RESUMO
OBJECTIVE: To explore the necessity of reception of sperm donors by full-time nurses in the sperm bank by analyzing the efficiency of sperm donation before and after staffing Guangdong Sperm Bank (GSB) with full-time nurses. METHODS: We selected 9 712 qualified sperm donors in GSB from January 1, 2016 to December 31, 2021 and compared the efficiency of sperm donation before and after staffing GSB with full-time nurses. RESULTS: After staffing GSB with full-time nurses, the proportion of qualified sperm donors screened from the quasi-qualified ones was dramatically increased from 66.2% (1 230/1 858) to 77.1% (3 252/4 218) (P < 0.01), that of HIV re-examinees after 6-month suspension from sperm donation increased from 84.6% (137/162) to 93.4% (599/641) (P < 0.01), and that of the candidate donors lost to follow-up during the screening period decreased from 23.2% (831/3 583) to 21.3% (1 308/6 129) (P = 0.034). CONCLUSION: After Guangdong Sperm Bank was staffed with full-time nurses for reception of sperm donors, the proportion of the candidate donors lost to follow-up was reduced and the efficiency of sperm donation was significantly improved. Individualized psychological intervention for the sperm donors by the nurses could dispel the worries of the donors and improve the compliance and efficiency of sperm donation.
Assuntos
Bancos de Esperma , Obtenção de Tecidos e Órgãos , Humanos , Masculino , Sêmen , Espermatozoides , Doadores de TecidosRESUMO
OBJECTIVE: To analyze the causes of failure in autologous sperm cryopreservation (ASCP) in the human sperm bank and propose some countermeasures to improve the success rate of ASCP and promote it in human sperm banks. METHODS: We retrospectively analyzed the reasons for and causes of failure in ASCP 1 156 males undergoing ASCP in the Human Sperm Bank of Guangdong Province from January 1, 2016 to December 31, 2019. RESULTS: Of the 1 156 cases of ASCP, 857 (74.1%) succeeded and 299 (25.9%) failed, with a failure rate of 56.1% (96/171) in the microdissection testicular sperm extraction (micro-TESE) group, 29.9% (67/224) in the reproduction insurance group, 21.2% (27/100) in the non-tumor disease group and 17.2% (109/525) in the tumor group, with statistically significant difference between the four groups (χ2 = 109.926, P < 0.01). The causes of failed ASCP included failure to extract semen (14.0% ï¼»42/299ï¼½), failure to meet the standard of sperm cryopreservation (67.6% ï¼»202/299ï¼½), giving up ASCP for low semen quality (7.4% ï¼»22/299ï¼½), and giving up ASCP for some other reasons (11.0% ï¼»33/299ï¼½), including worry about the reliability of cryopreservation technology (6.0% ï¼»18/299ï¼½), suspicion about the complexity of the ASCP procedures (3.0% ï¼»9/299ï¼½) and expectation for fertility recovery after chemotherapy withdrawal (2.0% ï¼»6/299ï¼½). CONCLUSIONS: In view of different causes of failure in ASCP, human sperm banks can provide individualized cryopreservation schemes, including guidance with masturbation or the use of sperm extraction instrument in sperm extraction, strengthening sperm preservation-related education and the awareness of reproduction protection and earlier sperm preservation among cancer patients, promoting the cryopreservation of microsamples of motile sperm by microsample or single sperm freezing, and development of testis tissue cryopreservation to preserve the fertility of children with cancer.
Assuntos
Preservação do Sêmen , Bancos de Esperma , Criança , Humanos , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos , Análise do Sêmen , EspermatozoidesRESUMO
OBJECTIVE: To investigate the relationship of the characteristics of sperm donors with the results of screening and provide some reference for the screening of sperm donors. METHODS: We statistically analyzed the screening data about 12 362 sperm donors at the Guangdong Human Sperm Bank from January 2003 to June 2017 and the relationship of the eligibility rate of screening with the donors' age, education, occupation, marriage, and fatherhood. RESULTS: Of the 12 362 sperm donors, 3 968 (32.1%) met the standards of semen quality and 3 127 (25.3%) filled all the requirements of sperm donation. The eligibility rate of screening was 27.7% in the donors aged 20ï¼24 years, 24.3% in those aged 25ï¼29 years, 23.8% in those aged 30ï¼34 years, and 17.5% in those aged =≥35 years (P < 0.01); 23.5% in the senior high school students, 24% in the junior college students, 25.9% in the undergraduates, and 30.3% in the postgraduates (P < 0.01); 29.3% in the students versus 22.9% in the others (P < 0.01), 41.5% in the married versus 20.7% in the unmarried (P < 0.01), and 45.6% in the fathers versus 20.9% in the childless husbands (P < 0.01). CONCLUSIONS: A higher eligibility rate of screening was found among the sperm donors aged <35 years or with a bachelor's or higher degree, particularly among students.
Assuntos
Espermatozoides , Doadores de Tecidos , Adulto , Humanos , Masculino , Análise do Sêmen/normas , Estudantes/estatística & dados numéricos , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos , Adulto JovemRESUMO
Varicocele is commonly associated with male infertility because it impairs normal sperm morphology and activity. Polyunsaturated fatty acids (PUFA) are important determinants of sperm cell structure and function, but their relationship with varicocele remains unclear. The aim of the present study was to investigate the PUFA composition in spermatozoa of infertile men with varicocele and to evaluate the potential relationship between PUFA and varicocele. This case control study recruited 92 infertile men with varicocele, 99 infertile men without varicocele and 95 fertile male control subjects. Semen morphology and activity parameters were assessed and seminal plasma 8-hydroxy-2-deoxyguanosine (8-OHdG) content was determined by ELISA. Sperm concentrations of omega-3 and omega-6 fatty acids were measured by gas chromatography. Infertile men with varicocele had lower concentrations of omega-3 PUFA, higher omega-6:omega-3 PUFA ratios and greater oxidative DNA damage in spermatozoa compared with infertile men without varicocele and normal subjects. The degree of varicocele and DNA damage was associated with decreased omega-3 PUFA concentrations and semen quality in infertile men with varicocele. The findings suggest that omega-3 PUFA deficiency could be implicated in varicocele-associated infertility, and highlight the need for intervention trials to test the usefulness of omega-3 supplementation in reducing sperm abnormalities in infertile men with varicocele.
Assuntos
Dano ao DNA , Ácidos Graxos Ômega-3/análise , Fertilidade , Infertilidade Masculina/metabolismo , Estresse Oxidativo , Espermatozoides/química , Varicocele/metabolismo , 8-Hidroxi-2'-Desoxiguanosina , Adulto , Estudos de Casos e Controles , Cromatografia Gasosa , Desoxiguanosina/análogos & derivados , Desoxiguanosina/análise , Regulação para Baixo , Ensaio de Imunoadsorção Enzimática , Ácidos Graxos Ômega-6/análise , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/patologia , Infertilidade Masculina/fisiopatologia , Masculino , Sêmen/química , Contagem de Espermatozoides , Motilidade dos Espermatozoides , Espermatozoides/patologia , Varicocele/diagnóstico , Varicocele/patologia , Varicocele/fisiopatologiaRESUMO
OBJECTIVE: To study the semen quality of confirmed fertile men with the time to pregnancy (TTP) of 12 months or less, and analyze the correlation of semen parameters with TTP. METHODS: We recruited 1 152 men aged 18 -50 years and with TTP of 12 months. We used questionnaire investigation, physical examination and semen analysis, calculated the normal reference ranges of semen parameters, and analyzed the effects of TTP and other biological characteristics on semen quality. RESULTS: Seminal examinations showed that the semen volume was 1.5 ml, sperm concentration 17 million per ml, total sperm number 39 million per ejaculate, total sperm motility 41%, progressive sperm motility 33%, normal sperm morphology 5.0%, sperm vitality 53%, and total number of progressively motile sperm 17 million per ejaculate in the 1 152 subjects. In comparison, the total number of progressively motile sperm was significantly smaller in those aged > or = 35 years (P < 0.01), morphologically normal sperm were markedly less in those with BMI > 25.0 (P < 0.01), and sperm concentration, total number of sperm, morphologically normal sperm rate and total number of progressively motile sperm were remarkably lower in those with BMI < 18. 5 (P < 0.05). Cigarette smoking significantly reduced the sperm volume (P < 0.01), and drinking (> 10 g per week) decreased the sperm volume and the total numbers of sperm, morphologically normal sperm and progressively motile perm (P < 0.05). TTP was negatively correlated with sperm concentration, total number of sperm and total number of progressively motile sperm (P < 0.01). The subjects with sexual abstinence of 5 -7 days showed markedly higher sperm concentration, total number of sperm and total number of progressively motile sperm than others (P < 0.01). CONCLUSION: In normal fertile men, the fifth centile of semen parameters is close to the WHO normal reference range, TTP is negatively correlated with semen quality, and age, BMI and lifestyle may affect some of the semen parameters.
Assuntos
Análise do Sêmen , Contagem de Espermatozoides , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Valores de Referência , Adulto JovemRESUMO
Sperm cryopreservation is an effective fertility preservation method for cancer patients before anticancer treatments. However, there are little data on fertility preservation in large cohorts of patients with cancer in southern China. This retrospective cross-sectional study aimed to assess the fertility preservation status of 1034 newly diagnosed male patients with cancer in the Human Sperm Bank of Guangdong Province in southern China (Guangzhou, China). Of these, 302 patients had reproductive system tumors, mostly testicular cancers (99.0%), and 732 had other tumors, including lymphoma (33.1%), gastrointestinal cancer (16.3%), nasopharyngeal carcinoma (15.7%), leukemia (7.7%), sarcoma (3.6%), and others (23.6%). Patients with reproductive system tumors had lower sperm concentration and prefreezing and post-thawing progressive motility than those with non-reproductive system tumors (all P < 0.001). Differences in sperm concentration, progressive motility, and normal morphology rate were observed between patients with and without anticancer surgery before sperm cryopreservation (all P < 0.05). As of April 30, 2022, 63 patients used their cryopreserved sperm for assisted reproductive technology treatments and 39 pregnancies were achieved. This study provides valuable data on the fertility preservation status in newly diagnosed cancer patients in southern China, demonstrating that patients with reproductive system tumors had poor sperm quality for their pretreatment fertility preservation.
Assuntos
Neoplasias , Preservação do Sêmen , Neoplasias Testiculares , Gravidez , Feminino , Humanos , Masculino , Estudos Retrospectivos , Estudos Transversais , Preservação do Sêmen/métodos , Sêmen , Neoplasias/epidemiologia , Criopreservação/métodos , Espermatozoides , Neoplasias Testiculares/terapia , China/epidemiologiaRESUMO
OBJECTIVE: To explore the application of factor analysis in comprehensive evaluation of semen quality. METHODS: Using factor analysis, we examined the semen samples from normal fertile men and comprehensively evaluated their quality by extracting typical common factors from the sperm parameters, such as semen volume, sperm concentration, total number of sperm, total motility, progressive motility, vitality, sperm morphology, total number of progressive motile sperm, total number of valid progressive motile sperm, teratozoospermia index (TZI), sperm deformity index (SDI), curvilinear velocity (VCL), straight-line velocity (VSL), average path velocity (VAP), amplitude of lateral head displacement (ALH), linearity (LIN), wobble (WOB), straightness (STR), beat-cross frequency (BCF) and mean angular displacement (MAD). RESULTS: Based on the principle of the cumulative variance contribution rate of 85% or more, we extracted 6 common factors with the cumulative variance contribution rate of 86. 647%, which in sequence represented sperm count, velocity, direction of movement, deformity index, semen volume and normal sperm morphology. The composite factor scores were calculated by the formula of (36.243 * F1 + 23.342 * F2 + 8.910 * F3 + 8.500 * F4 + 5.538 * F5 +4.115 * F6)/ 86.647, with a median of -0.0180. With the 5th percentile as the lower reference limit, 95.1% of the fertile males met the WHO limit for composite factor scores, while only 79.2% of them met the limit for semen parameters (P = 0. 000). CONCLUSION: Compared with the routine detection of sperm parameters, factor analysis or composite factor scores could give a more accurate comprehensive evaluation of semen quality.
Assuntos
Análise Fatorial , Análise do Sêmen , Humanos , Masculino , Contagem de Espermatozoides , Motilidade dos EspermatozoidesRESUMO
INTRODUCTION: Semen analysis (SA) plays a key role in guiding treatments of male reproductive diseases and infertility due to male factors; however, it remains challenging to conduct an accurate SA due to lack of standardization, highly subjective assessments, and problems with automated procedures. Therefore, quality assurance (QA) and teaching courses are essential for making the laboratory results more consistent. MATERIALS AND METHODS: The external quality assurance (EQA) scheme was organized by national human sperm bank technology training bases in Guangdong province in China between 2009 and 2020. Until 2020, 124 laboratories from China participated in the EQA program. The EQA scheme per year has been organized involving two semen aliquots for sperm concentration, two video recordings for motility, and two smears for sperm morphology. All samples used in the EQA scheme were obtained from different healthy donors or patients. RESULTS: We estimated that the median coefficient of variation (CV) of sperm concentration, ignoring the method used, was 26.6%. Using a 100 µm deep counting chamber led to a decreasing CV of 13.6%. For sperm motility, the median CV of nonprogressive motility was high (50.8%), but the CV of progressive motility (13.2%), immotile sperm (14.3%), and total motility (11.8%) were acceptable. The morphology assessment revealed large variability (44.4%) irrespective of the classification criteria. DISCUSSION: The reduction of interlaboratory variability is still a challenge during SA in China. Therefore, it is critical to increase awareness of joining EQA schemes and establish standardized training centers to follow WHO-recommended procedures toward Chinese standards.
Assuntos
Sêmen , Motilidade dos Espermatozoides , China , Humanos , Masculino , Análise do Sêmen , Contagem de Espermatozoides , EspermatozoidesRESUMO
PURPOSE: To determine the multidetector computed tomographic (CT) features of crush thoracic traumas resulting from the massive Sichuan earthquake. MATERIALS AND METHODS: This study was approved by the ethics committee of the medical school, and informed consent was waived. A retrospective review was undertaken of 215 multidetector chest CT scans of 112 male and 103 female patients who sustained crush thoracic injuries in the Sichuan earthquake at 2:28 pm Beijing time, May 12, 2008, and were rescued in the authors' hospital. Multidetector chest CT studies were performed between May 12, 2008, and June 7, 2008. The authors looked for injuries to the thoracic cage, pulmonary parenchyma, and pleura. RESULTS: One hundred forty-three patients (66.5%; 95% confidence interval [CI]: 60.2%, 72.8%) had at least one rib fracture; the mean number of rib fractures per patient was 6 [corrected]. Forty-five of these patients (31.5% of 143 patients; 95% CI: 23.9%, 39.1%) had flail chest, with a total of 288 ribs fractured. There were 46 patients (21.4%; 95% CI: 15.9%, 26.9%) with at least one vertebral fracture. There were 77 vertebral fractures total; 36 of these fractures were in T1 through T10. Twelve patients (5.6%; 95% CI: 2.5%, 8.7%) had sternal fractures, and 48 patients (22.3%; 95% CI: 16.7%, 27.9%) had either scapular or clavicular fractures. There were 117 patients (54.4%; 95% CI: 47.7%, 61.1%) with pulmonary parenchymal injuries and 146 (67.9%; 95% CI: 61.7%, 74.1%) with pleural injuries. CONCLUSION: Crush thoracic trauma resulting from the massive Sichuan earthquake was a life-threatening injury; this type of injury has the potential for multiple fractures and pulmonary parenchymal injuries.
Assuntos
Síndrome de Esmagamento/diagnóstico por imagem , Terremotos , Traumatismos Torácicos/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , China/epidemiologia , Síndrome de Esmagamento/epidemiologia , Feminino , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos , Traumatismos Torácicos/epidemiologia , Tomografia Computadorizada por Raios XRESUMO
INTRODUCTION: In recent years, several massive earthquakes have occurred across the globe. Multidetector computed tomography (MDCT) is reliable in detecting spinal injuries. The purpose of this study was to compare the features of spinal injuries resulting from the Sichuan earthquake with those of non-earthquake-related spinal trauma using MDCT. METHODS: Features of spinal injuries of 223 Sichuan earthquake-exposed patients and 223 non-earthquake-related spinal injury patients were retrospectively compared using MDCT. The date of non-earthquake-related spinal injury patients was collected from 1 May 2009 to 22 July 2009 to avoid the confounding effects of seasonal activity and clothing. We focused on anatomic sites, injury types and neurologic deficits related to spinal injuries. Major injuries were classified according to the grid 3-3-3 scheme of the Magerl (AO) classification system. RESULTS: A total of 185 patients (82.96%) in the earthquake-exposed cohort experienced crush injuries. In the earthquake and control groups, 65 and 92 patients, respectively, had neurologic deficits. The anatomic distribution of these two cohorts was significantly different (P < 0.001). Cervical spinal injuries were more common in the control group (risk ratio (RR) = 2.12, P < 0.001), whereas lumbar spinal injuries were more common in the earthquake-related spinal injuries group (277 of 501 injured vertebrae; 55.29%). The major types of injuries were significantly different between these cohorts (P = 0.002). Magerl AO type A lesions composed most of the lesions seen in both of these cohorts. Type B lesions were more frequently seen in earthquake-related spinal injuries (RR = 1.27), while we observed type C lesions more frequently in subjects with non-earthquake-related spinal injuries (RR = 1.98, P = 0.0029). CONCLUSIONS: Spinal injuries sustained in the Sichuan earthquake were located mainly in the lumbar spine, with a peak prevalence of type A lesions and a high occurrence of neurologic deficits. The anatomic distribution and type of spinal injuries that varied between earthquake-related and non-earthquake-related spinal injury groups were perhaps due to the different mechanism of injury.
Assuntos
Desastres , Terremotos , Traumatismos da Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Traumatismos da Coluna Vertebral/epidemiologia , Traumatismos da Coluna Vertebral/etiologia , Adulto JovemRESUMO
BACKGROUND: There are no reports regarding entire gastric fundic and esophageal varices evaluated with 64-row multidetector CT (MDCT). We attempt to clarify the feasibility of portal venography with this scanner in evaluation of these varices. METHODS: A total of 33 patients, with clinically confirmed gastric fundic and esophageal varices secondary to posthepatitic cirrhosis, underwent thoracicoabdominal triphasic enhancement scans using 64-row MDCT along with conventional angiographic portography. CT portography and conventional portography were compared by statistical agreement to determine whether CT maximum intensity projection (CT-MIP) portography is useful in evaluation of entire gastric fundic and esophageal varices. RESULTS: CT-MIP portography demonstrated gastric fundic and esophageal varices, and the inflowing and outflowing vessels of the varices. Gastric fundic varices were shown in 32 cases (97.0%), and esophageal varices were in 27 (81.8%). The inflowing vessels including the left gastric vein and posterior gastric vein/short gastric vein were illustrated in 31 (94.0%) and 17 (51.5%) cases, respectively. The outflowing vessels including the azygos vein, hemiazygos vein, and gastro-renal shunts were seen in 30 (90.9%), 8 (24.2%), and 12 (36.4%) cases, respectively. Findings of CT-MIP portography and conventional angiographic portography were in close agreement (Kappa value ranged from 0.621 to 1.000). CONCLUSION: CT-MIP venography with 64-row MDCT could be considered as a method for detecting entire gastric fundic and esophageal varices developed from posthepatitic cirrhosis.
Assuntos
Varizes Esofágicas e Gástricas/diagnóstico por imagem , Hepatite B/complicações , Cirrose Hepática Alcoólica/complicações , Cirrose Hepática/complicações , Veia Porta/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Varizes Esofágicas e Gástricas/etiologia , Feminino , Fundo Gástrico/irrigação sanguínea , Fundo Gástrico/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To investigate the profile of pelvic crush fractures in earthquake victims on digital radiography (DR) and multidetector computed tomography (MDCT). MATERIALS AND METHODS: One hundred and sixty-seven consecutive survivors of the 2008 Sichuan earthquake with pelvic crush fractures classified into types according to the Tile classification system, entered our study. One hundred and thirty-nine, and 28 patients underwent DR and MDCT scans, respectively. Data were reviewed retrospectively focusing on anatomical sites, numbers, and classification of pelvic ring fractures. RESULTS: Pelvic fractures occurred in the pubis in 88 patients (52.7%), in other pelvic bones in 32 (19.16%), and in both the pubis and other pelvic bones in 47 (28.14%). Pubic fractures were more common than fractures of other pelvic bones, and involvement of bilateral pubis was more common than that of the left or right pubis (all p < 0.05). As for the numbers of pelvic bones involved, multiple fractures occurred in 48.52% patients (81 out of 167) composed predominantly of fractures of two bones in 58.02% (47 out of 81), and were seen more often in bilateral pubis than in any other pelvic bones (p < 0.05). Regarding classifications of pelvic ring fractures, they were Type A in 31 patients (18.56%); Type B in 72 (43.11%), predominantly Type B2 in 26 (15.58%) and Type B3 in 28 (16.77%); and Type C in 64 (38.32%), predominantly Type C3 in 40 (23.95%). CONCLUSION: Pelvic crush fractures particularly including multiple pelvic fractures, occurring predominantly in bilateral pubis, and composed of Type C3 followed by Type B3 and Type B2, could be considered to be the profile of pelvic crush fractures in an earthquake.
Assuntos
Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/epidemiologia , Traumatismo Múltiplo/diagnóstico por imagem , Traumatismo Múltiplo/epidemiologia , Ossos Pélvicos/diagnóstico por imagem , Ossos Pélvicos/lesões , Intensificação de Imagem Radiográfica , Sobreviventes/estatística & dados numéricos , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto JovemRESUMO
CT scanning is sensitive and specific for the identification of pelvic fractures and injury to the pelvic wall soft tissue and the pelvic cavity. Crush pelvic trauma in an earthquake can be identified by multidetector CT scanning.
Assuntos
Terremotos , Fraturas Ósseas/diagnóstico por imagem , Tomografia Computadorizada Multidetectores , Ossos Pélvicos/lesões , Pelve/lesões , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , China , Feminino , Fraturas Ósseas/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Ossos Pélvicos/diagnóstico por imagem , Pelve/diagnóstico por imagem , Sensibilidade e Especificidade , Lesões dos Tecidos Moles/diagnóstico , Lesões dos Tecidos Moles/diagnóstico por imagem , Adulto JovemRESUMO
PURPOSE: To evaluate the accuracy of 64-section multidetector computed tomography (CT) for the assessment of the severity of isolated mitral regurgitation by measuring ventricular volumetrics compared with those at magnetic resonance (MR) imaging and echocardiography. MATERIALS AND METHODS: This study was approved by an institutional review board; patient informed consent was obtained. Forty-nine patients (22 men, 27 women; mean age, 39 years +/- 11 [standard deviation]) with isolated mitral regurgitation underwent retrospective electrocardiographically (ECG) gated 64-section CT, echocardiography, and MR imaging for the assessment of the severity of mitral regurgitation. Stroke volumes of the left and right ventricles were measured at 64-section CT and MR imaging. With these measurements, regurgitant volumes (RVs) and regurgitant fractions (RFs) were calculated and compared. The agreement between CT and MR imaging was tested by using linear regression and Bland-Altman analyses. RFs were compared with corresponding echocardiographic grades (grades I-IV) based on the absolute area of the regurgitation jet and in relation to the size of the left atrium by using Spearman rank order correlation and a weighted kappa test. RESULTS: No significant differences were found in calculated RV and RF between 64-section CT and MR imaging (P = .56 and .87, respectively; paired t test). Regression analysis showed that 64-section CT correlated well with MR imaging for the measurement of RV (r = 0.89; 95% confidence interval [CI]: 0.81, 0.94) and for calculating the RF (r = 0.91; 95% CI: 0.84, 0.95). Bland-Altman analysis showed no significant differences in RV (bias, -1.0 mL) and RF (bias, 0.2%) between 64-section CT and MR imaging. The severity of regurgitation estimated by using echocardiography correlated well with that estimated by using 64-section CT (r = 0.95; 95% CI: 0.92, 0.97) and MR imaging (r = 0.94; 95% CI: 0.91, 0.96). CONCLUSION: ECG-gated 64-section CT helps provide quantitative information with high accuracy for determining the severity of isolated mitral regurgitation.
Assuntos
Ecocardiografia/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Insuficiência da Valva Mitral/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto JovemRESUMO
Quantitative values of left ventricular (LV) function and muscle mass in patients with mitral regurgitation are independent predictors of cardiac morbidity and mortality. The aim of this study was to prospectively evaluate whether 64-MDCT can assess the LV function in patients with mitral regurgitation with high accuracy when compared with the MRI and echocardiography results. Fifty-one patients with mitral regurgitation underwent retrospectively ECG-gated 64-MDCT, echocardiography, and MRI for assessing the global ventricular function. End-diastolic and end-systolic volume, stroke volume, ejection fraction, and mass were measured on 64-MDCT and echocardiography, and compared with the results measured on MRI which served as the reference standard. Intertechnique agreement was tested by using Pearson's correlation and Bland-Altman analyses. No significant differences were revealed in calculated LV function and mass between the 64-MDCT and MRI (paired t test, p = 0.07-0.53). Pearson's correlation analysis showed the functional parameters and mass correlated closely between the 64-MDCT and MRI (r = 0.89-0.96, p < 0.001). When compared with MRI, echocardiography underestimated the volumetric parameters of LV (paired t test, p = 0.0003-0.004), but significantly overestimated the EF values (p = 0.003), and moderate correlations of functional parameters were obtained (r = 0.78, 0.60, 0.81, and 0.62, respectively). ECG-gated 64-MDCT allows for accurate and reliable assessment of LV function in patients with mitral regurgitation, whereas LV volumes measured by two-dimensional echocardiography were underestimated and the ejection fraction was overestimated when compared with those achieved by using MRI.
Assuntos
Ecocardiografia/métodos , Imageamento por Ressonância Magnética/métodos , Insuficiência da Valva Mitral/complicações , Insuficiência da Valva Mitral/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Esquerda/etiologia , Adulto , Humanos , Imageamento Tridimensional/métodos , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/cirurgia , Tamanho do Órgão , Cuidados Pré-Operatórios/métodos , Prognóstico , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Disfunção Ventricular Esquerda/cirurgia , Adulto JovemRESUMO
OBJECTIVE: To investigate features of crush extremity fractures associated with massive earthquake on digital radiography (DR) and multidetector computed tomography (MDCT). MATERIALS AND METHODS: Six hundred and twenty-three consecutive patients with clinically confirmed crush extremity fractures arising from the 2008 Sichuan earthquake were enrolled into our study. Six hundred and eleven patients with suggested extremity fractures underwent DR, and 12 patients with possible knee fractures underwent MDCT. Image data were retrospectively reviewed, with the focus on anatomic sites, numbers, and status of the fractures. RESULTS: Extremity fractures occurred in lower extremities in 428 patients, upper extremities in 151, and both lower and upper extremities in 44. Lower extremity fractures were more common than upper extremity fractures (P < 0.05), and the commonly involved bones were the tibia and fibula in 141 patients, femur in 102, tibia in 52, and fibula in 40. According to the numbers of bones involved, multiple bone fractures occurred in 336 patients and included lower extremity fractures in 231, upper extremity fractures in 61, and both lower and upper fractures in 44. Multiple fractures in lower extremities were seen more often than in upper extremities (P < 0.05). As for status of the extremity fractures, comminuted fractures occurred in 324 patients and included lower extremity fractures in 248, upper extremity fractures in 51, and both lower and upper extremity fractures in 25. Comminuted fractures were more common in lower extremities than in upper extremities (P < 0.05). CONCLUSION: Multiple and comminuted fractures, predominantly in the lower extremities, could be considered as features of crush extremity fractures associated with the massive Sichuan earthquake.
Assuntos
Desastres/estatística & dados numéricos , Terremotos/estatística & dados numéricos , Extremidades/lesões , Fraturas por Compressão/diagnóstico por imagem , Fraturas por Compressão/epidemiologia , Traumatismos da Perna/diagnóstico por imagem , Traumatismos da Perna/epidemiologia , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Extremidades/diagnóstico por imagem , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Intensificação de Imagem Radiográfica , Adulto JovemRESUMO
Sperm DNA damage is recognized as an important biomarker of male infertility. To investigate this, sperm DNA damage was assessed by the sperm chromatin dispersion (SCD) test in semen and motile spermatozoa harvested by combined density gradient centrifugation (DGC) and swim-up in 161 couples undergoing in vitro fertilization (IVF). Semen analysis and sperm DNA damage results were compared between couples who did or did not achieve pregnancy. The sperm DNA damage level was significantly different between the two groups (P < 0.05) and was negatively correlated with IVF outcomes. Logistic regression analysis confirmed that it was an independent predictor for achieving clinical pregnancy. The effects of different levels of sperm DNA damage on IVF outcomes were also compared. There were significant differences in day 3 embryo quality, blastocyst formation rate, and implantation and pregnancy rates (P < 0.05), but not in the basic fertilization rate between the two groups. Thus, sperm DNA damage as measured by the SCD appears useful for predicting the clinical pregnancy rate following IVF.
Assuntos
Dano ao DNA , Desenvolvimento Embrionário , Fertilização in vitro , Espermatozoides/fisiologia , Adulto , Cromatina/química , Implantação do Embrião , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Gravidez , Resultado da Gravidez , Taxa de Gravidez , Análise do Sêmen , Injeções de Esperma Intracitoplásmicas , Motilidade dos Espermatozoides , Espermatozoides/ultraestruturaAssuntos
Terremotos , Traumatismos da Coluna Vertebral/epidemiologia , China/epidemiologia , Fraturas por Compressão/epidemiologia , Humanos , Luxações Articulares/epidemiologia , Doenças do Sistema Nervoso/etiologia , Estudos Retrospectivos , Fraturas da Coluna Vertebral/epidemiologia , Traumatismos da Coluna Vertebral/classificação , Traumatismos da Coluna Vertebral/complicações , Traumatismos da Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To explore the correlation between the biological characteristics of volunteer donors and sperm parameters. METHODS: Sperm parameters were analyzed for 778 primary volunteer donors by CASA system with standard methods recommended by WHO including sperm concentration, motility rate, VCL, VSL, ALH, LIN, STR and BCF, and their biological characteristics were recorded. RESULTS: Of all the volunteer donors, students accounted for more than a third, 89.2 percent were under the age of 35 years, 71.6 percent between 166 and 175 cm in height, 91.7 percent of normal weight and 77.1 percent with college education. The median sperm concentration and motility rate were 107.00 x 10(6)/ml and 75 percent respectively. Age was weakly correlated with such semen indexes as concentration (r = 0.210, P = 0.000) , motility rate (r = 0.213, P = 0.000), volume (r = 0.165, P = 0.002), VAP (r = 0.259, P = 0.000), VSL (r = 0.281, P = 0.000), VCL (r = 0.190, P = 0.000), BCF (r = 0.243, P = 0.000) and LIN (r = 0.192, P = 0.000). The semen indexes of the 26-35 age group were a little better than those of the 20-25. Height showed no correlation to semen indexes. Education and occupation were somewhat related with other sperm parameters (P < 0.01) than ALH (P = 0.695/0.886). CONCLUSION: Age, occupation and education bear some correlation with sperm parameters except ALH, while height has none with any of them.
Assuntos
Sêmen , Espermatozoides/fisiologia , Doadores de Tecidos/estatística & dados numéricos , Adulto , Fatores Etários , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Ocupações , Sêmen/citologia , Contagem de Espermatozoides , Motilidade dos Espermatozoides/fisiologia , EstudantesRESUMO
Semen samples were collected from 1213 fertile men whose partners had a time-to-pregnancy (TTP) ≤12 months in Guangdong Province in Southern China, and semen parameters including semen volume, sperm concentration, total counts, motility, and morphology were evaluated according to the World Health Organization (WHO) 2010 guideline. All semen parameters analyzed were normal in ~62.2% of the total samples, whereas ~37.8% showed at least one of the semen parameters below normal threshold values. The fifth centiles (with 95% confidence intervals) were 1.3 (1.2-1.5) ml for semen volume, 20 × 10 6 (18×10 6 -20×10 6 ) ml-1 for sperm concentration, 40 × 10 6 (38×10 6 -44×10 6 ) per ejaculate for total sperm counts, 48% (47%-53%) for vitality, 39% (36%-43%) for total motility, 25% (23%-27%) for sperm progressive motility, 5.0% (4%-5%) for normal morphology. The pH values ranged from 7.2 to 8.0 with the mean ± standard deviation at 7.32 ± 0.17. No effects of age and body mass index were found on semen parameters. Occupation, smoking and alcohol abuse, varicocele appeared to decrease semen quality. Sperm concentration, but not sperm morphology, is positively correlated with TTP, whereas vitality is negatively correlated with TTP. Our study provides the latest reference values for the semen parameters of Chinese fertile men in Guangdong Province, which are close to those described in the new WHO guidelines (5 th Edition).