Pregnancy achieved following IVF-ET after surgery for infertility with perforate transverse vaginal septum and incomplete septate uterus: case report.

Transverse vaginal septum is a rare congenital anomaly. Imperforate transverse vaginal septum causes marked clinical symptoms, and is diagnosed at a young age in most cases. Perforate transverse vaginal septum is difficult to detect due to the absence of symptoms. In this study, we report a case of a 33-year-old infertile female with a perforate transverse vaginal septum and incomplete septate uterus who had wished to bear a child for over ten years, and consulted our hospital. Transverse vaginal septum was considered to be an etiological factor for infertility. After surgery for transverse vaginal septum, in vitro fertilization achieved pregnancy.

Improvement in exercise capacity with nitric oxide inhalation in patients with precapillary pulmonary hypertension.

BACKGROUND: Patients with precapillary pulmonary hypertension (PH) exhibit a poor exercise capacity due to an impaired vasodilatory response of their pulmonary arteries. By causing the pulmonary artery to dilate, inhaled nitric oxide (NO) may allow an increase in exercise capacity in patients with PH. METHODS AND RESULTS: On 2 separate days, 3 days apart, 14 patients with precapillary PH (10 primary PH, 4 residual PH after correction of an intracardiac shunt; age, 40+/-12 years; mean pulmonary artery pressure, 60+/-23 mm Hg) performed exercise, with and without inhalation of 20 ppm NO, on a cycle ergometer. The work rate was increased 15 W/min until their symptom-limited maximum, with breath-by-breath gas analysis. Patients were randomly and blindly selected to inhale NO on either their first or second test. Peak exercise load and anaerobic threshold tended to increase, but not significantly. Peak oxygen consumption (f1.gif" BORDER="0">O(2)) and Deltaf1.gif" BORDER="0">O(2)/DeltaW ratio increased significantly, by 18% and 22%, respectively (peak f1.gif" BORDER="0">O(2), 13.6+/-3.6 to 16.0+/-4. 1 mL. kg(-1). min(-1); Deltaf1.gif" BORDER="0">O(2)/DeltaW ratio, 5. 8+/-2.4 to 7.1+/-2.3 mL. kg(-1). min(-1). W(-1); both P<0.01). Peak f1.gif" BORDER="0">O(2) increased >10% in 12 of the 14 patients. However, respiratory quotient at peak exercise decreased from 1. 22+/-0.15 to 1.09+/-0.15 (P<0.01). CONCLUSIONS: Inhaled NO substantially increases oxygen consumption at the same workload during exercise. This finding supports the possibility of ambulatory NO inhalation therapy in patients with precapillary PH.

Zinc and IGF-I concentrations in pregnant women with anemia before and after supplementation with iron and/or zinc.

OBJECTIVE: The objective of our study was to investigate zinc (Zn) status and effects of Zn supplementation in relation to insulin-like growth factor-I (IGF-I) and iron deficiency anemia in pregnant women. The role of Zn and IGF-I in hematologic abnormalities has remained unclear. METHODS: Thirty-eight Japanese women, when examined at the second trimester of pregnancy, had hemoglobin concentrations below 11.0 g/dL and 32 of 38 had normocytic erythrocytes. These 38 women were divided into three groups, and we compared the hematological status and serum IGF-I levels before and after iron (Group A) or Zn (Group B) or iron plus Zn (Group C) supplementation. RESULTS: The concentrations of hemoglobin (Hb) did not change in groups A and B. In group C, Hb levels were significantly increased from 10.3+/-0.3 to 11.0+/-0.6 g/dL. Furthermore, numbers of RBC and reticulocytes also increased significantly. Concentrations of iron, IGF-I and total iron binding capacity (TIBC) were increased, and concentrations of erythropoietin were decreased, but not statistically. There were significant positive correlations between increases in IGF-I and increases in Hb and RBC in the Zn administered groups. CONCLUSION: Zn status to some extent can account for hematological abnormalities in pregnant women. Zn derived IGF-I has a role in the regulation of hematopoiesis in pregnant women.

A case of constrictive pericarditis with local thickening of the pericardium without manifest ventricular interdependence.

This is the first case report of postsurgical constrictive pericarditis confined to the left ventricle in which the majority of diagnosis tests were not indicative of the disease. A 50-year-old woman with a past history of mitral valve replacement was admitted for right heart failure. Cardiac catheterization showed impaired diastolic filling but lacked the characteristic ventricular interdependence recently reported to be specific for the disease, without manifest radiological appearance of pericardial thickening. However, a new technique using magnetic resonance tagging cine revealed pericardial adhesion, limited to the left ventricle, which was confirmed during pericardiectomy. After the surgery, right heart failure and diastolic filling abnormality disappeared with restoration of normal heart pressures.