Electrocoagulation versus suture after laparoscopic stripping of ovarian endometriomas assessed by antral follicle count: preliminary results of randomized clinical trial.

PURPOSE: The assessment of ovarian reserve by antral follicle count (AFC) following electrocoagulation versus suture after laparoscopic stripping of ovarian endometriomas. METHODS: Forty-five patients between 18 and 35 years, with unilateral endometriomas were randomly analyzed. Laparoscopic cystectomy was performed by the stripping method. Ovarian hemostasis was obtained either by suturing (group A, n = 23) or by bipolar electrocoagulation (group B, n = 22). AFC was performed by ultrasound on the third day of the three postoperative menstrual cycles. The sum of AFC was compared between sutured (A1) and electrocoagulated (B1) ovaries, as well as between intact ovaries of both groups (A0: intact ovaries in sutured group, B0: intact ovaries in electrocoagulated group). RESULTS: The median of AFC was significantly lower in operated ovaries than in intact ovaries in both groups of patients, regardless of suturing [A1 median: 12 (range 9-19) vs. A0 median: 21.0 (range 15-27), p < 0.05] or electrocoagulation [B1: 5.0 (2-10) vs. B0: 18.5 (8-29), p < 0.05]. The median AFC was significantly higher in sutured ovaries than in electrocoagulated ovaries [A1: 12 (9-19) vs. B1: 5.0 (2-10), p < 0.05]. CONCLUSION: Our preliminary data show that operation on ovarian endometriomas could reduce ovarian reserve. The AFC value suggests that the ovarian reserve was less reduced in sutured ovaries than in those electrocoagulated. Suturing as a method of hemostasis could be a better choice after stripping ovarian endometriomas.

Object recognition deficit in early- and adult-onset schizophrenia regardless of age at disease onset.

Perceptual closure is the ability of the brain to recognize a complete object based on fragmentary information and has been known to be impaired in schizophrenia. Here, the neural integrity of perceptual closure in schizophrenia with different disease onsets was evaluated by examining the generation of event-related potential (ERP) components (P100, N180, and N(cl)). ERPs were recorded from 40 patients (19 early-onset schizophrenia, "EOS" and 21 adult-onset schizophrenia, "AOS") and 40 age-matched healthy volunteers. Brain electric source analysis (BESA) was applied to localize the cerebral generators underlying perceptual closure. Patients showed an impaired generation of N(cl) and P100 components. P100 and N(cl) amplitudes were significantly reduced in both AOS and EOS (P<0.01). Moreover, N180 and N(cl) amplitudes were significantly increased with age in controls and patients (P<0.01). In the case of the N(cl), there was also a significant interaction (P<0.001) between age and group, indicating a greater age-dependent N(cl) increase in controls compared to patients. Visual information processing during perceptual closure is impaired in schizophrenia, regardless of age at disease onset. The combined influence of age and group on the amplitude of the N(cl) might support the idea of neurodevelopmental deficits in schizophrenia.