Showing papers in "National Medical Journal of China in 1984"

An overview of male infertility in the era of intracytoplasmic sperm injection.

Abstract: As a result of the technological advance provided by intracytoplasmic sperm injection (ICSI) in 1992, the evaluation and treatment of the infertile male has changed significantly. Many men who were previously thought to be irreversibly infertile have the potential to initiate their own biologic pregnancy. However, not all men having impaired semen parameters are ideal candidates for ICSI for numerous reasons including a lack of addressing the underlying problem causing the male infertility, unknown genetic consequences, and cost-effectiveness issues. In this era of ICSI, the fundamental approach to the male with suspected subfertility is unchanged and is based on a history, physical examination, and focused laboratory testing. The urologist should approach the patient with an intent to identify remediable causes of subfertility given the specific clinical situation. For instance, should a gentleman have his varicocele repaired or vasectomy reversed, or should he proceed directly with ICSI? If no factors can be improved in a timely manner, then ICSI should be considered using the available sperm. Examples of recent advances include the diagnosis and treatment of ejaculatory duct obstruction, indications and techniques for performing testis biopsy, and techniques for sperm harvesting. Potential genetic causes should be diagnosed and discussed with the patient. Cystic fibrosis gene mutations, karyotype abnormalities, and Y-chromosome microdeletions all have recently been identified as causative for male infertility in otherwise phenotypically normal men. While the long-term genetic consequences for these offspring are largely undefined, recent studies suggest that serious birth defects are not significantly increased in ICSI babies. An understanding of these advances by all physicians is important as we progress into the 21st century.

Real-time dynamic telepathology through the Internet: evaluation of a new and economic technology at Taipei Veterans General Hospital.

Abstract: BACKGROUND Computer-aided, digitalized telepathology was introduced about 10 years ago and is gaining acceptance as a mode of providing pathology to remote site. The usefulness of telepathology for remote diagnosis of histology, cytology and frozen section has been evaluated in USA, Europe and Japan. In Taiwan, the use of telepathology for pathological diagnosis is still rare. In order to evaluate the potential use of this technique, we undertook the study using commercialized and low-cost microscopy, personal computer and software on routine biopsy material. METHODS Sixty prostatic sextant transrectal needle biopsies, including 30 cases of adenocarcinoma and 30 cases of benign lesions, were retrieved retrospectively. The real-time dynamic images were transmitted to the remote site via internet and reviewed by a senior uropathologist who was unaware of the diagnosis. The diagnoses made at the remote site were correlated to the final diagnoses of the cases. RESULTS All malignant specimens (30/30) were correctly diagnosed by this method. Only one benign case (1/31) of nonspecific granulomatous prostatitis was misdiagnosed as poorly differentiated carcinoma. CONCLUSIONS Our results show that this method is a good way for teleconsultation. Further studies on other types of specimen worth encouragement for both intra- and inter-institutional consultation.

Clinical study on 23 cases of severe adenoviral pneumonia complicated by disseminated intravascular coagulation

Abstract: : We reported two cases of squamous cell carcinoma of the esophagus following endoscopic injection sclerotherapy (EIS) for esophageal varices. Both patients were cigarette smokers and had a long history of alcohol abuse. HBsAg and Anti-HCV were negative, and Anti-HBs was positive in one of the patients. They were diagnosed as alcoholic cirrhosis with esophageal varices and received EIS treatment. Sotradecol was utilized as the sclerosant with a mean total volume of around 30 ml. Patients developed dysphagia at 5 and 48 months following EIS, respectively. Endoscopic examination showed stenosis and ulcerative mass at the lower portion of the esophagus. Biopsy revealed well- to moderately differentiated squamous cell carcinoma of the esophagus. We conclude that endoscopic follow-up is essential and carcinoma of the esophagus should be included in the differential diagnosis for esophageal ulceration and dysphagia following EIS, particularly in those patients with risk factors for developing esophageal carcinoma.