventional implant loading protocols regarding implant failure (risk difference (RD) -0.02, 95% confidence interval (CI) -0.13 to 0.10; RD 0.09, 95% CI -0.03 to 0.20) or marginal bone loss (mean difference (MD) 0.09, 95% CI -0.10 to 0.28; MD -0.05, 95% CI -0.12 to 0.02) for implants supporting mandibular overdentures. These findings should be interpreted with great caution given the serious numerical limitations of the studies included. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Post-implantation mortality of in vitro produced embryos is associated with DNA methyltransferase 1 dysfunction in sheep placenta.

    Science.gov (United States)

    Ptak, Grazyna Ewa; D'Agostino, Antonella; Toschi, Paola; Fidanza, Antonella; Zacchini, Federica; Czernik, Marta; Monaco, Federica; Loi, Pasqualino

    2013-02-01

    Is DNA methyltransferase 1 (DNMT1) dysfunction involved in epigenetic deregulation of placentae from embryos obtained by assisted reproduction technologies (ARTs)? DNMT1 expression in growing placentae of in vitro produced (IVP) embryos is compromised and associated with pregnancy loss. DNMT1 maintains the methylation profile of genes during cell division. The methylation status of genes involved in placenta development is altered in embryos obtained in vitro. Disturbances in the epigenetic regulation of gene expression during placentogenesis could be involved in the frequent developmental arrest and loss of IVP embryos. Forty sheep were naturally mated (Group 1, CTR). IVP blastocysts (2-4 per ewe) were surgically transferred to the remaining 46 recipient sheep 6 days after oestrus (Group 2). Twenty-one recipients from Group 1 and 27 recipients from Group 2 were allowed to deliver in order to compare embryo survival in both groups at term (150 days). From the remaining recipients (n = 38), fetuses and placentae of both groups were recovered by paramedian laparotomy at Days 20, 22, 24, 26 and 28 of gestation. Immediately after collection, early placental tissues (chorion-allantois) were snap frozen in liquid nitrogen and DNMT1 expression and activity was evaluated. mRNA levels (for DNMT1, HDAC2, PCNA, DMAP1, MEST, IGF2, CDKN1C, H19) and the methylation status of H19 were also analyzed. Furthermore, embryo size and survival rate were measured. Our study shows that DNMT1 expression was reduced in early placentae from sheep IVP embryos. This reduction was associated with growth arrest and subsequent death of the sheep embryos. Conversely, normal levels of DNMT1 and its cofactors were observed in placentae from IVP embryos that survived this developmental bottleneck. Although DNA methylation machinery was severely compromised in IVP placentae only up to Day 24, the low DNMT1 enzymatic activity that persisted after this stage in IVP placentae was not lethal for the

  5. Effect of Bacterial Endotoxins on Superovulated Mouse Embryos In Vivo: Is CSF-1 Involved in Endotoxin-Induced Pregnancy Loss?

    Directory of Open Access Journals (Sweden)

    Yogesh Kumar Jaiswal

    2006-01-01

    Full Text Available Mammalian embryonic development is regulated by several cytokines and growth factors from embryonic or maternal origins. Since CSF-1 plays important role in embryonic development and implantation, we investigated its role in gram-negative bacterial LPS-induced implantation failure. The effect of LPS on normal (nonsuperovulated and superovulated in vivo-produced embryos was assessed by signs of morphological degeneration. A significantly similar number of morphologically degenerated embryos recovered from both nonsuperovulated and superovulated LPS treated animals on day 2.5 of pregnancy onwards were morphologically and developmentally abnormal as compared to their respective controls (P < .001. Normal CSF-1 expression level and pattern were also altered through the preimplantation period in the mouse embryos and uterine horns after LPS treatment. This deviation from the normal pattern and level of CSF-1 expression in the preimplantation embryos and uterine tissues suggest a role for CSF-1 in LPS-induced implantation failure.

  6. New Tools for Embryo Selection: Comprehensive Chromosome Screening by Array Comparative Genomic Hybridization

    Science.gov (United States)

    Cobo, Ana Cristina; Milán, Miguel; Al-Asmar, Nasser; García-Herrero, Sandra; Mir, Pere; Simón, Carlos

    2014-01-01

    The objective of this study was to evaluate the usefulness of comprehensive chromosome screening (CCS) using array comparative genomic hybridization (aCGH). The study included 1420 CCS cycles for recurrent miscarriage (n = 203); repetitive implantation failure (n = 188); severe male factor (n = 116); previous trisomic pregnancy (n = 33); and advanced maternal age (n = 880). CCS was performed in cycles with fresh oocytes and embryos (n = 774); mixed cycles with fresh and vitrified oocytes (n = 320); mixed cycles with fresh and vitrified day-2 embryos (n = 235); and mixed cycles with fresh and vitrified day-3 embryos (n = 91). Day-3 embryo biopsy was performed and analyzed by aCGH followed by day-5 embryo transfer. Consistent implantation (range: 40.5–54.2%) and pregnancy rates per transfer (range: 46.0–62.9%) were obtained for all the indications and independently of the origin of the oocytes or embryos. However, a lower delivery rate per cycle was achieved in women aged over 40 years (18.1%) due to the higher percentage of aneuploid embryos (85.3%) and lower number of cycles with at least one euploid embryo available per transfer (40.3%). We concluded that aneuploidy is one of the major factors which affect embryo implantation. PMID:24877108

  7. New Tools for Embryo Selection: Comprehensive Chromosome Screening by Array Comparative Genomic Hybridization

    Directory of Open Access Journals (Sweden)

    Lorena Rodrigo

    2014-01-01

    Full Text Available The objective of this study was to evaluate the usefulness of comprehensive chromosome screening (CCS using array comparative genomic hybridization (aCGH. The study included 1420 CCS cycles for recurrent miscarriage (n=203; repetitive implantation failure (n=188; severe male factor (n=116; previous trisomic pregnancy (n=33; and advanced maternal age (n=880. CCS was performed in cycles with fresh oocytes and embryos (n=774; mixed cycles with fresh and vitrified oocytes (n=320; mixed cycles with fresh and vitrified day-2 embryos (n=235; and mixed cycles with fresh and vitrified day-3 embryos (n=91. Day-3 embryo biopsy was performed and analyzed by aCGH followed by day-5 embryo transfer. Consistent implantation (range: 40.5–54.2% and pregnancy rates per transfer (range: 46.0–62.9% were obtained for all the indications and independently of the origin of the oocytes or embryos. However, a lower delivery rate per cycle was achieved in women aged over 40 years (18.1% due to the higher percentage of aneuploid embryos (85.3% and lower number of cycles with at least one euploid embryo available per transfer (40.3%. We concluded that aneuploidy is one of the major factors which affect embryo implantation.

  8. Intravenous intralipid therapy is not beneficial in having a live delivery in women aged 40-42 years with a previous history of miscarriage or failure to conceive despite embryo transfer undergoing in vitro fertilization-embryo transfer.

    Science.gov (United States)

    Check, J H; Check, D L

    2016-01-01

    To evaluate the efficacy of intralipid intravenous infusion in achieving a live pregnancy following IVF--embryo transfer in women of advanced reproductive age (40-42 years). A matched control was performed. Women aged 40-42 with a previous history of miscarriage or who failed to conceive despite previous embryo transfer who entered an IVF program were offered intravenous intralipid therapy (four ml of 20% liposyn II in 100 ml normal saline over one hour) during the mid-follicular phase. Clinical pregnancy rates (eight weeks with viable gestation) and live delivered pregnancy rates were then determined and compared. The results were evaluated after ten matched cycles. There were no clinical pregnancies in those receiving intralipid vs. a 40% clinical and a 30% live delivered pregnancy rate in the untreated controls (p = 0.087, Fisher's exact test). The study was terminated because of these preliminary data. In the test tube, adding intralipid to natural killer cells can inhibit their cytolytic action. However, the use of intravenous intralipid to suppress natural killer cell activity does not seem to improve the chance of a live delivery in women aged 40-42 years with a previous history of miscarriage. In fact this therapy may actually be detrimental in this age group. Since efficacy of this therapy was not found in a group of advanced reproductive age, it is not clear why this should be effective for a younger population. A controlled study for the younger group is needed. Perhaps such a study could be limited to only those with miscarriage rather than also concluding failure to conceive despite embryo transfer. Intralipid failed to improve live delivered pregnancy rates in women with prior miscarriage or previous failure with embryo transfer.

  9. Effects of low doses of mifepristone on human embryo implantation process in a three-dimensional human endometrial in vitro co-culture system.

    Science.gov (United States)

    Boggavarapu, N R; Berger, C; von Grothusen, C; Menezes, J; Gemzell-Danielsson, K; Lalitkumar, P G L

    2016-08-01

    We wanted to explore the effects of two different low doses (0.5μM and 0.05μM) of mifepristone, exposed during the receptive period, on the human embryo implantation process, using a well-established three-dimensional in vitro cell culture model, specifically developed to study this process. An in vitro three-dimensional cell culture model was constructed using human endometrial cells isolated from the endometrium of proven fertile women, collected on cycle day LH+4. After 5 days of culture, supernumerary human embryos were added and cultured for another 5 days with mifepristone 0.5μM (n=8) or 0.05μM (n=10) or vehicle as control (n=10). The cultures were checked for embryo attachment and terminated. We studied the expression of 16 reported endometrial receptivity markers in the endometrial constructs using real-time polymerase chain reaction. None of the embryos in 0.5μM of mifepristone attached to the endometrial constructs (p=.004), whereas 4 out of 10 in 0.05μM (p=.3698) and 7 out of 10 embryos in the control group attached to the cultures. We found that most of the studied receptivity markers were significantly altered with mifepristone exposure in a similar direction in both treatment groups. Only IL6 was significantly differentially expressed between the treatment groups (p=.017). We report for the first time that exposure to a low concentration (0.5μM) of mifepristone during the receptive period successfully inhibits human embryo implantation process in vitro. Further, we observed a dose-dependent effect of mifepristone on endometrial receptivity at the functional level. This study contributes new knowledge that low dose of mifepristone during the short period of receptive phase can inhibit endometrial receptivity, which further promotes mifepristone as a contraceptive agent. This could give women a treatment choice to avoid unwanted pregnancy with high efficacy and minimal side effects. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. [Failure of zirconia-based prostheses on natural teeth and implants: focus on risk factors].

    Science.gov (United States)

    Dupont, N; Koenig, V; Vanheusden, A; Mainjot, A

    2014-01-01

    Cohesive fracture of the veneering ceramic (chipping) is the first cause of failure of zirconia-based prostheses on natural teeth and implants. Besides risk factors related to the material (thermal stresses generated during the manufacturing process, framework inappropriate design), there are some clinical risk factors, which can influence the restoration prognosis. Indeed, unfavorable occlusal relationships and/or the presence of parafunctions such as bruxism and clenching, which are frequent pathologies, engender significant overloading. A retrospective study was performed at the University Hospital Center (CHU) of Liege on 147 dental and implants prostheses, placed between May 2003 and January 2012. This study highlighted a significant correlation between chipping and the absence of an occlusal nightguard (p = 0.0048), the presence of a ceramic restoration as an antagonist (p = 0.013), the presence of occlusal parafunctions (p = 0.018), and the presence of implants as support of the restorations (p = 0.026). These results underline the importance of external stress and occlusal risk factors diagnosis, as the need to perform an occlusal nightguard to patients with parafunctions.

  11. Ovarian stimulation and embryo quality

    NARCIS (Netherlands)

    Baart, Esther; Macklon, Nick S.; Fauser, Bart J. C. M.

    To Study the effects of different ovarian stimulation approaches on oocyte and embryo quality, it is imperative to assess embryo quality with a reliable and objective method. Embryos rated as high quality by standardized morphological assessment are associated with higher implantation and pregnancy

  12. Longitudinal hemodynamic measurements in swine heart failure using a fully implantable telemetry system.

    Directory of Open Access Journals (Sweden)

    Jenny S Choy

    Full Text Available Chronic monitoring of heart rate, blood pressure, and flow in conscious free-roaming large animals can offer considerable opportunity to understand the progression of cardiovascular diseases and can test new diagnostics and therapeutics. The objective of this study was to demonstrate the feasibility of chronic, simultaneous measurement of several hemodynamic parameters (left ventricular pressure, systemic pressure, blood flow velocity, and heart rate using a totally implantable multichannel telemetry system in swine heart failure models. Two solid-state blood pressure sensors were inserted in the left ventricle and the descending aorta for pressure measurements. Two Doppler probes were placed around the left anterior descending (LAD and the brachiocephalic arteries for blood flow velocity measurements. Electrocardiographic (ECG electrodes were attached to the surface of the left ventricle to monitor heart rate. The telemeter body was implanted in the right side of the abdomen under the skin for approximately 4 to 6 weeks. The animals were subjected to various heart failure models, including volume overload (A-V fistula, n = 3, pressure overload (aortic banding, n = 2 and dilated cardiomyopathy (pacing-induced tachycardia, n = 3. Longitudinal changes in hemodynamics were monitored during the progression of the disease. In the pacing-induced tachycardia animals, the systemic blood pressure progressively decreased within the first 2 weeks and returned to baseline levels thereafter. In the aortic banding animals, the pressure progressively increased during the development of the disease. The pressure in the A-V fistula animals only showed a small increase during the first week and remained stable thereafter. The results demonstrated the ability of this telemetry system of long-term, simultaneous monitoring of blood flow, pressure and heart rate in heart failure models, which may offer significant utility for understanding cardiovascular disease

  13. Oral rehabilitation of a patient with bruxism and cluster implant failures in the edentulous maxilla: a clinical report.

    Science.gov (United States)

    Lin, Wei-Shao; Ercoli, Carlo; Lowenguth, Roxanne; Yerke, Lisa M; Morton, Dean

    2012-07-01

    For most patients with failed dental implants, the placement of new implants is the only option that allows for retreatment with a fixed dental prosthesis. This clinical report describes the rehabilitation of a patient with a history of bruxism and cluster implant failures in the edentulous maxilla 10 years after the insertion of a milled bar overdenture. Seven failed implants were removed and simultaneous bone grafting was performed. After an 8-month healing period, 8 dental implants with new surfaces were placed. These supported a metal ceramic fixed complete denture with a metal occlusal surface. The prosthesis was retained with 3 sections of milled bars and 3 set screws. This clinical report describes the details of the treatment with an emphasis on prosthetics. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  14. Bio-Environment-Induced Degradation and Failure of Internal Fixation Implants

    Directory of Open Access Journals (Sweden)

    Yan Zhou

    2015-10-01

    Full Text Available Internal fixations provide fast healing but their failure remains problematic to patients. Here, we report an experimental study in failure of three typical cases of metals: a bent intramedullary stainless steel nail, a broken exterior pure Ti plate, and a broken intramedullary stainless steel nail. Characterization of the bent nail indicates that those metals are vulnerable to corrosion with the evidence of increased surface roughness and embrittlement. Depredated surface of the Ti plate resulted debris particles in the surrounding tissue of 15.2 ± 6.5 μm in size. Nanoparticles were observed in transmission electron microscope. The electron diffraction pattern of the debris indicates a combination of nanocrystalline and amorphous phases. The failure mode of the broken nail made of stainless steel was found to be fatigue initiated from the surface. This study clearly shows the biological-attack induced surface degradation resulting in debris and fatigue. Future design and selection of implant materials should consider such factors for improvement.

  15. No cytotoxic effects from application of pentoxifylline to spermatozoa on subsequent pre-implantation embryo development in mice

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Khalili

    2017-06-01

    Full Text Available The aim was to assess the effect of spermatozoa exposed to PTX on the rates of fertilization and embryo development and apoptotic cells within blastocysts in an animal model. Mice Oocytes were inseminated with spermatozoa exposed to 3.6 mmol PTX for 30 min, or with neat spermatozoa. Then fertilization and embryo development rate, blastocyst formation and quality, as well as total cell number of blastocyst, and DNA fragmentation index (DFI in blastocysts were surveyed in both groups. Fertilization and embryo development rate were similar between the groups. The rates of blastocyst formation did not differ significantly between control and PTX groups (52.4% vs. 51.8%. The average of total cell count in blastocysts and DFI in control and PTX groups were also insignificant (31.08 ± 1.5 vs. 34.14 ± 1.5 and 9.76 ± 5.0 vs. 11.77 ± 5.4. Application of PTX for enhancing sperm motility does not cause a cytotoxic effect on subsequent embryo development and embryo genome integrity.

  16. Injection of ligand-free gold and silver nanoparticles into murine embryos does not impact pre-implantation development

    Directory of Open Access Journals (Sweden)

    Ulrike Taylor

    2014-05-01

    Full Text Available Intended exposure to gold and silver nanoparticles has increased exponentially over the last decade and will continue to rise due to their use in biomedical applications. In particular, reprotoxicological aspects of these particles still need to be addressed so that the potential impacts of this development on human health can be reliably estimated. Therefore, in this study the toxicity of gold and silver nanoparticles on mammalian preimplantation development was assessed by injecting nanoparticles into one blastomere of murine 2 cell-embryos, while the sister blastomere served as an internal control. After treatment, embryos were cultured and embryo development up to the blastocyst stage was assessed. Development rates did not differ between microinjected and control groups (gold nanoparticles: 67.3%, silver nanoparticles: 61.5%, sham: 66.2%, handling control: 79.4%. Real-time PCR analysis of six developmentally important genes (BAX, BCL2L2, TP53, OCT4, NANOG, DNMT3A did not reveal an influence on gene expression in blastocysts. Contrary to silver nanoparticles, exposure to comparable Ag+-ion concentrations resulted in an immediate arrest of embryo development. In conclusion, the results do not indicate any detrimental effect of colloidal gold or silver nanoparticles on the development of murine embryos.

  17. Avoiding Untimely Implantable Cardioverter/Defibrillator Implantation by Intensified Heart Failure Therapy Optimization Supported by the Wearable Cardioverter/Defibrillator-The PROLONG Study.

    Science.gov (United States)

    Duncker, David; König, Thorben; Hohmann, Stephan; Bauersachs, Johann; Veltmann, Christian

    2017-01-17

    Optimal timing of implantation of an implantable cardioverter/defibrillator (ICD) after newly diagnosed heart failure is unclear given that late reverse remodelling may occur. We aimed to analyze left ventricular ejection fraction (LVEF) after diagnosis of an LVEF ≤35% during optimization of heart failure drug therapy. One hundred fifty-six patients with newly diagnosed LVEF ≤35% receiving a wearable cardioverter/defibrillator (WCD) were analyzed. WCD was prescribed for 3 months until first re-evaluation. Indications for prolongation of WCD wearing period instead of ICD implantation were: (1) LVEF at 3-month visit 30% to 35%; (2) increase in LVEF of ≥5% compared to the last visit; and (3) nonoptimized heart failure medication. Mean LVEF was 24±7% at diagnosis and 39±11% at last follow-up (mean, 12±10 months). Whereas 88 patients presented a primary preventive ICD indication (LVEF ≤35%) at 3-month follow-up, only 58 showed a persistent primary preventive ICD indication at last follow-up. This delayed improvement in LVEF was related to nonischemic origin of cardiomyopathy, New York Heart Association functional class at baseline, heart rate, better LVEF after 3 months, and higher dosages of mineralocorticoid receptor antagonist. Twelve appropriate WCD shocks for ventricular tachycardia/ventricular fibrillation occurred in 11 patients. Two patients suffered from ventricular tachycardia/ventricular fibrillation beyond 3 months after diagnosis. A relevant proportion of patients with newly diagnosed heart failure shows recovery of LVEF >35% beyond 3 months after initiation of heart failure therapy. To avoid untimely ICD implantation, prolongation of WCD period should be considered in these patients to prevent sudden cardiac death while allowing left ventricular reverse remodeling during intensified drug therapy. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  18. Annual failure rates and marginal bone-level changes of immediate compared to conventional loading of dental implants. A systematic review of the literature and meta-analysis.

    NARCIS (Netherlands)

    Engelhardt, S.; Papacosta, P.; Rathe, F.; Ozen, J.; Jansen, J.A.; Junker, R.

    2015-01-01

    BACKGROUND: Immediate loading of dental implants appears to be a successful option. Questions still remain whether annual failure rates (AFRs) as well as annual marginal bone-level changes are comparable with conventionally loaded implants. HYPOTHESIS: Immediately loaded implants (

  19. Future aspects of micromanipualtion with embryos for

    African Journals Online (AJOL)

    implantation embryos which are then aggregated within one. Figure 3 ... Aggregating the two. \\sr. Figure 7 Scheme for producing chimeras by microsurgery. Embryo ll. A. (( %)). \\\\% tl. \\/. I oenuoins tne. Y embryo. Table 1a Results after transfer of half-embryos (review) .... After isolation and dissociation of the inner cell mass,.

  20. Associations of combined polymorphisms of the platelet membrane glycoproteins Ia and IIIa and the platelet-endothelial cell adhesion molecule-1 and P-Selectin genes with IVF implantation failures.

    Science.gov (United States)

    Vlachadis, Nikolaos; Tsamadias, Vasileios; Vrachnis, Nikolaos; Kaparos, Georgios; Vitoratos, Nikolaos; Kouskouni, Evaggelia; Economou, Emmanuel

    2017-04-01

    The aim of the study was to investigate the combined impact of the genetic heterogeneity of the glycoproteins Ia (GpIa) and IIIa (GpIIIa) and the platelet-endothelial cell adhesion molecule-1 (PECAM-1) and P-Selectin genes on IVF embryo transfer implantation failures (IVF-ET failures). Sixty nulligravida women with previous IVF-ET failures and 60 fertile controls were genotyped for the GpIa-C807T, GpIIIa-PlA1/PA2, PECAM-1-C373G (Leu125Val) and P-Selectin-A37674C (Thr715Pro) polymorphisms by pyrosequencing. Compared with wild-type combined homozygotes, carriers of combinations of risk alleles in two gene loci were at significantly increased risk for IVF-ET failure, whereas carriers of the combination of GpIa-807T, GpIIIa-PlA2 and PECAM-1-373G alleles had OR = 52.50 (95%CI: 4.05-680.95, p IVF-ET failures especially for younger women and provided a genetic risk score with good diagnostic accuracy in the prediction of IVF-ET failures.

  1. Computational modelling of long bone fractures fixed with locking plates - How can the risk of implant failure be reduced?

    LENUS (Irish Health Repository)

    Nassiri, M

    2013-03-01

    The Locking Compression Plate (LCP) is part of a new plate generation requiring an adapted surgical technique and new thinking about commonly used concepts of internal fixation using plates. Knowledge of the fixation stability provided by these new plates is very limited and clarification is still necessary to determine how the mechanical stability and the risk of implant failure can best be controlled.

  2. Cobalt-alloy implant debris induce HIF-1α hypoxia associated responses: a mechanism for metal-specific orthopedic implant failure.

    Directory of Open Access Journals (Sweden)

    Lauryn Samelko

    Full Text Available The historical success of orthopedic implants has been recently tempered by unexpected pathologies and early failures of some types of Cobalt-Chromium-Molybdenum alloy containing artificial hip implants. Hypoxia-associated responses to Cobalt-alloy metal debris were suspected as mediating this untoward reactivity at least in part. Hypoxia Inducible Factor-1α is a major transcription factor involved in hypoxia, and is a potent coping mechanism for cells to rapidly respond to changing metabolic demands. We measured signature hypoxia associated responses (i.e. HIF-1α, VEGF and TNF-α to Cobalt-alloy implant debris both in vitro (using a human THP-1 macrophage cell line and primary human monocytes/macrophages and in vivo. HIF-1α in peri-implant tissues of failed metal-on-metal implants were compared to similar tissues from people with metal-on-polymer hip arthroplasties, immunohistochemically. Increasing concentrations of cobalt ions significantly up-regulated HIF-1α with a maximal response at 0.3 mM. Cobalt-alloy particles (1 um-diameter, 10 particles/cell induced significantly elevated HIF-1α, VEGF, TNF-α and ROS expression in human primary macrophages whereas Titanium-alloy particles did not. Elevated expression of HIF-1α was found in peri-implant tissues and synovial fluid of people with failing Metal-on-Metal hips (n = 5 compared to failed Metal-on-Polymer articulating hip arthroplasties (n = 10. This evidence suggests that Cobalt-alloy, more than other metal implant debris (e.g. Titanium alloy, can elicit hypoxia-like responses that if unchecked can lead to unusual peri-implant pathologies, such as lymphocyte infiltration, necrosis and excessive fibrous tissue growths.

  3. Heart-focused anxiety in patients with chronic heart failure before implantation of an implantable cardioverter defibrillator: baseline findings of the Anxiety-CHF Study.

    Science.gov (United States)

    Bunz, Maxie; Lenski, Denise; Wedegärtner, Sonja; Ukena, Christian; Karbach, Julia; Böhm, Michael; Kindermann, Ingrid

    2016-03-01

    We analysed heart-focused anxiety (HFA) and its predictors in patients with heart failure before implantation of an implantable cardioverter defibrillator (ICD). Herein, we report the baseline data of the Anxiety-CHF Study which investigates HFA before and after ICD implantation. HFA, general anxiety and depression, perceived quality of life (QoL) and type D personality were measured with validated psychological instruments. Clinical parameters such as severity of heart failure measured by NYHA class and left ventricular ejection fraction (EF) were determined. One hundred and ten patients were interrogated before ICD implantation (70 % male, mean age = 60.5 ± 14.9 years, mean EF = 31 % ± 9 %, 91 % NYHA II-III, 92 % primary prevention). HFA was present in 53 patients (48.6 %); 37 participants (33.9 %) showed increased levels of general anxiety and 33 patients (30.3 %) showed increased levels of depression with clinical significant levels in 16 subjects (14.7 %) for general anxiety and 13 subjects (11.9 %) for depression. Poor QoL was reported in 30 patients (27.5 %). HFA was correlated with QoL, general anxiety, depression, type D personality, myocardial infarction (MI), and systolic blood pressure. QoL, general anxiety and former MI were significant predictors of HFA (R (2) = 0.453). Heart-focused anxiety is highly prevalent in heart failure patients prior to ICD implantation. Measures of disease severity such as EF or NYHA class do not predict HFA, neither does Type D personality. HFA is predicted by a history of MI and psychological parameters such as general anxiety and impaired QoL. CLINICALTRIALS. NCT02226770.

  4. Thyroid Autoimmunity is Associated with Decreased Cytotoxicity T Cells in Women with Repeated Implantation Failure

    Directory of Open Access Journals (Sweden)

    Chunyu Huang

    2015-08-01

    Full Text Available Thyroid autoimmunity (TAI, which is defined as the presence of autoantibodies against thyroid peroxidase (TPO and/or thyroglobulin (TG, is related to repeated implantation failure (RIF. It is reported that TAI was involved in reproductive failure not only through leading thyroid function abnormality, but it can also be accompanied with immune imbalance. Therefore, this study was designed to investigate the association of thyroid function, immune status and TAI in women with RIF. Blood samples were drawn from 72 women with RIF to evaluate the prevalence of TAI, the thyroid function, the absolute numbers and percentages of lymphocytes. The prevalence of thyroid function abnormality in RIF women with TAI was not significantly different from that in RIF women without TAI (c2 = 0.484, p > 0.05. The absolute number and percentage of T cells, T helper (Th cells, B cells and natural killer (NK cells were not significantly different in RIF women with TAI compared to those without TAI (all p > 0.05. The percentage of T cytotoxicity (Tc cells was significantly decreased in RIF women with TAI compared to those without TAI (p < 0.05. Meanwhile, Th/Tc ratio was significantly increased (p < 0.05. These results indicated that the decreased Tc percentage and increased Th/Tc ratio may be another influential factor of adverse pregnancy outcomes in RIF women with TAI.

  5. Zirconia-Based Screw-Retained Prostheses Supported by Implants: A Retrospective Study on Technical Complications and Failures.

    Science.gov (United States)

    Worni, Andreas; Kolgeci, Lumni; Rentsch-Kollar, Andrea; Katsoulis, Joannis; Mericske-Stern, Regina

    2015-12-01

    Little information is yet available on zirconia-based prostheses supported by implants. To evaluate technical problems and failures of implant-supported zirconia-based prostheses with exclusive screw-retention. Consecutive patients received screw-retained zirconia-based prostheses supported by implants and were followed over a time period of 5 years. The implant placement and prosthetic rehabilitation were performed in one clinical setting, and all patients participated in the maintenance program. The treatment comprised single crowns (SCs) and fixed dental prostheses (FDPs) of three to 12 units. Screw-retention of the CAD/CAM-fabricated SCs and FDPs was performed with direct connection at the implant level. The primary outcome was the complete failure of zirconia-based prostheses; outcome measures were fracture of the framework or extensive chipping resulting in the need for refabrication. A life table analysis was performed, the cumulative survival rate (CSR) calculated, and a Kaplan-Meier curve drawn. Two hundred and ninety-four implants supported 156 zirconia-based prostheses in 95 patients (52 men, 43 women, average age 59.1 ± 11.7 years). Sixty-five SCs and 91 FDPs were identified, comprising a total of 441 units. Fractures of the zirconia framework and extensive chipping resulted in refabrication of nine prostheses. Nearly all the prostheses (94.2%) remained in situ during the observation period. The 5-year CSR was 90.5%, and 41 prostheses (14 SCs, 27 FDPs) comprising 113 units survived for an observation time of more than 5 years. Six SCs exhibited screw loosening, and polishing of minor chipping was required for five prostheses. This study shows that zirconia-based implant-supported fixed prostheses exhibit satisfactory treatment outcomes and that screw-retention directly at the implant level is feasible. © 2014 Wiley Periodicals, Inc.

  6. Retrospective analysis of reasons for failure of DDD pacemaker implantation in patients operated on between 1993 and 2005.

    Science.gov (United States)

    Lelakowski, Jacek; Majewski, Jacek; Małecka, Barbara; Bednarek, Jacek; Stypuła, Paweł; Szeglowski, Marcin

    2007-01-01

    During implantation of a DDD pacemaker the following difficulties may be encountered: venous anomalies (the absence of vessels of adequate calibre or difficulty in subclavian vein puncture), arrhythmias during implantation (episodes of atrial flutter/fibrillation while the atrial leads are being positioned), lack of mechanical stability of the electrode in the heart chamber and inability to achieve an acceptable pacing and sensing threshold during implantation. The purpose of the study was to analyse retrospectively the reasons for DDD pacemaker failure in patients operated on between 1993 and 2005. We reviewed retrospectively all implantation data from 1988 to 2005 to identify patients with primary failure of DDD pacemaker implantation. Further analysis included patients who had received a DDD pacemaker between 1993 and 2005, when this type of pacemaker made up between 9 and 40% of all pacemaker implantations. We implanted 7469 pacemakers, including 1958 (26.2%) dual-chamber pacemakers, in 783 patients with atrioventricular block (AVB), 392 with sick sinus syndrome (SSS), 450 with AVB +/- SSS and 333 with tachy-brady syndrome (TBS). The mean age of the patients was 65.5 +/- 17.3 years. DDD pacing was unsuccessful in 108 (1.4%) patients, including 32 with AVB, 22 with SSS, 16 with SSS +/- AVB and 38 with TBS. The mean age of these patients was 78.5 +/- 19.4 years. The reasons for failed implantation were venous anomalies in 12%, an arrhythmia episode in 27.8%, a high pacing threshold in the atrium in 17.6%, low atrial potential amplitude in 25.9% and lack of mechanical stability of the electrode in 16.7% of patients. The difficulties were encountered in elderly patients (p < 0.01), most frequently in patients with SSS and TBS (71). Between 2004 and 2005 venous anomalies and a high pacing threshold were the main causes of failure. Currently the main difficulties encountered during pacemaker implantation are venous anomalies and a high pacing threshold. Arrhythmia

  7. Profiles of cytokines secreted by isolated human endometrial cells under the influence of chorionic gonadotropin during the window of embryo implantation

    Science.gov (United States)

    2013-01-01

    Background Several studies have indicated that human pre-implantation embryo-derived chorionic gonadotropin (hCG) may influence the implantation process by its action on human endometrial epithelial and stromal cells. Despite reports indicating that hCG acts on these cells to affect the production of several cytokines and growth factors (e.g., MIF, IGF-I, VEGF, LIF, IL-11, GMCSF, CXL10 and FGF2), our understanding of the integral influence of hCG on paracrine interactions between endometrial stromal and epithelial cells during implantation is very limited. Methods In the present study, we examined the profile of 48 cytokines in the conditioned media of primary cell cultures of human implantation stage endometrium. Endometrial epithelial cells (group 1; n = 20), stromal cells (group 2; n = 20), and epithelial plus stromal cells (group 3; n = 20) obtained from mid-secretory stage endometrial samples (n = 60) were grown on collagen and exposed to different doses (0, 1, 10 and 100 IU/ml) of rhCG for 24 h in vitro. Immunochemical and qRT-PCR methods were used to determine cytokine profiles. Enrichment and process networks analyses were implemented using a list of cytokines showing differential secretion in response to hCG. Results Under basal conditions, endometrial epithelial and stromal cells exhibited cell type-specific profiles of secreted cytokines. Administration of hCG (100 IU) resulted in significantly (P endometrial epithelial and stromal cells. CG may also affect complex paracrine processes in the different endometrial cell types. PMID:24345207

  8. PROTECTING EGG DONORS AND HUMAN EMBRYOS-THE FAILURE OF THE SOUTH KOREAN BIOETHICS AND BIOSAFETY ACT

    National Research Council Canada - National Science Library

    Mukta Jhalani

    2008-01-01

    ... Korea passed the Bioethics and Biosafety Act to regulate biotechnology research. In its current form, the Bioethics and Biosafety Act fails to adequately protect egg donors and human embryos. The Bioethics and Biosafety Act does not have adequate safeguards to protect egg donors, such as a requirement of voluntary consent and a requirement tha...

  9. Incidence of Modern Alumina Ceramic and Alumina Matrix Composite Femoral Head Failures in Nearly 6 Million Hip Implants.

    Science.gov (United States)

    Lee, Gwo-Chin; Kim, Raymond H

    2017-02-01

    Because of improvements in ceramic materials and manufacturing, the incidence of ceramic failures has decreased over time. Recent concerns with corrosion have contributed to an increase in ceramic ball head utilization. The purpose of this study is to report the incidence of modern alumina bearing failures from a single major ceramic manufacturer in nearly 6 million hip implants and to identify trends in the modes of failure of these implants. Beginning in the year 2000, CeramTec AG (Plochingen, Germany) began a comprehensive program for reporting and gathering failure data on its products. From January 1, 2000, to December 31, 2013, over 3.2 million pure alumina (PA) and 2.78 million alumina matrix composite (AMC) ceramic ball heads were implanted worldwide. During this period, there were 672 PA and 28 AMC femoral head fractures. The fractures were analyzed with respect to time to failure, head size, and implant factors. The incidence of clinical fractures of modern PA femoral heads and AMC femoral heads was 1 in 5000 (0.0201%) and 1 in 100,000 (0.0010%), respectively (P dislocations. Large-diameter PA heads were associated with a lower rate of fracture compared to smaller-diameter femoral heads (0.0316% for 28-mm heads vs 0.0080% for heads 32 mm or greater [P < .01]). Similar trends were observed with AMC heads. The neck lengths of the femoral ball heads were also a factor: a short-taper 28-mm ball head was more likely to fracture compared to other neck lengths (P < .01). Modern PA ceramic heads are reliable with extremely low risk of fracture. The reliability is even better with AMC heads. Copyright © 2016. Published by Elsevier Inc.

  10. Influence of implant design on the method of failure for three implants designed for use in the treatment of intertrochanteric fractures: the dynamic hip screw (DHS), DHS blade and X-BOLT.

    Science.gov (United States)

    O'Neill, F; McGloughlin, T; Lenehan, B; Condon, F; Coffey, J C; Walsh, M

    2013-06-01

    The dynamic hip screw (DHS) has been widely adopted as the implant of choice in the treatment of intertrochanteric fractures. There have been attempts over the years to improve on the DHS lag screw design in order to reduce failure in the form of "cut out". The purpose of this study was to investigate how two new design variations of the DHS, the DHS blade and the X-BOLT, behave within bone, and if these design modifications do indeed improve the fixation achieved and lead to a reduction in failure due to cut out. "Pushout" tests were chosen as the means of investigating the failure modes and patterns for these implants that lead to cut out. These pushout studies were performed in artificial bone substrate in the form of polyurethane foam blocks and in cadaveric femoral heads. The results demonstrated that each individual implant produces its own specific distinct force-displacement curve or pattern of failure, and that despite the very different implant designs and methods of fixation, all of the implants tested reached very similar peak forces in each of the test materials used. The results demonstrated that implant design only influences the pattern of failure, and that the peak forces reached by each implant are determined by the quality of the bone or test material into which they are placed. However, altering the force-displacement curve or pattern of failure may be enough to improve the fixation achieved and to provide an increased resistance to cut out.

  11. Association of EphA4 polymorphism with swine reproductive traits and mRNA expression of EphA4 during embryo implantation.

    Science.gov (United States)

    Fu, Yanfeng; Fu, Jinluan; Wang, Aiguo

    2012-03-01

    The swine erythropoietin-producing hepatocellular A4 (EphA4) gene, which was detected in the endometrium during embryo implantation in pigs, was one of the potential candidate genes for reproductive traits. In the study, two single nucleotide polymorphism (SNP) loci (EphA4_1 and EphA4_2) in exon 3 of EphA4 gene were analyzed to determine whether EphA4 influenced total number born (TNB) and number born alive (NBA). Association of two diallelic polymorphisms with reproductive traits was assessed in Landrace, Yorkshire and Duroc populations with 2,014 litter records of 765 sows. The results showed that G allele at EphA4_1 locus or C allele at EphA4_2 locus seemed to have advantageous effects on litter size. And the combined analyzed results demonstrated that genotype AGTC, AGCC and GGCC are better than genotype AATT, AATC and AGTT for TNB and NBA in either single parity or all parities. The results in this study demonstrated that EphA4 gene was significantly associated with litter size in pigs. In addition, a high mRNA expression of EphA4 was found in small intestine, large intestine, stomach and endometrium, and the expression decreased during implantation in pigs. Further studies were needed to confirm these preliminary researches.

  12. Comparison between findings of saline infusion sonohysterography and office hysteroscopy in patients with recurrent implantation failure

    Directory of Open Access Journals (Sweden)

    Ahmed Reda

    2016-01-01

    Full Text Available Aim: This study aims to determine the accuracy of saline infusion sonohysterography (SIS in the diagnosis of intrauterine pathologies in women with recurrent implantation failure (RIF. Settings and Design: This is a prospective cross-over study which was carried out during the period between December 2013 and July 2014. Materials and Methods: The study involved sixty subfertile women with a history of RIF. All cases underwent a transvaginal ultrasonography, SIS and then an office hysteroscopy (1 day after SIS during early follicular phase. SIS was carried out by same sonographer, and then hysteroscopy was carried out by same gynecologist who was kept blind to findings at SIS. Statistical Analysis: Was done using IBM© SPSS© Statistics version 22. The sensitivity of SIS was calculated as it equals: True positive by SIS/all positive (true cases by hysteroscopy and specificity was calculated as it equals: True negative by SIS/all negatives (normal by hysteroscopy. Results: Overall uterine abnormalities were significantly less likely to be identified with SIS compared to hysteroscopy (P = 0.002, but analysis of each finding separately demonstrated a comparable difference between SIS and hysteroscopy (P > 0.05. We found that the sensitivity, specificity, positive predictive value, and negative predictive value of SIS to detect intrauterine pathology is 41.2%, 100%, 100%, and 81.1%, respectively. Conclusion: Our findings suggest a good role of SIS in the workup for RIF saving more invasive procedure for selected cases.

  13. Estudio de asociación entre enfermedades sistémicas y el fracaso de implantes dentales Study of association between systemic diseases and dental implant failure

    Directory of Open Access Journals (Sweden)

    J Domínguez

    2013-04-01

    , genero y el habito de fumar.Since the beginning of oral implant surgery it has been recommended to exclude or limit certain patients with health issues or smoking habits. The chronic non-communicable diseases are not considered an absolute contraindication to the use of oral implants, but the type of disease should be evaluated in detail, as a potential risk that could affect the process of osseointegration. There are certain systemic conditions, such as osteoporosis, cardiovascular disease, diabetes mellitus, and hypothyroidism, as well as the habit of smoking, that affect the success, survival or failure of the implants. The purpose of the investigation is to determine whether there is an association between the failure of dental implants and systemic diseases in the population of patients undergoing dental implant surgery of San José de Santiago de Chile Hospital. We conducted a retrospective observational study and the variables studied were systemic diseases (osteoporosis, hypertension, diabetes, and hypothyroidism and the criteria used to assess the health of implants were those of the International Congress of Oral Implantology of Pisa, where "failure" is the term used for implants requiring removal or that were already lost. These variables were recorded from the clinical record and during a clinical examination, in a data collection sheet. This allowed to describe variables and their distribution, and then to analyze the data to find statistically valid evidence. For this study we can conclude that the analysis of each of the variables such as systemic hypertension or ASA II, have an association with the failure of dental implants, but not osteoporosis, hypothyroidism, diabetes, age, nutritional status, gender and cigarette smoking.

  14. Comparisons of maximum deformation and failure forces at the implant-abutment interface of titanium implants between titanium-alloy and zirconia abutments with two levels of marginal bone loss

    National Research Council Canada - National Science Library

    Wang, Chiung-Fang; Huang, Heng-Li; Lin, Dan-Jae; Shen, Yen-Wen; Fuh, Lih-Jyh; Hsu, Jui-Ting

    2013-01-01

    .... Therefore, this study compared the maximum deformation and failure forces of titanium implants between titanium-alloy and zirconia abutments under oblique compressive forces in the presence of two...

  15. Implant-based multiparameter telemonitoring of patients with heart failure (IN-TIME): a randomised controlled trial.

    Science.gov (United States)

    Hindricks, Gerhard; Taborsky, Milos; Glikson, Michael; Heinrich, Ullus; Schumacher, Burghard; Katz, Amos; Brachmann, Johannes; Lewalter, Thorsten; Goette, Andreas; Block, Michael; Kautzner, Josef; Sack, Stefan; Husser, Daniela; Piorkowski, Christopher; Søgaard, Peter

    2014-08-16

    An increasing number of patients with heart failure receive implantable cardioverter-defibrillators (ICDs) or cardiac resynchronisation defibrillators (CRT-Ds) with telemonitoring function. Early detection of worsening heart failure, or upstream factors predisposing to worsening heart failure, by implant-based telemonitoring might enable pre-emptive intervention and improve outcomes, but the evidence is weak. We investigated this possibility in IN-TIME, a clinical trial. We did this randomised, controlled trial at 36 tertiary clinical centres and hospitals in Australia, Europe, and Israel. We enrolled patients with chronic heart failure, NYHA class II-III symptoms, ejection fraction of no more than 35%, optimal drug treatment, no permanent atrial fibrillation, and a recent dual-chamber ICD or CRT-D implantation. After a 1 month run-in phase, patients were randomly assigned (1:1) to either automatic, daily, implant-based, multiparameter telemonitoring in addition to standard care or standard care without telemonitoring. Investigators were not masked to treatment allocation. Patients were masked to allocation unless they were contacted because of telemonitoring findings. Follow-up was 1 year. The primary outcome measure was a composite clinical score combining all-cause death, overnight hospital admission for heart failure, change in NYHA class, and change in patient global self-assessment, for the intention-to-treat population. The trial is registered with ClinicalTrials.gov, number NCT00538356. We enrolled 716 patients, of whom 664 were randomly assigned (333 to telemonitoring, 331 to control). Mean age was 65·5 years and mean ejection fraction was 26%. 285 (43%) of patients had NYHA functional class II and 378 (57%) had NYHA class III. Most patients received CRT-Ds (390; 58·7%). At 1 year, 63 (18·9%) of 333 patients in the telemonitoring group versus 90 (27·2%) of 331 in the control group (p=0·013) had worsened composite score (odds ratio 0·63, 95% CI 0·43

  16. Retrospective analysis of porcelain failures of metal ceramic crowns and fixed partial dentures supported by 729 implants in 152 patients: patient-specific and implant-specific predictors of ceramic failure.

    Science.gov (United States)

    Kinsel, Richard P; Lin, Dongming

    2009-06-01

    Porcelain fracture associated with an implant-supported, metal ceramic crown or fixed partial denture occurs at a higher rate than in tooth-supported restorations, according to the literature. Implant-specific and patient-specific causes of ceramic failure have not been fully evaluated. The purpose of this retrospective study was to evaluate the potential statistical predictors for porcelain fracture of implant-supported, metal ceramic restorations. Over a 6-month period, a consecutive series of patients having previously received implant-supported, metal ceramic fixed restorations were examined during periodic recall appointments. The number of supporting implants, number of dental units, type of restoration, date of prosthesis insertion, location in the dental arch, opposing dentition, type of occlusion, presence of parafunctional habits, use of an occlusal protective device, presence or absence of ceramic fractures, gender, and age were recorded for each patient. The generalized estimating equation (GEE) approach was used for the intrasubject correlated measurements analysis of categorical outcomes (presence or absence of ceramic fractures) to determine which patient- and implant-specific factors would predict porcelain fracture (alpha=.05). Data were collected from 152 patients representing 998 dental units (390 single crowns and 94 fixed partial dentures) supported by 729 implants. Porcelain fractures of 94 dental units occurred in 35 patients. The fractures were significantly (Pimplant-supported metal ceramic restorations, bruxism, and not wearing a protective occlusal device. Metal ceramic prostheses (single crown or fixed partial dentures) had approximately 7 times higher odds of porcelain fracture (odds ratio (OR)=7.06; 95% confidence interval (CI): 2.57 to 19.37) and 13 times greater odds of a fracture requiring either repair or replacement (OR=13.95; 95% CI: 2.25 to 86.41) when in occlusion with another implant-supported restoration, as compared to

  17. Endometrial scratching in women with implantation failure after a first IVF/ICSI cycle; does it lead to a higher live birth rate? The SCRaTCH study: a randomized controlled trial (NTR 5342).

    Science.gov (United States)

    van Hoogenhuijze, N E; Torrance, H L; Mol, F; Laven, J S E; Scheenjes, E; Traas, M A F; Janssen, C; Cohlen, B; Teklenburg, G; de Bruin, J P; van Oppenraaij, R; Maas, J W M; Moll, E; Fleischer, K; van Hooff, M H; de Koning, C; Cantineau, A; Lambalk, C B; Verberg, M; Nijs, M; Manger, A P; van Rumste, M; van der Voet, L F; Preys-Bosman, A; Visser, J; Brinkhuis, E; den Hartog, J E; Sluijmer, A; Jansen, F W; Hermes, W; Bandell, M L; Pelinck, M J; van Disseldorp, J; van Wely, M; Smeenk, J; Pieterse, Q D; Boxmeer, J C; Groenewoud, E R; Eijkemans, M J C; Kasius, J C; Broekmans, F J M

    2017-07-21

    Success rates of assisted reproductive techniques (ART) are approximately 30%, with the most important limiting factor being embryo implantation. Mechanical endometrial injury, also called 'scratching', has been proposed to positively affect the chance of implantation after embryo transfer, but the currently available evidence is not yet conclusive. The primary aim of this study is to determine the effect of endometrial scratching prior to a second fresh in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle on live birth rates in women with a failed first IVF/ICSI cycle. Multicenter randomized controlled trial in Dutch academic and non-academic hospitals. A total of 900 women will be included of whom half will undergo an endometrial scratch in the luteal phase of the cycle prior to controlled ovarian hyperstimulation using an endometrial biopsy catheter. The primary endpoint is the live birth rate after the 2 nd fresh IVF/ICSI cycle. Secondary endpoints are costs, cumulative live birth rate (after the full 2 nd IVF/ICSI cycle and over 12 months of follow-up); clinical and ongoing pregnancy rate; multiple pregnancy rate; miscarriage rate and endometrial tissue parameters associated with implantation failure. Multiple studies have been performed to investigate the effect of endometrial scratching on live birth rates in women undergoing IVF/ICSI cycles. Due to heterogeneity in both the method and population being scratched, it remains unclear which group of women will benefit from the procedure. The SCRaTCH trial proposed here aims to investigate the effect of endometrial scratching prior to controlled ovarian hyperstimulation in a large group of women undergoing a second IVF/ICSI cycle. NTR 5342 , registered July 31 st , 2015. Version 4.10, January 4th, 2017.

  18. Riata implantable cardioverter-defibrillator lead failure: analysis of explanted leads with a unique insulation defect.

    Science.gov (United States)

    Hauser, Robert G; McGriff, Deepa; Retel, Linda Kallinen

    2012-05-01

    The Riata family of implantable cardioverter-defibrillator leads (St Jude Medical, Sylmar, CA) appears prone to a unique failure mechanism whereby the conductor cables wear through the silicone insulation from inside-out and are seen outside the lead body (externalized conductors). To assess the extent of Riata lead damage associated with inside-out insulation defects and their clinical consequences. In September 2011, we searched the U.S. Food and Drug Administration's Manufacturers and User Defined Experience medical device database for reports describing Riata lead failures that had been analyzed by the manufacturer. The Manufacturers and User Defined Experience search identified 105 leads that had inside-out insulation defects. Eight-French single-coil Riata leads accounted for a higher-than-expected proportion (25.7%) of the leads with this defect. A total of 226 insulation defects were found in the 105 leads (2.2 defects per lead), including 143 inside-out defects (1.4 defects per lead). The most common location of insulation defects was distal to the proximal coil (n = 108). Twenty-eight leads (26.7%) had inside-out insulation defects underneath the shocking coils. Of 43 leads whose cables were assessed for the integrity of the ethylene-tetrafluoroethylene cable coating, 22 (51.2%) were found to be abraded, exposing the conductor surfaces. On X-ray radiography or fluoroscopy, 7 leads were found to have externalized cables; 2 of these leads had no electrical abnormalities, while 4 exhibited noise or increased impedance. Inappropriate shocks were experienced by 31 of the 105 patients (29.5%). Riata leads that have inside-out insulation defects often have multiple defects, including additional inside-out abrasions along the body of the lead and beneath the shocking coils. Eight-French single-coil Riata models may be more prone to externalized cables than are dual-coil and 7-F designs. Externalized cables are but one manifestation of interior insulation damage

  19. Integrative Analyses of Uterine Transcriptome and MicroRNAome Reveal Compromised LIF-STAT3 Signaling and Progesterone Response in the Endometrium of Patients with Recurrent/Repeated Implantation Failure (RIF.

    Directory of Open Access Journals (Sweden)

    Youngsok Choi

    Full Text Available Intimate two-way interactions between the implantation-competent blastocyst and receptive uterus are prerequisite for successful embryo implantation. In humans, recurrent/repeated implantation failure (RIF may occur due to altered uterine receptivity with aberrant gene expression in the endometrium as well as genetic defects in embryos. Several studies have been performed to understand dynamic changes of uterine transcriptome during menstrual cycles in humans. However, uterine transcriptome of the patients with RIF has not been clearly investigated yet. Here we show that several signaling pathways as well as many genes and microRNAs are dysregulated in the endometrium of patients with RIF (RIFE. Whereas unsupervised hierarchical clustering showed that overall mRNA and microRNA profiles of RIFE were similar to those of endometria of healthy women, many genes were significantly dysregulated in RIFE (cut off at 1.5 fold change. The majority (~75% of differentially expressed genes in RIFE including S100 calcium binding protein P (S100P, Chemokine (C-X-C motif ligand 13 (CXCL13 and SIX homeobox 1 (SIX1 were down-regulated, suggesting that reduced uterine expression of these genes is associated with RIF. Gene Set Enrichment analyses (GSEA for mRNA microarrays revealed that various signaling pathways including Leukemia inhibitory factor (LIF signaling and a P4 response were dysregulated in RIFE although expression levels of Estrogen receptor α (ERα and Progesterone receptor (PR were not significantly altered in RIFE. Furthermore, expression and phosphorylation of Signal transducer and activator of transcription 3 (STAT3 are reduced and a gene set associated with Janus kinase (JAK-STAT signaling pathway is systemically down-regulated in these patients. Pairwise analyses of microRNA arrays with prediction of dysregulated microRNAs based on mRNA expression datasets demonstrated that 6 microRNAs are aberrantly regulated in RIFE. Collectively, we here

  20. Expression and localization of transcription factors SNAIL and SLUG in mouse ovaries and pre-implantation embryos.

    Science.gov (United States)

    Guo, Cui; Meng, Xiaoqian; Bai, Jing; Chen, Cheng; Liu, Tao; Liu, Shuzhen; Zhang, Cong; Li, Wei-Ping

    2014-11-01

    SNAIL and SLUG are zinc-finger transcription factors that participate in the regulation of cell division, cell survival, mesoderm formation and epithelial-to-mesenchymal transition. We investigate the expression of SNAIL and SLUG during follicular maturation, ovulation and luteinization in the ovaries of both neonatal mice and gonadotropin-induced immature mice. Furthermore, we examine the expression and localization of these transcription factors during early embryonic cleavage. Our data demonstrate that both SNAIL and SLUG are present in the epithelial cells of the ovarian surface in immature mice. SNAIL is first evident in the interstitial cells and theca cells by postnatal day (PD) 6 and then appears in the oocytes by PD 8, remaining at a constant expression level for all stages studied thereafter. SLUG is expressed in oocytes as early as PD 1. Its expression also increases with the development of the follicles in theca and interstitial cells but not in granulosa cells. In gonadotropin-induced immature mice, both SNAIL and SLUG are expressed in the corpora lutea. During early embryo cleavage, SNAIL occurs in the nucleus and cytoplasm of the majority of the embryo, excluding the nucleolus from the germinal vesicle breakdown (GVBD) to the 8-cell stage and is then localized in the cytoplasm during the morula stage and in the nucleus during the blastocyst stage. SLUG has an identical expression pattern as SNAIL from GVBD until the morula stage, except that it is localized in the cytoplasm during the blastocyst stage. Taken together, these different localization patterns suggest that SNAIL and SLUG probably play important roles during follicular development, luteinization and early embryonic development.

  1. Embryo splitting

    Directory of Open Access Journals (Sweden)

    Karl Illmensee

    2010-04-01

    Full Text Available Mammalian embryo splitting has successfully been established in farm animals. Embryo splitting is safely and efficiently used for assisted reproduction in several livestock species. In the mouse, efficient embryo splitting as well as single blastomere cloning have been developed in this animal system. In nonhuman primates embryo splitting has resulted in several pregnancies. Human embryo splitting has been reported recently. Microsurgical embryo splitting under Institutional Review Board approval has been carried out to determine its efficiency for blastocyst development. Embryo splitting at the 6–8 cell stage provided a much higher developmental efficiency compared to splitting at the 2–5 cell stage. Embryo splitting may be advantageous for providing additional embryos to be cryopreserved and for patients with low response to hormonal stimulation in assisted reproduction programs. Social and ethical issues concerning embryo splitting are included regarding ethics committee guidelines. Prognostic perspectives are presented for human embryo splitting in reproductive medicine.

  2. Frequency of chromosomal aneuploidy in high quality embryos from young couples using preimplantation genetic screening

    Directory of Open Access Journals (Sweden)

    Farzaneh Fesahat

    2017-09-01

    Full Text Available Background: Selection of the best embryo for transfer is very important in assisted reproductive technology (ART. Using morphological assessment for this selection demonstrated that the correlation between embryo morphology and implantation potential is relatively weak. On the other hand, aneuploidy is a key genetic factor that can influence human reproductive success in ART. Objective: The aim of this lab trial study was to evaluate the incidence of aneuploidies in five chromosomes in the morphologically high-quality embryos from young patients undergoing ART for sex selection. Materials and Methods: A total of 97 high quality embryos from 23 women at the age of 37or younger years that had previously undergone preimplantation genetic screening for sex selection were included in this study. After washing, the slides of blastomeres from embryos of patients were reanalyzed by fluorescence in-situ hybridization for chromosomes 13, 18 and 21. Results: There was a significant rate of aneuploidy determination in the embryos using preimplantation genetic screening for both sex and three evaluated autosomal chromosomes compared to preimplantation genetic screening for only sex chromosomes (62.9% vs. 24.7%, p=0.000. The most frequent detected chromosomal aneuploidy was trisomy or monosomy of chromosome 13. Conclusion: There is considerable numbers of chromosomal abnormalities in embryos generated in vitro which cause in vitro fertilization failure and it seems that morphological characterization of embryos is not a suitable method for choosing the embryos without these abnormalities

  3. Frequency of chromosomal aneuploidy in high quality embryos from young couples using preimplantation genetic screening.

    Science.gov (United States)

    Fesahat, Farzaneh; Montazeri, Fatemeh; Sheikhha, Mohammad Hasan; Saeedi, Hojjatollah; Dehghani Firouzabadi, Razieh; Kalantar, Seyed Mehdi

    2017-05-01

    Selection of the best embryo for transfer is very important in assisted reproductive technology (ART). Using morphological assessment for this selection demonstrated that the correlation between embryo morphology and implantation potential is relatively weak. On the other hand, aneuploidy is a key genetic factor that can influence human reproductive success in ART. The aim of this lab trial study was to evaluate the incidence of aneuploidies in five chromosomes in the morphologically high-quality embryos from young patients undergoing ART for sex selection. A total of 97 high quality embryos from 23 women at the age of 37or younger years that had previously undergone preimplantation genetic screening for sex selection were included in this study. After washing, the slides of blastomeres from embryos of patients were reanalyzed by fluorescence in-situ hybridization for chromosomes 13, 18 and 21. There was a significant rate of aneuploidy determination in the embryos using preimplantation genetic screening for both sex and three evaluated autosomal chromosomes compared to preimplantation genetic screening for only sex chromosomes (62.9% vs. 24.7%, p=0.000). The most frequent detected chromosomal aneuploidy was trisomy or monosomy of chromosome 13. There is considerable numbers of chromosomal abnormalities in embryos generated in vitro which cause in vitro fertilization failure and it seems that morphological characterization of embryos is not a suitable method for choosing the embryos without these abnormalities.

  4. Immediate nonfunctional versus immediate functional loading and dental implant failure rates: a systematic review and meta-analysis.

    Science.gov (United States)

    Chrcanovic, Bruno Ramos; Albrektsson, Tomas; Wennerberg, Ann

    2014-09-01

    The purpose of the present review was to test the null hypothesis of no difference in the implant failure rates, postoperative infection, and marginal bone loss for patients being rehabilitated using dental implants with immediate nonfunctional loading (INFL) compared to immediate functional loading (IFL), against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomized or not. The estimates of relative effect were expressed in risk ratio (RR) and mean difference (MD) in millimeters. 1059 studies were identified and 11 studies were included, of which 7 were of high risk of bias, whereas four studies were of low risk of bias. The results showed that the procedure used (nonfunctional vs. functional) did not significantly affect the implant failure rates (P=0.70), with a RR of 0.87 (95% CI 0.44-1.75). The wide CI demonstrates uncertainty about the effect size. The analysis of postoperative infection was not possible due to lack of data. No apparent significant effects of non-occlusal loading on the marginal bone loss (MD 0.01mm, 95% CI -0.04-0.06; P=0.74) were observed. The results of this study suggest that the differences in occlusal loading between INFL and IFL might not affect the survival of these dental implants and that there is no apparent significant effect on the marginal bone loss. There has been a controversy concerning whether dental implants should be subjected to immediate functional or nonfunctional loading. As the philosophies of treatment may alter over time, a periodic review of the different concepts is necessary to refine techniques and eliminate unnecessary procedures. This would form a basis for optimum treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Age and Outcomes of Primary Prevention Implantable Cardioverter-Defibrillators in Patients With Nonischemic Systolic Heart Failure.

    Science.gov (United States)

    Elming, Marie Bayer; Nielsen, Jens C; Haarbo, Jens; Videbæk, Lars; Korup, Eva; Signorovitch, James; Olesen, Line Lisbeth; Hildebrandt, Per; Steffensen, Flemming H; Bruun, Niels E; Eiskjær, Hans; Brandes, Axel; Thøgersen, Anna M; Gustafsson, Finn; Egstrup, Kenneth; Videbæk, Regitze; Hassager, Christian; Svendsen, Jesper Hastrup; Høfsten, Dan E; Torp-Pedersen, Christian; Pehrson, Steen; Køber, Lars; Thune, Jens Jakob

    2017-11-07

    The DANISH study (Danish Study to Assess the Efficacy of ICDs [Implantable Cardioverter Defibrillators] in Patients With Non-Ischemic Systolic Heart Failure on Mortality) did not demonstrate an overall effect on all-cause mortality with ICD implantation. However, the prespecified subgroup analysis suggested a possible age-dependent association between ICD implantation and mortality with survival benefit seen only in the youngest patients. The nature of this relationship between age and outcome of a primary prevention ICD in patients with nonischemic systolic heart failure warrants further investigation. All 1116 patients from the DANISH study were included in this prespecified subgroup analysis. We assessed the relationship between ICD implantation and mortality by age, and an optimal age cutoff was estimated nonparametrically with selection impact curves. Modes of death were divided into sudden cardiac death and nonsudden death and compared between patients younger and older than this age cutoff with the use of χ(2) analysis. Median age of the study population was 63 years (range, 21-84 years). There was a linearly decreasing relationship between ICD and mortality with age (hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.003-1.06; P=0.03). An optimal age cutoff for ICD implantation was present at ≤70 years. There was an association between reduced all-cause mortality and ICD in patients ≤70 years of age (HR, 0.70; 95% CI, 0.51-0.96; P=0.03) but not in patients >70 years of age (HR, 1.05; 95% CI, 0.68-1.62; P=0.84). For patients ≤70 years old, the sudden cardiac death rate was 1.8 (95% CI, 1.3-2.5) and nonsudden death rate was 2.7 (95% CI, 2.1-3.5) events per 100 patient-years, whereas for patients >70 years old, the sudden cardiac death rate was 1.6 (95% CI, 0.8-3.2) and nonsudden death rate was 5.4 (95% CI, 3.7-7.8) events per 100 patient-years. This difference in modes of death between the 2 age groups was statistically significant (P=0.01). In

  6. Macrovascular and microvascular function after implantation of left ventricular assist devices in end-stage heart failure: Role of microparticles.

    Science.gov (United States)

    Sansone, Roberto; Stanske, Beate; Keymel, Stefanie; Schuler, Dominik; Horn, Patrick; Saeed, Diyar; Boeken, Udo; Westenfeld, Ralf; Lichtenberg, Artur; Kelm, Malte; Heiss, Christian

    2015-07-01

    The hemodynamic vascular consequences of implanting left ventricular assist devices (LVADs) have not been studied in detail. We investigated the effect of LVAD implantation compared with heart transplant (HTx) on microvascular and macrovascular function in patients with end-stage heart failure and evaluated whether microparticles may play a role in LVAD-related endothelial dysfunction. Vascular function was assessed in patients with end-stage heart failure awaiting HTx, patients who had undergone implantation of a continuous-flow centrifugal LVAD, and patients who had already received a HTx. Macrovascular function was measured by flow-mediated vasodilation (FMD) using high-resolution ultrasound of the brachial artery. Microvascular function was assessed in the forearm during reactive hyperemia using laser Doppler perfusion imaging and pulsed wave Doppler. Age-matched patients without heart failure and without coronary artery disease (CAD) (healthy control subjects) and patients with stable CAD served as control subjects. Circulating red blood cell (CD253(+)), leukocyte (CD45(+)), platelet (CD31(+)/CD41(+)), and endothelial cell (CD31(+)/CD41(-), CD62e(+), CD144(+)) microparticles were determined by flow cytometry and free hemoglobin by enzyme-linked immunosorbent assay. FMD and microvascular function were significantly impaired in patients with end-stage heart failure compared with healthy control subjects and patients with stable CAD. LVAD implantation led to recovery of microvascular function, but not FMD. In parallel, increased free hemoglobin was observed along with red and white cell microparticles and endothelial and platelet microparticles. This finding indicates destruction of blood cells with release of hemoglobin and activation of endothelial cells. HTx and LVAD implantation led to similar improvements in microvascular function. FMD increased and microparticle levels decreased in patients with HTx, whereas shear stress during reactive hyperemia was

  7. Percutaneous implantation of a ventricular partitioning device for treatment of ischemic heart failure: initial experience of a center.

    Science.gov (United States)

    Silva, Guida; Melica, Bruno; Pires de Morais, Gustavo; Sousa, Olga; Bettencourt, Nuno; Ribeiro, José; Simões, Lino; Gama, Vasco

    2012-12-01

    The Parachute is a novel left ventricular (LV) partitioning device that is deployed percutaneously in the left ventricle in patients with anteroapical regional wall motion abnormalities, dilated LV and systolic dysfunction after anterior myocardial infarction (MI). The implantable device is a partitioning membrane that isolates the dysfunctional region of the ventricle and decreases chamber volume. Data from the first-in-human clinical trial - the Percutaneous Ventricular Restoration in Chronic Heart Failure (PARACHUTE) trial- has shown that this new device is associated with significant and sustained LV volume reduction and improvement in LV hemodynamics and functional capacity in the 12 months after implantation, with a relatively low rate of clinical events, indicating that it may have a beneficial effect in the treatment of ischemic heart failure. We aim to describe our initial experience with implantation of the Parachute LV partitioning device and its short-term safety, defined as the successful delivery and deployment of the device. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  8. Hemodynamic-guided heart-failure management using a wireless implantable sensor: Infrastructure, methods, and results in a community heart failure disease-management program.

    Science.gov (United States)

    Jermyn, Rita; Alam, Amit; Kvasic, Jessica; Saeed, Omar; Jorde, Ulrich

    2017-03-01

    The real-world impact of remote pulmonary artery pressure (PAP) monitoring on New York Heart Association (NYHA) class improvement and heart failure (HF) hospitalization rate is presented here from a single center. METHODS: Seventy-seven previously hospitalized outpatients with NYHA class III HF were offered PAP monitoring via device implantation in a multidisciplinary HF-management program. Prospective effectiveness analyses compared outcomes in 34 hemodynamically monitored patients to a group of similar patients (n = 32) who did not undergo device implantation but received usual care. NYHA class and 6-minute walk testing were assessed at baseline and 90 days. All hospitalizations were collected after 6 months of the implantation date (average follow-up, 15 months) and compared with the number of hospitalizations experienced prior to hemodynamic monitoring. Patients in both groups had similar distributions of age, sex, and ejection fraction. After 90 days, 61.8% of the monitored patients had NYHA class improvement of ≥1, compared with 12.5% in the controls (P management leads to significant improvements in NYHA class and HF hospitalization rate in a real-world setting compared with usual care delivered in a comprehensive disease-management program. © 2016 Wiley Periodicals, Inc.

  9. Reasons for mini-implants failure: choosing installation site should be valued!

    Directory of Open Access Journals (Sweden)

    Alberto Consolaro

    2014-04-01

    Full Text Available Mini-implant loss is often associated with physical and mechanical aspects that result from choosing an inappropriate placement site. It is worth highlighting that: a Interdental alveolar bone crests are flexible and deformable. For this reason, they may not offer the ideal absolute anchorage. The more cervical the structures, the more delicate they are, thus offering less physical support for mini-implant placement; b Alveolar bone crests of triangular shape are more deformable, whereas those of rectangular shape are more flexible; c The bases of the alveolar processes of the maxilla and the mandible are not flexible, for this reason, they are more likely to receive mini-implants; d The more cervical a mini-implant is placed, the higher the risk of loss; the more apical a mini-implant is placed, the better its prognosis will be; e 3D evaluations play a major role in planning the use of mini-implants. Based on the aforementioned considerations, the hypotheses about mini-implant loss are as follows: 1 Deflection of maxillary and mandibular alveolar processes when mini-implants are more cervically placed; 2 Mini-implants placed too near the periodontal ligament, with normal intra-alveolar tooth movement; 3 Low bone density, low thickness and low alveolar bone volume; 4 Low alveolar cortical bone thickness; 5 Excessive pressure inducing trabecular bone microfracture; 6 Sites of higher anatomical weakness in the mandible and the maxilla; 7 Thicker gingival tissue not considered when choosing the mini-implant.

  10. Development of a Patient-Specific Finite Element Model for Predicting Implant Failure in Pelvic Ring Fracture Fixation

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    Vickie Shim

    2017-01-01

    Full Text Available Introduction. The main purpose of this study is to develop an efficient technique for generating FE models of pelvic ring fractures that is capable of predicting possible failure regions of osteosynthesis with acceptable accuracy. Methods. Patient-specific FE models of two patients with osteoporotic pelvic fractures were generated. A validated FE model of an uninjured pelvis from our previous study was used as a master model. Then, fracture morphologies and implant positions defined by a trauma surgeon in the preoperative CT were manually introduced as 3D splines to the master model. Four loading cases were used as boundary conditions. Regions of high stresses in the models were compared with actual locations of implant breakages and loosening identified from follow-up X-rays. Results. Model predictions and the actual clinical outcomes matched well. For Patient A, zones of increased tension and maximum stress coincided well with the actual locations of implant loosening. For Patient B, the model predicted accurately the loosening of the implant in the anterior region. Conclusion. Since a significant reduction in time and labour was achieved in our mesh generation technique, it can be considered as a viable option to be implemented as a part of the clinical routine to aid presurgical planning and postsurgical management of pelvic ring fracture patients.

  11. [Combined application of interference therapy and "dry" carbon dioxide baths for the treatment of hemodynamic disorders in patients with implantation failure due to inflammation].

    Science.gov (United States)

    sokolova, Iu Iu; Silant'eva, E S; Serov, V N

    2010-01-01

    This work was designed to evaluate the influence of different physiotherapeutic modalities on the possibility of implantation, development and outcome of pregnancy in patients with chronic endometriosis and previous failures of implantation. The study confirmed initial sonographic changes and deficit of uterine blood supply as well as gradual improvement of these parameters under effect of adequate physiotherapy. Inclusion of dry carbon dioxide baths in the combined treatment of hemodynamic disorders made it possible to "prepare" endometrium for implantation and optimize blood circulation in the uterine vasculature in order to enhance the probability of implantation, development of pregnancy, and its success.

  12. Human Endometrial Transcriptomics: Implications for Embryonic Implantation

    Science.gov (United States)

    Gómez, Eva; Ruíz-Alonso, Maria; Miravet, Jose; Simón, Carlos

    2015-01-01

    Human endometrium has been extensively investigated in the search for markers capable of predicting its receptive status. The completion of the Human Genome Project has triggered a rapid development of new fields in molecular biology, the “transcriptomics” being a major turning point in the knowledge acquisition of endometrial receptivity. Based on this, a customized Endometrial Receptivity Array (ERA) has been developed, which is capable of identifying the genomic signature of receptivity. This diagnostic tool showed that the window of implantation (WOI) is displaced in one out of four patients with implantation failure, allowing the identification of their personalized WOI. This strategy allows performing a personalized embryo transfer (pET) on the day in which the endometrium is receptive. The combination of a systems biology approach and next-generation sequencing will overcome the limitations of microarrays, and will, in the future, allow elucidation of the mechanisms involved in embryo implantation. PMID:25818663

  13. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure.

    Science.gov (United States)

    Bardy, Gust H; Lee, Kerry L; Mark, Daniel B; Poole, Jeanne E; Packer, Douglas L; Boineau, Robin; Domanski, Michael; Troutman, Charles; Anderson, Jill; Johnson, George; McNulty, Steven E; Clapp-Channing, Nancy; Davidson-Ray, Linda D; Fraulo, Elizabeth S; Fishbein, Daniel P; Luceri, Richard M; Ip, John H

    2005-01-20

    Sudden death from cardiac causes remains a leading cause of death among patients with congestive heart failure (CHF). Treatment with amiodarone or an implantable cardioverter-defibrillator (ICD) has been proposed to improve the prognosis in such patients. We randomly assigned 2521 patients with New York Heart Association (NYHA) class II or III CHF and a left ventricular ejection fraction (LVEF) of 35 percent or less to conventional therapy for CHF plus placebo (847 patients), conventional therapy plus amiodarone (845 patients), or conventional therapy plus a conservatively programmed, shock-only, single-lead ICD (829 patients). Placebo and amiodarone were administered in a double-blind fashion. The primary end point was death from any cause. The median LVEF in patients was 25 percent; 70 percent were in NYHA class II, and 30 percent were in class III CHF. The cause of CHF was ischemic in 52 percent and nonischemic in 48 percent. The median follow-up was 45.5 months. There were 244 deaths (29 percent) in the placebo group, 240 (28 percent) in the amiodarone group, and 182 (22 percent) in the ICD group. As compared with placebo, amiodarone was associated with a similar risk of death (hazard ratio, 1.06; 97.5 percent confidence interval, 0.86 to 1.30; P=0.53) and ICD therapy was associated with a decreased risk of death of 23 percent (0.77; 97.5 percent confidence interval, 0.62 to 0.96; P=0.007) and an absolute decrease in mortality of 7.2 percentage points after five years in the overall population. Results did not vary according to either ischemic or nonischemic causes of CHF, but they did vary according to the NYHA class. In patients with NYHA class II or III CHF and LVEF of 35 percent or less, amiodarone has no favorable effect on survival, whereas single-lead, shock-only ICD therapy reduces overall mortality by 23 percent. Copyright 2005 Massachusetts Medical Society.

  14. Annual failure rates and marginal bone-level changes of immediate compared to conventional loading of dental implants. A systematic review of the literature and meta-analysis.

    Science.gov (United States)

    Engelhardt, Sebastian; Papacosta, Petros; Rathe, Florian; Özen, Jülide; Jansen, John A; Junker, Rüdiger

    2015-06-01

    Immediate loading of dental implants appears to be a successful option. Questions still remain whether annual failure rates (AFRs) as well as annual marginal bone-level changes are comparable with conventionally loaded implants. Immediately loaded implants (≤24 h after implantation) do not show different annual survival rates or peri-implant bone-level changes as compared to conventionally loaded implants (≥3 months after implantation). An electronic search in the National Library of Medicine and in Cochrane Central Register of Controlled Trials was performed for articles published up to November 2013. Only publications in English were considered. Additionally, the bibliographies of the full-text papers were searched. Primary outcome variable was percentage AFR; secondary outcome variable was annual radiographic bone-level change. Electronic search yielded 154 full-text articles; ten randomized controlled clinical trials were eventually meta-analyzed. Annual failure rates were 2.3% and 3.4% for conventionally and immediately loaded implants, respectively. No difference in implant failure rates was found (RR: 0.82). Regarding marginal bone-level changes, the weighted mean difference (WMD) between immediate and conventional loading amounted to 0.02 mm at 1 year (P > 0.05), to 0.08 mm at 2 years (P > 0.05), -0.10 mm at 3 years (P > 0.05) and -0.3 mm at 5 years (P 0.05). No clinically relevant differences regarding annual failure rates or radiographic bone-level changes between conventionally and immediately loaded implants can be found for up to 5 years of follow-up. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Failure to Treat Life-Threatening Ventricular Tachyarrhythmias in Contemporary Implantable Cardioverter-Defibrillators

    DEFF Research Database (Denmark)

    Thøgersen, Anna Margrethe; Larsen, Jacob Moesgaard; Johansen, Jens Brock

    2017-01-01

    BACKGROUND: In clinical trials, manufacturer-specific, strategic programming of implantable cardioverter-defibrillators (ICDs), including faster detection rates, reduces unnecessary therapy but permits therapy for ventricular tachycardia/ventricular fibrillation (VF). Present consensus recommends...

  16. Impact of Implantable Cardioverter-Defibrillator, Amiodarone, and Placebo on the Mode of Death in Stable Patients With Heart Failure

    Science.gov (United States)

    Packer, Douglas L.; Prutkin, Jordan M.; Hellkamp, Anne S.; Mitchell, L. Brent; Bernstein, Robert C.; Wood, Freda; Boehmer, John P.; Carlson, Mark D.; Frantz, Robert P.; McNulty, Steve E.; Rogers, Joseph G.; Anderson, Jill; Johnson, George W.; Walsh, Mary Norine; Poole, Jeanne E.; Mark, Daniel B.; Lee, Kerry L.; Bardy, Gust H.

    2010-01-01

    Background The Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) demonstrated that implantable cardioverterdefibrillator (ICD) therapy reduces all-cause mortality in patients with New York Heart Association class II/III heart failure and a left ventricular ejection fraction ≤35% on optimal medical therapy. Whether ICD therapy reduced sudden death caused by ventricular tachyarrhythmias without affecting heart failure deaths in this population is unknown. Methods and Results SCD-HeFT randomized 2521 subjects to placebo, amiodarone, or shock-only, single-lead ICD therapy. Over a median follow-up of 45.5 months, a total of 666 deaths occurred, which were reviewed by an Events Committee and initially categorized as cardiac or noncardiac. Cardiac deaths were further adjudicated as resulting from sudden death presumed to be ventricular tachyarrhythmic, bradyarrhythmia, heart failure, or other cardiac causes. ICD therapy significantly reduced cardiac mortality compared with placebo (adjusted hazard ratio, 0.76; 95% confidence interval, 0.60 to 0.95) and tachyarrhythmia mortality (adjusted hazard ratio, 0.40; 95% confidence interval, 0.27 to 0.59) and had no impact on mortality resulting from heart failure or noncardiac causes. The cardiac and tachyarrhythmia mortality reductions were evident in subjects with New York Heart Association class II but not in subjects with class III heart failure. The reduction in tachyarrhythmia mortality with ICD therapy was similar in subjects with ischemic and nonischemic disease. Compared with placebo, amiodarone had no significant effect on any mode of death. Conclusions ICD therapy reduced cardiac mortality and sudden death presumed to be ventricular tachyarrhythmic in SCD-HeFT and had no effect on heart failure mortality. Amiodarone had no effect on all-cause mortality or its cause-specific components, except an increase in non-cardiac mortality in class III patients. PMID:19917887

  17. Biological and technical complications and failures with fixed partial dentures (FPD) on implants and teeth after four to five years of function.

    Science.gov (United States)

    Brägger, U; Aeschlimann, S; Bürgin, W; Hämmerle, C H; Lang, N P

    2001-02-01

    The aim of this study was to compare the frequency of biological and technical complications with fixed partial dentures (FPDs) on implants, teeth and as mixed tooth-implant supported FPDs over 4 to 5 years of function. All implants belonged to the ITI Dental Implant System. Group I-I (implant FPD) included 33 patients with 40 FPDs, group T-T (tooth FPDs) 40 patients with 58 FPDs, group I-T (mixed tooth-implant FPDs) 15 with 18 FPD. Of the bridge abutments 144 were teeth and 105 were implants. The median number of units replaced by the FPDs was 3 (range 2-14). The mean age of the patients was 55.7 years (range 23-83). Complete failures resulted in the loss of one FPD in each group. Two implants were lost due to fracture secondarily to development of a bone defect. One tooth had a vertical fracture and 1 tooth was lost due to periodontitis. Biological complications (peri-implantitis, PPD > or = 5 mm and BOP+) occurred at 9.6% (10) of the implants. This number was, however, reduced to 5% if the threshold for definition of peri-implantitis was set at PPD > or = 6 mm and BOP+. Biological complications occurred in 11.8% (17) of the abutment teeth (NS compared to implants); 2.8% (4) had secondary caries, 4.9% (7) endodontic problems and 4.1% (6) had periodontitis (PPD > or = 5 mm, BOP+). Ten out of 32 patients with a general health problem indicated a biological complication, whereas 9 out of 53 patients with no general health problem had a biological complication (chi 2: NS). Statistically significantly more technical complications were found in FPDs on implants (chi 2, P bruxism. Out of 10 bruxers 6 had a technical complication whereas 13 out of 75 non-bruxers had such a complication (chi 2 implant abutments after 4-5 years of function. Loss of FPD over 4-5 years occurred at a similar rate with mixed, implant or tooth supported reconstructions. Significantly more porcelain fractures were found in FPDs on implants. Impaired general health status was not significantly

  18. The Pathology of Orthopedic Implant Failure Is Mediated by Innate Immune System Cytokines

    Directory of Open Access Journals (Sweden)

    Stefan Landgraeber

    2014-01-01

    Full Text Available All of the over 1 million total joint replacements implanted in the US each year are expected to eventually fail after 15–25 years of use, due to slow progressive subtle inflammation at the bone implant interface. This inflammatory disease state is caused by implant debris acting, primarily, on innate immune cells, that is, macrophages. This slow progressive pathological bone loss or “aseptic loosening” is a potentially life-threatening condition due to the serious complications in older people (>75 yrs of total joint replacement revision surgery. In some people implant debris (particles and ions from metals can influence the adaptive immune system as well, giving rise to the concept of metal sensitivity. However, a consensus of studies agrees that the dominant form of this response is due to innate reactivity by macrophages to implant debris where both danger (DAMP and pathogen (PAMP signalling elicit cytokine-based inflammatory responses. This paper discusses implant debris induced release of the cytokines and chemokines due to activation of the innate (and the adaptive immune system and the subsequent formation of osteolysis. Different mechanisms of implant-debris reactivity related to the innate immune system are detailed, for example, danger signalling (e.g., IL-1β, IL-18, IL-33, etc., toll-like receptor activation (e.g., IL-6, TNF-α, etc., apoptosis (e.g., caspases 3–9, bone catabolism (e.g., TRAP5b, and hypoxia responses (Hif1-α. Cytokine-based clinical and basic science studies are in progress to provide diagnosis and therapeutic intervention strategies.

  19. Automated microinjection of recombinant BCL-X into mouse zygotes enhances embryo development.

    Science.gov (United States)

    Liu, Xinyu; Fernandes, Roxanne; Gertsenstein, Marina; Perumalsamy, Alagammal; Lai, Ingrid; Chi, Maggie; Moley, Kelle H; Greenblatt, Ellen; Jurisica, Igor; Casper, Robert F; Sun, Yu; Jurisicova, Andrea

    2011-01-01

    Progression of fertilized mammalian oocytes through cleavage, blastocyst formation and implantation depends on successful implementation of the developmental program, which becomes established during oogenesis. The identification of ooplasmic factors, which are responsible for successful embryo development, is thus crucial in designing possible molecular therapies for infertility intervention. However, systematic evaluation of molecular targets has been hampered by the lack of techniques for efficient delivery of molecules into embryos. We have developed an automated robotic microinjection system for delivering cell impermeable compounds into preimplantation embryos with a high post-injection survival rate. In this paper, we report the performance of the system on microinjection of mouse embryos. Furthermore, using this system we provide the first evidence that recombinant BCL-XL (recBCL-XL) protein is effective in preventing early embryo arrest imposed by suboptimal culture environment. We demonstrate that microinjection of recBCL-XL protein into early-stage embryos repairs mitochondrial bioenergetics, prevents reactive oxygen species (ROS) accumulation, and enhances preimplantation embryo development. This approach may lead to a possible treatment option for patients with repeated in vitro fertilization (IVF) failure due to poor embryo quality.

  20. Automated microinjection of recombinant BCL-X into mouse zygotes enhances embryo development.

    Directory of Open Access Journals (Sweden)

    Xinyu Liu

    Full Text Available Progression of fertilized mammalian oocytes through cleavage, blastocyst formation and implantation depends on successful implementation of the developmental program, which becomes established during oogenesis. The identification of ooplasmic factors, which are responsible for successful embryo development, is thus crucial in designing possible molecular therapies for infertility intervention. However, systematic evaluation of molecular targets has been hampered by the lack of techniques for efficient delivery of molecules into embryos. We have developed an automated robotic microinjection system for delivering cell impermeable compounds into preimplantation embryos with a high post-injection survival rate. In this paper, we report the performance of the system on microinjection of mouse embryos. Furthermore, using this system we provide the first evidence that recombinant BCL-XL (recBCL-XL protein is effective in preventing early embryo arrest imposed by suboptimal culture environment. We demonstrate that microinjection of recBCL-XL protein into early-stage embryos repairs mitochondrial bioenergetics, prevents reactive oxygen species (ROS accumulation, and enhances preimplantation embryo development. This approach may lead to a possible treatment option for patients with repeated in vitro fertilization (IVF failure due to poor embryo quality.

  1. Failure of total hip implants: metals and metal release in 52 cases

    DEFF Research Database (Denmark)

    Jakobsen, Stig Storgaard; Lidén, Carola; Søballe, Kjeld

    2014-01-01

    cobalt, nickel and chromium(VI) release from, and the metal composition of, failed metal-on-ethylene total hip replacements. Materials/methods . Implant components from 52 revision cases were evaluated with spot tests for free nickel, cobalt, and chromium (VI) ions. Implant composition was determined...... with X-ray fluorescence spectroscopy, and information on the reason for revision and complications in relation to surgery was collected from the medical charts whenpossible (72%). For 10 implants, corrosion was further characterized with scanning electron microscopy. Results . We detected cobalt release...... from three of 38 removed femoral heads and from one of 24 femoral stems. Nickel release was detected from one of 24 femoral stems. No chromium(VI) release was detected. Conclusions . We found that cobalt and nickel were released from some failed total hip arthroplasties, and corrosion was frequently...

  2. Evaluation of failure modes of computerized planning phase of interstitial implants with high dose rate brachytherapy using HFMEA; Avaliacao dos modos de falha do planejamento computadorizado em implantes intersticiais com braquiterapia de alta taxa de dose usando HFMEA

    Energy Technology Data Exchange (ETDEWEB)

    Biazotto, Bruna; Tokarski, Marcio, E-mail: bruna@ceb.unicamp.br [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Centro de Engenharia Biomedica

    2014-08-15

    This paper evaluates the failure modes of the computerized planning step in interstitial implants with high dose rate brachytherapy. The prospective tool of risk management Health Care Failure Mode and Effects Analysis (HFMEA) was used. Twelve subprocesses were identified, and 33 failure modes of which 21 justified new safety actions, and 9 of them were intolerable risks. The method proved itself useful in identifying failure modes, but laborious and subjective in their assessment. The main risks were due to human factors, which require training and commitment of management to their mitigation. (author)

  3. Is preimplantation genetic diagnosis the ideal embryo selection method in aneuploidy screening?

    Science.gov (United States)

    Sahin, Levent; Bozkurt, Murat; Sahin, Hilal; Gürel, Aykut; Yumru, Ayse Ender

    2014-10-01

    To select cytogenetically normal embryos, preimplantation genetic diagnosis (PGD) aneuploidy screening (AS) is used in numerous centers around the world. Chromosomal abnormalities lead to developmental problems, implantation failure, and early abortion of embryos. The usefulness of PGD in identifying single-gene diseases, human leukocyte antigen typing, X-linked diseases, and specific genetic diseases is well-known. In this review, preimplantation embryo genetics, PGD research studies, and the European Society of Human Reproduction and Embryology PGD Consortium studies and reports are examined. In addition, criteria for embryo selection, technical aspects of PGD-AS, and potential noninvasive embryo selection methods are described. Indications for PGD and possible causes of discordant PGD results between the centers are discussed. The limitations of fluorescence in situ hybridization, and the advantages of the array comparative genomic hybridization are included in this review. Although PGD-AS for patients of advanced maternal age has been shown to improve in vitro fertilization outcomes in some studies, to our knowledge, there is not sufficient evidence to use advanced maternal age as the sole indication for PGD-AS. PGD-AS might be harmful and may not increase the success rates of in vitro fertilization. At the same time PGD, is not recommended for recurrent implantation failure and unexplained recurrent pregnancy loss. Copyright © 2014. Published by Elsevier Taiwan.

  4. Is preimplantation genetic diagnosis the ideal embryo selection method in aneuploidy screening?

    Directory of Open Access Journals (Sweden)

    Levent Sahin

    2014-10-01

    Full Text Available To select cytogenetically normal embryos, preimplantation genetic diagnosis (PGD aneuploidy screening (AS is used in numerous centers around the world. Chromosomal abnormalities lead to developmental problems, implantation failure, and early abortion of embryos. The usefulness of PGD in identifying single-gene diseases, human leukocyte antigen typing, X-linked diseases, and specific genetic diseases is well-known. In this review, preimplantation embryo genetics, PGD research studies, and the European Society of Human Reproduction and Embryology PGD Consortium studies and reports are examined. In addition, criteria for embryo selection, technical aspects of PGD-AS, and potential noninvasive embryo selection methods are described. Indications for PGD and possible causes of discordant PGD results between the centers are discussed. The limitations of fluorescence in situ hybridization, and the advantages of the array comparative genomic hybridization are included in this review. Although PGD-AS for patients of advanced maternal age has been shown to improve in vitro fertilization outcomes in some studies, to our knowledge, there is not sufficient evidence to use advanced maternal age as the sole indication for PGD-AS. PGD-AS might be harmful and may not increase the success rates of in vitro fertilization. At the same time PGD, is not recommended for recurrent implantation failure and unexplained recurrent pregnancy loss.

  5. Increased levels of CCR7(lo)PD-1(hi) CXCR5+CD4+T cells, and associated factors Bcl-6, CXCR5, IL-21 and IL-6 contribute to repeated implantation failure.

    Science.gov (United States)

    Gong, Qiaoqiao; Zhu, Yuejie; Pang, Nannan; Ai, Haiquan; Gong, Xiaoyun; La, Xiaolin; Ding, Jianbing

    2017-12-01

    In vitro fertilization-embryo transfer (IVF-ET) can be used by infertile couples to assist with reproduction; however, failure of the embryo to implant into the endometrial lining results in failure of the IVF treatment. The present study investigated the expression of chemokine receptor 7 (CCR7)(lo) programmed death-1(PD-1)(hi) chemokine receptor type 5 (CXCR5) + cluster of differentiation 4 (CD4) + T cells and associated factors in patients with repeated implantation failure (RIF). A total of 30 females with RIF and 30 healthy females were enrolled in the current study. Flow cytometry was used to detect the proportion of CCR7(lo)PD-1(hi) CXCR5 + CD4 + T cells in the peripheral blood. Cytokine bead arrays were performed to detect the levels of interleukin (IL)-6, -4 and -2 in the serum. ELISAs were used to detect the level of IL-21 in the serum. Quantitative real time polymerase chain reaction analysis and immunohistochemistry were used to investigate the expression of B-cell lymphoma 6 (Bcl-6), chemokine receptor type 5 (CXCR5) and IL-21 in the endometrium. The results revealed that the percentage of CCR7(lo)PD-1(hi) CXCR5 + CD4 + T cells was increased in the RIF group compared with the control group during the mid luteal phase. The mRNA and protein levels of Bcl-6, IL-21 and CXCR5 in the endometrium and the concentrations of IL-21 and IL-6 in the serum were significantly increased in the RIF group; however, no significant difference was observed between the two groups in regards to the expression of IL-4 and IL-2. Furthermore, a significant positive correlation was identified between the percentage of CCR7(lo)PD-1(hi) CXCR5 + CD4 + T cells and IL-21 and IL-6 levels. The expression of IL-21 also had a positive correlation with Bcl-6 and CXCR5 expression in the RIF group. These results suggest that increased levels of CCR7(lo)PD-1(hi) CXCR5 + CD4 + T cells and associated factors contribute to RIF and could therefore be a potential therapeutic target.

  6. Influence of Abutment Design on Stiffness, Strength, and Failure of Implant-Supported Monolithic Resin Nano Ceramic (RNC) Crowns.

    Science.gov (United States)

    Joda, Tim; Huber, Samuel; Bürki, Alexander; Zysset, Philippe; Brägger, Urs

    2015-12-01

    Recent technical development allows the digital manufacturing of monolithic reconstructions with high-performance materials. For implant-supported crowns, the fixation requires an abutment design onto which the reconstruction can be bonded. The aim of this laboratory investigation was to analyze stiffness, strength, and failure modes of implant-supported, computer-assisted design and computer-aided manufacturing (CAD/CAM)-generated resin nano ceramic (RNC) crowns bonded to three different titanium abutments. Eighteen monolithic RNC crowns were produced and loaded in a universal testing machine under quasi-static condition according to DIN ISO 14801. With regard to the type of titanium abutment, three groups were defined: (1) prefabricated cementable standard; (2) CAD/CAM-constructed individualized; and (3) novel prefabricated bonding base. Stiffness and strength were measured and analyzed statistically with Wilcoxon rank sum test. Sections of the specimens were examined microscopically. Stiffness demonstrated high stability for all specimens loaded in the physiological loading range with means and standard deviations of 1,579 ± 120 N/mm (group A), 1,733 ± 89 N/mm (group B), and 1,704 ± 162 N/mm (group C). Mean strength of the novel prefabricated bonding base (group C) was 17% lower than of the two other groups. Plastic deformations were detectable for all implant-abutment crown connections. Monolithic implant crowns made of RNC seem to represent a feasible and stable prosthetic construction under laboratory testing conditions with strength higher than the average occlusal force, independent of the different abutment designs used in this investigation. © 2014 Wiley Periodicals, Inc.

  7. Efficacy, Safety, and Risk Factors for Failure of Standalone Ab Interno Gelatin Microstent Implantation versus Standalone Trabeculectomy.

    Science.gov (United States)

    Schlenker, Matthew B; Gulamhusein, Husayn; Conrad-Hengerer, Ina; Somers, Alix; Lenzhofer, Markus; Stalmans, Ingeborg; Reitsamer, Herbert; Hengerer, Fritz H; Ahmed, Iqbal Ike K

    2017-11-01

    To compare the efficacy, safety, and risk factors for failure of standalone ab interno gelatin microstent implantation with mitomycin C (MMC) versus trabeculectomy with MMC. International, multicenter, retrospective interventional cohort study. Three hundred fifty-four eyes of 293 patients (185 microstent and 169 trabeculectomy) with no prior incisional surgery. Consecutive eyes with uncontrolled glaucoma underwent microstent or trabeculectomy surgery from January 1, 2011 through July 31, 2015 at 4 academic ophthalmology centers: Toronto, Canada; Frankfurt, Germany; Salzburg, Austria; and Leuven, Belgium. Primary outcome measure was hazard ratio (HR) of failure, with failure defined as 2 consecutive intraocular pressure (IOP) readings of 17 mmHg without glaucoma medications (complete success) at least 1 month after surgery despite in-clinic interventions (including needling). Secondary outcome measures included IOP thresholds of 6 to 14 mmHg and 6 to 21 mmHg and same thresholds allowing for medications (qualified success), interventions, complications, and reoperations. Baseline characteristics were similar, except more men (56% vs. 43%), younger patients (average, by 3 years), better preoperative visual acuity (22% vs. 32% with 0.4 logarithm of the minimum angle of resolution vision or worse), and more trabeculoplasty (52% vs. 30%) among microstent eyes. The adjusted HR of failure of the microstent relative to trabeculectomy was 1.2 (95% confidence interval [CI], 0.7-2.0) for complete success and 1.3 (95% CI, 0.6-2.8) for qualified success, and similar for other outcomes. Time to 25% failure was 11.2 months (95% CI, 6.9-16.1 months) and 10.6 months (95% CI, 6.8-16.2 months) for complete success and 30.3 months (95% CI, 19.0-∞ months) and 33.3 months (95% CI, 25.7-46.2 months) for qualified success. Overall, white ethnicity was associated with decreased risk of failure (adjusted HR, 0.49; 95% CI, 0.25-0.96), and diabetes was associated with increased risk of

  8. Reliability and failure modes of implant-supported zirconium-oxide fixed dental prostheses related to veneering techniques

    Science.gov (United States)

    Baldassarri, Marta; Zhang, Yu; Thompson, Van P.; Rekow, Elizabeth D.; Stappert, Christian F. J.

    2011-01-01

    Summary Objectives To compare fatigue failure modes and reliability of hand-veneered and over-pressed implant-supported three-unit zirconium-oxide fixed-dental-prostheses(FDPs). Methods Sixty-four custom-made zirconium-oxide abutments (n=32/group) and thirty-two zirconium-oxide FDP-frameworks were CAD/CAM manufactured. Frameworks were veneered with hand-built up or over-pressed porcelain (n=16/group). Step-stress-accelerated-life-testing (SSALT) was performed in water applying a distributed contact load at the buccal cusp-pontic-area. Post failure examinations were carried out using optical (polarized-reflected-light) and scanning electron microscopy (SEM) to visualize crack propagation and failure modes. Reliability was compared using cumulative-damage step-stress analysis (Alta-7-Pro, Reliasoft). Results Crack propagation was observed in the veneering porcelain during fatigue. The majority of zirconium-oxide FDPs demonstrated porcelain chipping as the dominant failure mode. Nevertheless, fracture of the zirconium-oxide frameworks was also observed. Over-pressed FDPs failed earlier at a mean failure load of 696 ± 149 N relative to hand-veneered at 882 ± 61 N (profile I). Weibull-stress-number of cycles-unreliability-curves were generated. The reliability (2-sided at 90% confidence bounds) for a 400N load at 100K cycles indicated values of 0.84 (0.98-0.24) for the hand-veneered FDPs and 0.50 (0.82-0.09) for their over-pressed counterparts. Conclusions Both zirconium-oxide FDP systems were resistant under accelerated-life-time-testing. Over-pressed specimens were more susceptible to fatigue loading with earlier veneer chipping. PMID:21557985

  9. A retrospective study on 1592 consecutively performed operations in one private referral clinic. Part I: Early inflammation and early implant failures.

    Science.gov (United States)

    Antoun, Hadi; Karouni, Michel; Abitbol, Jérémy; Zouiten, Ons; Jemt, Torsten

    2017-06-01

    Few large-scale follow-up studies are reported on routine implant treatment. To report retrospective data on early inflammatory and early implant failures in a large number of routine patients at one private referral clinic. A total of 1017 patients were consecutively provided with 3082 implants with an anodized surface (Nobel Biocare AB) at 1592 implant operations between 2000 and 2011. All patients reported with mucosa inflammation and bone loss and/or implant failures to the first annual examination were identified. A logistic multivariate data analysis was performed to identify possible factors with an association to the two events. Altogether 33 patients/operations presented early inflammation (2.1% operations). "History of periodontitis" (OR 3.91; 95% CI: 1.86-8.21), "numbers of implants" (OR1.33; 95% CI:1.07-1.67 per implant), "two stage surgical technique" (OR 3.70; 95% CI: 1.75-7.85), and "lower jaw" treatment (OR 4.73; 95% CI: 2.12-10.57) increased the risk for early mucositis with bone loss (P 2011; OR 1.22; 95% CI;1.08-1.39). History of periodontitis and two-stage surgery protocols with bone grafts in the (posterior) lower jaw increased the risk for early inflammatory problems after surgery (P clinical practice (P < .05). © 2017 Wiley Periodicals, Inc.

  10. Morphological characterization of pre- and peri-implantation in vitro cultured, somatic cell nuclear transfer and in vivo derived ovine embryos

    DEFF Research Database (Denmark)

    Tveden-Nyborg, Pernille Yde; Peura, T.T.; Hartwich, K.M.

    2005-01-01

    on day 6. All emryos were processed for examination by light and transmission electron microscopy or immunohistochemical labelling for alpha-1-fetoprotein and vimentin. Overall, morphological dev elopment of in vivo embryos was superior to IVC and SCNT embryos. Day 7 and particularly day 9 IVC and SCNT...

  11. A second-time percutaneous aortic-valve implantation for bioprosthetic failure.

    Science.gov (United States)

    Codner, Pablo; Assali, Abid; Vaknin Assa, Hana; Kornowski, Ran

    2015-09-01

    We report a case of an 84-year-old man with a history of surgical aortic-valve replacement for chronic aortic regurgitation (AR) who later developed severe prosthetic valve AR. Subsequent treatment with a Corevalve® was unsuccessful with severe AR seen at 3 years after the valve-in-valve procedure. The patient was then successfully treated with a second catheter-based Corevalve® implantation.

  12. Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure

    Science.gov (United States)

    Huang, Jingjing; Lin, Jialiu; Wu, Ziqiang; Xu, Hongzhi; Zuo, Chengguo; Ge, Jian

    2015-01-01

    Purpose The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV) implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries. Patients and methods Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1) intraocular pressure (IOP) ≥6 and ≤21 mmHg; 2) IOP reduction of at least 30% relative to preoperative values; and 3) without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications. Results Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56–30.80) mm, corneal diameter was 14.71±1.07 (13.0–16.0) mm, cup-to-disc ratio was 0.95±0.04 (0.9–1.0), and IOP was 39.5±5.7 (30–55) mmHg. The mean follow-up time was 18.29±10.96 (5–44, median 18) months. There were significant reductions in IOPs and the number of glaucoma medications (PAGV implantation remains a viable option for patients with advanced primary congenital glaucoma unresponsive to previous surgical intervention, despite a relatively high incidence of severe surgical complications. PMID:26082610

  13. Expectant Fathers, Abortion, and Embryos.

    Science.gov (United States)

    Purvis, Dara E

    2015-01-01

    One thread of abortion criticism, arguing that gender equality requires that men be allowed to terminate legal parental status and obligations, has reinforced the stereotype of men as uninterested in fatherhood. As courts facing disputes over stored pre-embryos weigh the equities of allowing implantation of the pre-embryos, this same gender stereotype has been increasingly incorporated into a legal balancing test, leading to troubling implications for ART and family law. © 2015 American Society of Law, Medicine & Ethics, Inc.

  14. Successful pregnancy outcome after in vitro fertilisation following Pre-implantation Genetic Diagnosis/Polymerase Chain Reaction screening for single gene disorder (sickle cell anaemia) before embryo transfer: The clinical experience of an in vitro fertilisation clinic in Nigeria.

    Science.gov (United States)

    Okeke, Chizara; Ailoje-Ibru, Kemi; Olukoya, Kemi; Ogbeche, Rose; Adewusi, Abiola; Iloabachie, Ebele; Ashiru, Oladapo

    2014-01-01

    A couple, both carriers of the sickle cell anaemia trait (Genotype HbAS) with an offspring already affected with the genetic disease underwent a Pre-implantation Genetic Diagnosis/Polymerase Chain Reaction screening of biopsied blastomeres. DNA analysis of single blastomeres was carried out to find out indicated a viable intra-uterine pregnancy with embryos which carried the sickle cell mutation, which resulted in a livebirth (HbAS). PGD/PCR in combination with IVF appears to be the most suitable treatment plan for patients who are at a higher risk of reproducing offspring affected with inheritable genetic diseases.

  15. Successful pregnancy outcome after in vitro fertilisation following Pre-implantation Genetic Diagnosis/Polymerase Chain Reaction screening for single gene disorder (sickle cell anaemia) before embryo transfer: The clinical experience of an in vitro fertilisation clinic in Nigeria

    OpenAIRE

    Chizara Okeke; Kemi Ailoje-Ibru; Kemi Olukoya; Rose Ogbeche; Abiola Adewusi; Ebele Iloabachie; Oladapo Ashiru

    2014-01-01

    A couple, both carriers of the sickle cell anaemia trait (Genotype HbAS) with an offspring already affected with the genetic disease underwent a Pre-implantation Genetic Diagnosis/Polymerase Chain Reaction screening of biopsied blastomeres. DNA analysis of single blastomeres was carried out to find out indicated a viable intra-uterine pregnancy with embryos which carried the sickle cell mutation, which resulted in a livebirth (HbAS). PGD/PCR in combination with IVF appears to be the most suit...

  16. Long-term monitoring of respiratory rate in patients with heart failure: the Multiparametric Heart Failure Evaluation in Implantable Cardioverter-Defibrillator Patients (MULTITUDE-HF) study.

    Science.gov (United States)

    Forleo, Giovanni B; Santini, Luca; Campoli, Massimiliano; Malavasi, Mario; Scaccia, Alberto; Menichelli, Maurizio; Riva, Umberto; Lamberti, Filippo; Carreras, Giovanni; Orazi, Serafino; Ribatti, Valentina; Di Biase, Luigi; Lovecchio, Mariolina; Natale, Andrea; Valsecchi, Sergio; Romeo, Francesco

    2015-08-01

    Monitoring respiratory rate (RR) is recommended at the time of hospital presentation for acute decompensation in heart failure (HF). Device-based continuous monitoring of RR may be helpful for diagnostic and prognostic stratification after implantable cardioverter-defibrillator (ICD) implantation. This study was undertaken to analyze short- and long-term changes in ICD-measured RR and to relate RR with the patient's clinical status and the occurrence of HF events. One hundred twenty-four consecutive HF patients who received ICD endowed with this diagnostic capability (Boston Scientific Inc., Natick, MA, USA) were prospectively enrolled. Patients were followed up for 12 months. At the baseline, the proportion of New York Heart Association (NYHA) class III-IV was higher among patients with daily maximum RR >27 breaths/min (third tertile) than those with HF hospitalizations (33 events) and urgent visits for HF (15 events), the weekly average of RR calculated over the 7 days preceding hospital accesses did not differ from values recorded at the baseline and before scheduled follow-up visits. However, the weekly variation in RR (i.e., the difference between maximum and minimum values collected over the week) was significantly higher prior to hospitalization (p 3 breaths/min in maximum RR predicted an impending hospital admission for HF with sensitivity of 73 % and specificity of 57%. In this study, elevated values of ICD-monitored RR identified patients with worse functional status and lower systolic function. The weekly variation in RR increased before HF exacerbation. This monitoring technology may represent a useful tool in the clinical management of patients with HF.

  17. Embodied Revelation: A Classic Grounded Theory of Heart Failure Patient Decision Making Surrounding Primary Prevention Implantable Cardioverter Defibrillator Therapy

    Directory of Open Access Journals (Sweden)

    Vera Barton-Caro Ph.D.,

    2015-12-01

    Full Text Available The purpose of this classic grounded theory study was to explain the complex decision making process of heart failure (HF patients considering primary prevention implantable cardioverter defibrillator (ICD therapy. Sudden cardiac death (SCD is the leading cause of death for people with HF as well as the primary cause of death in the United States (US. ICDs represent the standard of care as the only effective therapy for primary prevention of SCD. However, a significant proportion of qualifying HF patients declines this invasive, yet life-saving device. The grounded theory is of Embodied revelation. The threat of SCD for ICD candidates consists of four stages: living in conscious denial, heightening of awareness, sanctioning ICD therapy, and living in new assurance. The first stage ends abruptly with the critical juncture of grasping the threat of SCD. This grounded theory has implications for research, nursing and medical practice, as well as bioethical considerations.

  18. Progenitor Hematopoietic Cells Implantation Improves Functional Capacity of End Stage Coronary Artery Disease Patients with Advanced Heart Failure

    Directory of Open Access Journals (Sweden)

    Yoga Yuniadi

    2016-01-01

    Full Text Available Background. Proangiogenic Hematopoietic Cells (PHC which comprise diverse mixture of cell types are able to secrete proangiogenic factors and interesting candidate for cell therapy. The aim of this study was to seek for benefit in implantation of PHC on functional improvement in end stage coronary artery disease patients with advanced heart failure. Methods. Patients with symptomatic heart failure despite guideline directed medical therapy and LVEF less than 35% were included. Peripheral blood mononuclear cells were isolated, cultivated for 5 days, and then harvested. Flow cytometry and cell surface markers were used to characterize PHC. The PHC were delivered retrogradely via sinus coronarius. Echocardiography, myocardial perfusion, and clinical and functional data were analyzed up to 1-year observation. Results. Of 30 patients (56.4±7.40 yo preimplant NT proBNP level is 5124.5±4682.50 pmol/L. Harvested cells characterized with CD133, CD34, CD45, and KDR showed 0.87±0.41, 0.63±0.66, 99.00±2.60, and 3.22±3.79%, respectively. LVEF was improved (22±5.68 versus 26.8±7.93, p<0.001 during short and long term observation. Myocardial perfusion significantly improved 6 months after treatment. NYHA Class and six-minute walk test are improved during short term and long term follow-up. Conclusion. Expanded peripheral blood PHC implantation using retrograde delivery approach improved LV systolic function, myocardial perfusion, and functional capacity.

  19. Frequency and Consequences of Right-Sided Heart Failure After Continuous-Flow Left Ventricular Assist Device Implantation.

    Science.gov (United States)

    Kurihara, Chitaru; Critsinelis, Andre C; Kawabori, Masashi; Sugiura, Tadahisa; Loor, Gabriel; Civitello, Andrew B; Morgan, Jeffrey A

    2018-02-01

    Postoperative right-sided heart failure (RHF) is a common complication after continuous-flow left ventricular assist device implantation. Studies have examined RHF in the perioperative period, but few have assessed late-onset RHF. We analyzed the incidence of early and late RHF in patients with HeartMate II and HeartWare left ventricular assist devices and associated morbidity, mortality, and independent predictors of RHF. We retrospectively analyzed records of 526 patients with chronic heart failure who underwent continuous-flow left ventricular assist device implantation; 147 (27.9%) developed RHF (early RHF, n = 87, 16.5%; late RHF, n = 74, 14.4%). We examined demographics, postoperative complications, and long-term survival rate. Patients with RHF or late RHF had higher mortality (p RHF. Patients with RHF had a higher incidence of acute kidney injury (20.4% vs 11.9%, p = 0.01). Device type did not affect the incidence of early, late, or overall RHF. Patients with severe RHF requiring right ventricular assist device support had a low success of bridge to transplantation (11.1% vs 33.3%, p = 0.02). In Cox regression models, RHF was an independent predictor of mortality (hazard ratio = 1.69, 95% confidence interval = 1.28 to 2.22, p RHF were identified. RHF was significantly associated with increased mortality and a higher incidence of postoperative acute kidney injury. RHF decreased the success rate of bridging patients to transplantation when a right ventricular assist device was required. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Expression of ER-α and ER-β during peri-implantation period in uterus is essential for implantation and decidualization in golden hamster.

    Science.gov (United States)

    Kumar, Randhir; Yadav, Akhilesh; Pakrasi, P L

    2017-02-01

    The role of estrogen in embryo implantation in golden hamster (Mesocricetus auratus) is still ambiguous. In order to clarify it, we investigated the spatial distribution and expression of estrogen receptors, ER-α and ER-β in the uterus of pregnant hamster during peri-implantation period and identified the effect of estrogen receptor antagonist ICI-182,780 on the embryo implantation. We performed in vivo experiments on early pregnant hamsters involving treatment with ICI-182,780, an estrogen receptor antagonist. Immunohistochemistry, western blot analysis and quantitative PCR were employed to evaluate the spatio-temporal distribution and expression of ER-α and ER-β in the uterus of normal early pregnant and treated hamsters. Results showed that embryo implantation was completely absent in ICI-182,780 treated uterine horn while, normal implantation occurred in control and vehicle treated horns. Both the receptors were differentially expressed in the uterus of hamster from day 1 (D1) to day7 (D7). In contrast, treated horns without any implantation site showed no trace of any receptors. Protein and mRNA expression of both the receptors were high around the day of implantation while, ER-β expression was up-regulated on D7 of embryo implantation. P value˂0.05 is considered significant. Spatio-temporal expression of ERs in the uterus during peri-implantation period have crucial role for endometrium receptivity and implantation in hamster. Recurrent implantation failure is the devastating problem among the desirable couple and is mainly due to defect in endometrium receptivity. This study may provide a new insight to manage the problem of idiopathic infertility. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Degradation of implant materials

    CERN Document Server

    Eliaz, Noam

    2012-01-01

    This book surveys the degradation of implant materials, reviewing in detail such failure mechanisms as corrosion, fatigue and wear, along with monitoring techniques. Surveys common implant biomaterials, as well as procedures for implant retrieval and analysis.

  2. Intricate Assessment and Evaluation of Effect of Bruxism on Long-term Survival and Failure of Dental Implants: A Comparative Study.

    Science.gov (United States)

    Yadav, Kajal; Nagpal, Abhishek; Agarwal, S K; Kochhar, Aarti

    2016-08-01

    Dental implants are one of the common lines of treatment used for the treatment of missing tooth. Various risk factors are responsible for the failure of the dental implants and occurrence of postoperative complications. Bruxism is one such factor responsible for the failure of the dental implants. The actual relation between bruxism and dental implants is a subject of long-term controversy. Hence, we carried out this retrospective analysis to assess the complications occurring in dental implants in patients with and without bruxism. The present study included 1100 patients which were treated for rehabilitation by dental implant procedure at 21 dental offices of Ghaziabad (India) from 2004 to 2014. Analyzing the clinical records of the patients along with assessing the photographs of the patients was done for confirming the diagnosis of bruxism. Clinical re-evaluation of the patients, who came back for follow-up, was done to confirm the diagnosis of bruxism. Systemic questionnaires as used by previous workers were used to evaluate the patients about the self-conscience of the condition. Estimation of the mechanical complications was done only in those cases which occurred on the surfaces of the restoration of the dental implants. All the results were analyzed by Statistical Package for Social Sciences (SPSS) software. Student's t-test and Pearson's chi-square test were used to evaluate the level of significance. In both bruxer and non-bruxers, maximum number of dental implants was placed in anterior maxillary region. Significant difference was obtained while comparing the two groups for dimensions of the dental implants used. On comparing the total implant failed cases between bruxers and non-bruxers group, statistically significant result was obtained. Statistically significant difference was obtained while comparing the two study groups based on the health parameters, namely hypertension, diabetes, and smoking habit. Success of dental implant is significantly

  3. Failure to deliver a shock in a dual-chamber implantable cardioverter-defibrillator: a case report.

    Science.gov (United States)

    Sousa, Pedro A; Candeias, Rui; Jesus, Ilídio

    2015-01-01

    Inappropriate implantable cardioverter-defibrillator (ICD) therapies due to supraventricular tachyarrhythmia (SVT) are a common problem. The authors report this case to warn of a possible detection problem and subsequent failure of deliver appropriate therapy in patients with atrial fibrillation (AF) and a dual-chamber ICD using the PARAD+ algorithm. To our knowledge this is the first reported case of failure to deliver a shock in a dual-chamber ICD due to the PARAD+ algorithm. The authors present a case of a 68-year-old Caucasian man with permanent AF and a dual-chamber Sorin Paradym ICD with the PARAD+ algorithm, who presented an episode of sustained ventricular tachycardia (VT). The ICD did not store the event and did not delivery a therapy, although the heart rate curve was consistent with an episode of VT. No evidence of system dysfunction was found. Due to simultaneous occurrence of VT and AF rhythms and alternation in rhythm classification by the PARAD+ algorithm the number of cycles needed to diagnose VT was not achieved and no therapy was delivered. In patients with permanent or long-term persistent AF with a dual-chamber ICD using the PARAD+ algorithm, discrimination should be based only on the ventricular channel. In patients with paroxysmal or persistent recurrent AF the risk of not delivering VT therapy must be weighed against the risk of inappropriate therapy. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  4. Heart failure and respiratory hospitalizations are reduced in patients with heart failure and chronic obstructive pulmonary disease with the use of an implantable pulmonary artery pressure monitoring device.

    Science.gov (United States)

    Krahnke, Jason S; Abraham, William T; Adamson, Philip B; Bourge, Robert C; Bauman, Jordan; Ginn, Greg; Martinez, Fernando J; Criner, Gerard J

    2015-03-01

    Chronic obstructive pulmonary disease (COPD) is a frequent comorbidity in patients with heart failure (HF). Elevated pulmonary arterial (PA) pressure can be seen in both conditions and has been shown to predict morbidity and mortality. A total of 550 subjects with New York Heart Association functional class III HF were randomly assigned to the treatment (n = 270) and control (n = 280) groups in the CHAMPION Trial. Physicians had access to the PA pressure measurements in the treatment group only, in which HF therapy was used to lower the elevated pressures. HF and respiratory hospitalizations were compared in both groups. A total of 187 subjects met criteria for classification into the COPD subgroup. In the entire cohort, the treatment group had a 37% reduction in HF hospitalization rates (P respiratory hospitalization rates (P = .0061). In the COPD subgroup, the treatment group had a 41% reduction in HF hospitalization rates (P = .0009) and a 62% reduction in respiratory hospitalization rates (P = .0023). The rate of respiratory hospitalizations in subjects without COPD was not statistically different (P = .76). HF management incorporating hemodynamic information from an implantable PA pressure monitor significantly reduces HF and respiratory hospitalizations in HF subjects with comorbid COPD compared with standard care. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Outcomes of Ahmed glaucoma valve implantation in advanced primary congenital glaucoma with previous surgical failure

    Directory of Open Access Journals (Sweden)

    Huang J

    2015-06-01

    Full Text Available Jingjing Huang,1 Jialiu Lin,1 Ziqiang Wu,2 Hongzhi Xu,3 Chengguo Zuo,1 Jian Ge1 1State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Center for Advanced Eye Care, Carson City, NV, USA; 3Institute of Child Health Policy, University of Florida, Gainesville, FL, USA Purpose: The purpose of this study was to evaluate the intermediate surgical results of Ahmed glaucoma valve (AGV implantation in patients less than 7 years of age, with advanced primary congenital glaucoma who have failed previous surgeries.Patients and methods: Consecutive patients with advanced primary congenital glaucoma that failed previous operations and had undergone subsequent AGV implantation were evaluated retrospectively. Surgical success was defined as 1 intraocular pressure (IOP ≥6 and ≤21 mmHg; 2 IOP reduction of at least 30% relative to preoperative values; and 3 without the need for additional surgical intervention for IOP control, loss of light perception, or serious complications.Results: Fourteen eyes of eleven patients were studied. Preoperatively, the average axial length was 27.71±1.52 (25.56–30.80 mm, corneal diameter was 14.71±1.07 (13.0–16.0 mm, cup-to-disc ratio was 0.95±0.04 (0.9–1.0, and IOP was 39.5±5.7 (30–55 mmHg. The mean follow-up time was 18.29±10.96 (5–44, median 18 months. There were significant reductions in IOPs and the number of glaucoma medications (P<0.001 postoperatively. The IOPs after operation were 11.3±3.4, 13.6±5.1, 16.3±2.7, and 16.1±2.6 mmHg at 1 month, 6 months, 12 months, and 18 months, respectively. Kaplan–Meier estimates of the cumulative probability of valve success were 85.7%, 71.4%, and 71.4% at 6, 12, and 18 months, respectively. Severe surgical complications, including erosion of tube, endophthalmitis, retinal detachment, choroidal detachment, and delayed suprachoroidal hemorrhage, occurred in 28

  6. [Clinical indications for implant of CID in patients with coronary heart disease and cardiac failure].

    Science.gov (United States)

    Mendoza-González, Celso

    2006-01-01

    The mortality of the myocardial acute infarction has diminished with the introduction of the new strategies of reperfusion; this way, the number of patients with ventricular left dysfunction has increased. This one is a special population with risk greater than rest of people of suffering an event of cardiac sudden death (SD). This fact needs of a suitable process of stratification of the risk for SD that this population has and it is necessary measures of primary and secondary prevention to diminish the mortality of these patients. In this paper the clinical characteristics of this population by precedent of heart attack of the myocardium and/or ventricular left dysfunction are checked. These characters can suggest the indication for the implant of an automatic defibrillator.

  7. Insight into PreImplantation Factor (PIF* mechanism for embryo protection and development: target oxidative stress and protein misfolding (PDI and HSP through essential RIKP [corrected] binding site.

    Directory of Open Access Journals (Sweden)

    Eytan R Barnea

    Full Text Available Endogenous PIF, upon which embryo development is dependent, is secreted only by viable mammalian embryos, and absent in non-viable ones. Synthetic PIF (sPIF administration promotes singly cultured embryos development and protects against their demise caused by embryo-toxic serum. To identify and characterize critical sPIF-embryo protein interactions novel biochemical and bio-analytical methods were specifically devised.FITC-PIF uptake/binding by cultured murine and equine embryos was examined and compared with scrambled FITC-PIF (control. Murine embryo (d10 lysates were fractionated by reversed-phase HPLC, fractions printed onto microarray slides and probed with Biotin-PIF, IDE and Kv1.3 antibodies, using fluorescence detection. sPIF-based affinity column was developed to extract and identify PIF-protein interactions from lysates using peptide mass spectrometry (LC/MS/MS. In silico evaluation examined binding of PIF to critical targets, using mutation analysis.PIF directly targets viable cultured embryos as compared with control peptide, which failed to bind. Multistep Biotin-PIF targets were confirmed by single-step PIF-affinity column based isolation. PIF binds protein disulfide isomerases a prolyl-4-hydroxylase β-subunit, (PDI, PDIA4, PDIA6-like containing the antioxidant thioredoxin domain. PIF also binds protective heat shock proteins (70&90, co-chaperone, BAG-3. Remarkably, PIF targets a common RIKP [corrected] site in PDI and HSP proteins. Further, single PIF amino acid mutation significantly reduced peptide-protein target bonding. PIF binds promiscuous tubulins, neuron backbones and ACTA-1,2 visceral proteins. Significant anti-IDE, while limited anti-Kv1.3b antibody-binding to Biotin-PIF positive lysates HPLC fractions were documented.Collectively, data identifies PIF shared targets on PDI and HSP in the embryo. Such are known to play a critical role in protecting against oxidative stress and protein misfolding. PIF-affinity-column is a

  8. Interspecies embryo reconstruction in Tibetan antelope Pantholops ...

    African Journals Online (AJOL)

    user

    2011-03-21

    Mar 21, 2011 ... Interspecies implantation and mitochondria fate of panda-rabbit cloned embryos. Biol. Reprod. 67: 637-642. Dominko T, Ramalho-Santos J, Chan A, Moreno R, Luetjens C, Simerly. C, Hewitson L, Takahashi D, Martinovich C, White J (1999). Optimization strategies for production of mammalian embryos by.

  9. The Number of Recalled Leads is Highly Predictive of Lead Failure: Results From the Pacemaker and Implantable Defibrillator Leads Survival Study ("PAIDLESS").

    Science.gov (United States)

    Kersten, Daniel J; Yi, Jinju; Feldman, Alyssa M; Brahmbhatt, Kunal; Asheld, Wilbur J; Germano, Joseph; Islam, Shahidul; Cohen, Todd J

    2016-12-01

    The purpose of this study was to determine if implantation of multiple recalled defibrillator leads is associated with an increased risk of lead failure. The authors of the Pacemaker and Implantable Defibrillator Leads Survival Study ("PAIDLESS") have previously reported a relationship between recalled lead status, lead failure, and patient mortality. This substudy analyzes the relationship in a smaller subset of patients who received more than one recalled lead. The specific effects of having one or more recalled leads have not been previously examined. This study analyzed lead failure and mortality of 3802 patients in PAIDLESS and compared outcomes with respect to the number of recalled leads received. PAIDLESS includes all patients at Winthrop University Hospital who underwent defibrillator lead implantation between February 1, 1996 and December 31, 2011. Patients with no recalled ICD leads, one recalled ICD lead, and two recalled ICD leads were compared using the Kaplan-Meier method and log-rank test. Sidak adjustment method was used to correct for multiple comparisons. All calculations were performed using SAS 9.4. P-values leads implanted during the trial period. There were 2400 leads (59%) in the no recalled leads category, 1620 leads (40%) in the one recalled lead category, and 58 leads (1%) in the two recalled leads category. No patient received more than two recalled leads. Of the leads categorized in the two recalled leads group, 12 experienced lead failures (21%), which was significantly higher (Pleads group (60 failures, 2.5%) and one recalled lead group (81 failures; 5%). Multivariable Cox's regression analysis found a total of six significant predictive variables for lead failure including the number of recalled leads (Pleads group). The number of recalled leads is highly predictive of lead failure. Lead-based multivariable Cox's regression analysis produced a total of six predictive variable categories for lead failure, one of which was the number

  10. Urgent Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis and Acute Heart Failure: Procedural and 30-Day Outcomes.

    Science.gov (United States)

    Landes, Uri; Orvin, Katia; Codner, Pablo; Assali, Abid; Vaknin-Assa, Hana; Schwartznberg, Shmuel; Levi, Amos; Shapira, Yaron; Sagie, Alexander; Kornowski, Ran

    2016-06-01

    Transcatheter aortic valve implantation (TAVI) is recommended for patients with severe symptomatic aortic stenosis (AS) who are at prohibitive/high risk for surgical aortic valve replacement (SAVR). Patients with severe AS may experience acute decompensated heart failure (HF) that is resistant to medical therapy. We report our TAVI experience in treating patients with unstable AS who require urgent intervention for their aortic valve disease. Patients were restrictively included in the urgent TAVI registry if they were admitted with acute refractory and persistent HF despite medical therapy and had TAVI performed during the same hospital stay. All others were included in the elective TAVI group. Between November 2008 and April 2015, 410 consecutive patients underwent TAVI at our centre-27 (6.6%) urgently. Patients operated on urgently were more likely to be frail and carry higher SAVR mortality risk based on The Society of Thoracic Surgeons Predicted Risk of Mortality/logistic EuroSCORE (LES) measures. Pulmonary edema was the most common clinical presentation. Preprocedural assessment used fewer imaging modalities, yet implantation success remained high and reached 96.3% using an additional valve (valve-within-valve) required in 3 patients, with no difference in periprocedural complications according to the Valve Academic Research Consortium-2 definitions. Although 30-day functional capacity was reduced, patients had similar 30-day mortality and major adverse cardiovascular event rates compared with patients who underwent elective TAVI. Short-term outcome after urgent TAVI appears to be reasonable. For patients with severe AS who experience acute decompensated HF that is recalcitrant to optimal medical therapy and who are at high risk with SAVR, urgent TAVI may be a viable treatment strategy. Larger prospective studies and data on long-term outcomes are needed. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  11. Clinical outcome of implantable cardioverter defibrillators with recalled and non-recalled leads in Japanese patients. Increased failure rate of the Sprint Fidelis lead.

    Science.gov (United States)

    Yanagisawa, Satoshi; Inden, Yasuya; Shimano, Masayuki; Yoshida, Naoki; Ichiyanagi, Hiroshi; Fujita, Masaya; Ohguchi, Shiou; Ishikawa, Shinji; Kato, Hiroyuki; Okumura, Satoshi; Miyoshi, Aya; Nagao, Tomoyuki; Yamamoto, Toshihiko; Hirai, Makoto; Murohara, Toyoaki

    2014-01-01

    In recent years, there has been a series of recalls of popular implantable cardioverter defibrillators leads, and several reports have demonstrated an increasing rate of failure of such leads over time in Caucasian patients. However, little is known about the performance of these leads in Asian patients. The aim of this study was to investigate the rate of failure of the recalled leads and the characteristics as compared with non-recalled leads in Japanese patients. A retrospective chart review was conducted in 214 patients (75 Sprint Fidelis, 8 Riata, and 131 Sprint Quattro leads) who underwent implantation and follow-up at Nagoya University Hospital. During the follow-up period, 14 Sprint Fidelis leads (19%) and 1 Riata lead (13%) failed, but no abnormality was found in the Sprint Quattro, non-recalled leads. Five patients (4 Sprint Fidelis and 1 Riata, 33% of lead failure patients) received inappropriate shocks. The 3-, 4-, and 5-year lead survival rates in Sprint Fidelis leads were 95.1% (95% confidence interval [CI]: 89.6%-100%), 89.8% (95% CI: 82.1%-97.6%), and 88.0% (95% CI: 79.6%-96.4%), respectively. A previous device implantation before Sprint Fidelis lead was the only significant predictor for lead fracture (hazard ratio, 5.33; 95% CI: 1.55-18.4; P=0.008). The rate of Sprint Fidelis lead failure continues to increase over time in Japanese patients.  

  12. Evidence that the endometrial microbiota has an effect on implantation success or failure.

    Science.gov (United States)

    Moreno, Inmaculada; Codoñer, Francisco M; Vilella, Felipe; Valbuena, Diana; Martinez-Blanch, Juan F; Jimenez-Almazán, Jorge; Alonso, Roberto; Alamá, Pilar; Remohí, Jose; Pellicer, Antonio; Ramon, Daniel; Simon, Carlos

    2016-12-01

    Bacterial cells in the human body account for 1-3% of total body weight and are at least equal in number to human cells. Recent research has focused on understanding how the different bacterial communities in the body (eg, gut, respiratory, skin, and vaginal microbiomes) predispose to health and disease. The microbiota of the reproductive tract has been inferred from the vaginal bacterial communities, and the uterus has been classically considered a sterile cavity. However, while the vaginal microbiota has been investigated in depth, there is a paucity of consistent data regarding the existence of an endometrial microbiota and its possible impact in reproductive function. This study sought to test the existence of an endometrial microbiota that differs from that in the vagina, assess its hormonal regulation, and analyze the impact of the endometrial microbial community on reproductive outcome in infertile patients undergoing in vitro fertilization. To identify the existence of an endometrial microbiota, paired samples of endometrial fluid and vaginal aspirates were obtained simultaneously from 13 fertile women in prereceptive and receptive phases within the same menstrual cycle (total samples analyzed n = 52). To investigate the hormonal regulation of the endometrial microbiota during the acquisition of endometrial receptivity, endometrial fluid was collected at prereceptive and receptive phases within the same cycle from 22 fertile women (n = 44). Finally, the reproductive impact of an altered endometrial microbiota in endometrial fluid was assessed by implantation, ongoing pregnancy, and live birth rates in 35 infertile patients undergoing in vitro fertilization (total samples n = 41) with a receptive endometrium diagnosed using the endometrial receptivity array. Genomic DNA was obtained either from endometrial fluid or vaginal aspirate and sequenced by 454 pyrosequencing of the V3-V5 region of the 16S ribosomal RNA (rRNA) gene; the resulting sequences were

  13. Relation of symptomatic heart failure and psychological status to persistent depression in patients with implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Hoogwegt, Madelein T; Jordaens, Luc

    2011-01-01

    Association class III-IV (OR 2.95; 95% CI 1.47 to 5.89), Type D personality (OR 7.98; 95% CI 3.98 to 16.04), and the use of psychotropic medication (OR 2.73; 95% CI 1.27 to 5.84) were independent correlates of persistent depression. In conclusion, symptomatic heart failure, psychological status......Studies on psychological morbidity in patients with an implantable cardioverter-defibrillator (ICD) have focused on mean differences rather than intraindividual differences. Such an approach masks the chronicity of symptoms in individual patients and the potential differences in cardiac outcomes.......26 to 4.15), cardiac resynchronization therapy (OR 1.92; 95% CI 1.05 to 3.52), New York Heart Association class III-IV (OR 2.47; 95% CI 1.36 to 4.48), diabetes (OR 2.09; 95% CI 1.01 to 4.29), Type D personality (OR 8.30; 95% CI 4.42 to 15.58), high levels of ICD concerns (OR 2.60; 95% CI 1.44 to 1...

  14. Prevalence of chromosomal abnormalities and timing of karyotype analysis in patients with recurrent implantation failure (RIF) following assisted reproduction

    Science.gov (United States)

    De Sutter, P.; Stadhouders, R.; Dutré, M.; Gerris, J.; Dhont, M.

    2012-01-01

    Aims: To analyze the prevalence and type of karyotype abnormalities in RIF patients and to evaluate the adequate timing for analysis and the presence of possible risk factors. Methods: 615 patients (317 women and 298 men) with RIF, having undergone at least 3 sequential failed IVF/ICSI cycles prior to karyotype analysis, were included in this study. Anomaly rates found were compared with published series. Results: Chromosomal abnormalities were diagnosed in 2.1% of patients (13/615): 8 females (2.5%) and 5 males (1.7%) which is significantly higher for the females than in unselected newborns (0.8%) and normo-ovulatory women (0.6%) but lower than in women with high-order implantation failure (10.8%). No significant differences were found with couples at the start of IVF/ICSI (2.0%). Karyotyping all patients prior to IVF/ICSI results in a higher cost than selecting RIF patients. Two subgroups showed an increased prevalence of abnormalities: secondary infertile women with a history of only miscarriages (9.1%) and women with female infertility (6.0%). Conclusion: A karyotype analysis is indicated in all women with RIF. Nulliparous women with a history of miscarriage and women with documented infertility are at greater risk of CA and are to be advised to undergo karyotyping. PMID:24753890

  15. Depression and anxiety symptoms are associated with reduced dietary adherence in heart failure patients treated with an implantable cardioverter defibrillator.

    Science.gov (United States)

    Luyster, Faith S; Hughes, Joel W; Gunstad, John

    2009-01-01

    Heart failure (HF) patients treated with an implantable cardioverter defibrillator (ICD) are a growing patient population for whom the general treatment guidelines for HF still apply. Dietary recommendations, sodium and fluid restriction and daily weight monitoring, are a critical component of HF self-management. However, HF patients often report poor adherence to these recommendations. Studies that have investigated factors associated with poor diet adherence have focused on knowledge and beliefs. The current study extends previous research by examining the impact of psychosocial factors (depression, anxiety, and social support) on adherence to dietary recommendations in this growing subgroup of HF patients. Eighty-eight HF patients, with a mean age of 70 years, treated with an ICD (77% male) completed questionnaires assessing depression and anxiety symptoms, social support, and dietary adherence. Most patients reported following dietary recommendations in the past week most of the time (63%), whereas only 16% of patients reported following dietary recommendations all of the time. Greater depression and anxiety symptoms were associated with poorer dietary adherence, whereas social support did not predict reported dietary adherence. Findings suggest that many HF patients treated with an ICD do not comply with dietary recommendations. Depression and anxiety symptoms were found to be associated with worse dietary adherence, whereas social support was not related to adherence. Further research is needed to understand the role of social support in dietary adherence in HF patients.

  16. Genetic Variation of Methylenetetrahydrofolate Reductase (MTHFR) and Thymidylate Synthase (TS) Genes Is Associated with Idiopathic Recurrent Implantation Failure.

    Science.gov (United States)

    Choi, Youngsok; Kim, Jung Oh; Shim, Sung Han; Lee, Yubin; Kim, Ji Hyang; Jeon, Young Joo; Ko, Jung Jae; Lee, Woo Sik; Kim, Nam Keun

    2016-01-01

    The one-carbon metabolism pathway disorder was important role in successful pregnancy. The MTHFR and TS protein were crucial factor in one-carbon metabolism. To investigate the association between recurrent implantation failure (RIF) and enzymes in the one-carbon metabolism pathway. A total of 120 women diagnosed with RIF and 125 control subjects were genotyped for MTHFR 677C>T, 1298A>C, TSER 2R/3R and TS 1494del/ins by a polymerase chain reaction-restriction fragment length polymorphism assay. According to the gene-gene combination analysis, the MTHFR 677/MTHFR 1298 (TT/AA) and MTHFR 677/TS 1494 (TT/6bp6bp) genetic combinations were associated with relatively higher risks [adjusted odds ratio (AOR), 2.764; 95% CI, 1.065-7.174; P = 0.037 and AOR, 3.186; 95% CI, 1.241-8.178; P = 0.016] in RIF patients compared to the CC/AA (MTHFR 677/MTHFR 1298) and TT/6bp6bp (MTHFR 677/TS 1494) combinations, respectively. The results suggested that the combined MTHFR 677/MTHFR 1298 genotype might be associated with increased risk of RIF. To the best of our knowledge, this study is the first to elucidate the potential association of MTHFR, TS and TSER polymorphisms with RIF risk in Korean patients.

  17. Timing embryo biopsy for PGD - before or after cryopreservation?

    Science.gov (United States)

    Shinar, S; Kornecki, N; Schwartz, T; Mey-Raz, N; Amir, H; Almog, B; Shavit, T; Hasson, J

    2016-09-01

    Pre-implantation genetic diagnosis (PGD) is required in order to screen and diagnose embryos of patients at risk of having a genetically affected offspring. A biopsy to diagnose the genetic profile of the embryo may be performed either before or after cryopreservation. The aim of this study was to determine which biopsy timing yields higher embryo survival rates. Retrospective cohort study of all PGD patients in a public IVF unit between 2010 and 2013. Inclusion criteria were patients with good-quality embryos available for cryopreservation by the slow freezing method. Embryos were divided into two groups: biopsy before and biopsy after cryopreservation. The primary outcome was embryo survival rates post thawing. Sixty-five patients met inclusion criteria. 145 embryos were biopsied before cryopreservation and 228 embryos were cryopreserved and biopsied after thawing. Embryo survival was significantly greater in the latter group (77% vs. 68%, p Cryopreservation preceding biopsy results in better embryo survival compared to biopsy before cryopreservation.

  18. Development of pre-implantation porcine embryos cultured within alginate hydrogel systems either supplemented with secreted phosphoprotein 1 or conjugated with arg-gly-asp peptide

    Science.gov (United States)

    Although deficiencies in porcine embryo elongation play a significant role on early embryonic mortality and establishment of within–litter developmental variation, the exact mechanisms of elongation are poorly understood. Secreted phosphoprotein 1 (SPP1) is increased within the uterine milieu during...

  19. Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy.

    Science.gov (United States)

    Cicinelli, Ettore; Matteo, Maria; Tinelli, Raffaele; Lepera, Achiropita; Alfonso, Raffaello; Indraccolo, Ugo; Marrocchella, Sonia; Greco, Pantaleo; Resta, Leonardo

    2015-02-01

    What is the prevalence of chronic endometritis (CE) in women with repeated unexplained implantation failure (RIF) at IVF, and how does antibiotic treatment affect the reproductive outcome? Chronic endometritis, associated with infection with common bacteria or mycoplasma, is common in women complaining of RIF and antibiotic treatment significantly improves the reproductive outcome at a subsequent IVF cycle. We have reported that CE is a frequent finding in women with repeated pregnancy loss and a significantly higher rate of successful pregnancies was achieved after adequate antibiotic treatment. Moreover, CE was identified in 30.3% of patients with repeated implantation failure at IVF and women diagnosed with CE had lower implantation rates (11.5%) after IVF cycles. In contrast, other authors reported that the clinical implication of CE should be considered minimal and that the reproductive outcome at IVF/ICSI cycles was not negatively affected by CE. A retrospective study was performed from January 2009 through June 2012 on 106 women with unexplained infertility and a history of RIF. All patients underwent hysteroscopy and endometrial sampling for histology and microbiological investigations. Women diagnosed with CE underwent antibiotic treatment and the effect of treatment was confirmed by hysteroscopy with biopsy. Within 6 months after treatment all women had a further IVF attempt. The IVF outcomes were compared in women without signs of CE (Group 1) and persistent CE (Group 2) after antibiotic treatment. Clinical pregnancy rate (PR), and live birth rate (LBR) were compared at post-treatment IVF attempt. Seventy (66.0%) women were diagnosed with CE at hysteroscopy. In 61 (57.5%) CE was confirmed by histology and 48 (45.0%) by cultures. Common bacteria and mycoplasma were the most prevalent agents. In 46 (75.4%) out of 61 women, with diagnosis of CE at hysteroscopy and histology, examinations were normal after appropriate antibiotic treatment control (Group 1

  20. Does endometrial injury enhances implantation in recurrent in-vitro fertilization failures? A prospective randomized control study from tertiary care center

    Directory of Open Access Journals (Sweden)

    Neeta Singh

    2015-01-01

    Full Text Available Background: Though Assisted Reproductive Techniques have overcome many fertility disorders, implantation is still considered, the rate-limiting step for the success of IVF. Aim0 : The aim of this study was to evaluate the role of endometrial scratching in improving the implantation rate in patients undergoing IVF-ET cycles. Design: Prospective randomized control trial. Methods and Material: Sixty infertile women with a history of >1 previous failed IVF-ET cycles were randomizedinto two groups of 30 each. The patients in group 1 underwent endometrial scratching once between days 14-21 of menstrual cycle in the cycle prior to embryo transfer (ET, while in group 2scratching were not done. Implantation rate, ongoing pregnancy rate, abortion rate and live birth rate were comparedbetween both groups. Statistical Analysis: Mean values were compared between two groups using Student′s′t′ independent test. Frequency distributions of categorical variables were compared using Chi-Square/ Fisher′s exact test as appropriate. Results: Implantation rate in group 1 was 19.4% whereas in group 2 it was 8.1%. Difference between two groups was statistically significant (P =0.028. The live birth rate was higher in the group 2 compared to group 1, however this difference was not statistically significant (3.3% vs 10%, P =0.612. No significant difference was observed between the two groups regarding the ongoing pregnancy rate (16.7% vs 0.0%; P =0.052, abortion rate (10.0% vs 3.3%, P =0.612 and miscarriage rate (6.7% vs 3.3%, P =0.99. Conclusions: Implantation rate increases significantly after endometrial scratching in patients with previous failed IVF-ET.

  1. The effect of intermittent atrial tachyarrhythmia on heart failure or death in cardiac resynchronization therapy with defibrillator versus implantable cardioverter-defibrillator patients

    DEFF Research Database (Denmark)

    Ruwald, Anne-Christine; Pietrasik, Grzegorz; Goldenberg, Ilan

    2014-01-01

    OBJECTIVES: This study aimed to investigate the effect of both history of intermittent atrial tachyarrhythmias (IAT) and in-trial IAT on the risk of heart failure (HF) or death comparing cardiac resynchronization therapy with defibrillator (CRT-D) to implantable cardioverter-defibrillator (ICD......, respectively, a history of IAT at baseline and time-dependent development of in-trial IAT during follow-up in 1,264 patients with LBBB enrolled in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy) study. RESULTS: The overall beneficial effect of CRT...... of in-trial atrial tachyarrhythmias. (MADIT-CRT: Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy; NCT00180271)....

  2. Beneficial aspects of real time flow measurements for the management of acute right ventricular heart failure following continuous flow ventricular assist device implantation

    Directory of Open Access Journals (Sweden)

    Spiliopoulos Sotirios

    2012-11-01

    Full Text Available Abstract Background Optimal management of acute right heart failure following the implantation of a left ventricular assist device requires a reliable estimation of left ventricular preload and contractility. This is possible by real-time pump blood flow measurements. Clinical case We performed implantation of a continuous flow left ventricular assist device in a 66 years old female patient with an end-stage heart failure on the grounds of a dilated cardiomyopathy. Real-time pump blood flow was directly measured by an ultrasonic flow probe placed around the outflow graft. Diagnosis The progressive decline of real time flow and the loss of pulsatility were associated with an increase of central venous pressure, inotropic therapy and progressive renal failure suggesting the presence of an acute right heart failure. Diagnosis was validated by echocardiography and thermodilution measurements. Treatment Temporary mechanical circulatory support of the right ventricle was successfully performed. Real time flow measurement proved to be a useful tool for the diagnosis and ultimately for the management of right heart failure including the weaning from extracorporeal membrane oxygenation.

  3. Cost-utility analysis of the EVOLVO study on remote monitoring for heart failure patients with implantable defibrillators: randomized controlled trial.

    Science.gov (United States)

    Zanaboni, Paolo; Landolina, Maurizio; Marzegalli, Maurizio; Lunati, Maurizio; Perego, Giovanni B; Guenzati, Giuseppe; Curnis, Antonio; Valsecchi, Sergio; Borghetti, Francesca; Borghi, Gabriella; Masella, Cristina

    2013-05-30

    Heart failure patients with implantable defibrillators place a significant burden on health care systems. Remote monitoring allows assessment of device function and heart failure parameters, and may represent a safe, effective, and cost-saving method compared to conventional in-office follow-up. We hypothesized that remote device monitoring represents a cost-effective approach. This paper summarizes the economic evaluation of the Evolution of Management Strategies of Heart Failure Patients With Implantable Defibrillators (EVOLVO) study, a multicenter clinical trial aimed at measuring the benefits of remote monitoring for heart failure patients with implantable defibrillators. Two hundred patients implanted with a wireless transmission-enabled implantable defibrillator were randomized to receive either remote monitoring or the conventional method of in-person evaluations. Patients were followed for 16 months with a protocol of scheduled in-office and remote follow-ups. The economic evaluation of the intervention was conducted from the perspectives of the health care system and the patient. A cost-utility analysis was performed to measure whether the intervention was cost-effective in terms of cost per quality-adjusted life year (QALY) gained. Overall, remote monitoring did not show significant annual cost savings for the health care system (€1962.78 versus €2130.01; P=.80). There was a significant reduction of the annual cost for the patients in the remote arm in comparison to the standard arm (€291.36 versus €381.34; P=.01). Cost-utility analysis was performed for 180 patients for whom QALYs were available. The patients in the remote arm gained 0.065 QALYs more than those in the standard arm over 16 months, with a cost savings of €888.10 per patient. Results from the cost-utility analysis of the EVOLVO study show that remote monitoring is a cost-effective and dominant solution. Remote management of heart failure patients with implantable defibrillators

  4. A microfluidic system supports single mouse embryo culture leading to full-term development

    NARCIS (Netherlands)

    Esteves, Telma Cristina; van Rossem, F.; Nordhoff, Verena; Schlatt, Stefan; Boiani, Michele; le Gac, Severine

    2013-01-01

    The present study demonstrates the feasibility of application of a microfluidic system for in vitro culture of pre-implantation mouse embryos, with subsequent development to full-term upon embryo transfer. Specifically, embryos cultured in groups in nL volume chambers achieve pre-implantation

  5. Fatigue resistance and failure mode of novel-design anterior single-tooth implant restorations: influence of material selection for type III veneers bonded to zirconia abutments.

    Science.gov (United States)

    Magne, Pascal; Paranhos, Maria Paula Gandolfi; Burnett, Luiz Henrique; Magne, Michel; Belser, Urs Christoph

    2011-02-01

    This study assessed the fatigue resistance and failure mode of type III porcelain and composite resin veneers bonded to custom zirconia implant abutments. Twenty-four standardized zirconia implant abutments were fabricated. Using the CEREC 3 machine, type III veneers of standardized shape were milled in ceramic Vita Mark II or in composite resin Paradigm MZ100. The intaglio surfaces of the restorations were hydrofluoric acid etched and silanated (Mark II) or airborne-particle abraded and silanated (MZ100). The fitting surface of the abutments was airborne-particle abraded, cleaned, and inserted into a bone level implant (BLI RC SLActive 10 mm). All veneers (n=24) were adhesively luted with a zirconia primer (Z-Prime Plus), adhesive resin (Optibond FL) and a pre-heated light-curing composite resin (Filtek Z100). Cyclic isometric chewing (5 Hz) was simulated, starting with a load of 40 N, followed by stages of 80, 120, 160, 200, 240, and 280 N (20,000 cycles each). Samples were loaded until fracture or to a maximum of 140,000 cycles. Groups were compared using the life table survival analysis (Logrank test at P=.05). Mark II and MZ100 specimens fractured at an average load of 216 N and 229 N (survival rate of 17% and 8%), respectively, with no difference in survival probability (P=.18). Among the fractured samples, 40% of the failures were at the abutment level for Mark II and 27% were at the abutment level for MZ100. No exclusive adhesive failures were observed. Type III Mark II and Paradigm MZ100 veneers showed similar fatigue resistance when bonded to custom non-retentive zirconia implant abutments. The bond was strong enough to induce abutment fractures. MZ100 presented a higher percentage of "friendly" failures, i.e. maintaining the restoration-abutment adhesive interface and the abutment itself intact. © 2010 John Wiley & Sons A/S.

  6. Use of the 6-min walk distance to identify variations in treatment benefits from implantable cardioverter-defibrillator and amiodarone: results from the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)

    National Research Council Canada - National Science Library

    Fishbein, Daniel P; Hellkamp, Anne S; Mark, Daniel B; Walsh, Mary Norine; Poole, Jeanne E; Anderson, Jill; Johnson, George; Lee, Kerry L; Bardy, Gust H

    2014-01-01

    ... (Sudden Cardiac Death in Heart Failure Trial), a pre-specified subgroup analysis showed that patients with New York Heart Association functional class III symptoms did not benefit from implantable cardioverter-defibrillator (ICD...

  7. Impact of quadripolar LV leads on heart failure hospitalization rates among patients implanted with CRT-D: data from the Israeli ICD Registry.

    Science.gov (United States)

    Leshem, Eran; Suleiman, Mahmoud; Laish-Farkash, Avishag; Haim, Moti; Geist, Michael; Luria, David; Glikson, Michael; Goldenberg, Ilan; Michowitz, Yoav

    2018-01-01

    Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure (HF); however, a third of patients are non-responders. The development of quadripolar left ventricular (LV) lead was shown, mainly in single manufactures' registry, to improve LV remodeling and overall mortality. However, limited reports exist on the impact of quadripolar LV leads on HF hospitalization rates in real-life cohorts. We evaluated the clinical outcomes associated with quadripolar LV leads in a large nation-wide registry including all patients implanted with a cardiac resynchronization therapy with defibrillator (CRT-D). Between July 2010 and October 2016, 2913 consecutive patients were implanted with a CRT-D and all were prospectively enrolled in the Israeli ICD Registry. Quadripolar LV leads were implanted in 973 (33.4%) patients during this period, and their clinical outcomes were compared to CRT-D recipients implanted with a bipolar LV lead. Primary endpoint was HF hospitalization rate. Quadripolar leads were implanted more in patients with non-ischemic cardiomyopathy and for primary prevention indication and less in post-infarction patients and for secondary prevention of sudden death. Longer QRS duration was observed with quadripolar leads (147 ± 23 vs 143 ± 25; p < 0.001). Outcome event rate for 100 patient years revealed no difference in HF hospitalization rates between bipolar and quadripolar LV leads. Quadripolar lead implant led to lower cardiac mortality, with no influence on overall mortality. Multivariate analysis revealed no significant differences in study endpoints between bipolar and quadripolar LV leads. In a large real-life registry, implantation of quadripolar LV leads in patients with CRT-D did not influence HF hospitalization rates.

  8. Clinical outcomes after cell-seeded autologous chondrocyte implantation of the knee: when can success or failure be predicted?

    Science.gov (United States)

    Pestka, Jan M; Bode, Gerrit; Salzmann, Gian; Steinwachs, Mathias; Schmal, Hagen; Südkamp, Norbert P; Niemeyer, Philipp

    2014-01-01

    Autologous chondrocyte implantation (ACI) has been associated with satisfying results. Still, it remains unclear when success or failure after ACI can be estimated. To evaluate the clinical outcomes of cell-seeded collagen matrix-supported ACI (ACI-Cs) for the treatment of cartilage defects of the knee at 36 months and to determine a time point after ACI-Cs at which success or failure can be estimated. Cohort study; Level of evidence, 3. A total of 80 patients with isolated full-thickness cartilage defects of the knee joint treated with ACI-Cs were prospectively assessed before surgery as well as postoperatively by use of the International Knee Documentation Committee (IKDC) score and Lysholm knee score. Preoperative IKDC and Lysholm scores increased from 49.6 and 59.5, respectively, to 79.1 and 83.5, respectively, at 36 months. Only half the patients (46.6%) with poor IKDC scores (ie, <70) at 6 months postoperatively showed continued poor or fair scores at 36 months' follow-up. The probability of poor scores at 36 months after surgery further increased to 0.61 and 0.81, respectively, when scores were persistent at 12 and 24 months. All 3 patients (100%) with good IKDC scores (ie, 81-90) at 6 months after surgery showed constant or even improved scores at 36 months' follow-up. Ninety-one percent of patients with good and excellent scores at 12 months and 83% of patients with good and excellent scores at 24 months (a total of 23 and 37 patients, respectively) were able to maintain these scores at 36 months' follow-up. Similar results were obtained for the Lysholm score. With regard to the improvements in functional outcomes after ACI-Cs at 36 months after surgery, the technique described here appears to lead to satisfying and stable clinical results. This study helps the treating physician to predict the likeliness of further clinical improvements or constant unsatisfactory results after ACI. In patients with good/excellent scores shortly after surgery

  9. Fatigue resistance and failure mode of CAD/CAM composite resin implant abutments restored with type III composite resin and porcelain veneers.

    Science.gov (United States)

    Magne, Pascal; Oderich, Elisa; Boff, Luís Leonildo; Cardoso, Antônio Carlos; Belser, Urs Christoph

    2011-11-01

    This study assessed the fatigue resistance and failure mode of type III porcelain and composite resin veneers bonded to custom composite resin implant abutments. Using the CEREC 3 machine, 28 composite resin implant abutments (Paradigm MZ100) were fabricated along with non-retentive type III veneers, milled either in ceramic Paradigm C (n=14) or in composite resin Paradigm MZ100 (n=14). The intaglio surfaces of the veneers were hydrofluoric acid etched and silanated (Paradigm C) or airborne-particle abraded and silanated (MZ100). The fitting surface of the abutments was airborne-particle abraded, cleaned, silanated and inserted into a bone level implant (10 mm, BLI RC). All veneers were luted with adhesive resin (Optibond FL) and a preheated light curing composite resin (Filtek Z100). Cyclic isometric chewing (5 Hz, 30° angle) was simulated, starting with a load of 40 N, followed by stages of 80, 120, 160, 200, 240 and 280 N (20,000 cycles each). Samples were loaded until fracture or to a maximum of 140,000 cycles. Groups were compared using the life table survival analysis (Log rank test at P=0.05). Previously published data using same-design zirconia abutments were included for comparison. Paradigm C and MZ100 specimens fractured at an average load of 243 and 206 N (survival rate of 21% and 0%), respectively, with a significant difference in survival probability (P=0.02). Fractured specimens presented mixed failure modes and solely adhesive failures were not observed. The survival of composite resin abutments was similar to that of identical zirconia abutments from a previous study (P=0.76). Non-retentive porcelain veneers bonded to custom composite resin implant abutments presented a higher survival rate when compared with composite resin veneers. Survival of composite resin abutment did not differ from zirconia ones. © 2011 John Wiley & Sons A/S.

  10. Outcome after implantation of cardiac resynchronization/defibrillation systems in patients with congestive heart failure and left bundle-branch block.

    Science.gov (United States)

    Pfau, Giselher; Schilling, Thomas; Kozian, Alf; Lux, Anke; Götte, A; Huth, Christof; Hachenberg, Thomas

    2010-02-01

    The implantation of cardiac resynchronization/defibrillation devices (CRT-Ds) increasingly is used in patients with congestive heart failure and left bundle-branch block. There are no data on the effects of anesthesia and surgery on outcome after implantation. A retrospective, observational study; postoperative survey. University hospital. Three hundred forty-one patients (258 men/83 women, 63 +/- 9 years) with congestive heart failure and left bundle-branch block who underwent CRT-D implantation in 1996 to 2005. Perioperative data were retrieved from the patients' records. Cardiologists caring for the patients were contacted to obtain information on current New York Heart Association (NYHA) status and mortality after CRT-D implantation. Preoperatively, 45 patients were classified as NYHA II, 246 as NYHA III, and 50 as NYHA IV. CRT was performed via thoracotomy in 100 and transvenously in 241 cases. General anesthesia (propofol or sevoflurane and remifentanil) was performed in 273 and local anesthesia (lidocaine) in 68 patients. Hypotension occurred mainly during general anesthesia (43% v 4%). The 30-day mortality was 0%. The postoperative survey started in 2006 and was completed by 215 patients. The mean survival time was 77 months; 151 patients survived the study period. Outcome was not influenced by local and general anesthesia. Presence of preoperative NYHA class >II (odds ratio [OR] = 1.6, confidence interval [CI] = 0.5-5.1), mitral regurgitation (OR = 2.5, CI = 1.2-5.5), and serum creatinine >1.1 mg/dL (OR = 3.0, CI = 1.5-6.2) resulted in an inferior prognosis. In patients with severely impaired cardiac function, general anesthesia for the implantation of a biventricular pacing device can be used with justifiable risk. The method of anesthesia did not influence outcome. Copyright 2010 Elsevier Inc. All rights reserved.

  11. Transcatheter treatment of heart failure with preserved or mildly reduced ejection fraction using a novel interatrial implant to lower left atrial pressure

    DEFF Research Database (Denmark)

    Søndergaard, Lars; Reddy, Vivek; Kaye, David

    2014-01-01

    BACKGROUND: Heart failure with preserved or mildly reduced ejection fraction (HFpEF) is common and, to date, therapeutic options are limited. Increased left atrial pressure is a key contributor to the symptoms associated with HFpEF, particularly during physical activity. We report the 30-day......Hg (exercise); and ≥1 hospitalization for heart failure within the past 12 months, or persistent NYHA class III/IV for at least 3 months. Mean age, LVEF, and NYHA class were 70 ± 12 years, 57 ± 9%, and 3.2 ± 0.4, respectively. Most patients had significant co-morbidities. The interatrial septal device (IASD...... patients, one class in five patients, and worsened by one class in one patient. No patient developed pulmonary hypertension. Two serious adverse events occurred; heart failure re-hospitalization, and implant malposition successfully treated with a new device. CONCLUSION: Contemporary management of HFp...

  12. Autoinflation Leading to Failure of Two-Piece Ambicor Implantable Penile Prosthesis: An Outcome from a Methodical Treatment of Recalcitrant Stuttering Priapism

    Directory of Open Access Journals (Sweden)

    R. Charles Welliver

    2014-01-01

    Full Text Available Introduction. We present the case of a patient who received a two-piece Ambicor penile prosthesis for idiopathic recurrent “stuttering” priapism refractory to other treatment options. The patient returned unable to deflate the device due to an interesting anatomically induced mechanical failure. Aims. To describe the method and findings of this inflatable prosthesis failure. Results. Prosthesis failure occurred due to restrictive corporal diameter and the unique characteristics of fluid reservoir location in the two-piece inflatable prosthesis. The patient was successfully converted to a semirigid prosthesis with resolution of the pain that was due to his prosthesis autoinflation. Conclusion. Stuttering priapism remains a challenging clinical problem. Penile implantation is a reasonable long-term solution in a patient refractory to less invasive options. In patients with fibrotic corpora, a malleable device should be considered (at least temporarily if unable to dilate comfortably to 13 mm.

  13. Estudio de asociación entre enfermedades sistémicas y el fracaso de implantes dentales Study of association between systemic diseases and dental implant failure

    OpenAIRE

    J Domínguez; J Acuña; M Rojas; J Bahamondes; S Matus

    2013-01-01

    Desde los inicios de la cirugía de implantes orales, se ha recomendado excluir o limitar a ciertos pacientes con problemas de salud o hábitos de tabaquismo. Los enfermedades crónicas no transmisibles de salud, no son considerados una contraindicación absoluta para la utilización de implantes orales, pero si se debe evaluar con detalle el tipo de enfermedad presente, por ser un potencial riesgo que podría afectar el proceso de oseointegración. Hay ciertas condiciones sistémicas, como la osteop...

  14. Mechanical failure of hydroxyapatite-coated titanium and cobalt-chromium-molybdenum alloy implants. An animal study

    DEFF Research Database (Denmark)

    Nimb, L; Gotfredsen, K; Steen Jensen, J

    1993-01-01

    a histological and biomechanical evaluation of HA-coated titanium and cobalt-chromium-molybdenum alloy implants in a non-weight-bearing model. Twelve cylindrical plugs were inserted into the medial femoral condyle on 6 mongrel dogs. HA-coatings of 80-120 microns thickness were applied to 6 Cr-Co-Mo implants...

  15. Veno-venous extracorporeal membrane oxygenation using a double-lumen bi-caval cannula for severe respiratory failure post total artificial heart implantation.

    Science.gov (United States)

    Miessau, J; Yang, Q; Unai, S; Entwistle, J W C; Cavarocchi, N C; Hirose, H

    2015-07-01

    We report a unique utilization of a double-lumen, bi-caval Avalon cannula for veno-venous (VV) extracorporeal membrane oxygenation (ECMO) during placement of a total artificial heart (TAH, SynCardia, Tucson, AZ). A 22-year-old female with post-partum cardiomyopathy was rescued on veno-arterial (VA) ECMO because of cardiogenic shock. The inability to wean ECMO necessitated implantation of the TAH as a bridge to transplant. In addition, the patient continued to have respiratory failure and concomitant VV ECMO was planned with the implant. During TAH implantation, the Avalon cannula was placed percutaneously from the right internal jugular vein into the inferior vena cava (IVC) under direct vision while the right atrium was open. During VV ECMO support, adequate flows on both ECMO and TAH were maintained without adverse events. VV ECMO was discontinued, without reopening the chest, once the patient's respiratory failure improved. However, the patient subsequently developed a profound respiratory acidosis and required VV ECMO for CO2 removal. The Avalon cannula was placed in the femoral vein to avoid accessing the internal jugular vein and risking damage to the TAH. The patient's oxygenation eventually improved and the cannula was removed at the bedside. The patient was supported for 22 days on VV ECMO and successfully weaned from the ventilator prior to her orthotropic heart transplantation. © The Author(s) 2014.

  16. Camouflage of a high-angle skeletal Class II open-bite malocclusion in an adult after mini-implant failure during treatment.

    Science.gov (United States)

    Franzotti Sant'Anna, Eduardo; Carneiro da Cunha, Amanda; Paludo Brunetto, Daniel; Franzotti Sant'Anna, Claudia

    2017-03-01

    The treatment of skeletal anterior open-bite malocclusion requires complex orthodontic planning that considers its multifactorial etiology, treatment limitations, and high relapse rates. This case report illustrates a successful treatment approach for a skeletal high-angle Class II malocclusion in an adult with a severe open bite. The treatment consisted of a high-pull headgear therapy after mini-implants failure during fixed orthodontic therapy. Adequate esthetics and function were achieved. Despite its low probability, the unexpected event of mini-implant loosening during complex treatments should be considered. Therefore, classic orthodontic mechanics should be established, especially when treating patients for whom invasive procedures such as miniplates or orthognathic surgery are not available options. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  17. Intramyocardial implantation of differentiated rat bone marrow mesenchymal stem cells enhanced by TGF-β1 improves cardiac function in heart failure rats

    Energy Technology Data Exchange (ETDEWEB)

    Lv, Y. [Department of Histology and Embryology, Hebei Medical University, Shijiazhuang, Hebei (China); Liu, B. [Department of Pathology, the First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei (China); Wang, H.P. [Department of Histology and Embryology, Hebei North University, Zhangjiakou, Hebei (China); Zhang, L. [Department of Histology and Embryology, Hebei Medical University, Shijiazhuang, Hebei (China)

    2016-05-31

    The present study tested the hypotheses that i) transforming growth factor beta 1 (TGF-β1) enhances differentiation of rat bone marrow mesenchymal stem cells (MSCs) towards the cardiomyogenic phenotype and ii) intramyocardial implantation of the TGF-β1-treated MSCs improves cardiac function in heart failure rats. MSCs were treated with different concentrations of TGF-β1 for 72 h, and then morphological characteristics, surface antigens and mRNA expression of several transcription factors were assessed. Intramyocardial implantation of these TGF-β1-treated MSCs to infarcted heart was also investigated. MSCs were initially spindle-shaped with irregular processes. On day 28 after TGF-β1 treatment, MSCs showed fusiform shape, orientating parallel with one another, and were connected with adjoining cells forming myotube-like structures. Immunofluorescence revealed the expression of cardiomyocyte-specific proteins, α-sarcomeric actin and troponin T, in these cells. The mRNA expression of GATA4 and Nkx2.5 genes was slightly increased on day 7, enhanced on day 14 and decreased on day 28 while α-MHC gene was not expressed on day 7, but expressed slightly on day 14 and enhanced on day 28. Transmission electron microscopy showed that the induced cells had myofilaments, z line-like substances, desmosomes, and gap junctions, in contrast with control cells. Furthermore, intramyocardial implantation of TGF-β1-treated MSCs to infarcted heart reduced scar area and increased the number of muscle cells. This structure regeneration was concomitant with the improvement of cardiac function, evidenced by decreased left ventricular end-diastolic pressure, increased left ventricular systolic pressure and increased maximal positive pressure development rate. Taken together, these results indicate that intramyocardial implantation of differentiated MSCs enhanced by TGF-β1 improved cardiac function in heart failure rats.

  18. Fracture strength and failure mode of maxillary implant-supported provisional single crowns: a comparison of composite resin crowns fabricated directly over PEEK abutments and solid titanium abutments.

    Science.gov (United States)

    Santing, Hendrik Jacob; Meijer, Henny J A; Raghoebar, Gerry M; Özcan, Mutlu

    2012-12-01

    Polyetheretherketone (PEEK) temporary abutments have been recently introduced for making implant-supported provisional single crowns. Little information is available in the dental literature on the durability of provisional implant-supported restorations. The objectives of this study were to evaluate the fracture strength of implant-supported composite resin crowns on PEEK and solid titanium temporary abutments, and to analyze the failure types. Three types of provisional abutments, RN synOcta Temporary Meso Abutment (PEEK; Straumann), RN synOcta Titanium Post for Temporary Restorations (Straumann), and Temporary Abutment Engaging NobRplRP (Nobel Biocare) were used, and provisional screw-retained crowns using composite resin (Solidex) were fabricated for four different locations in the maxilla. The specimens were tested in a universal testing machine at a crosshead speed of 1 mm/minute until fracture occurred. The failure types were analyzed and further categorized as irreparable (Type 1) or reparable (Type 2). No significant difference was found between different abutment types. Only for the position of the maxillary central incisor, composite resin crowns on PEEK temporary abutments showed significantly lower (p resin crowns (75 out of 104), followed by screw loosening (18 out of 104). According to reparability, the majority of the specimens were classified as Type 1 (82 out of 104). Type 2 failures were not often observed (22 out of 104). Provisional crowns on PEEK abutments showed similar fracture strength as titanium temporary abutments except for central incisors. Maxillary right central incisor composite resin crowns on PEEK temporary abutments fractured below the mean anterior masticatory loading forces reported to be approximately 206 N. © 2010 Wiley Periodicals, Inc.

  19. Impact of implantable cardioverter-defibrillator, amiodarone, and placebo on the mode of death in stable patients with heart failure: analysis from the sudden cardiac death in heart failure trial.

    Science.gov (United States)

    Packer, Douglas L; Prutkin, Jordan M; Hellkamp, Anne S; Mitchell, L Brent; Bernstein, Robert C; Wood, Freda; Boehmer, John P; Carlson, Mark D; Frantz, Robert P; McNulty, Steve E; Rogers, Joseph G; Anderson, Jill; Johnson, George W; Walsh, Mary Norine; Poole, Jeanne E; Mark, Daniel B; Lee, Kerry L; Bardy, Gust H

    2009-12-01

    The Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) demonstrated that implantable cardioverter-defibrillator (ICD) therapy reduces all-cause mortality in patients with New York Heart Association class II/III heart failure and a left ventricular ejection fraction death caused by ventricular tachyarrhythmias without affecting heart failure deaths in this population is unknown. SCD-HeFT randomized 2521 subjects to placebo, amiodarone, or shock-only, single-lead ICD therapy. Over a median follow-up of 45.5 months, a total of 666 deaths occurred, which were reviewed by an Events Committee and initially categorized as cardiac or noncardiac. Cardiac deaths were further adjudicated as resulting from sudden death presumed to be ventricular tachyarrhythmic, bradyarrhythmia, heart failure, or other cardiac causes. ICD therapy significantly reduced cardiac mortality compared with placebo (adjusted hazard ratio, 0.76; 95% confidence interval, 0.60 to 0.95) and tachyarrhythmia mortality (adjusted hazard ratio, 0.40; 95% confidence interval, 0.27 to 0.59) and had no impact on mortality resulting from heart failure or noncardiac causes. The cardiac and tachyarrhythmia mortality reductions were evident in subjects with New York Heart Association class II but not in subjects with class III heart failure. The reduction in tachyarrhythmia mortality with ICD therapy was similar in subjects with ischemic and nonischemic disease. Compared with placebo, amiodarone had no significant effect on any mode of death. ICD therapy reduced cardiac mortality and sudden death presumed to be ventricular tachyarrhythmic in SCD-HeFT and had no effect on heart failure mortality. Amiodarone had no effect on all-cause mortality or its cause-specific components, except an increase in non-cardiac mortality in class III patients. [corrected] URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000609.

  20. Scriptaid and 5-aza-2'deoxycytidine enhanced expression of pluripotent genes and in vitro developmental competence in interspecies Black-footed cat cloned embryos

    Science.gov (United States)

    Gómez, M. C.; Biancardi, M.N.; Jenkins, J.A.; Dumas, C.; Galiguis, J.; Wang, G.; Earle Pope, C.

    2012-01-01

    Somatic cell nuclear transfer offers the possibility of preserving endangered species including the black-footed cat, which is threatened with extinction. The effectiveness and efficiency of somatic cell nuclear transfer (SCNT) depends on a variety of factors, but 'inappropriate epigenetic reprogramming of the transplanted nucleus is the primary cause of the developmental failure of cloned embryos. Abnormal epigenetic events such as DNA methylation and histone modifications during SCNT perturb the expression of imprinted and pluripotent-related genes that, consequently, may result in foetal and neonatal abnormalities. We have demonstrated that pregnancies can be established after transfer of black-footed cat cloned embryos into domestic cat recipients, but none of the implanted embryos developed to term and the foetal failure has been associated to aberrant reprogramming in cloned embryos. There is growing evidence that modifying the epigenetic pattern of the chromatin template of both donor cells and reconstructed embryos with a combination of inhibitors of histone deacetylases and DNA methyltransferases results in enhanced gene reactivation and improved in vitro and in vivo developmental competence. Epigenetic modifications of the chromatin template of black-footed cat donor cells and reconstructed embryos with epigenetic-modifying compounds enhanced in vitro development, and regulated the expression of pluripotent genes, but these epigenetic modifications did not improve in vivo developmental competence.

  1. Lineage specification in the early mouse embryo.

    Science.gov (United States)

    Lanner, Fredrik

    2014-02-01

    Before the mammalian embryo is ready to implant in the uterine wall, the single cell zygote must divide and differentiate into three distinct tissues; trophectoderm (prospective placenta), primitive endoderm (prospective yolk sac), and pluripotent epiblast cells which will form the embryo proper. In this review I will discuss our current understanding of how positional information, cell polarization, signaling pathways, and transcription factor networks converge to drive and regulate the progressive segregation of the first three cell types in the mouse embryo. © 2013 Published by Elsevier Inc.

  2. The effect of intermittent atrial tachyarrhythmia on heart failure or death in cardiac resynchronization therapy with defibrillator versus implantable cardioverter-defibrillator patients: a MADIT-CRT substudy (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy).

    Science.gov (United States)

    Ruwald, Anne-Christine; Pietrasik, Grzegorz; Goldenberg, Ilan; Kutyifa, Valentina; Daubert, James P; Ruwald, Martin H; Jons, Christian; McNitt, Scott; Wang, Paul; Zareba, Wojciech; Moss, Arthur J

    2014-04-01

    This study aimed to investigate the effect of both history of intermittent atrial tachyarrhythmias (IAT) and in-trial IAT on the risk of heart failure (HF) or death comparing cardiac resynchronization therapy with defibrillator (CRT-D) to implantable cardioverter-defibrillator (ICD) treatment in mildly symptomatic HF patients with left bundle branch block (LBBB). Limited data exist regarding the benefit of CRT-D in patients with IAT. The benefit of CRT-D in reducing the risk of HF/death was evaluated using multivariate Cox models incorporating the presence of, respectively, a history of IAT at baseline and time-dependent development of in-trial IAT during follow-up in 1,264 patients with LBBB enrolled in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy) study. The overall beneficial effect of CRT-D versus ICD on the risk of HF/death was not significantly different between LBBB patients with or without history of IAT (HR: 0.50, p = 0.028, and HR: 0.46, p Defibrillator Implantation Trial With Cardiac Resynchronization Therapy; NCT00180271). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  3. Derivation and Validation of a Novel Right-Sided Heart Failure Model After Implantation of Continuous Flow Left Ventricular Assist Devices:The EUROMACS (European Registry for Patients with Mechanical Circulatory Support) Right-Sided Heart Failure Risk Score.

    Science.gov (United States)

    Soliman, Osama I; Akin, Sakir; Muslem, Rahatullah; Boersma, Eric; Manintveld, Olivier C; Krabatsch, Thomas; Gummert, Jan F; de By, Theo M M H; Bogers, Ad J J C; Zijlstra, Felix; Mohacsi, Paul; Caliskan, Kadir

    2017-08-27

    Background -The aim of the study was to derive and validate a novel risk score for early right-sided heart failure (RHF) after left ventricular assist device implantation. Methods -The European Registry for Patients with Mechanical irculatory Support (EUROMACS) was used to identify adult patients undergoing continuous-flow left ventricular assist device implantation with mainstream devices. Eligible patients (n=2988) were randomly divided into derivation (n=2000) and validation (n=988) cohorts. The primary outcome was early (RHF, defined as receiving short- or long-term rightsided circulatory support, continuous inotropic support for ≥14 days, or nitric oxide ventilation for ≥48 hours. The secondary outcome was all-cause mortality and length of stay in the intensive care unit. Covariates found to be associated with RHF (exploratory univariate PRHF in the derivation cohort occurred in 433 patients (21.7%) after left ventricular assist device implantation and was associated with a lower 1-year (53% versus 71%; PRHF. RHF risk ranged from 11% (low risk score 0-2) to 43.1% (high risk score >4; PRHF, respectively (PRHF risk score outperformed (PRHF. Conclusions -This novel EUROMACS-RHF risk score outperformed currently known risk scores and clinical predictors of early postoperative RHF. This novel score may be useful for tailored risk-based clinical assessment and management of patients with advanced HF evaluated for ventricular assist device therapy.

  4. [Association of human chorionic gonadotropin level in embryo culture media with early embryo development].

    Science.gov (United States)

    Wang, Haiying; Zhang, Renli; Han, Dong; Liu, Caixia; Cai, Jiajie; Bi, Yanling; Wen, Anmin; Quan, Song

    2014-06-01

    To investigate the association of human chorionic gonadotropin (HCG) level on day 3 of embryo culture with embryo development. Spent culture media were collected from individually cultured embryos on day 3 of in vitro fertilization and embryo transfer (IVF-ET) cycles. HCG concentration in the culture media was measured using an ELISA kit and its association with embryo development was assessed. In the 163 samples of embryo culture media from 60 patients, HCG was positive in 153 sample (93.8%) with a mean level of 0.85 ± 0.43 mIU/ml. The concentration of hCG in the culture media increased gradually as the number of blastomeres increased (F=2.273, P=0.03), and decreased as the morphological grade of the embryo was lowered (F=3.900, P=0.02). ELISA is capable of detecting HCG levels in spent culture media of embryos on day 3 of in vitro culture. The concentration of HCG in spent culture media is positively correlated with the status of early embryo development and implantation rate and thus serves as a useful marker for embryo selection in IVF-ET procedure.

  5. Rationale and study design of the REM-HF study: remote management of heart failure using implanted devices and formalized follow-up procedures.

    Science.gov (United States)

    Morgan, John M; Dimitrov, Borislav D; Gill, Jas; Kitt, Sue; Ng, G Andre; McComb, Janet M; Raftery, James; Roderick, Paul; Seed, Alison; Williams, Simon G; Witte, Klaus K; Wright, D Jay; Yao, Guiqing Lily; Cowie, Martin R

    2014-09-01

    We wish to assess the clinical and cost-effectiveness of remote monitoring of heart failure patients with cardiac implanted electronic devices. REM-HF is a multicentre, randomized, non-blinded, parallel trial designed to compare weekly remote monitoring-driven management with usual care for patients with cardiac implanted electronic devices (ICD, CRT-D, or CRT-P). The trial is event driven, and the final analysis will be performed when 546 events have been observed or the study is terminated at the interim analysis. We have randomized 1650 patients to be followed up for a minimum of 2 years. Patients will remain in the trial up to study termination. The first patient was randomized in September 2011 and the study is expected to complete in early 2016. The primary combined endpoint is time to first event of all-cause death or unplanned hospitalization for cardiovascular reasons. An economic evaluation will be performed, estimating the cost per quality-adjusted life year, with direct costs estimated from the National Health Service perspective and quality of life assessed by the EQ-5D, Short-Form 12, and Kansas City Cardiomyopathy Questionnaires. The study design has been informed by a feasibility study. REM-HF is a multicentre randomized study that will provide important data on the effect of remote monitoring-driven management of implanted cardiac devices on morbidity and mortality, as well as the cost-effectiveness of this approach. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.

  6. Failure of Urological Implants in Spinal Cord Injury Patients due to Infection, Malfunction, and Implants Becoming Obsolete due to Medical Progress and Age-Related Changes in Human Body Making Implant Futile: Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2013-01-01

    Full Text Available Any new clinical data, whether positive or negative, generated about a medical device should be published because health professionals should know which devices do not work, as well as those which do. We report three spinal cord injury patients in whom urological implants failed to work. In the first, paraplegic, patient, a sacral anterior root stimulator failed to produce erection, and a drug delivery system for intracavernosal administration of vasoactive drugs was therefore implanted; however, this implant never functioned (and, furthermore, such penile drug delivery systems to produce erection had effectively become obsolete following the advent of phosphodiesterase type 5 inhibitors. Subsequently, the sacral anterior root stimulator developed a malfunction and the patient therefore learned to perform self-catheterisation. In the second patient, also paraplegic, an artificial urinary sphincter was implanted but the patient developed a postoperative sacral pressure sore. Eight months later, a suprapubic cystostomy was performed as urethral catheterisation was very difficult. The pressure sore had not healed completely even after five years. In the third case, a sacral anterior root stimulator was implanted in a tetraplegic patient in whom, after five years, a penile sheath could not be fitted because of penile retraction. This patient was therefore established on urethral catheter drainage. Later, infection with Staphylococcus aureus around the receiver block necessitated its removal. In conclusion, spinal cord injury patients are at risk of developing pressure sores, wound infections, malfunction of implants, and the inability to use implants because of age-related changes, as well as running the risk of their implants becoming obsolete due to advances in medicine. Some surgical procedures such as dorsal rhizotomy are irreversible. Alternative treatments such as intermittent catheterisations may be less damaging than bladder stimulator in

  7. Clinical Management of Implant Prostheses in Patients with Bruxism

    OpenAIRE

    Osamu Komiyama; Frank Lobbezoo; Antoon De Laat; Takashi Iida; Tsuyoshi Kitagawa; Hiroshi Murakami; Takao Kato; Misao Kawara

    2012-01-01

    There is general agreement that excessive stress to the bone-implant interface may result in implant overload and failure. Early failure of the implant due to excessive loading occurs shortly after uncovering the implant. Excess load on a final restoration after successful implant integration can result in physical failure of the implant structure. Many clinicians believe that overload of dental implants is a risk factor for vertical peri-implant bone loss and/or may be detrimental for the su...

  8. Risk factors for the development of right ventricular failure after left ventricular assist device implantation-a single-centre retrospective with focus on deformation imaging.

    Science.gov (United States)

    Boegershausen, Nadia; Zayat, Rashad; Aljalloud, Ali; Musetti, Giulia; Goetzenich, Andreas; Tewarie, Lachmandath; Moza, Ajay; Amerini, Andrea; Autschbach, Rüdiger; Hatam, Nima

    2017-12-01

    Right heart failure (RHF) after the implantation of a left ventricular assist device (LVAD) remains a dreaded postoperative complication. Using 2D speckle-tracking echocardiography, it is possible to acquire right ventricular global and regional function. The aim of our study was to assess whether speckle-tracking echocardiography values will better predict the RHF post-continuous-flow LVAD implantation. From January 2014 to January 2016, 54 patients who underwent LVAD implantation were included and retrospectively analysed. Clinical, invasive haemodynamic (right and left heart catheterization), laboratory and transthoracic echocardiography data were reviewed. Multivariable logistic regression was performed using RHF as dependent variable. Thirteen patients (24%) developed RHF. These patients had significantly elevated procalcitonin (P = 0.011), elevated central venous pressure (CVP) pre- and post-LVAD implantation (P = 0.002 and 0.031, respectively), higher right ventricular (RV) and pulmonary systolic pressure (P = 0.016 and 0.013, respectively), higher Michigan Risk Score (P = 0.001) and a lower peak systolic longitudinal strain of the basal RV free wall (P = 0.032). Haemoglobin, procalcitonin, RV systolic pressure, basal right ventricular free wall and pre-CVP entered the final multivariable analysis, only basal right ventricular free wall (P RHF. The sensitivity and specificity of the final model were 85.7% and 95.4%, respectively. The negative predictive value reached 94%. 2D strain parameters of the RV free wall seem to be auspicious for RV function and predicting RHF. Moreover, intraoperative CVP should not be neglected since elevated values proved to be highly associated with RHF. Our results represent a valuable supplement to other scores by considering both echocardiography and intraoperative data.

  9. ECG-derived spatial QRS-T angle is associated with ICD implantation, mortality and heart failure admissions in patients with LV systolic dysfunction.

    Directory of Open Access Journals (Sweden)

    Sarah Gleeson

    Full Text Available Increased spatial QRS-T angle has been shown to predict appropriate implantable cardioverter defibrilIator (ICD therapy in patients with left ventricular systolic dysfunction (LVSD. We performed a retrospective cohort study in patients with left ventricular ejection fraction (LVEF 31-40% to assess the relationship between the spatial QRS-T angle and other advanced ECG (A-ECG as well as echocardiographic metadata, with all-cause mortality or ICD implantation for secondary prevention.534 patients ≤75 years of age with LVEF 31-40% were identified through an echocardiography reporting database. Digital 12-lead ECGs were retrospectively matched to 295 of these patients, for whom echocardiographic and A-ECG metadata were then generated. Data mining was applied to discover novel ECG and echocardiographic markers of risk. Machine learning was used to develop a model to predict possible outcomes.49 patients (17% had events, defined as either mortality (n = 16 or ICD implantation for secondary prevention (n = 33. 72 parameters (58 A-ECG, 14 echocardiographic were univariately different (p110° had an adjusted HR of 3.4 (95% CI 1.6 to 7.4 for secondary ICD implantation or all-cause death and adjusted HR of 4.1 (95% CI 1.2 to 13.9 for future heart failure admission. There was a loss of complexity between A-ECG and echocardiographic variables with an increasing degree of disease.Spatial QRS-T angle >110° was strongly associated with arrhythmic events and all-cause death. Deep analysis of global ECG and echocardiographic metadata revealed underlying relationships, which otherwise would not have been appreciated. Delivered at scale such techniques may prove useful in clinical decision making in the future.

  10. Retrograde peri-implantitis

    Directory of Open Access Journals (Sweden)

    Mohamed Jumshad

    2010-01-01

    Full Text Available Retrograde peri-implantitis constitutes an important cause for implant failure. Retrograde peri-implantitis may sometimes prove difficult to identify and hence institution of early treatment may not be possible. This paper presents a report of four cases of (the implant placed developing to retrograde peri-implantitis. Three of these implants were successfully restored to their fully functional state while one was lost due to extensive damage. The paper highlights the importance of recognizing the etiopathogenic mechanisms, preoperative assessment, and a strong postoperative maintenance protocol to avoid retrograde peri-implant inflammation.

  11. Regenerative Surgical Treatment of Peri-implantitis

    Science.gov (United States)

    2016-08-31

    Failure of Dental Implant Due to Infection; Infection; Inflammation; Peri-implantitis; Bacterial Infections; Bleeding of Subgingival Space; Molecular Sequence Variation; Periodontal Diseases; Mouth Diseases

  12. Immunohistochemical localization of integrin alpha V beta 3 and osteopontin suggests that they do not interact during embryo implantation in ruminants

    Directory of Open Access Journals (Sweden)

    MacLaren Leslie A

    2004-04-01

    Full Text Available Abstract Background It has been suggested that trophoblast attachment requires co-expression of integrin alpha V beta 3 and its ligand osteopontin at the fetal-maternal interface. Until now the expression patterns of integrin alpha V beta 3 and osteopontin in the pregnant bovine uterus were unknown. The objectives of this study were to localize integrin alpha V beta 3 and osteopontin in bovine and sheep endometrium during the periimplantation period and to compare the distribution patterns using antibodies that had not yet been tested in sheep. Methods Cell compartments within endometrial tissue sections were scored for immunohistochemical staining intensity and data were analyzed to determine the effects of day of pregnancy or cycle. Results In pregnant bovine endometrium, integrin alpha V beta 3 was detected in luminal epithelium, stroma, myometrium and smooth muscle. A strong band of immunoreactivity was observed in the subepithelial stroma of intercaruncular regions, but there was reduced reactivity in the caruncles and glands. Bovine trophoblast did not express integrin alpha V beta 3 at any stage of pregnancy. In ovine endometrium a different pattern of staining for integrin alpha V beta 3 was observed. Reactivity was not present in the luminal epithelium or trophoblast. There was strong staining of the deep glands and no reactivity in the superficial glands. Osteopontin distribution was similar for sheep and cattle. For both species, apical staining was present on the luminal epithelium and glands and on embryonic tissues. Conclusion In ruminants, integrin alpha V beta 3 and osteopontin do not co-localize at the fetal-maternal interface indicating that these proteins could not interact to facilitate embryo attachment as has been proposed in other species.

  13. Human embryo-conditioned medium stimulates in vitro endometrial angiogenesis

    NARCIS (Netherlands)

    Kapiteijn, K.; Koolwijk, P.; Weiden, R.M.F. van der; Nieuw Amerongen, G. van; Plaisier, M.; Hinsbergh, V.W.M. van; Helmerhorst, F.M.

    2006-01-01

    Objective: Successful implantation and placentation depend on the interaction between the endometrium and the embryo. Angiogenesis is crucial at this time. In this article we investigate the direct influence of the human embryo on in vitro endometrial angiogenesis. Design: In vitro study. Setting:

  14. Percutaneous implantation of an intraventricular device for the treatment of heart failure: experimental results and proof of concept.

    Science.gov (United States)

    Nikolic, Serjan D; Khairkhahan, Alex; Ryu, Miho; Champsaur, Gerard; Breznock, Eugene; Dae, Michael

    2009-11-01

    A percutaneous system to implant a ventricular partitioning device (VPD) has been developed to partition the left ventricular (LV) cavity for treating regional wall motion abnormalities associated with post-left anterior descending (LAD) infarction, dilated left ventricle, and systolic dysfunction. The hemodynamic effects of this novel approach were evaluated in an ovine model with an anteroapical infarction created by a coil placed in the LAD. LV anteroapical infarction (MI) was induced in 10 animals. The VPD device was implanted at 6 weeks after MI in 5 animals. The hemodynamic status of each animal was evaluated at 30 weeks post-MI in treated ("VPD+MI" group, n=5) and nontreated ("MI" group, n=5). The comparison of end-point hemodynamic variables shows a significantly smaller end-systolic LV volume in the animals receiving the implant (70.1+/-9.0 mL in "VPD+MI" group vs. 102.9+/-10.3 mL in "MI" group, P < .02), improved ejection fraction (46.9+/-5.2% in "VPD+MI" group vs. 34.7+/-6.8% in "MI" group, P < .04) and preserved cardiac output (5.2+/-0.7 L/min in "VPD+MI" group vs. 5.0+/-1.8 L/min in "MI" group, P=NS), suggesting more efficient mechanical performance of the LV with the implanted VPD. A significant reduction in LV volumes and corresponding improvement in LV function occurred after device implantation indicating a potential beneficial effect of this new device in treatment of post MI LV dilation.

  15. Maternal reproductive health: Expression patterns of antioxidant enzyme selenoproteins of post-implantation embryos conceived by ethanol-treated murine mothers supplemented with α-tocopherol

    Directory of Open Access Journals (Sweden)

    Gliceria B Ramos

    2017-01-01

    Full Text Available Objective: To investigate if the protective effect of α-tocopherol against the impact of ethanol on brain morphogenesis involved the activity of the selenoproteins phospholipid hydroperoxide glutathione peroxidase (PHGPx; GPx4 and selenoprotein P (SelPP that have roles against oxidative stress. Methods: Forty female mice were randomly assigned into natural control (CON, positive control (ETOH, low-, medium-, and high-α-tocopherolsupplemented- ethanol groups (LTOC, MTOC, HTOC, respectively. CON received drinking water without ethanol while ETOH, LTOC, MTOC and HTOC groups received 20% ethanol in drinking water. The supplemented groups were given respective dosages of α-tocopherol, 0.410, 0.819, and 1.640 mg/g body weight, at day 14 before mating onwards to the day 9 of gestation. At 10.5 ED of gestation (1 100 h, the pregnant females were sacrificed by cervical dislocation and the embryos were harvested. Total RNA were extracted, cDNA synthesis and qRT- PCR analyses were carried out. Results: The level of expression of PHGPx in the positive control was significantly lower than that of the natural control. Among the three α- tocopherol-supplemented groups, only the medium dose- group was significantly higher than the positive control. The level of expression of SelPP in the positive control was significantly lower than those of the natural control, the low- and medium- dose α-tocopherol supplemented groups. In the high dose-α-tocopherol supplemented group, the level of expression was not significantly different from the positive control but significantly lower than the natural control. Conclusions: The activity of the selenoproteins PHGPx and SelPP are involved in the internetwork of antioxidative enzymes with vitamin E when given up to a medium dose only and is one of the possible pathways of shielding embryonic development against the impact of ethanol on brain morphogenesis. This study strengthens the impact of dietaryα-tocopherol and

  16. Influence of the radiation (Co{sub 60}) in pre-implants rabbit embryos: effect on atypic mitotic index and embryo pole development; Influencia da radiacao ionizante (bomba de cobalto) em embrioes de coelha na fase de pre-implantacao: influencia no numero de mitoses atipicas e no grau de desenvolvimento do polo

    Energy Technology Data Exchange (ETDEWEB)

    Approbato, Mario S.; Oliveira Moura, Katia K.V. de; Souza Florencio, Rodopiano de; Garcia, Ricardo; Faria, Renato S.; Benedetti, Leonardo N.; Goulart, Flamarion B. [Goias Univ., Goiania, GO (Brazil). Faculdade de Medicina. Dept. de Ginecologia e Obstetricia

    1995-08-01

    We studied the effect of ionizing irradiation on 12 New Zealand rabbits (65 embryos), at three different times: at match time (zero hour), two days after and four days after, with two different irradiation doses: five c Gy and ten c Gy. Six rabbits (36 blastocysts) were used as controls. the matching instant was the zero hour. Exactly six days after ({+-} 60 minutes) the embryos of each rabbit was picked up by flushing the uterus with culture media. the embryos were fixed in methanol for 48 hours, and colored with acid Mayer hematoxylin. The following embryo parameters were studied: embryo pole development; percentage of abnormal mitotic figures. irradiation time was associated with lower scores of embryo pole development, but not with irradiation dose. There were no gross abnormalities of embryo pole. The abnormal mitotic cells was affected both by the time and dose of irradiation. (author). 12 refs., 4 figs.

  17. Increased risk of joint failure in hip prostheses infected with Staphylococcus aureus treated with debridement, antibiotics and implant retention compared to Streptococcus.

    Science.gov (United States)

    Betz, Michael; Abrassart, Sophie; Vaudaux, Pierre; Gjika, Ergys; Schindler, Maximilian; Billières, Julien; Zenelaj, Besa; Suvà, Domizio; Peter, Robin; Uçkay, Ilker

    2015-03-01

    The debridement, antibiotic and implant retention (DAIR) procedure is an option for patients with prosthetic hip joint infections for whom arthroplasty removal is problematic. Unfortunately, some of the guidelines proposed for deciding on DAIR management of arthroplasty infections fail to take into consideration the role of the infecting pathogen. While Staphylococcus aureus and streptococci are major contributors to infected hip arthroplasties, their respective contributions to treatment success or failure rates with the DAIR procedure have not been thoroughly analysed from a microbiological perspective. This retrospective study included all patients who were hospitalised in Geneva University Hospitals between 1996 and 2012 and were initially treated with DAIR for prosthetic hip joint monomicrobial infection due to S. aureus or Streptococcus spp. The outcome of DAIR treatment was evaluated after a minimal follow-up of two years. A literature search was also performed to retrieve data from additional DAIR-treated cases in other institutions. In our institution, 38 DAIR-treated patients with hip arthroplasty monomicrobial infections underwent at least one surgical debridement (median two, range one to five), exchange of mobile parts and concomitant targeted antibiotic therapy for several weeks or months. A literature search identified outcome data in other institutions from 52 additional DAIR-treated cases according to our study criteria. After merging our own data with those retrieved from other reports, we found a failure rate of 21 % instead of 24 % for S. aureus-infected, DAIR-treated patients, but no failure in 14 streptococcal-infected patients. In the pooled data, the failure rate linked with S. aureus infections was significantly higher than that with Streptococcus ssp. (19/90 vs 0/14 episodes; Fisher's exact test, P = 0.07). DAIR-treated patients with prosthetic hip joint infections due to S. aureus tended to have worse outcomes than those infected with

  18. Lack of current implantable cardioverter defibrillator guidelines application for primary prevention of sudden cardiac death in Latin American patients with heart failure: a cross-sectional study.

    Science.gov (United States)

    Gonzalez-Zuelgaray, Jorge; Pellizon, Oscar; Muratore, Claudio A; Oropeza, Elsa Silva; Rabinovich, Rafael; Ramos, José Luis; Tentori, Maria Cristina; Reyes, Nicolás; Aguayo, Rubén; Marin, Jorge; Peterson, Brett J

    2013-02-01

    This cross-sectional study evaluated the application of accepted international implantable cardioverter defibrillator (ICD) guidelines for primary prevention of sudden cardiac death in patients with heart failure. The PLASMA (Probabilidad de Sufrir Muerte Arritmica) study was designed to characterize management of cardiac patients in Latin America. Twelve centres included 1958 consecutively admitted patients in cardiology units in 2008 and 2009. Discharged patients were evaluated for primary prevention, ICD indication and prescription by general cardiologists. Of 1711 discharged patients, 1525 (89%) had data available for evaluating indication status. Class I indications for ICD therapy were met for 153 (10%) patients based on collected data. Only 20 (13%, 95% confidence interval: 7.7-18.4%) patients with indication were prescribed an ICD. Patients prescribed an ICD were younger than patients who were not prescribed an ICD (62 vs. 68 years, P Latin America, international guidelines for primary prevention ICD implantation are not well followed. The main reason is that cardiologists believe that patients do not meet indication criteria, even though study data confirm that criteria are met. This poses a significant challenge and underlines the importance of continuous and improved medical education.

  19. A multi-centre randomised controlled study of pre-IVF outpatient hysteroscopy in women with recurrent IVF implantation failure: Trial of Outpatient Hysteroscopy - [TROPHY] in IVF

    Directory of Open Access Journals (Sweden)

    Khalaf Yacoub

    2009-12-01

    Full Text Available Abstract Background The success rate of IVF treatment is low. A recent systematic review and meta-analysis found that the outcome of IVF treatment could be improved in patients who have experienced recurrent implantation failure if an outpatient hysteroscopy (OH is performed before starting the new treatment cycle. However, the trials were of variable quality, leading to a call for a large and high-quality randomised trial. This protocol describes a multi-centre randomised controlled trial to test the hypothesis that performing an OH prior to starting an IVF cycle improves the live birth rate of the subsequent IVF cycle in women who have experienced two to four failed IVF cycles. Methods and design Eligible and consenting women will be randomised to either OH or no OH using an internet based trial management programme that ensures allocation concealment and employs minimisation for important stratification variables including age, body mass index, basal follicle stimulating hormone level and number of previous failed IVF cycles. The primary outcome is live birth rate per IVF cycle started. Other outcomes include implantation, clinical pregnancy and miscarriage rates. The sample size for this study has been estimated as 758 participants with 379 participants in each arm. Interim analysis will be conducted by an independent Data Monitoring Committee (DMC, and final analysis will be by intention to treat. A favourable ethical opinion has been obtained (REC reference: 09/H0804/32. Trail Registration The trial has been assigned the following ISRCTN number: ISRCTN35859078

  20. Patient-related predictors of implant failure after primary total hip replacement in the initial, short- and long-terms

    DEFF Research Database (Denmark)

    Johnsen, S.P.; Sørensen, H.T.; Lucht, Ulf

    2006-01-01

    replacement, an age of 80 years or more and hip replacement undertaken as a sequela of trauma, for avascular necrosis or paediatric conditions, were associated with an increased risk of failure. However, during six months to 8.6 years after surgery, being less than 60 years old was associated...

  1. Embryo disposition and the new death scene

    Directory of Open Access Journals (Sweden)

    Ellison, David

    2011-01-01

    Full Text Available In the IVF clinic - a place designed principally for the production and implantation of embryos - scientists and IVF recipients are faced with decisions regarding the disposition of frozen embryos. At this time there are hundred of thousands of cryopreserved embryos awaiting such determinations. They may be thawed for transfer to the woman herself, they may be donated for research or for use by other infertile couples, they may remain in frozen storage, or they may variously be discarded by being allowed to 'succumb', or 'perish'. Where the choice is discard, some IVF clients have chosen to formalise the process through ceremony. A new language is emerging in response to the desires of the would-be-parents who might wish to characterise the discard experience as a ‘good death’. This article examines the procedure known as ‘compassionate transfer’ where the embryo to be discarded is placed in the woman’s vagina where it is clear that it will not develop further. An alternate method has the embryo transferred in the usual manner but without the benefit of fertility-enhancing hormones at a point in the cycle unreceptive to implantation. The embryo destined for disposal is thus removed from the realm of technological possibility and ‘returned’ to the female body for a homely death. While debates continue about whether or not embryos constitute life, new practices are developing in response to the emotional experience of embryo discard. We argue that compassionate transfer is a death scene taking shape. In this article, we take the measure of this new death scene’s fabrication, and consider the form, significance, and legal complexity of its ceremonies.

  2. Influence of irradiation (Co{sub 6}0) in pre-implant rabbits embryos: effect on blastocyst diameters and embryos smaller than 2 mm; Influencia da radiacao ionizante (bomba de cobalto) em embrioes de coelha na fase de pre-implantacao: efeito no diametro das blastulas e embrioes com menos de 2mm

    Energy Technology Data Exchange (ETDEWEB)

    Approbato, Mario S.; Oliveira Moura, Katia K.V. de; Souza Florencio, Rodopiano de; Cunha Junior, Carlos; Garcia, Ricardo; Faria, Renato S.; Benedetti, Leonardo N.; Goulart, Flamarion B.

    1995-06-01

    We studied the effect of ionizing irradiation on 12 New Zealand rabbits (65 embryos), in three different times: at match time (zero hour), two days after and four days after, with two different irradiation doses, 5 c Gy and 10 c Gy. Six rabbits (36 blastocysts) were used as controls. The matching instant was the zero hour. Exactly six days after ({+-} 60 minutes) the embryos of each rabbit was picked up by flushing the uterus with culture media. The embryos were fixed in methanol for 48 hours, and colored with acid Mayer hematoxylin. The following embryos parameters were studied: diameter growth; percentage of embryos smaller than 2 mm. We observed that only the irradiation time influenced the blastocysts diameter (no irradiation dose). There was no relation between percentage of embryos smaller than 2 mm and the irradiation. (author). 11 refs., 2 figs.

  3. Frailty and Clinical Outcomes in Advanced Heart Failure Patients Undergoing Left Ventricular Assist Device Implantation: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Tse, Gary; Gong, Mengqi; Wong, Sunny Hei; Wu, William K K; Bazoukis, George; Lampropoulos, Konstantinos; Wong, Wing Tak; Xia, Yunlong; Wong, Martin C S; Liu, Tong; Woo, Jean

    2017-11-09

    Frailty has been identified as a risk factor for adverse clinical outcomes after cardiac intervention or surgery. However, whether it increases the risk of adverse outcomes in patients undergoing left ventricular assist device (LVAD) therapy has been controversial. Therefore, we conducted a systematic review and meta-analysis of the frailty measures and clinical outcomes of length of stay and mortality in this setting. PubMed and Embase were searched until September 11, 2017, for studies evaluating the association between frailty and clinical outcomes in advanced heart failure patients undergoing LVAD implantation. A total of 46 and 79 entries were retrieved from our search strategy. A total of 13 studies involving 3435 patients were included in the final meta-analysis (mean age: 57.7 ± 15.3 years; 79% male, follow-up duration was 13 ± 14 months). Compared to nonfrail patients (n = 2721), frail patients (n = 579) had significantly longer time-to-extubation (n = 3; mean difference: 45 ± 6 hours; I(2): 0%) and hospital length of stay (n = 4; mean difference: 2.9 ± 1.2 days; P = .001; I(2): 21%). Frailty was not a predictor of inpatient or short-term mortality [n = 3; hazard ratio (HR): 1.22, 95% confidence interval (CI): 0.66-2.26; P > .05; I(2): 0%] but predicted long-term mortality (n = 7; HR: 1.44, 95% CI: 1.15-1.80; P = .001; I(2): 0%). Frailty leads to significantly longer time to extubation, hospital length of stay, and long-term mortality in advanced heart failure patients who have undergone LVAD implantation. Older patients being considered for LVAD implantation should therefore be assessed for frailty status. The risk and benefit of the procedure should be explained to the patient, emphasizing that frailty increases the likelihood of adverse clinical outcomes. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  4. Somatic donor cell type correlates with embryonic, but not extra-embryonic, gene expression in postimplantation cloned embryos.

    Directory of Open Access Journals (Sweden)

    Ryutaro Hirasawa

    Full Text Available The great majority of embryos generated by somatic cell nuclear transfer (SCNT display defined abnormal phenotypes after implantation, such as an increased likelihood of death and abnormal placentation. To gain better insight into the underlying mechanisms, we analyzed genome-wide gene expression profiles of day 6.5 postimplantation mouse embryos cloned from three different cell types (cumulus cells, neonatal Sertoli cells and fibroblasts. The embryos retrieved from the uteri were separated into embryonic (epiblast and extraembryonic (extraembryonic ectoderm and ectoplacental cone tissues and were subjected to gene microarray analysis. Genotype- and sex-matched embryos produced by in vitro fertilization were used as controls. Principal component analysis revealed that whereas the gene expression patterns in the embryonic tissues varied according to the donor cell type, those in extraembryonic tissues were relatively consistent across all groups. Within each group, the embryonic tissues had more differentially expressed genes (DEGs (>2-fold vs. controls than did the extraembryonic tissues (P<1.0 × 10(-26. In the embryonic tissues, one of the common abnormalities was upregulation of Dlk1, a paternally imprinted gene. This might be a potential cause of the occasional placenta-only conceptuses seen in SCNT-generated mouse embryos (1-5% per embryos transferred in our laboratory, because dysregulation of the same gene is known to cause developmental failure of embryos derived from induced pluripotent stem cells. There were also some DEGs in the extraembryonic tissues, which might explain the poor development of SCNT-derived placentas at early stages. These findings suggest that SCNT affects the embryonic and extraembryonic development differentially and might cause further deterioration in the embryonic lineage in a donor cell-specific manner. This could explain donor cell-dependent variations in cloning efficiency using SCNT.

  5. Age and Outcomes of Primary Prevention Implantable Cardioverter Defibrillators in Patients with Non-Ischemic Systolic Heart Failure

    DEFF Research Database (Denmark)

    Elming, Marie Bayer; Nielsen, Jens C; Haarbo, Jens

    2017-01-01

    of death between the two age groups was statistically significant (p=0.01). Conclusions -In patients with systolic heart failure not caused by ischemic heart disease, the association between the ICD and survival decreased linearly with increasing age. In this study population, an age cut-off for ICD...... analysis suggested a possible age-dependent association between the ICD and mortality with survival benefit seen only in the youngest patients. The nature of this relationship between age and outcome of a primary prevention ICD in patients with non-ischemic systolic heart failure warrants further...... investigation. Methods -All 1116 patients from the DANISH study were included in this pre-specified subgroup analysis. We assessed the relationship between the ICD and mortality by age, and an optimal age cut-off was estimated non-parametrically using selection impact curves. Modes of death were divided...

  6. Does the transfer of a poor quality embryo together with a good quality embryo affect the In Vitro Fertilization (IVF) outcome?

    Science.gov (United States)

    Wintner, Eliana Muskin; Hershko-Klement, Anat; Tzadikevitch, Keren; Ghetler, Yehudith; Gonen, Ofer; Wintner, Oren; Shulman, Adrian; Wiser, Amir

    2017-01-13

    IVF cycles which result in only one good quality embryo, and a second poor quality embryo present a dilemma when the decision involves transferring two embryos. The aim of this study was to evaluate whether a poor quality embryo has a negative effect on a good quality embryo when transferred along with a good quality embryo. We retrospectively evaluated in vitro fertilization (IVF) cycles involving single embryo transfers (SET) and double embryo transfers (DET). Embryo quality was divided into poor "P" and good "G" quality. The main outcome measures were: live birth, implantation rate, miscarriage rate, clinical pregnancy rate and multiple pregnancy ratio. Six hundred three women were included. The study group consisted of 180 (29.9%) patients who had a double embryo transfer (DET) with one poor quality embryo and one good quality embryo (P + G). Control 1 group included 303 (50.2%) patients who had DET with two good quality embryos (G + G), and control 2 group consisted of 120 (19.9%) patients who had a single embryo transfer (SET) with one good quality embryo (G). Live birth rates were not significantly different when compared between study groups: 30.8% in the SET group (G), 27.2% in the (G + P) group and 33.7% in the (G + G) group. The SET group had the highest implantation rate (33.9%) compared to the DET groups (21.8% (G + P), 25.4% (G + G)) (P =0.022). The clinical pregnancy rate was 33.3% in the SET group (G), 33.3% in the (G + P) group, and 39.3% in the (G + G) group (P =0.39). The miscarriage rate was comparable in all groups. A poor quality embryo does not negatively affect a good quality embryo, when transferred together in a double embryo transfer.

  7. Cochlear Implants

    Science.gov (United States)

    ... implant procedure Welcome to the Food and Drug Administration (FDA) website on cochlear implants. Cochlear implants are electronic hearing devices. Doctors implant cochlear implants into people ...

  8. Preimplantation death of xenomitochondrial mouse embryo harbouring bovine mitochondria

    Science.gov (United States)

    Kawahara, Manabu; Koyama, Shiori; Iimura, Satomi; Yamazaki, Wataru; Tanaka, Aiko; Kohri, Nanami; Sasaki, Keisuke; Takahashi, Masashi

    2015-01-01

    Mitochondria, cellular organelles playing essential roles in eukaryotic cell metabolism, are thought to have evolved from bacteria. The organization of mtDNA is remarkably uniform across species, reflecting its vital and conserved role in oxidative phosphorylation (OXPHOS). Our objectives were to evaluate the compatibility of xenogeneic mitochondria in the development of preimplantation embryos in mammals. Mouse embryos harbouring bovine mitochondria (mtB-M embryos) were prepared by the cell-fusion technique employing the haemagglutinating virus of Japan (HVJ). The mtB-M embryos showed developmental delay at embryonic days (E) 3.5 after insemination. Furthermore, none of the mtB-M embryos could implant into the maternal uterus after embryo transfer, whereas control mouse embryos into which mitochondria from another mouse had been transferred developed as well as did non-manipulated embryos. When we performed quantitative PCR (qPCR) of mouse and bovine ND5, we found that the mtB-M embryos contained 8.3% of bovine mitochondria at the blastocyst stage. Thus, contamination with mitochondria from another species induces embryonic lethality prior to implantation into the maternal uterus. The heteroplasmic state of these xenogeneic mitochondria could have detrimental effects on preimplantation development, leading to preservation of species-specific mitochondrial integrity in mammals. PMID:26416548

  9. Development of the ventral body wall in the human embryo

    NARCIS (Netherlands)

    Mekonen, Hayelom K.; Hikspoors, Jill P. J. M.; Mommen, Greet; Köhler, S. Eleonore; Lamers, Wouter H.

    2015-01-01

    Migratory failure of somitic cells is the commonest explanation for ventral body wall defects. However, the embryo increases ~ 25-fold in volume in the period that the ventral body wall forms, so that differential growth may, instead, account for the observed changes in topography. Human embryos

  10. Clinical usefulness of blood metal measurements to assess the failure of metal-on-metal hip implants

    Science.gov (United States)

    Sampson, Barry; Hart, Alister

    2012-01-01

    In April 2010, a Medicines and Healthcare Products Regulatory Agency safety alert concerning all metal-on-metal (MOM) hip replacements recommended measuring chromium and cobalt concentrations when managing patients with painful prostheses. The need for this review is illustrated by the recent surge in requests for these blood tests from orthopaedic surgeons following this alert. The aim is to provide guidance to laboratories in assessing these requests and advising clinicians on interpretation. First, we summarize the basic terminology regarding the types of hip replacements, with emphasis on the MOM type. Second, we describe the clinical concerns over implant-derived wear debris in the local tissues and distant sites. Analytical aspects of the measurement of the relevant metal ions and what factors affect the levels measured are discussed. The application of inductively coupled plasma mass spectrometry techniques to the measurement of these metals is considered in detail. The biological effects of metal wear products are summarized with local toxicity and systemic biological effects considered, including carcinogenicity, genotoxicity and systemic toxicity. Clinical cases are used to illustrate pertinent points. PMID:22155921

  11. Embryo development and embryo transfer in the European mink (Mustela lutreola), an endangered mustelid species.

    Science.gov (United States)

    Amstislavsky, S; Kizilova, E; Ternovskaya, Y; Zudova, G; Lindeberg, H; Aalto, J; Valtonen, M

    2006-01-01

    The European mink is an endangered Mustelidae species and thus requires effective conservation measures, although little is known about reproduction in this species. In particular, preimplantation development has not been studied and, therefore, embryonic development and the growth of embryos was documented in the present study for European mink using light and fluorescent microscopy. Embryos develop in the oviducts and then migrate into the uterus on Day 6 post coitum (p.c.) at the morula stage. Embryos expanded as blastocysts from Day 7 until implantation on Day 12 p.c. Based on these findings, the use of embryo transfer for a conservation programme for the European mink was evaluated. Embryos were flushed from European mink resource females and transferred into the uterine horns of recipient hybrid females (honoriks and nohoriks). These hybrids were obtained by mating European polecat males with European mink females and vice versa. A total of 40 embryos was transferred and 20 live kits were born. The rates of pre- and postnatal survival were 50% and 70%, respectively. Both male and female offspring were lighter at birth in the embryo transfer group compared with naturally born controls, but there was no difference at 3 months of age.

  12. Clinical management of implant prostheses in patients with bruxism

    NARCIS (Netherlands)

    Komiyama, O.; Lobbezoo, F.; de Laat, A.; Iida, T.; Kitagawa, T.; Murakami, H.; Kato, T.; Kawara, M.

    2012-01-01

    There is general agreement that excessive stress to the bone-implant interface may result in implant overload and failure. Early failure of the implant due to excessive loading occurs shortly after uncovering the implant. Excess load on a final restoration after successful implant integration can

  13. Fracture Strength and Failure Mode of Maxillary Implant-Supported Provisional Single Crowns : A Comparison of Composite Resin Crowns Fabricated Directly Over PEEK Abutments and Solid Titanium Abutments

    NARCIS (Netherlands)

    Santing, H.J.; Meijer, Henny J.A.; Raghoebar, G.M.; Ozcan, M.

    2012-01-01

    Background: Polyetheretherketone (PEEK) temporary abutments have been recently introduced for making implant-supported provisional single crowns. Little information is available in the dental literature on the durability of provisional implant-supported restorations. Purpose: The objectives of this

  14. Rates of Reconstruction Failure in Patients Undergoing Immediate Reconstruction With Tissue Expanders and/or Implants and Postmastectomy Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Fowble, Barbara, E-mail: BFowble@radonc.ucsf.edu [Department of Radiation Oncology, University of California San Francisco, San Francisco, California (United States); Park, Catherine [Department of Radiation Oncology, University of California San Francisco, San Francisco, California (United States); Wang, Frederick; Peled, Anne [Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, California (United States); Alvarado, Michael; Ewing, Cheryl; Esserman, Laura [Carol Franc Buck Breast Care Center, Department of Surgery, University of California San Francisco, San Francisco, California (United States); Foster, Robert; Sbitany, Hani [Division of Plastic and Reconstructive Surgery, University of California San Francisco, San Francisco, California (United States); Hanlon, Alex [University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania (United States)

    2015-07-01

    Objectives: Mastectomy rates for breast cancer have increased, with a parallel increase in immediate reconstruction. For some women, tissue expander and implant (TE/I) reconstruction is the preferred or sole option. This retrospective study examined the rate of TE/I reconstruction failure (ie, removal of the TE or I with the inability to replace it resulting in no final reconstruction or autologous tissue reconstruction) in patients receiving postmastectomy radiation therapy (PMRT). Methods and Materials: Between 2004 and 2012, 99 women had skin-sparing mastectomies (SSM) or total nipple/areolar skin-sparing mastectomies (TSSM) with immediate TE/I reconstruction and PMRT for pathologic stage II to III breast cancer. Ninety-seven percent had chemotherapy (doxorubicin and taxane-based), 22% underwent targeted therapies, and 78% had endocrine therapy. Radiation consisted of 5000 cGy given in 180 to 200 cGy to the reconstructed breast with or without treatment to the supraclavicular nodes. Median follow-up was 3.8 years. Results: Total TE/I failure was 18% (12% without final reconstruction, 6% converted to autologous reconstruction). In univariate analysis, the strongest predictor of reconstruction failure (RF) was absence of total TE/I coverage (acellular dermal matrix and/or serratus muscle) at the time of radiation. RF occurred in 32.5% of patients without total coverage compared to 9% with coverage (P=.0069). For women with total coverage, the location of the mastectomy scar in the inframammary fold region was associated with higher RF (19% vs 0%, P=.0189). In multivariate analysis, weight was a significant factor for RF, with lower weight associated with a higher RF. Weight appeared to be a surrogate for the interaction of total coverage, thin skin flaps, interval to exchange, and location of the mastectomy scar. Conclusions: RFs in patients receiving PMRT were lowered with total TE/I coverage at the time of radiation by avoiding inframammary fold incisions and

  15. Effects of sphingosine-1-phosphate on gene expression of two cell mouse embryos induced by C2-Ceramide

    Directory of Open Access Journals (Sweden)

    Xujing Geng

    2014-06-01

    Conclusions: This study provides a map of genes in the pre-implantation two cell mouse embryo. Further investigation based on these data will provide a better understanding of the effects of S1P on the pre-implantation embryos in other mammalian species, especially human.

  16. Oviduct: roles in fertilization and early embryo development.

    Science.gov (United States)

    Li, Shuai; Winuthayanon, Wipawee

    2017-01-01

    Animal oviducts and human Fallopian tubes are a part of the female reproductive tract that hosts fertilization and pre-implantation development of the embryo. With an increasing understanding of roles of the oviduct at the cellular and molecular levels, current research signifies the importance of the oviduct on naturally conceived fertilization and pre-implantation embryo development. This review highlights the physiological conditions within the oviduct during fertilization, environmental regulation, oviductal fluid composition and its role in protecting embryos and supplying nutrients. Finally, the review compares different aspects of naturally occurring fertilization and assisted reproductive technology (ART)-achieved fertilization and embryo development, giving insight into potential areas for improvement in this technology. © 2017 Society for Endocrinology.

  17. Effect of hyaluronic acid-enriched transfer medium on frozen-thawed embryo transfer outcomes.

    Science.gov (United States)

    Fu, Wei; Yu, Min; Zhang, Xiao-Jin

    2018-02-14

    To determine if hyaluronic acid-enriched transfer medium (HETM) affects the implantation rate (IR) and clinical pregnancy rate (PR) in women undergoing frozen-thawed embryo transfer (FET). The records of women who underwent FET from May 2014 to October 2014 were retrospectively reviewed. Outcome measures were IR and PR. In all 1721 cycles of 1632 patients were included in this study. HETM was used for 347 cycles of 342 patients, and standard medium for 1374 cycles of 1290 patients. Overall, FET outcomes were similar between the groups. For patients undergoing their first FET attempt, the IR (24.3% vs 31.6%, P = 0.042) and clinical PR (34.3% vs 50.1%, P = 0.004) were lower in the HETM group. For patients undergoing their second FET attempt, pregnancy outcomes were similar between the groups. For patients undergoing their third or more FET attempt, HETM was associated with a higher IR (33.3% vs 16.4%, P < 0.001) and higher PR (52.2% vs 27.4%, P < 0.001). HETM can improve the embryo IR and clinical PR in patients with repeated implantation failure in the third or more FET attempt. However, the use of HETM for first and second FET should be done with caution. © 2018 Japan Society of Obstetrics and Gynecology.

  18. Cochlear implant

    Science.gov (United States)

    Hearing loss - cochlear implant; Sensorineural - cochlear; Deaf - cochlear; Deafness - cochlear ... of the cochlear implant. WHO USES A COCHLEAR IMPLANT? Cochlear implants allow deaf people to receive and process ...

  19. Incidence and prognostic significance of sustained ventricular tachycardias in heart failure patients implanted with biventricular pacemakers without a back-up defibrillator: results from the prospective, multicentre, Mona Lisa cohort study.

    Science.gov (United States)

    Boveda, Serge; Marijon, Eloi; Jacob, Sophie; Defaye, Pascal; Winter, Jobst B; Bulava, Alan; Gras, Daniel; Albenque, Jean Paul; Combes, Nicolas; Pavin, Dominique; Delarche, Nicolas; Teubl, Alexander; Lambiez, Marie; Chevalier, Philippe

    2009-05-01

    The aim of this study was to investigate the 12-month incidence, predictive factors, and prognosis of sustained ventricular tachycardia (VT) in chronic heart failure patients implanted with biventricular pacemakers without a back-up defibrillator (CRT-P), assessed by continuous intracardiac ventricular electrograms. The Mona Lisa study, a prospective, multicentre, cohort study, designed to determine the incidence of sustained VT and its prognostic impact in CRT-P recipients within the year after implant enrolled 198 patients with moderate or severe chronic heart failure, despite optimal pharmacological therapy. An independent committee reviewed the data from all arrhythmic episodes as well as causes of death according to predefined criteria. During a mean follow-up of 9.8 +/- 3.1 months after implantation, 8 patients experienced at least one episode of sustained VT [4.3%; 95% confidence interval (CI), 1.1-7.5] and 21 deaths occurred, giving a 12-month mortality rate of 11.7% (95% CI, 6.4-16.9). The presence of sustained VT was associated with a high risk of sudden cardiac death (SCD) and the lowest 12-month overall survival (P < 0.0001). The incidence of sustained VT remains relatively low in the first year after CRT-P implantation, but when present appears closely associated with short-term adverse outcomes, especially SCD. This emphasizes the possible value of remote monitoring to detect high-risk patients for urgent upgrading.

  20. Blocking connexin channels improves embryo development of vitrified bovine blastocysts

    OpenAIRE

    Ortiz Escribano, Nerea; Szymanska, Katarzyna; BOL, MELISSA; Vandenberghe, Lynn; Decrock, Elke; Van Poucke, Mario; Peelman, Luc; Van den Abbeel, Etienne; Soom, Ann Van; Leybaert, Luc

    2017-01-01

    Connexins (Cxs) are required for normal embryo development and implantation. They form gap junctions (GJs) connecting the cytoplasm of adjacent cells and hemichannels (HCs), which are normally closed but open in response to stress conditions. Excessive HC opening is detrimental for cell function and may lead to cell death. We found that hatching of in vitro-produced bovine embryos, matured in serum-containing conditions, was significantly improved when vitrification/warming was done in the pr...

  1. Effects of aerobic interval training on measures of anxiety, depression and quality of life in patients with ischaemic heart failure and an implantable cardioverter defibrillator: A prospective non-randomized trial.

    Science.gov (United States)

    Isaksen, Kjetil; Munk, Peter Scott; Giske, Rune; Larsen, Alf Inge

    2016-03-01

    To evaluate the short- and long-term effects of aerobic interval training on quality of life and on symptoms of anxiety and depression among patients with ischaemic heart failure and an implantable cardioverter defibrillator. Prospective, non-randomized controlled study. Patients with ischaemic heart failure and an implantable cardioverter defibrillator, willing to undergo an aerobic interval training programme. A total of 31 patients were enrolled (19 were assigned to the aerobic interval training group and 12 to the control group). The aerobic interval training group performed a 12-week exercise training programme. All patients were evaluated with the Short Form-36 (SF-36), the Hospital Anxiety and Depression Scale (HADS) and the International Physical Activity Questionnaire at baseline, after 12 weeks and at 2 years. The aerobic interval training group showed significant improvements in several SF-36 subscores at 12 weeks. There was an unadjusted significant reduction in the HADS depression (HADS-D) score. At follow-up, results in the aero-bic interval training group moved towards baseline or remained stable, whereas in the control group HADS-D scores and some SF-36 subscores deteriorated. Participation in a 12-week aerobic interval training programme resulted in significant improvements in several measures of quality of life and the unadjusted HADS-D score in patients with ischaemic heart failure with an implantable cardioverter defibrillator. At follow-up there was significantly less sedentary activity in the aerobic interval training group, while psychometric measures were no longer significantly different from baseline.

  2. Dilemmas encountered with preimplantation diagnosis of aneuploidy in human embryos.

    Science.gov (United States)

    Allan, John; Edirisinghe, Rohini; Anderson, Jasen; Jemmott, Rodney; Nandini, A V; Gattas, Michael

    2004-04-01

    An increased embryo aneuploidy rate is associated with advancing maternal age. Preimplantation genetic diagnosis (PGD) using fluorescence in situ hybridisation (FISH) coupled with in vitro fertilisation (IVF)/embryo biopsy provides a powerful tool to improve the take home baby rates for this poor prognostic group. To report the preliminary findings of a PGD study for aneuploidy screening and to discuss the dilemmas encountered. Preimplantation genetic diagnosis was offered in egg pick up-PGD and frozen embryo transfer-PGD cycles. Embryo biopsy was carried out on day 3 and FISH was used to detect chromosomal abnormalities. The outcome of 75 patients, 100 treatment cycles; 62 egg pick up-PGD and 38 frozen embryo transfer-PGD are presented. The embryo biopsy rate, blastomere survival, presence of nuclei and successful FISH rates for egg pick-up and frozen embryo transfer cycles were similar giving a chromosomal abnormality rate of 57.5 and 51.2% for the respective treatment group. The positive pregnancy, clinical pregnancy and implantation rates were, for egg pick up-PGD 22.7, 13.6 and 21.1% and for frozen embryo transfer-PGD 13.8, 10.3 and 10.0%, respectively. Preimplantation genetic diagnosis coupled with IVF treatment seems to give satisfactory pregnancy rates. The high embryo aneuploidy rates, chromosomal mosaicism and other issues have presented significant ethical and management dilemmas for our physicians and patients alike. These issues highlight the importance of skillful pretreatment counselling for patients considering PGD.

  3. Electrical treatment of atrial arrhythmias in heart failure patients implanted with a dual defibrillator CRT device. Results from the TRADE-HF study.

    Science.gov (United States)

    Botto, Giovanni Luca; Padeletti, Luigi; Covino, Gregorio; Pieragnoli, Paolo; Liccardo, Mattia; Mariconti, Barbara; Favale, Stefano; Molon, Giulio; De Filippo, Paolo; Bolognese, Leonardo; Landolina, Maurizio; Raciti, Giovanni; Boriani, Giuseppe

    2017-06-01

    Ventricular and atrial arrhythmias commonly occur in heart failure patients and are a significant source of symptoms, morbidity and mortality. Some specific generators referred to as dual defibrillators, Dual CRT-Ds, have the ability to treat atrial and ventricular arrhythmias. TRADE-HF is a prospective two-arm randomized study aimed at assessing the benefits of complete automatic management of atrial arrhythmias in patients implanted with a dual CRT-D. Primary objective of the TRADE-HF study was to document reduction of unplanned hospital admission for cardiac reasons or death for cardiovascular causes or progression to permanent AF, by comparing fully-automatic device driven therapy for atrial tachycardia or fibrillation (AT/AF) to an in-hospital approach for treatment of symptomatic AT/AF. Randomized Patients were followed every 6months for 3years to assess the primary objective. Four-hundred-twenty patients have been enrolled in the study. At the end of the study 30 subjects died for cardiovascular causes, 60 had at least one hospitalization for cardiovascular causes and 14 developed permanent AF. Eighty-seven patients experienced a composite event. Hazard Ratio for device-managed automatic therapy arm compared to traditional was 0.987 (95% CI: 0.684-1.503; p=0.951). The primary endpoint analysis resulted in no difference between the device managed and in-hospital treatment arm. The TRADE-HF study failed to demonstrate a reduction in the composite of unplanned hospitalizations for cardiovascular causes or death for cardiovascular causes or progression to permanent AF using automatic atrial therapy compared to a traditional approach including hospitalization for symptomatic episodes and/or in-hospital treatment of AT/AF. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Soluble CD146, an innovative and non-invasive biomarker of embryo selection for in vitro fertilization.

    Directory of Open Access Journals (Sweden)

    Sylvie Bouvier

    Full Text Available Although progress was made in in vitro fertilization (IVF techniques, the majority of embryos transferred fail to implant. Morphology embryo scoring is the standard procedure for most of IVF centres for choosing the best embryo, but remains limited since even the embryos classified as "top quality" may not implant. As it has been shown that i CD146 is involved in embryo implantation and ii membrane form is shed to generate soluble CD146 (sCD146, we propose that sCD146 in embryo supernatants may constitute a new biomarker of embryo selection. Immunocytochemical staining showed expression of CD146 in early embryo stages and sCD146 was detected by ELISA and Western-blot in embryo supernatants from D2. We retrospectively studied 126 couples who underwent IVF attempt. The embryo culture medium from each transferred embryo (n = 222 was collected for measurement of sCD146 by ELISA. Significantly higher sCD146 concentrations were present in embryo supernatants that did not implant (n = 185 as compared to those that successfully implanted (n = 37 (1310 +/- 1152 pg.mL-1 vs. 845+/- 1173 pg.mL-1, p = 0.024. Sensitivity analysis performed on single embryo transfers (n = 71 confirmed this association (p = 0.0054. The computed ROC curve established that the optimal sCD146 concentration for embryo implantation is under 1164 pg.mL-1 (sensitivity: 76%, specificity: 48%, PPV: 25% and NPV: 92%. Over this sCD146 threshold, the implantation rate was significantly lower (9% with sCD146 levels >1164 pg.ml-1 vs. 22% with sCD146 levels ≤ 1164 pg.mL-1, p = 0.01. Among the embryos preselected by morphologic scoring, sCD146 determination could allow a better selection of the embryo(s, thus improving the success of elective single embryo transfer. This study establishes the proof of concept for the use of sCD146 as a biomarker for IVF by excluding the embryo with the highest sCD146 level. A multicentre prospective study will now be necessary to further establish its use in

  5. Inverse Relationship of Blood Pressure to Long-Term Outcomes and Benefit of Cardiac Resynchronization Therapy in Patients With Mild Heart Failure: A Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy Long-Term Follow-Up Substudy.

    Science.gov (United States)

    Biton, Yitschak; Moss, Arthur J; Kutyifa, Valentina; Mathias, Andrew; Sherazi, Saadia; Zareba, Wojciech; McNitt, Scott; Polonsky, Bronislava; Barsheshet, Alon; Brown, Mary W; Goldenberg, Ilan

    2015-09-01

    Previous studies have shown that low blood pressure is associated with increased mortality and heart failure (HF) in patients with left ventricular dysfunction. Cardiac resynchronization therapy (CRT) was shown to increase systolic blood pressure (SBP). Therefore, we hypothesized that treatment with CRT would provide incremental benefit in patients with lower SBP values. The independent contribution of SBP to outcome was analyzed in 1267 patients with left bundle brunch block enrolled in Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT). SBP was assessed as continuous measures and further categorized into approximate quintiles. The risk of long-term HF or death and CRT with defibrillator versus implantable cardioverter defibrillator benefit was assessed in multivariate Cox proportional hazards regression models. Multivariate analysis showed that in the implantable cardioverter defibrillator arm, each 10-mm Hg decrement of SBP was independently associated with a significant 21% (P2-fold risk-increase. CRT with defibrillator provided the greatest HF or mortality risk reduction in patients with SBPSBP≥136 mm Hg and hazard ratio of 0.94, P=0.808, with SBP>136 mm Hg (P for trend=0.001). In patients with mild HF, prolonged QRS, and left bundle brunch block, low SBP is related to higher risk of mortality or HF with implantable cardioverter defibrillator therapy alone. Treatment with CRT is associated with incremental clinical benefits in patients with lower baseline SBP values. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00180271. © 2015 American Heart Association, Inc.

  6. Comparison between Conventional Blind Embryo Transfer and Embryo Transfer Based on Previously Measured Uterine Length

    Directory of Open Access Journals (Sweden)

    Nasrin Saharkhiz

    2014-11-01

    Full Text Available Background: Embryo transfer (ET is one of the most important steps in assisted reproductive technology (ART cycles and affected by many factors namely the depth of embryo deposition in uterus. In this study, the outcomes of intracytoplasmic sperm injection (ICSI cycles after blind embryo transfer and embryo transfer based on previously measured uterine length using vaginal ultrasound were compared. Materials and Methods: This prospective randomised clinical trial included one hundred and forty non-donor fresh embryo transfers during January 2010 to June 2011. In group I, ET was performed using conventional (blind method at 5-6cm from the external os, and in group II, ET was done at a depth of 1-1.5 cm from the uterine fundus based on previously measured uterine length using vaginal sonography. Appropriate statistical analysis was performed using Student’s t test and Chi-square or Fisher’s exact test. The software that we used was PASW statistics version 18. A p value <0.05 was considered statistically significant. Results: Chemical pregnancy rate was 28.7% in group I and 42.1% in group II, while the difference was not statistically significant (p=0.105. Clinical pregnancy, ongoing pregnancy and implantation rates for group I were 21.2%, 17.7%, and 12.8%, while for group II were 33.9%, 33.9%, and 22.1, respectively. In group I and group II, abortion rates were 34.7% and 0%, respectively, indicating a statistically significant difference (p<0.005. No ectopic pregnancy occurred in two groups. Conclusion: The use of uterine length measurement during treatment cycle in order to place embryos at depth of 1-1.5cm from fundus significantly increases clinical and ongoing pregnancy and implantation rates, while leads to a decrease in abortion rate (Registration Number: IRCT2014032512494N1.

  7. Illness perceptions in patients with heart failure and an implantable cardioverter defibrillator: Dimensional structure, validity, and correlates of the brief illness perception questionnaire in Dutch, French and German patients.

    Science.gov (United States)

    Timmermans, I; Versteeg, H; Meine, M; Pedersen, S S; Denollet, J

    2017-06-01

    Patients' illness perceptions are associated with psychological wellbeing and can be measured with the Brief Illness Perception Questionnaire (B-IPQ). However, little is known about illness perceptions in patients with heart failure. We examined the dimensional structure, validity and clinical and psychological correlates of the B-IPQ in Dutch, French and German patients with heart failure and an implantable cardioverter defibrillator (ICD). European heart failure patients (n=585) participating in the REMOTE-CIED study completed a set of questionnaires 1-2weeks post ICD-implantation, including the B-IPQ. Information on clinical data was captured from patients' medical records. A two-factor structure (I='Consequences'; II='Control') represented 7 out of 8 B-IPQ items in the total sample and Dutch, German and French subgroups. The total B-IPQ had a Cronbach's α of 0.69, with the 'Consequences' subscale being more internally consistent (α=0.80). Both the B-IPQ and its 'Consequences' subscale were significantly correlated with a number of psychological characteristics, but not with clinical characteristics. Multivariable logistic regression analysis indicated that threatening illness perceptions as measured with the total B-IPQ were associated with poor health status (OR=2.66, 95%CI=1.72-4.11), anxiety (OR=1.79, 95%CI=1.001-3.19), depression (OR=2.81, 95%CI=1.65-4.77), negative affectivity (OR=1.93, 95%CI=1.21-3.09) and poor ICD acceptance (OR=2.68, 95%CI=1.70-4.22). The B-IPQ demonstrated good psychometric properties in Dutch, French and German patients with heart failure. Psychological factors were the most important correlates of patients' perceptions of heart failure, emphasizing the importance of targeting maladaptive illness perceptions in this population, due to their impact on patients' wellbeing and quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. The Relationship between Cell Number, Division Behavior and Developmental Potential of Cleavage Stage Human Embryos: A Time-Lapse Study.

    Science.gov (United States)

    Kong, Xiangyi; Yang, Shuting; Gong, Fei; Lu, Changfu; Zhang, Shuoping; Lu, Guangxiu; Lin, Ge

    2016-01-01

    Day 3 cleavage embryo transfer is routine in many assisted reproductive technology centers today. Embryos are usually selected according to cell number, cell symmetry and fragmentation for transfer. Many studies have showed the relationship between cell number and embryo developmental potential. However, there is limited understanding of embryo division behavior and their association with embryo cell number and developmental potential. A retrospective and observational study was conducted to investigate how different division behaviors affect cell number and developmental potential of day 3 embryos by time-lapse imaging. Based on cell number at day 3, the embryos (from 104 IVF/intracytoplasmic sperm injection (ICSI) treatment cycles, n = 799) were classified as follows: less than 5 cells (10C; n = 42). Division behavior, morphokinetic parameters and blastocyst formation rate were analyzed in 5 groups of day 3 embryos with different cell numbers. In 10C embryos increased compared to 7-8C embryos (45.8%, 33.3% vs. 11.1%, respectively). In ≥5C embryos, FR and DC significantly reduced developmental potential, whereas potential irrespective of division behaviors. In NB embryos, the blastocyst formation rate increased with cell number from 7.4% (10C). In NB embryos, the cell cycle elongation or shortening was the main cause for abnormally low or high cell number, respectively. After excluding embryos with abnormal division behaviors, the developmental potential, implantation rate and live birth rate of day 3 embryos increased with cell number.

  9. Increasing twinning rate in beef cattle through embryo transfer ...

    African Journals Online (AJOL)

    Thirty-nine Limousin X Friesian heifers and forty-five Limousin X Friesian cows were randomly allocated to three treatments in a twin-induction breeding program. Animals were inseminated twice with Limousin semen (treatment A) or inseminated twice also with Hereford semen and each implanted with one embryo 7 days ...

  10. Hybrid approach of ventricular assist device and autologous bone marrow stem cells implantation in end-stage ischemic heart failure enhances myocardial reperfusion

    Directory of Open Access Journals (Sweden)

    Khayat Andre

    2011-01-01

    Full Text Available Abstract We challenge the hypothesis of enhanced myocardial reperfusion after implanting a left ventricular assist device together with bone marrow mononuclear stem cells in patients with end-stage ischemic cardiomyopathy. Irreversible myocardial loss observed in ischemic cardiomyopathy leads to progressive cardiac remodelling and dysfunction through a complex neurohormonal cascade. New generation assist devices promote myocardial recovery only in patients with dilated or peripartum cardiomyopathy. In the setting of diffuse myocardial ischemia not amenable to revascularization, native myocardial recovery has not been observed after implantation of an assist device as destination therapy. The hybrid approach of implanting autologous bone marrow stem cells during assist device implantation may eventually improve native cardiac function, which may be associated with a better prognosis eventually ameliorating the need for subsequent heart transplantation. The aforementioned hypothesis has to be tested with well-designed prospective multicentre studies.

  11. A randomized clinical trial to evaluate the effect of granulocyte- macrophage colony-stimulating factor (GM-CSF) in embryo culture medium for in vitro fertilization

    DEFF Research Database (Denmark)

    Ziebe, Søren; Loft, Anne; Povlsen, Betina B.

    2013-01-01

    To evaluate the effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) in embryo culture medium on ongoing implantation rate (OIR).......To evaluate the effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) in embryo culture medium on ongoing implantation rate (OIR)....

  12. Vitrification can modify embryo cleavage stage after warming. Should we change endometrial preparation?

    Science.gov (United States)

    Cercas, R; Villas, C; Pons, I; Braña, C; Fernandez-Shaw, S

    2012-12-01

    Studies have shown that embryo metabolism and cell cleavage after warming vitrified embryos is faster than after thawing frozen embryos. We study vitrified embryo transfer (VET) results depending on the developmental stage of warmed embryos and the duration of progesterone treatment before embryo transfer. We designed a prospective study, patients were randomized in two groups, starting progesterone three (D + 3) or four days (D + 4) before embryo transfer. We recruited 88 patients with embryos vitrified on day 3. We didn't find statitistical differences in pregnancy rate when we transferred embryos in D + 3 vs D + 4 (38.2 % vs 40.5 % p ≥ 0.05). The day after warming, 54.6 % of embryos had developed to morula or early blastocyst, 32.4 % to cleavage stage and 13 % didn't cleave. Transfers were with morula/blastocysts stage embryos (52.1 %; n:37), cleavage stage embryos (18.3 %; n:13) or mixed (29.6 %; n:21). Implantation rate was significantly higher in morula/blastocyst stage than in cleavage stage or mixed transfers (44 %, 22 % and 16.3 %; p = 0.011). Pregnancy and implantation rates were significantly higher in morula/blastocyst transfers on D + 4 than on D + 3 (68.7 % and 64.7 % vs 33.3 %, and 33.3 %, p = 0.033 and p = 0.034). Our findings suggest that a majority of embryos will develop to morula/blastocyst stage after warming. VET results with morula/blastocysts, and after four days of progesterone supplementation, are better than with cleavage stage embryos.

  13. Percutaneous implantation of the left ventricular partitioning device for chronic heart failure: a pilot study with 1-year follow-up.

    Science.gov (United States)

    Sagic, Dragan; Otasevic, Petar; Sievert, Horst; Elsasser, Albrecht; Mitrovic, Veselin; Gradinac, Sinisa

    2010-06-01

    To assess short-term safety defined as the successful delivery and deployment of the ventricular partitioning device (VPD) implant, as well as 12-month functional, clinical, and haemodynamic effectiveness. Ventricular partitioning device implantation was successful in 15/18 (83%) patients with anteroapical regional wall motion abnormalities following myocardial infarction. In one patient, the VPD was removed 3 days post implantation and the patient subsequently died due to extra-cardiac sepsis. When compared with baseline, there was significant improvement at 6 and 12 months following VPD implantation in NYHA class (2.21 +/- 0.57 vs. 1.28 +/- 0.46 vs. 1.23 +/- 0.4.3, respectively, P < 0.001 for both), left ventricular (LV) end-systolic volume (189 +/- 45 vs. 142 +/- 29 vs. 151 +/- 48 mL/m(2), respectively, P < 0.001 for both), and LV end-diastolic volume (260 +/- 47 vs. 208 +/- 33 vs. 222 +/- 58 mL/m(2), respectively, P < 0.001 for both). After 12 months, an improvement in LV ejection fraction was noted (28 +/- 7 vs. 32 +/- 7 vs. 33 +/- 9%, respectively, P = 0.02) as well as improvement in 6 min walk distance (382 +/- 123 vs. 409 +/- 7 vs. 425 +/- 140 m) when compared with pre-procedural values. Our data indicate that VPD implantation is safe and feasible, and that VPD implantation improves LV haemodynamics and functional capacity in the 12 months following the procedure.

  14. Embryo-maternal communication

    DEFF Research Database (Denmark)

    Østrup, Esben; Hyttel, Poul; Østrup, Olga

    2011-01-01

    Communication during early pregnancy is essential for successful reproduction. In this review we address the beginning of the communication between mother and developing embryo; including morphological and transcriptional changes in the endometrium as well as epigenetic regulation mechanisms...... directing the placentation. An increasing knowledge of the embryo-maternal communication might not only help to improve the fertility of our farm animals but also our understanding of human health and reproduction....

  15. The association between embryo quality and perinatal outcome of singletons born after single embryo transfers: a pilot study.

    Science.gov (United States)

    Oron, Galia; Son, Weon-Young; Buckett, William; Tulandi, Togas; Holzer, Hananel

    2014-07-01

    Does the quality of a single transferred embryo have an effect on the pregnancy outcome? After adjusting for confounding maternal variables, poor embryo quality was not associated with adverse obstetric or perinatal outcome in this small pilot study. Embryo quality is a major predictor of the success of in vitro fertilization treatment and studies have demonstrated a strong association between embryo morphology, implantation and clinical pregnancy rates. However, the association with obstetric and perinatal outcomes has not been evaluated. This single center, retrospective cohort study included 1541 fresh single embryo transfers (SETs) using non-donor oocytes in women ≤40 years between December 2008 and 2012. We compared the cycle outcome and singleton live births resulting from the transfer of a single fresh good quality (Grade 2) embryo with those resulting from the transfer of a single poor quality (fair, Grade 3 or poor, Grade 4) embryo in the cleavage or blastocyst stages. The cycle outcome parameters were biochemical pregnancy and clinical intrauterine pregnancy. The pregnancy outcomes were live birth, miscarriages and stillbirths after 20 weeks of gestation. Among the live births, perinatal outcome parameters included birthweight, small for gestational age, preterm delivery, pre-eclampsia, placental abruption and neonatal complications. Covariates were maternal age, body mass index, smoking status, parity and gender of the baby. There were 1193 good quality SETs and 348 poor quality embryo transfers. SETs performed during the study period resulted in 563 pregnancies and 440 singleton births. There was a higher clinical pregnancy rate (41.5%) and live birth rate (32.3%) in the good quality embryo transfer group compared with that in the poor quality transfer group (19.2 and 15.5%, respectively; P quality embryo. Multivariable logistic regression analyses for pregnancy complications revealed no increased risk of maternal or neonatal complications with the

  16. Cryopreservation of canine embryos.

    Science.gov (United States)

    Abe, Yasuyuki; Suwa, Yoshinori; Asano, Tomoyoshi; Ueta, Yoshiko Yanagimoto; Kobayashi, Nanae; Ohshima, Natsumi; Shirasuna, Saori; Abdel-Ghani, Mohammed Ali; Oi, Maya; Kobayashi, Yoshiyasu; Miyoshi, Masafumi; Miyahara, Kazuro; Suzuki, Hiroshi

    2011-02-01

    The assisted reproductive techniques (ARTs) such as in vitro fertilization, embryo transfer, and cryopreservation of gametes have contributed considerably to the development of biomedical sciences in addition to improving infertility treatments in humans as well as the breeding of domestic animals. However, ARTs used in canine species have strictly limited utility when compared with other mammalian species, including humans. Although successful somatic cell cloning has been reported, artificial insemination by frozen semen to date is only available for the improved breeding and reproduction for companion and working dogs as well as guide dogs for the blind. We describe here the successful cryopreservation of embryos and subsequent embryo transfer in dogs. Canine embryos were collected from excised reproductive organs after artificial insemination and subsequently cryopreserved by a vitrification method. When the 4-cell to morula stage of cryopreserved embryos were nonsurgically transferred into the uteri of nine recipient bitches using a cystoscope, five recipients became pregnant and four of them delivered a total of seven pups. The cryopreservation of embryos in canine species will facilitate the transportation and storage of genetic materials and will aid in the elimination of vertically transmitted diseases in dogs. In addition, this technique will contribute to the improved breeding of companion and working dogs such as guide dogs, drug-detecting dogs, and quarantine dogs.

  17. The Relationship between Cell Number, Division Behavior and Developmental Potential of Cleavage Stage Human Embryos: A Time-Lapse Study.

    Directory of Open Access Journals (Sweden)

    Xiangyi Kong

    Full Text Available Day 3 cleavage embryo transfer is routine in many assisted reproductive technology centers today. Embryos are usually selected according to cell number, cell symmetry and fragmentation for transfer. Many studies have showed the relationship between cell number and embryo developmental potential. However, there is limited understanding of embryo division behavior and their association with embryo cell number and developmental potential. A retrospective and observational study was conducted to investigate how different division behaviors affect cell number and developmental potential of day 3 embryos by time-lapse imaging. Based on cell number at day 3, the embryos (from 104 IVF/intracytoplasmic sperm injection (ICSI treatment cycles, n = 799 were classified as follows: less than 5 cells (10C; n = 42. Division behavior, morphokinetic parameters and blastocyst formation rate were analyzed in 5 groups of day 3 embryos with different cell numbers. In 10C embryos increased compared to 7-8C embryos (45.8%, 33.3% vs. 11.1%, respectively. In ≥5C embryos, FR and DC significantly reduced developmental potential, whereas 10C. In NB embryos, the cell cycle elongation or shortening was the main cause for abnormally low or high cell number, respectively. After excluding embryos with abnormal division behaviors, the developmental potential, implantation rate and live birth rate of day 3 embryos increased with cell number.

  18. Embryo manipulation and experimentation.

    Science.gov (United States)

    Warren, M A

    1991-09-01

    I have argued that early human embryos are not human beings, and do not have normal rights. Like human sperm and ova, they are both alive and biologically human. However, they lack the physiological development necessary to sustain a capacity for sentience. If Ford is right, then they are not yet individual human organisms. But the more important point is that their lack of a capacity for sentience makes them inappropriate candidates for the ascription of moral rights. Thus, research on human embryos produced in vitro is not a wrong against them--at least so long as experimentally manipulated embryos are not returned to the womb, or artificially gestated to a stage at which they might become sentient. Some of the more difficult issues about embryo experimentation involve the rights of women as experimental subject and donors. The consent of both male and female gamete donors should normally be required for the production or experimental use of IVF embryos. (Possible exceptions might include cases in which one or both progenitors have died, and the survivor or other responsible family member wished to donate the (frozen) IVF embryos for research or other uses.) However, it is women's rights that are most apt to be endangered, for example, if the large scale therapeutic or commercial use of human embryos leads to a demand for large numbers of ova. Thus, it is vital that researchers and policy-makers heed feminist concerns about embryo research and the new biomedical technologies it may yield. Given adequate information and appropriate procedural protections, women are capable of making autonomous decisions about donating ova or embryos for biomedical research. But regulatory safeguards are needed to ensure against their being coerced, deceived, or manipulated into becoming ovum or embryo donors. As Daniel Callahan has detailed, biomedical technology has reached the point where we can no longer afford to provide everyone with all of the innovative therapies that might

  19. Short dental implants: an emerging concept in implant treatment.

    Science.gov (United States)

    Al-Hashedi, Ashwaq Ali; Taiyeb Ali, Tara Bai; Yunus, Norsiah

    2014-06-01

    Short implants have been advocated as a treatment option in many clinical situations where the use of conventional implants is limited. This review outlines the effectiveness and clinical outcomes of using short implants as a valid treatment option in the rehabilitation of edentulous atrophic alveolar ridges. Initially, an electronic search was performed on the following databases: Medline, PubMed, Embase, Cochrane Database of Systematic Reviews, and DARE using key words from January 1990 until May 2012. An additional hand search was included for the relevant articles in the following journals: International Journal of Oral and Maxillofacial Implants, Clinical Oral Implants Research, Journal of Clinical Periodontology, International Journal of Periodontics, Journal of Periodontology, and Clinical Implant Dentistry and Related Research. Any relevant papers from the journals' references were hand searched. Articles were included if they provided detailed data on implant length, reported survival rates, mentioned measures for implant failure, were in the English language, involved human subjects, and researched implants inserted in healed atrophic ridges with a follow-up period of at least 1 year after implant-prosthesis loading. Short implants demonstrated a high rate of success in the replacement of missing teeth in especially atrophic alveolar ridges. The advanced technology and improvement of the implant surfaces have encouraged the success of short implants to a comparable level to that of standard implants. However, further randomized controlled clinical trials and prospective studies with longer follow-up periods are needed.

  20. Factors associated with dizygotic twinning after IVF treatment with double embryo transfer

    NARCIS (Netherlands)

    Groeneveld, E.; Lambers, M.J.; Stakelbeek, M.E.; Mooij, T.M.; Belt-Dusebout, A.W. van den; Heymans, M.W.; Schats, R.; Hompes, P.G.; Hoek, A.; Burger, C.W.; Leeuwen, F.E. van; Lambalk, C.B.; Kortman, M.; Laven, J.S.E.; Jansen, C.A; Helmerhorst, F.M.; Cohlen, B.J.; Braat, D.D.M.; Smeenk, J.M.; Simons, A.H.; Veen, F. van der; Evers, J.L.; Dop, P.A. van

    2012-01-01

    BACKGROUND: Dizygotic twin pregnancies after IVF treatment are the result of multiple embryos transferred into the uterine cavity, followed by successful double implantation. Factors that increase the chance of multiple implantation after IVF are relatively unknown. The present study aimed to

  1. Factors associated with dizygotic twinning after IVF treatment with double embryo transfer

    NARCIS (Netherlands)

    Groeneveld, E.; Lambers, M. J.; Stakelbeek, M. E. F.; Mooij, T. M.; van den Belt-Dusebout, A. W.; Heymans, M. W.; Schats, R.; Hompes, P. G. A.; Hoek, A.; Burger, C. W.; van Leeuwen, F. E.; Lambalk, C. B.

    2012-01-01

    Dizygotic twin pregnancies after IVF treatment are the result of multiple embryos transferred into the uterine cavity, followed by successful double implantation. Factors that increase the chance of multiple implantation after IVF are relatively unknown. The present study aimed to investigate

  2. Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology.

    Science.gov (United States)

    Glujovsky, Demián; Blake, Debbie; Farquhar, Cindy; Bardach, Ariel

    2012-07-11

    Advances in cell culture media have led to a shift in in vitro fertilization (IVF) practice from early cleavage embryo transfer to blastocyst stage transfer. The rationale for blastocyst culture is to improve both uterine and embryonic synchronicity and enable self selection of viable embryos thus resulting in higher implantation rates. To determine if blastocyst stage (Day 5 to 6) embryo transfers (ETs) improve live birth rate and other associated outcomes compared with cleavage stage (Day 2 to 3) ETs. Cochrane Menstrual Disorders and Subfertility Group Specialised Register of controlled trials, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE and Bio extracts. The last search date was 21 February 2012. Trials were included if they were randomised and compared the effectiveness of early cleavage versus blastocyst stage transfers. Of the 50 trials that were identified, 23 randomised controlled trials (RCTs) met the inclusion criteria and were reviewed (five new studies were added in this update). The primary outcome was rate of live birth. Secondary outcomes were rates per couple of clinical pregnancy, cumulative clinical pregnancy, multiple pregnancy, high order pregnancy, miscarriage, failure to transfer embryos and cryopreservation. Quality assessment, data extraction and meta-analysis were performed following Cochrane guidelines. Twelve RCTs reported live birth rates and there was evidence of a significant difference in live birth rate per couple favouring blastocyst culture (1510 women, Peto OR 1.40, 95% CI 1.13 to 1.74) (Day 2 to 3: 31%; Day 5 to 6: 38.8%, I(2) = 40%). This means that for a typical rate of 31% in clinics that use early cleavage stage cycles, the rate of live births would increase to 32% to 42% if clinics used blastocyst transfer.There was no difference in clinical pregnancy rate between early cleavage and blastocyst transfer in the 23 RCTs (Peto OR 1.14, 95% CI 0.99 to 1.32) (Day 2 to 3: 38

  3. Implantation Serine Proteinases heterodimerize and are critical in hatching and implantation

    Directory of Open Access Journals (Sweden)

    Meng Guoliang

    2006-12-01

    Full Text Available Abstract Background We have recently reported the expression of murine Implantation Serine Proteinase genes in pre-implantation embryos (ISP1 and uterus (ISP1 and ISP2. These proteinases belong to the S1 proteinase family and are similar to mast cell tryptases, which function as multimers. Results Here, we report the purification and initial characterization of ISP1 and 2 with respect to their physico-chemical properties and physiological function. In addition to being co-expressed in uterus, we show that ISP1 and ISP2 are also co-expressed in the pre-implantation embryo. Together, they form a heterodimer with an approximate molecular weight of 63 kD. This complex is the active form of the enzyme, which we have further characterized as being trypsin-like, based on substrate and inhibitor specificities. In addition to having a role in embryo hatching and outgrowth, we demonstrate that ISP enzyme is localized to the site of embryo invasion during implantation and that its activity is important for successful implantation in vivo. Conclusion On the basis of similarities in structural, chemical, and functional properties, we suggest that this ISP enzyme complex represents the classical hatching enzyme, strypsin. Our results demonstrate a critical role for ISP in embryo hatching and implantation.

  4. [From implantable cardioverter-defibrillator to cardiac resynchronization therapy with the use of epicardial left ventricular lead. The evolution of the treatment of post inflammatory heart failure--a case report].

    Science.gov (United States)

    Gepner, Katarzyna; Sterliński, Maciej; Przybylski, Andrzej; Maciag, Aleksander; Kołsut, Piotr; Szwed, Hanna

    2006-10-01

    The authors present a case of a 77-year-old man with heart failure in the course of dilated cardiomyopathy (DCM) and atrial fibrillation (AF), after implantation of an automatic cardioverter-defibrillator (ICD) due to recurrent symptomatic ventricular tachycardia (VT). Addition of cardiac resynchronization therapy (CRT) was decided due to the heart-failure dependent intensification of the arrhythmia and poststimulation enlargement of QRS. CRT was led to withdraw patient's arrhythmia and to improvement of the general condition of the patient for approximately one year. After the arrhythmia reoccurred due to dislocation of the electrode in the coronary sinus with loss of left ventricle stimulation. Multiple attempts at restoration of resynchronization function via a transvenous approach failed. The patient was qualified for implantation of an epicardial left ventricle electrode. The surgery was combined with a planned exchange of ICD-CRT. Basing on a 6-month observation period an improvement heart performance and general state of health have been observed. No arrhythmic event has been noted in device memory. Performed procedures are picturing the evolution of in pacing techniques and automatic defibrillation in Poland over recent years.

  5. The Impact of Biopsy on Human Embryo Developmental Potential during Preimplantation Genetic Diagnosis

    Directory of Open Access Journals (Sweden)

    Danilo Cimadomo

    2016-01-01

    Full Text Available Preimplantation Genetic Diagnosis and Screening (PGD/PGS for monogenic diseases and/or numerical/structural chromosomal abnormalities is a tool for embryo testing aimed at identifying nonaffected and/or euploid embryos in a cohort produced during an IVF cycle. A critical aspect of this technology is the potential detrimental effect that the biopsy itself can have upon the embryo. Different embryo biopsy strategies have been proposed. Cleavage stage blastomere biopsy still represents the most commonly used method in Europe nowadays, although this approach has been shown to have a negative impact on embryo viability and implantation potential. Polar body biopsy has been proposed as an alternative to embryo biopsy especially for aneuploidy testing. However, to date no sufficiently powered study has clarified the impact of this procedure on embryo reproductive competence. Blastocyst stage biopsy represents nowadays the safest approach not to impact embryo implantation potential. For this reason, as well as for the evidences of a higher consistency of the molecular analysis when performed on trophectoderm cells, blastocyst biopsy implementation is gradually increasing worldwide. The aim of this review is to present the evidences published to date on the impact of the biopsy at different stages of preimplantation development upon human embryos reproductive potential.

  6. The Impact of Biopsy on Human Embryo Developmental Potential during Preimplantation Genetic Diagnosis

    Science.gov (United States)

    Cimadomo, Danilo; Capalbo, Antonio; Ubaldi, Filippo Maria; Scarica, Catello; Palagiano, Antonio; Canipari, Rita; Rienzi, Laura

    2016-01-01

    Preimplantation Genetic Diagnosis and Screening (PGD/PGS) for monogenic diseases and/or numerical/structural chromosomal abnormalities is a tool for embryo testing aimed at identifying nonaffected and/or euploid embryos in a cohort produced during an IVF cycle. A critical aspect of this technology is the potential detrimental effect that the biopsy itself can have upon the embryo. Different embryo biopsy strategies have been proposed. Cleavage stage blastomere biopsy still represents the most commonly used method in Europe nowadays, although this approach has been shown to have a negative impact on embryo viability and implantation potential. Polar body biopsy has been proposed as an alternative to embryo biopsy especially for aneuploidy testing. However, to date no sufficiently powered study has clarified the impact of this procedure on embryo reproductive competence. Blastocyst stage biopsy represents nowadays the safest approach not to impact embryo implantation potential. For this reason, as well as for the evidences of a higher consistency of the molecular analysis when performed on trophectoderm cells, blastocyst biopsy implementation is gradually increasing worldwide. The aim of this review is to present the evidences published to date on the impact of the biopsy at different stages of preimplantation development upon human embryos reproductive potential. PMID:26942198

  7. Temporal Influence of Heart Failure Hospitalizations Prior to Implantable Cardioverter Defibrillator or Cardiac Resynchronization Therapy With Defibrillator on Subsequent Outcome in Mild Heart Failure Patients (from MADIT-CRT)

    DEFF Research Database (Denmark)

    Lee, Andy Y; Moss, Arthur J; Ruwald, Martin H

    2015-01-01

    and effects on subsequent outcomes and benefit from cardiac resynchronization therapy with a defibrillator (CRT-D). Multivariate Cox models were used to determine the temporal influence of previous HF hospitalization on the end point of HF or death within all left bundle branch block implantable cardioverter...

  8. Transcriptomic and proteomic analysis reveals mechanisms of embryo abortion during chrysanthemum cross breeding

    Science.gov (United States)

    Zhang, Fengjiao; Wang, Zhiquan; Dong, Wen; Sun, Chunqing; Wang, Haibin; Song, Aiping; He, Lizhong; Fang, Weimin; Chen, Fadi; Teng, Nianjun

    2014-01-01

    Embryo abortion is the main cause of failure in chrysanthemum cross breeding, and the genes and proteins associated with embryo abortion are poorly understood. Here, we applied RNA sequencing and isobaric tags for relative and absolute quantitation (iTRAQ) to analyse transcriptomic and proteomic profiles of normal and abortive embryos. More than 68,000 annotated unigenes and 700 proteins were obtained from normal and abortive embryos. Functional analysis showed that 140 differentially expressed genes (DEGs) and 41 differentially expressed proteins (DEPs) were involved in embryo abortion. Most DEGs and DEPs associated with cell death, protein degradation, reactive oxygen species scavenging, and stress-response transcriptional factors were significantly up-regulated in abortive embryos relative to normal embryos. In contrast, most genes and proteins related to cell division and expansion, the cytoskeleton, protein synthesis and energy metabolism were significantly down-regulated in abortive embryos. Furthermore, abortive embryos had the highest activity of three executioner caspase-like enzymes. These results indicate that embryo abortion may be related to programmed cell death and the senescence- or death-associated genes or proteins contribute to embryo abortion. This adds to our understanding of embryo abortion and will aid in the cross breeding of chrysanthemum and other crops in the future. PMID:25288482

  9. First-in-man implantation of left ventricular partitioning device in a patient with chronic heart failure: twelve-month follow-up.

    Science.gov (United States)

    Otasevic, Petar; Sagic, Dragan; Antonic, Zelimir; Nikolic, Serjan D; Khairakhan, Alexander; Radovancevic, Branislav; Gradinac, Sinisa

    2007-09-01

    The ventricular partitioning device (VPD) (Cardiokinetix Inc., Redwood City, Calif) is a novel device that is deployed percutaneously in the left ventricle in patients with anteroapical regional wall motion abnormalities after a myocardial infarction (MI) to partition the ventricle and segregate the dysfunctional region. In this case report we present the first implantation of the VPD in a human, with a 12-month efficacy and safety follow-up. A 48-year-old man had an anterior MI in 2004. A coronary angiogram showed an occlusion of the proximal segment of the left anterior descending artery with no stenosis on other major epicardial vessels. Echocardiography revealed a dilated left ventricle (62 mm) with anteroapical wall motion abnormalities, no apical thrombus, a calculated ejection fraction of 26.8% (by Simpson biplane formula), and an end-systolic volume index (ESVi) of 76.8 mL/m(2). The VPD implant was delivered percutaneously from the femoral artery by the standard techniques for left-sided heart catheterization. The postimplantation course was uneventful. Echocardiography on discharge showed the VPD implanted at the apex, with a left ventricular ejection fraction of 30.9% and an ESVi of 57.2 mL/m(2). Left ventricular ejection fraction and ESVi remained improved during the 12-month follow-up. This case report demonstrates that VPD implantation in this particular patient was feasible and that it may provide a nonsurgical approach to prevent or reverse left ventricle remodeling.

  10. The Effects of Progesterone on Oocyte Maturation and Embryo Development

    Directory of Open Access Journals (Sweden)

    Saeed Zavareh

    2013-01-01

    Full Text Available Oocyte maturation and embryo development are controlled by intra-ovarian factors suchas steroid hormones. Progesterone (P4 exists in the follicular fluid that contributes tonormal mammalian ovarian function and has several critical functions during embryodevelopment and implantation, including endometrial receptivity, embryonic survivalduring gestation and transformation of the endometrial stromal cells to decidual cells.It is well known that the physiological effects of P4 during the pre-implantation stages ofsome mammal’s embryos are mediated by P4 receptors and their gene expression is determined.The effects of P4 on oocytes and embryo development have been assessed bysome investigations, with contradictory results. P4, a dominant steroid in follicular fluidat approximately 18 hours after the luteinizing hormone (LH surge may have a criticalrole in maturation of oocytes at the germinal stage. However, it has been shown that differentconcentrations of P4 could not improve in vitro maturation rates of germinal vesicles(GV in cumulus oocyte complexes (COCs and cumulus denuded oocytes (CDOs.Culture media supplemented with P4 significantly improved mouse embryo development.In addition, an in vivo experimental design has shown high blastocyst survival andimplantation rates in P4-treated mice.In this review we explain some of the findings that pertain to the effects of P4 onoocyte maturation and embryo development both in vitro and in vivo.

  11. Different effectiveness of closed embryo culture system with time-lapse imaging (EmbryoScope(TM)) in comparison to standard manual embryology in good and poor prognosis patients: a prospectively randomized pilot study.

    Science.gov (United States)

    Wu, Yan-Guang; Lazzaroni-Tealdi, Emanuela; Wang, Qi; Zhang, Lin; Barad, David H; Kushnir, Vitaly A; Darmon, Sarah K; Albertini, David F; Gleicher, Norbert

    2016-08-24

    Previously manual human embryology in many in vitro fertilization (IVF) centers is rapidly being replaced by closed embryo incubation systems with time-lapse imaging. Whether such systems perform comparably to manual embryology in different IVF patient populations has, however, never before been investigated. We, therefore, prospectively compared embryo quality following closed system culture with time-lapse photography (EmbryoScope™) and standard embryology. We performed a two-part prospectively randomized study in IVF (clinical trial # NCT92256309). Part A involved 31 infertile poor prognosis patients prospectively randomized to EmbryoScope™ and standard embryology. Part B involved embryos from 17 egg donor-recipient cycles resulting in large egg/embryo numbers, thus permitting prospectively alternative embryo assignments to EmbryoScope™ and standard embryology. We then compared pregnancy rates and embryo quality on day-3 after fertilization and embryologist time utilized per processed embryo. Part A revealed in poor prognosis patients no differences in day-3 embryo scores, implantation and clinical pregnancy rates between EmbryoScope™ and standard embryology. The EmbryoScope™, however, more than doubled embryology staff time (P embryology. Appropriately designed and powered prospectively randomized studies appear urgently needed in well-defined patient populations before the uncontrolled utilization of these instruments further expands. NCT02246309 Registered September 18, 2014.

  12. Management of dental implant fractures. A case history.

    Science.gov (United States)

    Al Quran, Firas A M; Rashan, Bashar A; Al-Dwairi, Ziad N

    2009-01-01

    The widespread use of endosseous osseointegrated implants to replace missing natural teeth increases the chances of implant complications and failures, despite the high initial success rate reported in the literature. Implant fracture is one possible complication that results in ultimate failure of the dental implant. Such a complication poses a management crisis even for the most experienced clinician. This article reports on a case of implant fracture, its possible causes, and how the case was managed.

  13. Management of peri-implantitis

    Science.gov (United States)

    Prathapachandran, Jayachandran; Suresh, Neethu

    2012-01-01

    Peri-implantitis is a site-specific infectious disease that causes an inflammatory process in soft tissues, and bone loss around an osseointegrated implant in function. The etiology of the implant infection is conditioned by the status of the tissue surrounding the implant, implant design, degree of roughness, external morphology, and excessive mechanical load. The microorganisms most commonly associated with implant failure are spirochetes and mobile forms of Gram-negative anaerobes, unless the origin is the result of simple mechanical overload. Diagnosis is based on changes of color in the gingiva, bleeding and probing depth of peri-implant pockets, suppuration, X-ray, and gradual loss of bone height around the tooth. Treatment will differ depending upon whether it is a case of peri-implant mucositis or peri-implantitis. The management of implant infection should be focused on the control of infection, the detoxification of the implant surface, and regeneration of the alveolar bone. This review article deals with the various treatment options in the management of peri-implantitis. The article also gives a brief description of the etiopathogenesis, clinical features, and diagnosis of peri-implantitis. PMID:23559913

  14. Management of peri-implantitis

    Directory of Open Access Journals (Sweden)

    Jayachandran Prathapachandran

    2012-01-01

    Full Text Available Peri-implantitis is a site-specific infectious disease that causes an inflammatory process in soft tissues, and bone loss around an osseointegrated implant in function. The etiology of the implant infection is conditioned by the status of the tissue surrounding the implant, implant design, degree of roughness, external morphology, and excessive mechanical load. The microorganisms most commonly associated with implant failure are spirochetes and mobile forms of Gram-negative anaerobes, unless the origin is the result of simple mechanical overload. Diagnosis is based on changes of color in the gingiva, bleeding and probing depth of peri-implant pockets, suppuration, X-ray, and gradual loss of bone height around the tooth. Treatment will differ depending upon whether it is a case of peri-implant mucositis or peri-implantitis. The management of implant infection should be focused on the control of infection, the detoxification of the implant surface, and regeneration of the alveolar bone. This review article deals with the various treatment options in the management of peri-implantitis. The article also gives a brief description of the etiopathogenesis, clinical features, and diagnosis of peri-implantitis.

  15. The First Human Cloned Embryo.

    Science.gov (United States)

    Cibelli, Jose B.; Lanza, Robert P.; West, Michael D.; Ezzell, Carol

    2002-01-01

    Describes a process known as parthenogenesis which produces cloned, early-stage embryos and human embryos generated only from eggs. Speculates that this technology puts therapeutic cloning within reach. (DDR)

  16. Illness perceptions in patients with heart failure and an implantable cardioverter defibrillatorDimensional structure, validity, and correlates of the brief illness perception questionnaire in Dutch, French and German patients

    DEFF Research Database (Denmark)

    Timmermans, I.; Versteeg, H.; Meine, Mathias M

    2017-01-01

    Background Patients' illness perceptions are associated with psychological wellbeing and can be measured with the Brief Illness Perception Questionnaire (B-IPQ). However, little is known about illness perceptions in patients with heart failure. We examined the dimensional structure, validity...... and clinical and psychological correlates of the B-IPQ in Dutch, French and German patients with heart failure and an implantable cardioverter defibrillator (ICD). Method European heart failure patients (n=585) participating in the REMOTE-CIED study completed a set of questionnaires 1–2weeks post ICD...... perceptions as measured with the total B-IPQ were associated with poor health status (OR=2.66, 95%CI=1.72–4.11), anxiety (OR=1.79, 95%CI=1.001–3.19), depression (OR=2.81, 95%CI=1.65–4.77), negative affectivity (OR=1.93, 95%CI=1.21–3.09) and poor ICD acceptance (OR=2.68, 95%CI=1.70–4.22). Conclusion The B...

  17. Imaging of common breast implants and implant-related complications: A pictorial essay

    Directory of Open Access Journals (Sweden)

    Amisha T Shah

    2016-01-01

    Full Text Available The number of women undergoing breast implant procedures is increasing exponentially. It is, therefore, imperative for a radiologist to be familiar with the normal and abnormal imaging appearances of common breast implants. Diagnostic imaging studies such as mammography, ultrasonography, and magnetic resonance imaging are used to evaluate implant integrity, detect abnormalities of the implant and its surrounding capsule, and detect breast conditions unrelated to implants. Magnetic resonance imaging of silicone breast implants, with its high sensitivity and specificity for detecting implant rupture, is the most reliable modality to asses implant integrity. Whichever imaging modality is used, the overall aim of imaging breast implants is to provide the pertinent information about implant integrity, detect implant failures, and to detect breast conditions unrelated to the implants, such as cancer.

  18. Imaging of common breast implants and implant-related complications: A pictorial essay

    Science.gov (United States)

    Shah, Amisha T; Jankharia, Bijal B

    2016-01-01

    The number of women undergoing breast implant procedures is increasing exponentially. It is, therefore, imperative for a radiologist to be familiar with the normal and abnormal imaging appearances of common breast implants. Diagnostic imaging studies such as mammography, ultrasonography, and magnetic resonance imaging are used to evaluate implant integrity, detect abnormalities of the implant and its surrounding capsule, and detect breast conditions unrelated to implants. Magnetic resonance imaging of silicone breast implants, with its high sensitivity and specificity for detecting implant rupture, is the most reliable modality to asses implant integrity. Whichever imaging modality is used, the overall aim of imaging breast implants is to provide the pertinent information about implant integrity, detect implant failures, and to detect breast conditions unrelated to the implants, such as cancer. PMID:27413269

  19. impact on embryo quality

    Directory of Open Access Journals (Sweden)

    Marijan Tandara

    2013-05-01

    Conclusions: In men with poorer semen quality, evaluated by standard semen parameters, a higher proportion of sperm with damaged DNA can also be expected. Higher sperm DNA damage, established by Halosperm test, also had an impact on embryo quality in this group of patients.

  20. A three-dimensional culture system using alginate hydrogel prolongs hatched cattle embryo development in vitro.

    Science.gov (United States)

    Zhao, Shuan; Liu, Zhen-Xing; Gao, Hui; Wu, Yi; Fang, Yuan; Wu, Shuai-Shuai; Li, Ming-Jie; Bai, Jia-Hua; Liu, Yan; Evans, Alexander; Zeng, Shen-Ming

    2015-07-15

    No successful method exists to maintain the three-dimensional architecture of hatched embryos in vitro. Alginate, a linear polysaccharide derived from brown algae, has characteristics that make it an ideal material as a three-dimensional (3D) extracellular matrix for in vitro cell, tissue, or embryo culture. In this study, alginate hydrogel was used for IVC of posthatched bovine embryos to observe their development under the 3D system. In vitro-fertilized and parthenogenetically activated posthatched bovine blastocysts were cultured in an alginate encapsulation culture system (AECS), an alginate overlay culture system (AOCS), or control culture system. After 18 days of culture, the survival rate of embryos cultured in AECS was higher than that in the control group (P cultured in the normal culture system, 9.09% of them attached to the bottoms of the plastic wells and grew rapidly, with the largest area of an attached embryo being 66.00 mm(2) on Day 32. The embryos cultured in AOCS developed monovesicular or multivesicular morphologies. Total cell number of the embryos cultured in AECS on Day 19 was significantly higher than that of embryos on Day 8. Additionally, AECS and AOCS supported differentiation of the embryonic cells. Binuclear cells were visible in Day-26 adherent embryos, and the messenger RNA expression patterns of Cdx2 and Oct4 in AOCS-cultured embryos were similar to those in vivo embryos, whereas IFNT and ISG15 messenger RNA were still expressed in Day-26 and Day-32 prolong-cultured embryos. In conclusion, AECS and AOCS did support cell proliferation, elongation, and differentiation of hatched bovine embryos during prolonged IVC. The culture system will be useful to further investigate the molecular mechanisms controlling ruminant embryo elongation and implantation. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Embryo Aggregation in Pig Improves Cloning Efficiency and Embryo Quality.

    Science.gov (United States)

    Buemo, Carla Paola; Gambini, Andrés; Moro, Lucia Natalia; Hiriart, María Inés; Fernández-Martín, Rafael; Collas, Philippe; Salamone, Daniel Felipe

    2016-01-01

    In this study, we analyzed the effects of the cloned embryo aggregation on in vitro embryo development and embryo quality by measuring blastocyst diameter and cell number, DNA fragmentation levels and the expression of genes associated with pluripotency, apoptosis, trophoblast and DNA methylation in the porcine. Zona-free reconstructed cloned embryos were cultured in the well of the well system, placing one (1x non aggregated group) or three (3x group) embryos per microwell. Our results showed that aggregation of three embryos increased blastocyst formation rate and blastocyst diameter of cloned pig embryos. DNA fragmentation levels in 3x aggregated cloned blastocysts were significantly decreased compared to 1x blastocysts. Levels of Oct4, Klf4, Igf2, Bax and Dnmt 1 transcripts were significantly higher in aggregated embryos, whereas Nanog levels were not affected. Transcripts of Cdx2 and Bcl-xl were essentially non-detectable. Our study suggests that embryo aggregation in the porcine may be beneficial for cloned embryo development and embryo quality, through a reduction in apoptotic levels and an improvement in cell reprogramming.

  2. Arrhythmias in Heart Failure.

    Science.gov (United States)

    Auricchio; Klein

    2000-08-01

    Cardiac arrhythmias are very common in the setting of heart failure, with atrial and ventricular arrhythmias often present in the same patient. The risk and the benefit of antiarrhythmic therapies are still a matter of debate. Class I antiarrhythmic drugs should be avoided in patients with heart failure, cardiac ischemia, or previous myocardial infarction. Beta-blocker agents reduce morbidity and decrease mortality in patients suffering from moderate to severe heart failure. Amiodarone may be beneficial in patients with advanced heart failure and increased resting heart rates. This class III drug may be effective to suppress episodes of atrial fibrillation but can also be beneficial in reducing ventricular response by slowing atrioventricular conduction during chronic atrial fibrillation. Implantable cardioverter-defibrillators (ICDs) markedly reduce sudden cardiac death in patients with ventricular tachycardia or ventricular fibrillation. In patients with advanced heart failure, however, the ICD may not markedly extend survival. Recently analyzed data from the Canadian Implantable Defibrillator Study (CIDS), Antiarrhythmics Versus Implantable Defibrillators (AVID) registry, Multicenter Unsustained Tachycardia Trial (MUSTT), and Multicenter Automatic Defibrillator Implantation Trial (MADIT) have consistently shown that it is the sickest patient who benefits the most from ICD therapy. Patients with markedly depressed ejection fraction (death will translate into a reduction of all-cause mortality. For patients resuscitated from sustained ventricular tachycardia or ventricular fibrillation, an ICD or, in some cases, amiodarone should be considered. Catheter or surgical ablation can be considered for selected patients with ventricular tachycardia.

  3. Evaluation of day one embryo quality and IVF outcome – a comparison of two scoring systems

    Directory of Open Access Journals (Sweden)

    Svobodova Magda

    2009-02-01

    Full Text Available Abstract Background The aim of our retrospective study was to compare the clinical usefulness of two non-invasive embryo scoring systems based either on a simplified pronuclear morphology of the zygote or on early cleavage rate, as well as their combination, for the selection of embryos with the best implantation potential in embryo transfer (ET. Methods Over a period of five years, the quality of 2708 embryos from 364 IVF cycles in women under the age of 39 years was assessed using these scoring systems in a university assisted reproduction centre. ET was always performed on day 3 of cultivation. The outcome of ETs of 702 embryos scored in the respective systems or their combination was retrospectively analyzed in terms of biochemical (bPR and clinical pregnancy rates (cPR and implantation rate (IR. Mann-Whitney U test and t-test for differences between relative values were used, p Results There was no difference in outcome parameters in 109 cycles where only Pattern "0" zygotes, according to our simplified pronuclear morphology classification, were transferred and 140 cycles where only "other" pattern zygotes were transferred, regardless of their cleavage rate. On the contrary, significantly greater cPR and IR (p = 0.003 and p = 0.006, respectively were achieved in 120 cycles where only early cleavage (EC embryos were transferred compared with 152 cycles where only non early cleavage (NEC embryos were transferred regardless of their pronuclear morphology. The best outcome in terms of cPR (56% and IR (43% was found in 50 cycles when Pattern "0" and EC embryos only were used for transfer. Conclusion The results indicate that early cleavage is a better independent marker of implantation potential than zygote morphology. The best outcome can be achieved if both embryo scoring systems are used jointly and the embryo is classified as EC and Pattern "0".

  4. Biomechanical effects of implant number and diameter on stress distributions in maxillary implant-supported overdentures.

    Science.gov (United States)

    Dimililer, Gizem; Kücükkurt, Sercan; Cetiner, Sedat

    2017-05-26

    Implant-supported overdentures (ISOs) are considered a good alternative to conventional removable dentures. However, varying rates of failure have been reported in some clinical studies. Excessive stress on surrounding tissues is one of the possible causes of implant failure. As stress is transmitted to the bone through the implant, careful planning, correct number of implants, and implant positioning are keys to ensuring appropriate stress distribution. However, research of the optimal number of implants necessary to support a maxillary ISO is insufficient. The purpose of this in vitro finite element study was to determine the optimal implant location, number, and diameter to support a maxillary ISO. Three-dimensional models of an atrophic maxilla, dental implants, and ball attachments were modeled, and different loading conditions were applied to simulate realistic conditions. Six models with different numbers and diameters of implants, including mini-dental implants and differently located implants, were formed, and stress values were compared by implementing a finite element analysis. The study showed that, as the implant number increased, decreased stress values were observed in periimplant bone and implants in the maxillary ISO prosthesis. However, changes in implant diameter had no significant effect on stresses. Increasing the implant diameter was not advantageous; the use of mini-dental implants may be a viable alternative method. However, using 4 implants for maxillary ISOs is indicated. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  5. Optimization of a novel nylon mesh container for human embryo ultrarapid vitrification.

    Science.gov (United States)

    Nakashima, Akira; Ino, Nao; Kusumi, Maki; Ohgi, Shirei; Ito, Megumu; Horikawa, Takashi; Nakagawa, Koji; Saito, Takakazu; Kamura, Toshiharu; Saito, Hidekazu

    2010-05-01

    To evaluate the efficacy of a nylon mesh container in vitrification of human embryos and to determine the optimal osmotic pressure of the initial thawing solution. Retrospective analysis. National Center for Child Health and Development, Tokyo, Japan. Infertile patients undergoing either in vitro fertilization or intracytoplasmic sperm injection in our hospital. Embryos, at the cleavage stage, were cryopreserved using the vitrification method in either a plastic straw or a nylon mesh container. The embryos were thawed using an initial osmotic pressure of either 0.5 M or 1.0 M sucrose with subsequent step-wise dilution. After thawing, the embryos were transferred to the uterus. Survival rate of blastomeres, embryo survival rate, implantation, and pregnancy rates, cancellation rate because of embryo damage. Use of nylon mesh and the 1.0 M sucrose thawing solution significantly improved blastomere survival rate (98.0 +/- 1.0%, mean +/- SEM), pregnancy rate (41.0%) and implantation rate (32.3%). Vitrification using a nylon mesh container and subsequent thawing in a 1.0 M sucrose solution is an easy and inexpensive method that improves the reliability of embryo cryopreservation of embryos without adverse effects on clinical outcomes. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Distinct differences in global gene expression profiles in non-implanted blastocysts and blastocysts resulting in live birth.

    Science.gov (United States)

    Kirkegaard, Kirstine; Villesen, Palle; Jensen, Jacob Malte; Hindkjær, Johnny Juhl; Kølvraa, Steen; Ingerslev, Hans Jakob; Lykke-Hartmann, Karin

    2015-10-25

    Results from animal models points towards the existence of a gene expression profile that is distinguishably different in viable embryos compared with non-viable embryos. Knowledge of human embryo transcripts is however limited, in particular with regard to how gene expression is related to clinical outcome. The purpose of the present study was therefore to determine the global gene expression profiles of human blastocysts. Next Generation Sequencing was used to identify genes that were differentially expressed in non-implanted embryos and embryos resulting in live birth. Three trophectoderm biopsies were obtained from morphologically high quality blastocysts resulting in live birth and three biopsies were obtained from non-implanting blastocysts of a comparable morphology. Total RNA was extracted from all samples followed by complete transcriptome sequencing. Using a set of filtering criteria, we obtained a list of 181 genes that were differentially expressed between trophectoderm biopsies from embryos resulting in either live birth or no implantation (negative hCG), respectively. We found that 37 of the 181 genes displayed significantly differential expression (plive birth and non-implanting, respectively. Out of the 181 genes, almost 80% (145 genes) were up-regulated in biopsies from un-implanted embryos, whereas only 20% (36 genes) showed an up-regulation in the samples from embryos resulting in live birth. Our findings suggest the presence of molecular differences visually undetectable between implanted and non-implanted embryos, and represent a proof of principle study. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Effect of cardiac resynchronization therapy-defibrillator implantation on health status in patients with mild versus moderate symptoms of heart failure

    DEFF Research Database (Denmark)

    Versteeg, Henneke; van den Broek, Krista C; Theuns, Dominic A M J

    2011-01-01

    Indications for cardiac resynchronization therapy (CRT) have expanded to include patients with mild congestive heart failure (CHF) symptoms (New York Heart Association [NYHA] functional class II) because of a demonstrated morbidity reduction in this subset of patients. However, little is known...

  8. Use of the 6-min walk distance to identify variations in treatment benefits from implantable cardioverter-defibrillator and amiodarone: results from the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial).

    Science.gov (United States)

    Fishbein, Daniel P; Hellkamp, Anne S; Mark, Daniel B; Walsh, Mary Norine; Poole, Jeanne E; Anderson, Jill; Johnson, George; Lee, Kerry L; Bardy, Gust H

    2014-06-17

    The purpose of this study was to determine if 6-min walk test data assists in treatment decisions for patients with heart failure. In the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial), a pre-specified subgroup analysis showed that patients with New York Heart Association functional class III symptoms did not benefit from implantable cardioverter-defibrillator (ICD) therapy and appeared to be harmed by amiodarone, whereas New York Heart Association functional class II patients obtained significant survival benefit from ICD. We postulated that a more objective measure of functional capacity, such as 6-min walk (6MW) distance, might provide a better tool for selecting these preventive therapies. A 6MW test was performed before randomization in 2,397 patients. Median follow-up was 45.5 months. All-cause mortality was the primary endpoint, with cause-specific mortality (heart failure, arrhythmic) examined in secondary analyses. The hazard ratios (HRs) for ICD therapy compared to placebo were estimated within tertiles of baseline 6MW distance: HR: 0.42 (95% confidence interval [CI]: 0.26 to 0.66) for 6MW distance >386 m (top tertile); HR: 0.57 (95% CI: 0.39 to 0.83) for 6MW distance 288 to 386 m (middle tertile); and HR: 1.02 (95% CI: 0.75 to 1.39) for 6MW distance amiodarone compared to placebo were 0.68 (95% CI: 0.46 to 1.02) for the top, 0.86 (95% CI: 0.61 to 1.21) for the middle, and 1.56 (95% CI: 1.17 to 2.09) for the bottom tertile. The 6MW distance was inversely related to heart failure-related mortality but not to arrhythmic mortality. ICD therapy reduced arrhythmic mortality in the top 2 tertiles of 6MW, but had no effect on heart failure mortality. A baseline 6MW distance amiodarone therapy and did not benefit from ICD. (Sudden Cardiac Death in Heart Failure Trial [SCD-HeFT]; NCT00000609). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  9. [Dental implants in tooth grinders].

    Science.gov (United States)

    Lobbezoo, F; Brouwers, J E; Cune, M S; Naeije, M

    2004-03-01

    Bruxism (tooth grinding and clenching) is generally considered a contraindication for dental implants, although the evidence is usually based on clinical experience only. So far, studies to the possible cause-and-effect relationship between bruxism and implant failure do not yield consistent and specific outcomes. This is partly due to the large variation in the technical and the biological aspects of the investigations. Although there is still no proof that bruxism causes overload of dental implants and their suprastructures, a careful approach is recommended. Practical advices as to minimize the chance of implant failure are given. Besides the recommendation to reduce or eliminate bruxism itself, these advices concern the number and dimensions of the implants, the design of the occlusion and articulation patterns, and the use of a hard nightguard.

  10. Human trophoblast function during the implantation process

    Directory of Open Access Journals (Sweden)

    Staun-Ram Elsebeth

    2005-10-01

    Full Text Available Abstract The implantation process involves complex and synchronized molecular and cellular events between the uterus and the implanting embryo. These events are regulated by paracrine and autocrine factors. Trophoblast invasion and migration through the uterine wall is mediated by molecular and cellular interactions, controlled by the trophoblast and the maternal microenvironment. This review is focused on the molecular constituents of the human trophoblast, their actions and interactions, including interrelations with the uterine endometrium.

  11. Relation of QRS Duration to Clinical Benefit of Cardiac Resynchronization Therapy in Mild Heart Failure Patients Without Left Bundle Branch Block: The Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy Substudy.

    Science.gov (United States)

    Biton, Yitschak; Kutyifa, Valentina; Cygankiewicz, Iwona; Goldenberg, Ilan; Klein, Helmut; McNitt, Scott; Polonsky, Bronislava; Ruwald, Anne Christine; Ruwald, Martin H; Moss, Arthur J; Zareba, Wojciech

    2016-02-01

    There are conflicting data regarding the efficacy of cardiac resynchronization therapy (CRT) in patients with heart failure (HF) and without left bundle branch block. We evaluated the long-term clinical outcomes of 537 non-left bundle branch block patients with mild HF enrolled in the Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy (MADIT-CRT) study by QRS duration or morphology further stratified by PR interval. At 7 years of follow-up, the cumulative probability of HF hospitalization or death was 45% versus 56% among patients randomized to implantable cardioverter-defibrillator and CRT with defibrillator (CRT-D), respectively (P=0.209). Multivariable-adjusted subgroup analysis by QRS duration showed that patients from the lower quartile QRS duration group (≤ 134 ms) experienced 2.4-fold (P=0.015) increased risk for HF hospitalization or death with CRT-D versus implantable cardioverter-defibrillator only therapy, whereas the effect of CRT-D in patients from the upper quartiles group (QRS>134 ms) was neutral (hazard ratio [HR] =0.97, P=0.86; P value for interaction =0.024). In a second analysis incorporating PR interval, patients with prolonged QRS (>134 ms) and prolonged PR (>230 ms) were protected with CRT-D (HR=0.31, P=0.003), whereas the association was neutral with prolonged QRS (>134 ms) and shorter PR (≤ 230 ms;, HR=1.19, P=0.386; P value for interaction =0.002). The effect was neutral, regardless of morphology, right bundle branch block (HR=1.01, P=0.975), and intraventricular conduction delay (HR=1.31, P=0.172). Overall, patients with mild HF but without left bundle branch block morphology did not derive clinical benefit with CRT-D during long-term follow-up. Relatively shorter QRS was associated with a significantly increased risk with CRT-D relative to implantable cardioverter-defibrillator -only. URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00180271, NCT01294449, and NCT02060110. © 2016

  12. Effects of steroidal glycoalkaloids from potatoes (Solanum tuberosum) on in vitro bovine embryo development.

    Science.gov (United States)

    Wang, S; Panter, K E; Gaffield, W; Evans, R C; Bunch, T D

    2005-02-01

    alpha-Solanine and alpha-chaconine are two naturally occurring steroidal glycoalkaloids in potatoes (Solanum tuberosum), and solanidine-N-oxide is a corresponding steroidal aglycone. The objective of this research was to screen potential cyto-toxicity of these potato glycoalkaloids using bovine oocyte maturation, in vitro fertilization techniques and subsequent embryonic development as the in vitro model. A randomized complete block design with four in vitro oocyte maturation (IVM) treatments (Experiment 1) and four in vitro embryo culture (IVC) treatments (Experiment 2) was used. In Experiment 1, bovine oocytes (n=2506) were matured in vitro in medium supplemented with 6 microM of alpha-solanine, alpha-chaconine, solanidine-N-oxide or IVM medium only. The in vitro matured oocytes were then subject to routine IVF and IVC procedures. Results indicated that exposure of bovine oocytes to the steroidal glycoalkaloids during in vitro maturation inhibited subsequent pre-implantation embryo development. Potency of the embryo-toxicity varied between these steroidal glycoalkaloids. In Experiment 2, IVM/IVF derived bovine embryos (n=2370) were cultured in vitro in medium supplemented with 6 microM of alpha-solanine, alpha-chaconine, solanidine-N-oxide or IVC medium only. The results showed that the pre-implantation embryo development is inhibited by exposure to these glycoalkaloids. This effect is significant during the later pre-implantation embryo development period as indicated by fewer numbers of expanded and hatched blastocysts produced in the media containing these alkaloids. Therefore, we conclude that in vitro exposure of oocytes and fertilized ova to the steroidal glycoalkaloids from potatoes inhibits pre-implantation embryo development. Furthermore, we suggest that ingestion of Solanum species containing toxic amounts of glycoalkaloids may have negative effects on pre-implantation embryonic survival.

  13. Embryo transfer in competition horses: Managing mares and expectations

    Science.gov (United States)

    Campbell, M L H

    2014-01-01

    Embryo transfer (ET) is an accepted and successful technique for obtaining foals from mares without interrupting their competition careers. Recent research, however, suggests that the potential of factors including heat, exercise, repeated embryo flushing and repeated manipulation of the reproductive cycle using exogenous hormones to have a negative impact on fertility may have been underestimated. This paper reviews the evidence base for involvement of these factors in repeated failures to recover embryos from nongeriatric competition mares without obvious clinical or pathological indications of reproductive abnormalities. It concludes that, for some mares at least, a cessation of exercise for the periovulatory period and the period between ovulation and embryo flushing, combined with careful management of flushing-induced endometritis, and minimal hormonal manipulation of the reproductive cycle, may be necessary to optimise embryo recovery rates. Mare owners may have been encouraged to request ET for their mares following high-profile examples in the media of elite mares that have produced foals by ET whilst competing. The veterinarian should educate mare owners about the multiple factors that may affect the chances of recovering an embryo from their mares, and should manage the expectations of mare owners so that they do not approach ET programmes in the expectation that there will be no disruption to their training and competition plans. PMID:25977596

  14. Methods for assessing the quality of mammalian embryos: How far we are from the gold standard?

    Science.gov (United States)

    Rocha, José C; Passalia, Felipe; Matos, Felipe D; Maserati, Marc P; Alves, Mayra F; Almeida, Tamie G de; Cardoso, Bruna L; Basso, Andrea C; Nogueira, Marcelo F G

    2016-08-01

    Morphological embryo classification is of great importance for many laboratory techniques, from basic research to the ones applied to assisted reproductive technology. However, the standard classification method for both human and cattle embryos, is based on quality parameters that reflect the overall morphological quality of the embryo in cattle, or the quality of the individual embryonic structures, more relevant in human embryo classification. This assessment method is biased by the subjectivity of the evaluator and even though several guidelines exist to standardize the classification, it is not a method capable of giving reliable and trustworthy results. Latest approaches for the improvement of quality assessment include the use of data from cellular metabolism, a new morphological grading system, development kinetics and cleavage symmetry, embryo cell biopsy followed by pre-implantation genetic diagnosis, zona pellucida birefringence, ion release by the embryo cells and so forth. Nowadays there exists a great need for evaluation methods that are practical and non-invasive while being accurate and objective. A method along these lines would be of great importance to embryo evaluation by embryologists, clinicians and other professionals who work with assisted reproductive technology. Several techniques shows promising results in this sense, one being the use of digital images of the embryo as basis for features extraction and classification by means of artificial intelligence techniques (as genetic algorithms and artificial neural networks). This process has the potential to become an accurate and objective standard for embryo quality assessment.

  15. In vitro maturation is associated with increased early embryo arrest without impairing morphokinetic development of useable embryos progressing to blastocysts.

    Science.gov (United States)

    Walls, M L; Ryan, J P; Keelan, J A; Hart, R

    2015-08-01

    Does polycystic ovarian syndrome (PCOS) or in vitro maturation (IVM) treatment affect embryo development events and morphokinetic parameters after time-lapse incubation? There was an increase in some abnormal phenotypic events in PCOS-IVM embryos as well as an increase in early arrest of PCOS-IVM and PCOS-ICSI embryos; however, IVM treatment or PCOS status did not alter morphokinetic development of embryos suitable for transfer of vitrification. IVM has been less successful than standard IVF in terms of clinical pregnancy, implantation and live birth rates. There is currently no information available about the development of IVM embryos according to time-lapse analysis. This article represents a prospective case-control study. The study involved 93 participants who underwent 93 treatment cycles. Cycles were completed between January 2013 and July 2014. Participants were recruited for the study at Fertility Specialists of WA and Fertility Specialists South, Perth, Western Australia. Of the PCOS diagnosed patients, 32 underwent IVM treatment (PCOS-IVM) and 23 had standard ICSI treatment (PCOS-ICSI). There were 38 patients without PCOS who underwent standard ICSI treatment comprising the control group (control-ICSI). The PCOS-IVM group showed significantly more embryos with multinucleated two cells (P = 0.041), multinucleated four cells (P = 0.001) and uneven two cells (P = 0.033) compared with the control-ICSI group, but not the PCOS-ICSI group. There were no significant differences in the rates of any abnormal events between the PCOS-ICSI and control-ICSI groups. Embryo arrest between Days 2 and 3 was higher in the PCOS-IVM and PCOS-ICSI groups compared with the control-ICSI group (P events from embryos generated using this approach for patients diagnosed with PCOS and shows that embryos generated from IVM have an increased rate of early embryo arrest, however; morphokinetic development is not impaired in embryos that progress to the useable blastocyst stage. The

  16. Expression of plasminogen activators in preimplantation rat embryos developed in vivo and in vitro

    Directory of Open Access Journals (Sweden)

    Har-Vardi Iris

    2005-02-01

    Full Text Available Abstract Background Embryo implantation plays a major role in embryogenesis and the outcome of pregnancy. Plasminogen activators (PAs have been implicated in mammalian fertilization, early stages of development and embryo implantation. The invasion of trophoblast cells into the endometrium during the implantation process can be blocked by inhibitors of serine proteases, illustrating the role of these enzymes in the invasion process. As in vitro developing embryos resulted in lower implantation rate than those developed in vivo we assume that a reduced PAs activity may lead to it. There is hardly any information regarding qualitative or quantitative differences in expression of PAs in preimplantation embryos, or comparisons between in vivo and in vitro developed embryos. The purpose of this study was to assess the expression of urokinase type (uPA and tissue type (tPA plasminogen activators in in vivo and in vitro preimplantation development in rat embryos using immunofluorescence confocal microscopy and computerized image analysis. Methods Zygotes, 2-cell, 4-cell, 8-cell, morula and blastocyst stages of development were flushed from the reproductive tract (control groups of Wistar rats. Zygotes were flushed and grown in vitro to the above mentioned developmental stages and comprised the experimental groups. Immunofluorescence microscopy and computerized image analysis were used to evaluate both qualitative (localization and quantitative expression of plasminogen activators. Results uPA and tPA were found to be expressed in rat embryos throughout their preimplantation development, both in vivo and in vitro. While uPA was localized mainly in the cell cytoplasm, the tPA was detected mainly on cell surface and in the perivitelline space. In blastocysts, both in vivo and in vitro, uPA and tPA were localized in the trophectoderm cells. Total uPA content per embryo was higher in the in vivo as compared with the in vitro developed embryos at all stages

  17. Implantation of Total Artificial Heart in Congenital Heart Disease

    OpenAIRE

    Adachi, Iki; Morales, David S. L.

    2014-01-01

    In patients with end-stage heart failure (HF), a total artificial heart (TAH) may be implanted as a bridge to cardiac transplant. However, in congenital heart disease (CHD), the malformed heart presents a challenge to TAH implantation.

  18. Gender determination of avian embryo

    Energy Technology Data Exchange (ETDEWEB)

    Daum, Keith A. (Idaho Falls, ID); Atkinson, David A. (Idaho Falls, ID)

    2002-01-01

    Disclosed is a method for gender determination of avian embryos. During the embryo incubation process, the outer hard shells of eggs are drilled and samples of allantoic fluid are removed. The allantoic fluids are directly introduced into an ion mobility spectrometer (IMS) for analysis. The resulting spectra contain the relevant marker peaks in the positive or negative mode which correlate with unique mobilities which are sex-specific. This way, the gender of the embryo can be determined.

  19. Development block of golden hamster ICSI embryos is associated with decreased expression of HDAC1, HSPA1A and MYC.

    Science.gov (United States)

    Pan, Xiaoyan; Kong, Delong; Liu, Limei; Gao, Fei; Zhang, Xueming; Tang, Bo; Li, Ziyi

    2014-11-01

    We have investigated the mechanism for embryo development block in vitro and to improve the development rate of golden hamster embryos in vitro. Intracytoplasmic sperm injection (ICSI) technique was used to produce golden hamster ICSI embryos. The changes in the histone acetylation and the expression of histone deacetylase and related genes were analyzed by immunocytochemical staining and real-time PCR both in golden hamster in vivo embryos and in ICSI embryos. Aged oocytes significantly increased the oocyte spontaneous activation rate. In vitro cultured ICSI embryos suffered from severe development block in M199TE medium. Expression of histone deacetylase 1 (HDAC1) was significantly decreased in the nuclei of the arrested ICSI 2-cell embryos, and its nuclear and cytoplasmic expression pattern was also markedly altered. The acetylation level of H4K5, however, was not significantly changed between golden hamster in vivo embryos and ICSI embryos. HSPA1A and MYC, the marker genes for zygotic genome activation (ZGA), were transcriptionally decreased in arrested ICSI 2-cell embryos. Transcription of HDAC1 was also downregulated in these embryos, whereas the mRNA expression of the proapoptotic gene, BAX, was not changed. These results indicate that the golden hamster ICSI embryo development block during ZGA is associated with decreased nuclear expression and altered expression of HDAC1. HSPA1A, MYC, and HDAC1 mRNA levels, which decrease, resulting in ZGA failure. © 2014 International Federation for Cell Biology.

  20. Avaliação da cavidade uterina com hístero-sonografia em pacientes com falha de implantação após fertilização in vitro Evaluation of the uterine cavity by sonohysterography in patients with implantation failure after in vitro fertilization

    Directory of Open Access Journals (Sweden)

    Teiichi Ninomiya

    2003-08-01

    HSoG for anormal, sugerimos confirmar o exame pela histeroscopia diagnóstica. Pelo fato de a HSoG apresentar boa especificidade e bom valor preditivo negativo, poderíamos sugerir que diante de HSoG normal não há necessidade de indicação de se avaliar a cavidade uterina pela histeroscopia diagnóstica antes de realizar a fertilização in vitro. Concluímos que a histero-sonografia é bom método para rastreamento de lesões polipóides da cavidade uterina que possam responder pela falha de implantação nas técnicas de fertilização in vitro.PURPOSE: to analyze the accuracy of sonohysterography for the evaluation of the uterine cavity in patients with an implantation failure, at the first attempt of an in vitro fertilization cycle. METHODS: in a prospective double blind study, the authors analyzed patients previously submitted to at least one embryo transfer, who presented implantation failures. The patients were submitted to a sonohysterographic examination followed by a diagnostic hysteroscopic examination, carried out by different professionals each of whom was not aware of the results of the other. The results were recorded and only interpreted after the end of the trial. Sonohysterography was performed by the introduction of a urethral catheter 8 into the uterine cervix followed by infusion of physiological saline. The anechoic interface shown by the physiological saline can reveal abnormalities, like uterine polyps or submucosal myomas. Hysteroscopy was performed with a Karl Storz equipment, 4 mm 30º rigid telescope, and infusion of physiological saline for uterine cavity distention. RESULTS: twenty-eight of the 33 originally selected patients for this study were analyzed. Sonohysterography detected abnormalities in 8 patients, five with endometrial polyps (62.5%, two with endocervical polyps (25.0%, and one with submucosal myoma (12.5%. Hysteroscopy (gold standard detected abnormalities in 7 patients, two with endometrial polyps (28.6%, two with

  1. Who abandons embryos after IVF?

    LENUS (Irish Health Repository)

    Walsh, A P H

    2010-04-01

    This investigation describes features of in vitro fertilisation (IVF) patients who never returned to claim their embryos following cryopreservation. Frozen embryo data were reviewed to establish communication patterns between patient and clinic; embryos were considered abandoned when 1) an IVF patient with frozen embryo\\/s stored at our facility failed to make contact with our clinic for > 2 yrs and 2) the patient could not be located after a multi-modal outreach effort was undertaken. For these patients, telephone numbers had been disconnected and no forwarding address was available. Patient, spouse and emergency family contact\\/s all escaped detection efforts despite an exhaustive public database search including death records and Internet directory portals. From 3244 IVF cycles completed from 2000 to 2008, > or = 1 embryo was frozen in 1159 cases (35.7%). Those without correspondence for > 2 yrs accounted for 292 (25.2%) patients with frozen embryos; 281 were contacted by methods including registered (signature involving abandoned embryos did not differ substantially from other patients. The goal of having a baby was achieved by 10\\/11 patients either by spontaneous conception, adoption or IVF. One patient moved away with conception status unconfirmed. The overall rate of embryo abandonment was 11\\/1159 (< 1%) in this IVF population. Pre-IVF counselling minimises, but does not totally eliminate, the problem of abandoned embryos. As the number of abandoned embryos from IVF accumulates, their fate urgently requires clarification. We propose that clinicians develop a policy consistent with relevant Irish Constitutional provisions to address this medical dilemma.

  2. Which set of embryo variables is most predictive for live birth? A prospective study in 6252 single embryo transfers to construct an embryo score for the ranking and selection of embryos.

    Science.gov (United States)

    Rhenman, A; Berglund, L; Brodin, T; Olovsson, M; Milton, K; Hadziosmanovic, N; Holte, J

    2015-01-01

    Which embryo score variables are most powerful for predicting live birth after single embryo transfer (SET) at the early cleavage stage? This large prospective study of visual embryo scoring variables shows that blastomere number (BL), the proportion of mononucleated blastomeres (NU) and the degree of fragmentation (FR) have independent prognostic power to predict live birth. Other studies suggest prognostic power, at least univariately and for implantation potential, for all five variables. A previous study from the same centre on double embryo transfers with implantation as the end-point resulted in the integrated morphology cleavage (IMC) score, which incorporates BL, NU and EQ. A prospective cohort study of IVF/ICSI SET on Day 2 (n = 6252) during a 6-year period (2006-2012). The five variables (BL NU, FR, EQ and symmetry of cleavage (SY)) were scored in 3- to 5-step scales and subsequently related to clinical pregnancy and LBR. A total of 4304 women undergoing IVF/ICSI in a university-affiliated private fertility clinic were included. Generalized estimating equation models evaluated live birth (yes/no) as primary outcome using the embryo variables as predictors. Odds ratios with 95% confidence intervals and P-values were presented for each predictor. The C statistic (i.e. area under receiver operating characteristic curve) was calculated for each model. Model calibration was assessed with the Hosmer-Lemeshow test. A shrinkage method was applied to remove bias in c statistics due to over-fitting. LBR was 27.1% (1693/6252). BL, NU, FR and EQ were univariately highly significantly associated with LBR. In a multivariate model, BL, NU and FR were independently significant, with c statistic 0.579 (age-adjusted c statistic 0.637). EQ did not retain significance in the multivariate model. Prediction model calibration was good for both pregnancy and live birth. We present a ranking tree with combinations of values of the BL, NU and FR embryo variables for optimal

  3. Radionuclide Exposure of the Embryo/Fetus

    Energy Technology Data Exchange (ETDEWEB)

    Blundell, Helen

    1999-06-01

    This report addresses the determination of radiation dose to the embryo (the conceptus from fertilisation to organogenesis) and the fetus (post-organogenesis to birth) from radionuclides that are present in the woman before her pregnancy or that enter her during her pregnancy. This exposure may be via nuclear medicine procedures, occupational exposures or environmental sources that may affect the general population. The effects of radiation on the embryo/fetus are greatly influenced by the dependence on stage of gestation, which affects the transfer of radioactivity from the pregnant woman to the fetoplacental system, the distribution of the activity and the developmental effects of the resulting radiation absorbed doses. A chapter is therefore devoted to a detailed discussion of development of the embryo/fetus through the stages of pre-implantation, implantation and post-implantation development and the fetal period. To an non-expert the anatomical detail and nomenclature are rather difficult, but diagrams are clear and well labelled and a useful glossary of terms is provided. Mechanisms of maternal-fetal exchange and the effects of the maternal organs and placenta as external sources of radiation are then discussed, though it is stressed here - as throughout the report - that most information about the distribution and retention of materials during pregnancy has been obtained from studies in experimental animals. Extrapolation of animal data to humans is difficult and potentially inaccurate. The effects of prenatal irradiation are categorised as early, delayed and late effects. Early effects are further divided into the pre-implantation period (blastogenesis), period of organ formation (organogenesis) and period of the fetus (fetogenesis). Chapters 7 and 8 deal with compartmental modelling, dosimetry and estimation of embryo/fetus dose in radiation protection practice. The ICRP and MIRD methodologies are discussed, both of which differentiate source and target

  4. Sequential provisional implant prosthodontics therapy.

    Science.gov (United States)

    Zinner, Ira D; Markovits, Stanley; Jansen, Curtis E; Reid, Patrick E; Schnader, Yale E; Shapiro, Herbert J

    2012-01-01

    The fabrication and long-term use of first- and second-stage provisional implant prostheses is critical to create a favorable prognosis for function and esthetics of a fixed-implant supported prosthesis. The fixed metal and acrylic resin cemented first-stage prosthesis, as reviewed in Part I, is needed for prevention of adjacent and opposing tooth movement, pressure on the implant site as well as protection to avoid micromovement of the freshly placed implant body. The second-stage prosthesis, reviewed in Part II, should be used following implant uncovering and abutment installation. The patient wears this provisional prosthesis until maturation of the bone and healing of soft tissues. The second-stage provisional prosthesis is also a fail-safe mechanism for possible early implant failures and also can be used with late failures and/or for the necessity to repair the definitive prosthesis. In addition, the screw-retained provisional prosthesis is used if and when an implant requires removal or other implants are to be placed as in a sequential approach. The creation and use of both first- and second-stage provisional prostheses involve a restorative dentist, dental technician, surgeon, and patient to work as a team. If the dentist alone cannot do diagnosis and treatment planning, surgery, and laboratory techniques, he or she needs help by employing the expertise of a surgeon and a laboratory technician. This team approach is essential for optimum results.

  5. Semi-Quantitative Analysis of Endometrial HOXA10 and BTEB1 Mrna Expressions in the Implantation Window of Patients With Endometriosis and Myoma

    Directory of Open Access Journals (Sweden)

    Alizadeh Z

    2012-01-01

    Full Text Available Background: The techniques used in assisted reproductive technologies have progressed considerably, but many embryos do not implant after transfer upon the use of these techniques. One of the causes of infertility is repeated implantation failure due to decreased endometrial receptivity. Furthermore, in clinical conditions such as endometriosis and myoma, implantation decreases after embryo transfer. In this case-control study the expression patterns of HOXA-10 and BTEB1 mRNAs were evaluated at the time of implantation in patients with myoma and endometriosis.Methods : In this study performed in Hamadan University of Medical Sciences during 1389, the cases included 16 patients with endometriosis and myoma (8 in each group and the control group consisted of 8 fertile women. Endometrial sampling was performed at mid-secretory phase. Later, the expression patterns of HOXA-10 and BTEB1 mRNAs were evaluated using a semi-quantitative RT-PCR method. Results : The optimal PCR cycles determined were 30, 32 and 26 for HOXA10, BTEB1 and β-actin, respectively. Endometrial HOXA-10 and BTEB1 mRNA expression levels (normalized to ß-actin expression at the time of implantation were significantly decreased in the endometrium of infertile patients with endometriosis compared with that of healthy fertile controls (P<0.05. A similar pattern was seen in patients with myomas for both HOXA10 and BTEB1 genes, (P<0.05. Conclusion: It seems that lower expression of HOXA-10 and BTEB1 mRNAs in the implantation window of endometrium that increase normally, could account for some aspects of infertility in patients with endometriosis and myoma.

  6. Oral-aboral axis specification in the sea urchin embryo, IV: hypoxia radializes embryos by preventing the initial spatialization of nodal activity.

    Science.gov (United States)

    Coffman, James A; Wessels, Abigail; DeSchiffart, Carolyn; Rydlizky, Katarina

    2014-02-15

    The oral-aboral axis of the sea urchin embryo is specified conditionally via a regulated feedback circuit involving the signaling gene nodal and its antagonist lefty. In normal development nodal activity becomes localized to the prospective oral side of the blastula stage embryo, a process that requires lefty. In embryos of Strongylocentrotus purpuratus, a redox gradient established by asymmetrically distributed mitochondria provides an initial spatial input that positions the localized domain of nodal expression. This expression is perturbed by hypoxia, leading to development of radialized embryos lacking an oral-aboral axis. Here we show that this radialization is not caused by a failure to express nodal, but rather by a failure to localize nodal activity to one side of the embryo. This occurs even when embryos are removed from hypoxia at late cleavage stage when nodal is first expressed, indicating that the effect involves the initiation phase of nodal activity, rather than its positive feedback-driven amplification and maintenance. Quantitative fluorescence microscopy of MitoTracker Orange-labeled embryos expressing nodal-GFP reporter gene revealed that hypoxia abolishes the spatial correlation between mitochondrial distribution and nodal expression, suggesting that hypoxia eliminates the initial spatial bias in nodal activity normally established by the redox gradient. We propose that absent this bias, the initiation phase of nodal expression is spatially uniform, such that the ensuing Nodal-mediated community effect is not localized, and hence refractory to Lefty-mediated enforcement of localization. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Oxidative markers in cryopreservation medium from frozen-thawed embryos: a possible tool for improved embryo selection in in vitro fertilization?

    Science.gov (United States)

    Wiener-Megnazi, Zofnat; Lahav-Baratz, Shirly; Blais, Idit; Matarasso, Sarah; Koifman, Mara; Shnizer, Sergei; Ishai, David; Peer, Gil; Younes, Grace; Zilberlicht, Ariel; Auslander, Ron; Dirnfeld, Martha

    2016-06-01

    The present study evaluated the association between oxidative parameters in embryo cryopreservation medium and laboratory and clinical outcomes. This prospective laboratory study was conducted in an IVF unit in a university-affiliated hospital with 91 IVF patients undergoing a frozen-thawed embryo transfer cycle. Following thawing, 50 μL of embryo cryopreservation medium was retrieved from each cryotube and tested by the thermochemiluminescence (TCL) assay. TCL amplitudes after 50 (H1), 150 (H2), and 280 s (H3) were recorded in counts per second (CPS) and the TCL ratio determined for comparison with implantation and pregnancy rates. A total of 194 embryos were transferred in 85 frozen-thaw cycles. Twenty-one pregnancies (24.7 %) occurred. Implantation and overall and clinical pregnancy rates were higher when the median TCL H1 amplitude was <32 CPS compared to ≥32 CPS (14.6 vs. 5.3 %, 37.5 vs. 17 %, 28.1 vs. 9.4 %, respectively). No pregnancies occurred when the H1 amplitude was ≥40 CPS. Logistic regression multivariate analysis found that only the median TCL H1 amplitude was associated with the occurrence of pregnancy (OR = 2.93, 95 % CI 1.065-8.08). The TCL ratio inversely correlated with the duration of embryo cryopreservation (r = -0.37). The results indicate that thawed embryos may express oxidative processes in the cryopreservation medium, and higher oxidative levels are associated with lower implantation rates. These findings may aid in the improved selection of frozen-thawed embryos for IVF.

  8. Embryos, genes, and birth defects

    National Research Council Canada - National Science Library

    Ferretti, Patrizia

    2006-01-01

    ... Structural anomalies The genesis of chromosome abnormalities Embryo survival The cause of high levels of chromosome abnormality in human embryos Relative parental risks - age, translocations, inversions, gonadal and germinal mosaics 33 33 34 35 36 44 44 45 4 Identification and Analysis of Genes Involved in Congenital Malformation Syndromes Peter J. Scambler Ge...

  9. Clinical Management of Implant Prostheses in Patients with Bruxism

    Directory of Open Access Journals (Sweden)

    Osamu Komiyama

    2012-01-01

    Full Text Available There is general agreement that excessive stress to the bone-implant interface may result in implant overload and failure. Early failure of the implant due to excessive loading occurs shortly after uncovering the implant. Excess load on a final restoration after successful implant integration can result in physical failure of the implant structure. Many clinicians believe that overload of dental implants is a risk factor for vertical peri-implant bone loss and/or may be detrimental for the suprastructure in implant prostheses. It has been documented that occlusal parafunction, such as, bruxism (tooth grinding and clenching affects the outcome of implant prostheses, but there is no evidence for a causal relation between the failures and overload of dental implants. In spite of this lack of evidence, often metal restorations are preferred instead of porcelain for patients in whom bruxism is presumed on the basis of tooth wear. The purpose of this paper is to discuss the importance of the occlusal scheme used in implant restorations for implant longevity and to suggest a clinical approach and occlusal materials for implant prostheses in order to prevent complications related to bruxism.

  10. Clinical Management of Implant Prostheses in Patients with Bruxism

    Science.gov (United States)

    Komiyama, Osamu; Lobbezoo, Frank; De Laat, Antoon; Iida, Takashi; Kitagawa, Tsuyoshi; Murakami, Hiroshi; Kato, Takao; Kawara, Misao

    2012-01-01

    There is general agreement that excessive stress to the bone-implant interface may result in implant overload and failure. Early failure of the implant due to excessive loading occurs shortly after uncovering the implant. Excess load on a final restoration after successful implant integration can result in physical failure of the implant structure. Many clinicians believe that overload of dental implants is a risk factor for vertical peri-implant bone loss and/or may be detrimental for the suprastructure in implant prostheses. It has been documented that occlusal parafunction, such as, bruxism (tooth grinding and clenching) affects the outcome of implant prostheses, but there is no evidence for a causal relation between the failures and overload of dental implants. In spite of this lack of evidence, often metal restorations are preferred instead of porcelain for patients in whom bruxism is presumed on the basis of tooth wear. The purpose of this paper is to discuss the importance of the occlusal scheme used in implant restorations for implant longevity and to suggest a clinical approach and occlusal materials for implant prostheses in order to prevent complications related to bruxism. PMID:22701484

  11. Clinical management of implant prostheses in patients with bruxism.

    Science.gov (United States)

    Komiyama, Osamu; Lobbezoo, Frank; De Laat, Antoon; Iida, Takashi; Kitagawa, Tsuyoshi; Murakami, Hiroshi; Kato, Takao; Kawara, Misao

    2012-01-01

    There is general agreement that excessive stress to the bone-implant interface may result in implant overload and failure. Early failure of the implant due to excessive loading occurs shortly after uncovering the implant. Excess load on a final restoration after successful implant integration can result in physical failure of the implant structure. Many clinicians believe that overload of dental implants is a risk factor for vertical peri-implant bone loss and/or may be detrimental for the suprastructure in implant prostheses. It has been documented that occlusal parafunction, such as, bruxism (tooth grinding and clenching) affects the outcome of implant prostheses, but there is no evidence for a causal relation between the failures and overload of dental implants. In spite of this lack of evidence, often metal restorations are preferred instead of porcelain for patients in whom bruxism is presumed on the basis of tooth wear. The purpose of this paper is to discuss the importance of the occlusal scheme used in implant restorations for implant longevity and to suggest a clinical approach and occlusal materials for implant prostheses in order to prevent complications related to bruxism.

  12. Potential role of telemedical service centers in managing remote monitoring data transmitted daily by cardiac implantable electronic devices: results of the early detection of cardiovascular events in device patients with heart failure (detecT-Pilot) study.

    Science.gov (United States)

    Müller, Axel; Goette, Andreas; Perings, Christian; Nägele, Herbert; Konorza, Thomas; Spitzer, Wilhelm; Schulz, Sabine-Susan; von Bary, Christian; Hoffmann, Matthias; Albani, Marco; Sack, Stefan; Niederlöhner, Annegret; Lewalter, Thorsten

    2013-06-01

    Implantable cardioverter-defibrillators (ICDs) alone or combined with cardiac resynchronization therapy (CRT-Ds) featuring automatic home monitoring (HM) function can be monitored remotely on a daily basis. Different ways of implementing HM into clinical routines are possible, with efficient patient management being the main objective. In this study, a concept using a telemedical service center (TmSC) to manage HM data was developed and investigated regarding patients' satisfaction, physicians' satisfaction, and alert filtering. Fifty-five ICD or CRT-D patients with symptomatic heart failure were enrolled. The TmSC received HM data, identified "actionable parameters" (APs) by following protocol-defined procedures, conducted structured patient interviews, and forwarded selected APs to the respective follow-up clinic. Satisfaction of patients and physicians with the TmSC was evaluated at the end of the study by purpose-designed questionnaires. During a mean follow-up of 402±200 days, 3,831 APs were identified and analyzed at the TmSC (5.28 per patient-month). Most APs were triggered by a pilot detection algorithm for worsening heart failure (2.80 per patient-month), followed by atrial tachyarrhythmia episodes (1.10 per patient-month) and ventricular pacing issues (0.87 per patient-month). The TmSC forwarded 682 APs (18% of all APs) to 10 study sites. Approximately 65% of physicians and patients deemed the TmSC improved patient care. The TmSC-based management concept was well accepted and appreciated by the majority of physicians and patients. It may be helpful in gaining symptomatic information on top of automatic HM data and in supporting smaller clinics in the follow-up of their device patients.

  13. Effect of Administration of Single Dose GnRH Agonist in Luteal Phase on Outcome of ICSI-ET Cycles in Women with Previous History of IVF/ICSI Failure: A Randomized Controlled Trial

    Science.gov (United States)

    Zafardoust, Simin; Jeddi-Tehrani, Mahmood; Akhondi, Mohammad Mehdi; Sadeghi, Mohammad Reza; Kamali, Koroush; Mokhtar, Sara; Badehnoosh, Bita; Arjmand-Teymouri, Fatemeh; Fatemi, Farnaz; Mohammadzadeh, Afsaneh

    2015-01-01

    Background GnRH agonist administration in the luteal phase has been suggested to beneficially affect the outcome of intracytoplasmic sperm injection (ICSI) and embryo transfer (ET) cycles. This blind randomized controlled study evaluates the effect of GnRH (Gonadotropine Releasing Hormone) agonist administration on ICSI outcome in GnRH antagonist ovarian stimulation protocol in women with 2 or more previous IVF/ICSI-ET failures. Methods One hundred IVF failure women who underwent ICSI cycles and stimulated with GnRH antagonist ovarian stimulation protocol, were included in the study. Women were randomly assigned to intervention (received a single dose injection of GnRH agonist (0.1 mg of Decapeptil) subcutaneously 6 days after oocyte retrieval) and control (did not receive GnRH agonist) groups. Implantation and clinical pregnancy rates were the primary outcome measures. Results Although the age of women, the number of embryos transferred in the current cycle and the quality of the transferred embryos were similar in the two groups, there was a significantly higher rate of implantation (Mann Whitney test, p = 0.041) and pregnancy (32.6% vs. 12.5%, p = 0.030, OR = 3.3, 95%CI, 1.08 to 10.4) in the intervention group. Conclusion Our results suggested that, in addition to routine luteal phase support using progesterone, administration of 0.1 mg of Decapeptil 6 days after oocyte retrieval in women with previous history of 2 or more IVF/ICSI failures led to a significant improvement in implantation and pregnancy rates after ICSI following ovarian stimulation with GnRH antagonist protocol. PMID:25927026

  14. Clinical Management of a Peri-Implant Giant Cell Granuloma

    OpenAIRE

    Pacifici, A.; Carbone, D.; Marini, R.; Sfasciotti, G. L.; Pacifici, L.

    2015-01-01

    Purpose. Implant therapy plays an important role in contemporary dentistry with high rates of long-term success. However, in recent years, the incidence of peri-implantitis and implant failures has significantly increased. The peripheral giant cell granuloma (PGCG) rarely occurs in peri-implant tissues and it is clinically comparable to the lesions associated with natural teeth. Therefore, the study of possible diseases associated with dental implants plays an important role in order to be ab...

  15. Digital Microfluidic Dynamic Culture of Mammalian Embryos on an Electrowetting on Dielectric (EWOD) Chip.

    Science.gov (United States)

    Huang, Hong-Yuan; Shen, Hsien-Hua; Tien, Chang-Hung; Li, Chin-Jung; Fan, Shih-Kang; Liu, Cheng-Hsien; Hsu, Wen-Syang; Yao, Da-Jeng

    2015-01-01

    Current human fertilization in vitro (IVF) bypasses the female oviduct and manually inseminates, fertilizes and cultivates embryos in a static microdrop containing appropriate chemical compounds. A microfluidic microchannel system for IVF is considered to provide an improved in-vivo-mimicking environment to enhance the development in a culture system for an embryo before implantation. We demonstrate a novel digitalized microfluidic device powered with electrowetting on a dielectric (EWOD) to culture an embryo in vitro in a single droplet in a microfluidic environment to mimic the environment in vivo for development of the embryo and to culture the embryos with good development and live births. Our results show that the dynamic culture powered with EWOD can manipulate a single droplet containing one mouse embryo and culture to the blastocyst stage. The rate of embryo cleavage to a hatching blastocyst with a dynamic culture is significantly greater than that with a traditional static culture (pmicrofluidic device is capable of culturing mammalian embryos in a microfluidic biological manner, presaging future clinical application.

  16. Application of next-generation sequencing for 24-chromosome aneuploidy screening of human preimplantation embryos.

    Science.gov (United States)

    Zheng, Haiyan; Jin, Hua; Liu, Lian; Liu, Jianqiao; Wang, Wei-Hua

    2015-01-01

    Aneuploidy is a leading cause of repeat implantation failure and recurrent miscarriages. Preimplantation genetic screening (PGS) enables the assessment of the numeral and structural chromosomal errors of embryos before transfer in patients undergoing in vitro fertilization. Array comparative genomic hybridization (aCGH) has been demonstrated to be an accurate PGS method and in present thought to be the gold standard, but new technologies, such as next-generation sequencing (NGS), continue to emerge. Validation of the new comprehensive NGS-based 24-chromosome aneuploidy screening technology is still needed to determine the preclinical accuracy before it might be considered as an alternative method for human PGS. In the present study, 43 human trophectoderm (TE) biopsy samples and 5 cytogenetically characterized cell lines (Coriell Cell Repositories) were tested. The same whole genome amplified product of each sample was blindly assessed with Veriseq NGS and Agilent aCGH to identify the aneuploidy status. The result showed that the NGS identified all abnormalities identified in aCGH including the numeral chromosomal abnormalities (again or loss) in the embryo samples and the structural (partial deletion and duplication) in the Coriell cell lines. Both technologies can identify a segmental imbalance as small as 1.8 Mb in size. Among the 41 TE samples with abnormal karyotypes in this study, eight (19.5 %) samples presented as multiple chromosome abnormalities. The abnormalities occurred to almost all chromosomes, except chromosome 6, 7, 17 and Y chromosome. Given its reliability and high level of consistency with an established aCGH methodology, NGS has demonstrated a robust high-throughput methodology ready for extensive clinical application in reproductive medicine, with potential advantages of reduced costs and enhanced precision. Then, a randomized controlled clinical trial confirming its clinical effectiveness is advisable to obtain a larger sequencing dataset

  17. Should intrauterine human chorionic gonadotropin infusions ever be used prior to embryo transfer?

    Science.gov (United States)

    Volovsky, Michelle; Healey, Martin; MacLachlan, Vivien; Vollenhoven, Beverley J

    2017-09-25

    The aim of this study was to explore the factors that influence the outcome of intrauterine human chorionic gonadotropin (hCG) infusion at the time of embryo transfer (ET), in particular, the effect of hCG infusions on fresh and frozen embryo transfers (FETs) and whether prior recurrent implantation failure (RIF) impacts upon outcomes. This was a case-control study based on a standardized database from a multi-site in vitro fertilization clinic. The analysis contains 458 cases and 749 matched controls, with an intervention group of those given intrauterine hCG prior to ET and a control group of patients receiving no hCG infusion. Outcomes were defined as clinical pregnancy and live birth rates. Two analyses were performed. The first separated FETs (cases n = 224, controls n = 325) and fresh ETs (cases n = 234, controls n = 424), with outcomes calculated in each group. The second analysis divided patients into those with RIF (cases n = 149, controls n = 200) and those without (cases n = 309, controls n = 549). Results in fresh ETs demonstrated a 5.8% reduction (adjusted odds ratio (AOR) = 0.60, p = 0.041) in clinical pregnancy rates with the use of intrauterine hCG. In those without defined RIF, clinical pregnancy rates were reduced by 8.1% (AOR = 0.61, p = 0.023) and live birth rates by 7.2% (AOR = 0.56, p = 0.32) with intrauterine hCG use. There were no significant differences in outcomes in FETs and in the RIF cohort. Intrauterine hCG at the time of ET not only seems to have no benefit, but rather a negative effect in fresh ETs and those without RIF.

  18. Survival analysis of orthodontic mini-implants.

    Science.gov (United States)

    Lee, Shin-Jae; Ahn, Sug-Joon; Lee, Jae Won; Kim, Seong-Hun; Kim, Tae-Woo

    2010-02-01

    Survival analysis is useful in clinical research because it focuses on comparing the survival distributions and the identification of risk factors. Our aim in this study was to investigate the survival characteristics and risk factors of orthodontic mini-implants with survival analyses. One hundred forty-one orthodontic patients (treated from October 1, 2000, to November 29, 2007) were included in this survival study. A total of 260 orthodontic mini-implants that had sandblasted (large grit) and acid-etched screw parts were placed between the maxillary second premolar and the first molar. Failures of the implants were recorded as event data, whereas implants that were removed because treatment ended and those that were not removed during the study period were recorded as censored data. A nonparametric life table method was used to visualize the hazard function, and Kaplan-Meier survival curves were generated to identify the variables associated with implant failure. Prognostic variables associated with implant failure were identified with the Cox proportional hazard model. Of the 260 implants, 22 failed. The hazard function for implant failure showed that the risk is highest immediately after placement. The survival function showed that the median survival time of orthodontic mini-implants is sufficient for relatively long orthodontic treatments. The Cox proportional hazard model identified that increasing age is a decisive factor for implant survival. The decreasing pattern of the hazard function suggested gradual osseointegration of orthodontic mini-implants. When implants are placed in a young patient, special caution is needed to lessen the increased probability of failure, especially immediately after placement.

  19. Latrunculin A treatment prevents abnormal chromosome segregation for successful development of cloned embryos.

    Directory of Open Access Journals (Sweden)

    Yukari Terashita

    Full Text Available Somatic cell nuclear transfer to an enucleated oocyte is used for reprogramming somatic cells with the aim of achieving totipotency, but most cloned embryos die in the uterus after transfer. While modifying epigenetic states of cloned embryos can improve their development, the production rate of cloned embryos can also be enhanced by changing other factors. It has already been shown that abnormal chromosome segregation (ACS is a major cause of the developmental failure of cloned embryos and that Latrunculin A (LatA, an actin polymerization inhibitor, improves F-actin formation and birth rate of cloned embryos. Since F-actin is important for chromosome congression in embryos, here we examined the relation between ACS and F-actin in cloned embryos. Using LatA treatment, the occurrence of ACS decreased significantly whereas cloned embryo-specific epigenetic abnormalities such as dimethylation of histone H3 at lysine 9 (H3K9me2 could not be corrected. In contrast, when H3K9me2 was normalized using the G9a histone methyltransferase inhibitor BIX-01294, the Magea2 gene-essential for normal development but never before expressed in cloned embryos-was expressed. However, this did not increase the cloning success rate. Thus, non-epigenetic factors also play an important role in determining the efficiency of mouse cloning.

  20. CO2 laser surface treatment of failed dental implants for re-implantation: an animal study.

    Science.gov (United States)

    Kasraei, Shahin; Torkzaban, Parviz; Shams, Bahar; Hosseinipanah, Seyed Mohammad; Farhadian, Maryam

    2016-07-01

    The aim of the present study was to evaluate the success rate of failed implants re-implanted after surface treatment with CO2 laser. Despite the widespread use of dental implants, there are many incidents of failures. It is believed that lasers can be applied to decontaminate the implant surface without damaging the implant. Ten dental implants that had failed for various reasons other than fracture or surface abrasion were subjected to CO2 laser surface treatment and randomly placed in the maxillae of dogs. Three failed implants were also placed as the negative controls after irrigation with saline solution without laser surface treatment. The stability of the implants was evaluated by the use of the Periotest values (PTVs) on the first day after surgery and at 1, 3, and 6 months post-operatively. The mean PTVs of treated implants increased at the first month interval, indicating a decrease in implant stability due to inflammation followed by healing of the tissue. At 3 and 6 months, the mean PTVs decreased compared to the 1-month interval (P implant stability. The mean PTVs increased in the negative control group compared to baseline (P implants were significantly lower than control group at 3 and 6 months after implant placement (P implantation of failed implants in Jack Russell Terrier dogs after CO2 laser surface debridement is associated with a high success rate in terms of implant stability.

  1. Obesity does not aggravate vitrification injury in mouse embryos: a prospective study

    Directory of Open Access Journals (Sweden)

    Ma Wenhong

    2012-08-01

    Full Text Available Abstract Background Obesity is associated with poor reproductive outcomes, but few reports have examined thawed embryo transfer in obese women. Many studies have shown that increased lipid accumulation aggravates vitrification injury in porcine and bovine embryos, but oocytes of these species have high lipid contents (63 ng and 161 ng, respectively. Almost nothing is known about lipids in human oocytes except that these cells are anecdotally known to be relatively lipid poor. In this regard, human oocytes are considered to be similar to those of the mouse, which contain approximately 4 ng total lipids/oocyte. To date, no available data show the impact of obesity on vitrification in mouse embryos. The aim of this study was to establish a murine model of maternal diet-induced obesity and to characterize the effect of obesity on vitrification by investigating the survival rate and embryo developmental competence after thawing. Methods Prospective comparisons were performed between six–eight-cell embryos from obese and normal-weight mice and between fresh and vitrified embryos. Female C57BL/6 mice were fed standard rodent chow (normal-weight group or a high-fat diet (obese group for 6 weeks. The mice were mated, zygotes were collected from oviducts and cultured for 3 days, and six–eight-cell embryos were then selected to assess lipid content in fresh embryos and to evaluate differences in apoptosis, survival, and development rates in response to vitrification. Results In fresh embryos from obese mice, the lipid content (0.044 vs 0.030, Pvs.9.3%, Pvs. 93.1%, P Conclusions This study demonstrated that differences in survival and developmental rates between embryos from obese and normal-weight mice were eliminated after vitrification. Thus, maternal obesity does not aggravate vitrification injury, but obesity alone greatly impairs pre-implantation embryo survival and development.

  2. Implantable contraception.

    Science.gov (United States)

    Meckstroth, K R; Darney, P D

    2000-12-01

    Although levonorgestrel contraceptive implants have been available for over 15 years, innovations have only recently led to a wider choice. These new implants offer easier insertion and removal and other advantages depending on the type of progestin. Implants prevent pregnancy by several mechanisms, including inhibition of ovulation and luteal function and alteration of cervical mucus and the endometrium. The high efficacy and ease of maintenance make implants an ideal contraceptive for many women, including adolescents, a population that uses implants infrequently but reports high satisfaction. Implants are appropriate for women who are breastfeeding, who have contraindications to estrogen, or who have diseases such as diabetes, hypertension, sickle cell anemia, or an HIV infection because implants have few metabolic or hematologic effects. Long-term use has not been associated with a decrease in BMD and generally leads to increased blood levels and iron stores. Women who wish to space their pregnancies appreciate the nearly immediate onset of action with insertion and the rapid termination of all effects with removal. All types of implants lead to menstrual changes and other side effects in some women. Adverse effects that occur in implant users more than the general population include headaches and acne. Women must be thoroughly counseled regarding the potential for menstrual alteration, side effects, and sexually transmitted infections if they do not use condoms. Despite their initial high cost, implants are a cost-effective method over several years, even when discontinued before the life of the implant.

  3. Improvement of pregnancy outcome by extending embryo culture in IVF-ET during clinical application.

    Science.gov (United States)

    Zhao, Xiaopeng; Ma, Binbin; Mo, Shaokang; Ma, Lu; Chang, Fei; Zhang, Liyuan; Xu, Fang; Wang, Ling

    2017-11-09

    The purpose of this study is to investigate the application value of the extended embryo culture for 7-8 h in day 3 morning during IVF-ET process. Embryos were retrospectively assessed during 08:00-09:00 on the morning of day 3 in the control group, and were assessed once again at 16:00 in the afternoon in the extended culture (EC) group. The embryos with good developmental potential were preferentially selected to transfer. The cumulative pregnancy outcomes were analyzed in one oocyte retrieval cycle. Similar proportions were found in the rates of cumulative clinical pregnancy, cumulative live birth, and the perinatal/neonatal outcomes per oocyte retrieval cycle (P > 0.05). But higher total clinical pregnancy rate, higher total implantation rate, and lower total abortion rate were obtained in the EC group (P < 0.05). After EC, 53.58% of the embryos were able to continue to develop. The transferred embryos were mainly composed of ≥ 8-cell embryos (75.90%) in the EC group and ≤ 8-cell embryos (82.92%) in the control group. Interestingly, the implantation rates were increasingly improved with the increasing blastomere number up to 56.31% at the morula stage in the EC group, while they were limited to 32.33% at 8-cell stage in the control group. The extended culture of day 3 embryos for 7-8 h not only reduced the risk of IVF-ET treatment compared to blastocyst culture through another 2-3 days, but also improved the clinical outcomes and the efficiency of every transferred cycle and every transferred embryo.

  4. Comprehensive chromosome screening improves embryo selection: a meta-analysis.

    Science.gov (United States)

    Dahdouh, Elias M; Balayla, Jacques; García-Velasco, Juan Antonio

    2015-12-01

    To study whether preimplantation genetic screening with comprehensive chromosome screening (PGS-CCS) improves clinical implantation rates (IR) and sustained IR (beyond 20 weeks) compared with routine care for embryo selection in IVF cycles. Meta-analysis of randomized controlled trials (RCTs) and observational studies (OSs). University-affiliated teaching hospital. Infertile couples undergoing IVF. PGS-CCS with the use of different genetic platforms performed on polar body (PB), cleavage embryo, or blastocyst following embryo biopsy. Clinical IR and sustained IR in RCTs as well as OSs comparing PGS-CCS and routine care were determined after a complete review of the literature. Pooled estimates of risk ratios (RRs) with their 95% confidence intervals (CIs) according to a fixed-effects model with the use of the Mantel-Haenszel method were calculated after the meta-analysis. Forest plots are provided for comparative purposes. Out of 763 citations identified, 29 articles met initial eligibility criteria and were further analyzed. Of these, only three RCTs and eight OSs met full inclusion criteria, allowing direct comparison of PGS-CCS and routine IVF care based on embryo morphology selection. In the RCTs, all embryo biopsies were performed on day 5-6 of embryo development. In the OSs, biopsies were performed on different stages of embryo development, including PB, day 3, or day 5-6. Meta-analysis of the RCTs (3 studies; n = 659) showed that PGS-CCS was associated with a significantly higher clinical IR, with a pooled RR of 1.29 (95% CI 1.15-1.45), as well as a significantly higher sustained IR, with a pooled RR of 1.39 (95% CI 1.21-1.60). Similar findings were shown in the OSs, where the pooled RR for clinical IR was 1.78 (95% CI 1.60-1.99; 7 studies; n = 2,993) and for sustained IR was 1.75 (95% CI 1.48-2.07; 4 studies; n = 1,124). Statistical heterogeneity (I(2)) was minimal for RCTs and substantial among OSs. PGS with the use of CCS technology increases clinical

  5. Dental Implant Surgery

    Science.gov (United States)

    ... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is ... to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is ...

  6. [Osteoradionecrosis and dental implants].

    Science.gov (United States)

    Ben Slama, L; Hasni, W; De Labrouhe, C; Bado, F; Bertrand, J-C

    2008-12-01

    Osteoradionecrosis (ORN) is a severe complication of radiation therapy (RT). A triggering factor is frequently present. It is often a dental, periodental, or surgical traumatism. We report the case of a bilateral ORN: the first lesion appeared 3months after the end of RT around the osteosynthesis plate and was treated by mandibular resection. The second lesion appeared 40months after RT on the opposite side, due to peri-implantitis. Dental implants had been inserted 10years before cancer therapy. No case of ORN in post-implantation RT had been previously reported. A 75-year-old woman was admitted for a squamous cell carcinoma of the right cheek extending to the intermaxillary commissure, the maxillary tuberosity, the soft palate, the lingual junction, and the vestibule up to the second premolar area. There was no suspicious lymph node. She had undergone dental implant procedure 15 and 10 years before, respectively, one in the second premolar position of the right maxilla and four in the premolar and molar left mandible area. All of them were osseo-integrated and charged. A trans-mandibular buccopharyngectomy with modified radical neck dissection was performed, completed by RT. The total dose of irradiation was 65Gy in the oral cavity and 45Gy on cervical and supraclavicular areas. Delayed mucosal healing was observed on the right mandible and ORN appeared in this area 3months after the end of irradiation. Mandibular resection was necessary. Later, the right maxillary implant was lost, and multiple dental extractions were required. Forty months after RT, peri-implantitis was observed on the left side of the mandible, complicated by ORN and pathological fracture. No surgical reconstruction could be performed because of the patient's age and state. The patient was carrying a complete removable maxillary prosthesis on latest follow-up. This was the first case of ORN on dental implants placed before RT. RT is a risk factor of implant failure, a relatively rare and

  7. Carbon monoxide and the embryo.

    Science.gov (United States)

    Robkin, M A

    1997-04-01

    Mammals are homeotherms and expend considerable energy maintaining their body temperatures. The temperature of a mammalian embryo on the other hand is maintained by the mother and the embryo can devote its metabolic energy to growth and development. The mammalian embryo is acting as a poikilotherm and its energy needs are thus considerably less than if it were a comparably sized homeotherm. The energy requirements of the preimplantation rat embryo are generated by anaerobic metabolism. As it grows, aerobic metabolism develops. In culture, the addition of carbon monoxide to the perfusing gas for early rat embryos has a much smaller effect than decreasing the oxygen concentration. Carbon monoxide appears to be a relatively mild toxicant until the embryo is much larger, is depending much more on transport of oxygen by red blood cells, and the fraction of required metabolic energy produced by anaerobic metabolism has become quite small. The effect from smoking during gestation may be either by the concomitant reduction in food intake or a more direct toxic effect from some components in the smoke. Carbon monoxide does not seem to be the culprit. The possible mitigating effect of a compensatory increase in fetal hematocrit in response to any hypoxia must also be considered. Humans have no yolk sac placenta as rodents do, but if the switch from anaerobic to aerobic metabolism is correlated with the stage of development, then carbon monoxide exposure should not represent any significant risk to the human embryo until later in gestation.

  8. Assisted reproduction technique outcomes for fresh versus deferred cryopreserved day-2 embryo transfer: a retrospective matched cohort study.

    Science.gov (United States)

    Bourdon, Mathilde; Santulli, Pietro; Gayet, Vanessa; Maignien, Chloé; Marcellin, Louis; Pocate-Cheriet, Khaled; Chapron, Charles

    2017-03-01

    Ovarian stimulation could adversely affect endometrial receptivity and consequently embryo implantation. One emerging strategy is the 'freeze-all' approach. Most studies have focused on blastocyst transfers, with limited research on day-2 deferred cryopreserved embryo transfers. In this large retrospective cohort study, outcomes were compared between day-2 fresh versus deferred cryopreserved embryo transfers. After matching by age and number of previous cycles, 325 cycles were included in the fresh group and 325 in the deferred cryopreserved embryo transfers group: no significant differences were found between groups in implantation (0.20 ± 0.33 versus 0.17 ± 0.31, respectively) and ongoing pregnancy rates (21.85% versus 18.46%). Independent predictors for ongoing pregnancy after a multiple logistic regression analysis were the women's age (OR = 0.92; 95% CI 0.88 to 0.97), body mass index (OR = 0.94; 95% CI 0.89 to 0.99), the number of two pronuclei embryos (OR = 1.19; 95% CI 1.04 to 1.40) and at least one grade 1 embryo transferred (OR = 1.97; 95% CI 1.26 to 3.05). In the case of a day-2 embryo transfer, outcomes after treatment with assisted reproduction techniques are similar for fresh versus deferred cryopreserved embryo transfers when pre-transfer progesterone exposures are similar in the two groups. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  9. A Chemically Defined Medium for Rabbit Embryo Cryopreservation

    Science.gov (United States)

    Bruyère, Pierre; Baudot, Anne; Joly, Thierry; Commin, Loris; Pillet, Elodie; Guérin, Pierre; Louis, Gérard; Josson-Schramme, Anne; Buff, Samuel

    2013-01-01

    This study evaluates a new synthetic substitute (CRYO3, Ref. 5617, Stem Alpha, France) for animal-based products in rabbit embryo cryopreservation solutions. This evaluation was performed using two approaches: a thermodynamic approach using differential scanning calorimetry and a biological approach using rabbit embryo slow-freezing. During the experiment, foetal calf serum (FCS) was used as a reference. Because FCS varies widely by supplier, three different FCS were selected for the thermodynamic approach. The rabbit embryo slow-freezing solutions were made from Dulbecco's phosphate buffer saline containing 1.5 M Dimethyl Sulfoxide and 18% (v.v−1) of CRYO3 or 18% (v.v−1) of FCS. These solutions were evaluated using four characteristics: the end of melting temperature, the enthalpy of crystallisation (thermodynamic approach) and the embryo survival rates after culture and embryo transfer (biological approach). In the thermodynamic approach, the solutions containing one of the three different FCS had similar mean thermodynamic characteristics but had different variabilities in the overall data with aberrant values. The solution containing CRYO3 had similar thermodynamic properties when compared to those containing FCS. Moreover, no aberrant value was measured in the solution containing CRYO3. This solution appears to be more stable than the solutions containing a FCS. In the biological approach, the in vitro embryo survival rates obtained with the solution containing CRYO3 (73.7% and 81.3%) and with the solution containing a FCS (77.6% and 71.9%) were similar (p = 0.7). Nevertheless, during the in vivo evaluation, the implantation rate (21.8%) and the live-foetuses rate (18.8%) of the CRYO3 group were significantly higher than the implantation rate (7.1%, p = 0.0002) and the live-foetuses rate (5.3%, p = 0.0002) of the FCS group. The pregnancy rate was also higher in the CRYO3 group compared to the FCS group (81.3% and 43.8%, respectively, p = 0

  10. Influence of radiation (Co{sub 60}) in pre-implant rabbit embryos: effect on mitotic index and embryonic pole malformations; Influencia da radiacao ionizante (bomba de cobalto) em embrioes de coelha na fase de pre-implantacao: influencia no indice mitotico e malformacoes no polo embrionario

    Energy Technology Data Exchange (ETDEWEB)

    Approbato, M.S.; Moura, K.K.V.O.; Florencio, R.S.; Cunha Junior, C.; Garcia, R.; Faria, R.S.; Benedetti, L.N.; Goulart, F.B. [Goias Univ., Goiania, GO (Brazil). Faculdade de Medicina. Dept. de Ginecologia e Obstetricia

    1995-03-01

    We studied the effect of ionizing irradiation on 12 New Zealand rabbits (65 embryos), at three different times: at match time (zero hour), two days after and four days after, with two different irradiation doses: five c Gy and ten c Gy. Six rabbits (36 blastocysts) were used as controls. the matching instant was the zero hour. Exactly six days after ({+-} 60 minutes) the embryos of each rabbit was picked up by flushing the uterus with culture media. the embryos were fixed in methanol for 48 hours, and colored with acid Mayer hematoxylin. The following embryo parameters were studied: mitotic index; embryonic pole malformations. There were no gross abnormalities of embryo pole. The mitotic index were altered both by the time and doses. (author). 12 refs., 3 figs.

  11. Corrosion on spinal implants.

    Science.gov (United States)

    Kirkpatrick, John S; Venugopalan, Ramakrishna; Beck, Preston; Lemons, Jack

    2005-06-01

    Modular spine implants are used as an aid to obtaining fusion, but fretting and corrosion occur between modular components in a biologic environment. Forty-eight spinal implant constructs manufactured by a variety of companies were retrieved from 47 patients and were subjected to surface analysis stereomicroscopy. Stainless-steel implants (n = 23) had either semirigid constructs with mild or no surface alteration (n = 7) or rigid constructs with moderate or severe alteration (n = 16). Surface damage was consistent with previously observed mechanically assisted crevice corrosion phenomena. Titanium alloy implants (n = 25) showed no significant corrosion but had three constructs with fatigue failure of anchoring screws. One cobalt alloy construct showed no evidence of corrosion. Long-term effects of fretting and corrosion are unclear, and minimization of these phenomena seems justified. Selection of modular components with similar materials and surface finish may help the surgeon minimize localized changes over time. Stainless-steel implants with rigid interconnections and those with different surface finishes between rods and connectors are most susceptible to corrosion.

  12. In Vitro Elongation of Porcine Embryos Using Alginate Hydrogels as a Three-Dimensional Extracellular Matrix

    Science.gov (United States)

    In the pig, the pre-implantation period of pregnancy is highly influential on sow productivity and therefore the profitability of swine production. Between Day 11 and 12 of gestation, the embryo undergoes a significant morphological change, during which it transforms from an ovoid structure of about...

  13. Chromosomal abnormalities and embryo development in recurrent miscarriage couples.

    Science.gov (United States)

    Rubio, C; Simón, C; Vidal, F; Rodrigo, L; Pehlivan, T; Remohí, J; Pellicer, A

    2003-01-01

    Chromosomal abnormalities are an important cause of spontaneous abortion and recurrent miscarriage (RM). Therefore, we have analysed the incidence of chromosomal abnormalities and embryo development in patients with RM. Preimplantation genetic diagnosis (PGD) was performed on 71 couples with RM and 28 couples undergoing PGD for sex-linked diseases (control group). Chromosomes 13, 16, 18, 21, 22, X and Y were analysed by fluorescence in-situ hybridization. The implantation rate in RM patients was 28% and three patients (13%) miscarried. The percentage of abnormal embryos was significantly increased (P abnormal in 19 cycles (22.1%) and repeated PGD cycles yielded similar rates of chromosomal abnormalities in 14 couples. Anomalies for chromosomes 16 and 22 were significantly higher (P abnormal embryos (61.7 versus 24.9%; P chromosomally abnormal embryos, of which some are able to develop to the blastocyst stage. IVF plus PGD is an important step in the management of these couples, but the technique has to move towards a full chromosome analysis.

  14. Soft, Brown Rupture: Clinical Signs and Symptoms Associated with Ruptured PIP Breast Implants

    Directory of Open Access Journals (Sweden)

    Yvette Godwin, FRCS

    2014-11-01

    Conclusions: Preoperative signs can be predictive of PIP implant failure. Brown-stained implants are more prone to rupture. The presence of iodine in the gel suggests unacceptable permeability of the shell early in the implant’s life span. A noninvasive screening test to detect brown implants in situ could help identify implants at risk of failure in those who elect to keep their implants.

  15. Dental Implants: Plasma polymerization for antibacterial coatings

    OpenAIRE

    Buxadera Palomero, Judit; Canal Barnils, Cristina; Gil Mur, Francisco Javier; Rodríguez Rius, Daniel

    2016-01-01

    Dental implants are widely used to overcome tooth loss. The material of choice for this application is titanium, due to its excellent mechanical properties, high corrosion resistance, and high biocompatibility. Despite the high success rate of titanium dental implants, there are a significant number of failures due to the infection of the surrounding tissues. The best way to avoid infections related to the use of dental implants is to achieve an antibacterial surface, either by physical or ch...

  16. Relation between bruxism and dental implants

    OpenAIRE

    Torcato, Leonardo Bueno [UNESP; Zuim,Paulo Renato Junqueira; Brandini, Daniela Atili; Falcón-Antenucci, Rosse Mary [UNESP

    2014-01-01

    OBJECTIVE: The aim of this study was to gather information and discuss the predictability of implant-supported prostheses in patients with bruxism by performing a literature review.METHODS: In order to select the studies included in this review, a detailed search was performed in PubMed and Medlinedatabases, using the following key words: bruxism, dental implants, implant supported prosthesis, and dental restoration failure. Items that were included are: case reports, randomized controlled tr...

  17. Physiopathology of human embryonic implantation: clinical incidences.

    Directory of Open Access Journals (Sweden)

    Pauline Demailly

    2010-01-01

    Full Text Available Embryo implantation consists of a series of events promoting the invasion of the endometrium and then the uterine arterial system by the extra-embryonic trophoblast. In order for this semi-heterologous implantation to succeed, the endometrium has to first undergo a number of structural and biochemical changes (decidualization. The decidua's various constituents subsequently play a role in the embryonic implantation. The third step is the transformation of the uterine vascular system and the growth of the placenta, which will provide the foetoplacental unit with nutrients. Several physiopathological aspects will be discussed: 1 the implantation window, regulated by maternal and embryonic hormonal secretions and thus influenced by any defects in the latter: dysharmonic luteal phase, 21-hydroxylase block, abnormal integrin expression, 2 the successive trophoblast invasions of uterine vessels which, when defective, lead to early embryo loss or late-onset vascular pathologies, as preeclampsia, 3 the pregnancy's immunological equilibrium, with a spontaneously tolerated semi-allogeneic implant, 4 the impact of pro-coagulant factors (thrombophilia on the pregnancy's progression, 5 the environment of the uterus, ranging from hydrosalpinx to uterine contractions. In summary, the least anatomical or physiological perturbation can interfere with human embryonic implantation - a very particular phenomenon and a true biological paradox.

  18. Identification of chromosomal errors in human preimplantation embryos with oligonucleotide DNA microarray.

    Directory of Open Access Journals (Sweden)

    Lifeng Liang

    Full Text Available A previous study comparing the performance of different platforms for DNA microarray found that the oligonucleotide (oligo microarray platform containing 385K isothermal probes had the best performance when evaluating dosage sensitivity, precision, specificity, sensitivity and copy number variations border definition. Although oligo microarray platform has been used in some research fields and clinics, it has not been used for aneuploidy screening in human embryos. The present study was designed to use this new microarray platform for preimplantation genetic screening in the human. A total of 383 blastocysts from 72 infertility patients with either advanced maternal age or with previous miscarriage were analyzed after biopsy and microarray. Euploid blastocysts were transferred to patients and clinical pregnancy and implantation rates were measured. Chromosomes in some aneuploid blastocysts were further analyzed by fluorescence in-situ hybridization (FISH to evaluate accuracy of the results. We found that most (58.1% of the blastocysts had chromosomal abnormalities that included single or multiple gains and/or losses of chromosome(s, partial chromosome deletions and/or duplications in both euploid and aneuploid embryos. Transfer of normal euploid blastocysts in 34 cycles resulted in 58.8% clinical pregnancy and 54.4% implantation rates. Examination of abnormal blastocysts by FISH showed that all embryos had matching results comparing microarray and FISH analysis. The present study indicates that oligo microarray conducted with a higher resolution and a greater number of probes is able to detect not only aneuploidy, but also minor chromosomal abnormalities, such as partial chromosome deletion and/or duplication in human embryos. Preimplantation genetic screening of the aneuploidy by DNA microarray is an advanced technology used to select embryos for transfer and improved embryo implantation can be obtained after transfer of the screened normal

  19. The oviduct: from sperm selection to the epigenetic landscape of the embryo.

    Science.gov (United States)

    Pérez-Cerezales, Serafín; Ramos-Ibeas, Priscila; Acuña, Omar Salvador; Avilés, Manuel; Coy, Pilar; Rizos, Dimitrios; Gutiérrez-Adán, Alfonso

    2017-12-08

    The mammalian oviduct is the place where life begins as it is the site of fertilization and preimplantation embryo development. Recent research has highlighted the important role played by the oviduct both in sperm selection for natural fertilization and in the genetic and epigenetic reprogramming of pre-implantation embryo development. This review examines oviduct fluid composition with a special emphasis on exosomes and the role played by the oviduct in sperm selection, early embryo development, and in reshaping the epigenetic landscape of the embryo. In addition, the implications of data obtained for improving assisted reproductive technologies are discussed. © The Author(s) 2017. Published by Oxford University Press on behalf of Society for the Study of Reproduction. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. [Cryopreservation of early human embryo stages].

    Science.gov (United States)

    Vökler, T; Fliess, F R

    1988-01-01

    A short review of freezing procedures applied to early human embryos is given. It is noted that human embryos survived freezing and thawing at a developmental stage of 1. cell to blastocyst. But it seems to be necessary to use for any developmental stage of early embryo a special freezing and thawing method. Embryo survival is correlated with their morphologic features where as neither age of embryos nor developmental stage were involved in freezing and thawing ability.