Abstract. Paclitaxel/carboplatin chemotherapy for cancer (TC therapy) exhibits neurotoxicity and causes peripheral neuropathy at a high frequency, which is difficult to cope with. In this study, we investigated the efficacy of Goshajinkigan, a traditional Japanese herbal medicine, for TC therapy-induced peripheral neuropathy. The subjects included in our study were patients with ovarian or endometrial cancer who underwent TC therapy and developed peripheral neuropathy. The patients were randomly divided into Group A, comprising of 14 patients (vitamin B12 treatment), and Group B, comprising of 15 patients (vitamin B12 + Goshajinkigan treatment). The observation period was 6 weeks following treatment initiation, and the evaluation items were as follows: i) the current perception threshold (CPT value) of the peripheral nerve, ii) visual analogue scale for numbness, iii) National Cancer Institute Common Terminology Criteria for Adverse Events v3.0 grade of neurotoxicity, and iv) a questionnaire on the subjective symptoms of peripheral neuropathy (functional assessment of cancer therapy-taxane). These were compared between the groups and no significant differences were noted in any item. However, CTCAE grade 3 neurotoxicity developed in 2 patients (14.3%) after 6 weeks of administration in Group A, whereas no neurotoxicity was observed in Group B. When the change in the frequency of abnormal CPT ratio at 6 weeks of administration from that before treatment was compared between the groups, the frequency of abnormal value was significantly lower in Group B than in Group A (p<0.05). This suggests that Goshajinkigan inhibits the progression of peripheral neuropathy.
PurposeTo compare the embryo outcomes of in vitro fertilization/intra-cytoplasmic sperm injection with a gonadotropin-releasing hormone (GnRH) antagonist protocol with follicle stimulating hormone (FSH) and with human menopausal gonadotropin (hMG).MethodsWe performed a retrospective cohort study in 465 patients. Stimulation was started by daily FSH injection, and either FSH was continued (FSH alone group) or hMG was administrated (FSH-hMG group) after administration of a GnRH antagonist. Primary outcomes were the embryo profile (number of retrieved, mature, and fertilized eggs, and morphologically good embryos on day 3) and endocrine profile. Secondary outcomes were the doses and durations of gonadotropin. Data were stratified by the patients’ age into two groups: <35 years and ≥35 years.ResultsIn patients aged <35 years, the number of retrieved oocytes in the FSH alone group was significantly increased than that in the FSH-hMG group (13.7 vs 9.2, P = 0.04), while there was no difference at other age groups. The FSH-hMG group required a significantly greater amount of gonadotropins at any age (all ages, P < 0.001; <35 years, P = 0.013; ≥35 years, P < 0.001).ConclusionsExogenous FSH alone is probably sufficient for follicular development and hMG may not improve the embryo profile in a GnRH antagonist protocol across all age.
Herpes simplex virus types 1 (HSV-1) and 2 (HSV-2) cause genital herpes, which can enhance the acquisition of human immunodeficiency virus. The development of anti-HSV agents with novel mechanisms of action is urgently required in the topical therapy of genital herpes. In this study, the in vitro and in vivo anti-HSV effects of Epomin SP-012(®), a highly cationic polyethylenimine, were evaluated. When the in vitro antiviral effects of SP-012 were assessed, this compound showed potent activity against HSV-1 and HSV-2. It inhibited the attachment of HSV-2 to host cells and cell-to-cell spread of infection in a concentration-dependent manner and exerted a virucidal effect. No SP-012-resistant HSV-2 was found when the virus was successively passaged in the presence of SP-012. In a mouse genital herpes model, topically administered SP-012 inhibited the progression of the disease caused by HSV infection. These data illustrate that SP-012 may be a novel class of HSV inhibitor that would be acceptable for long-term topical application.
We report cases of two sisters with complete androgen insensitivity syndrome (CAIS). A complete female appearance, blind-ending vagina, and testes in the pelvis are characteristics of CAIS. Prophylactic laparoscopic gonadectomy was performed in both cases. Anti-Müllerian hormone (AMH) level is known to be very high in patients with CAIS; AMH is secreted by Sertoli cells and testosterone suppresses the secretion. In our cases, serum AMH was very high before gonadectomy and dramatically decreased after gonadectomy. AMH could be the diagnostic feature for patients with CAIS.
Although intrauterine insemination (IUI) utilizing the husband's semen is widely used as a general fertility treatment, there are no clear policies determining the appropriate number of IUI cycles or a selection criteria for couples at our institution. In this study we investigated IUIs performed at our facilities in the past 3 years, and examined prognostic factors for pregnancy based on age, number of inseminations, and semen findings. A total of 341 patients who underwent 1,229 cycles of IUIs performed at our institution between January 2016 and December 2018 were included. The pregnancy rate was 6.2% per cycle and 21.1% per couple. In terms of age, we noted both men and women contributed to a decrease in the pregnancy rate with increasing age, but the effects of aging tended to be slightly less pronounced in men. The cumulative pregnancy rate for the number of times insemination was performed was approximately 50% by the second cycle, and 90% by the sixth. Assessment of semen analysis showed significant differences in motility and adjusted recovered sperm concentration (P<0.05).
Purpose: This study aimed to reveal the clinical significance of hysteroscopyin infertility treatment.
Methods:This retrospective, single-center, cohort study included 613 women of reproductive age who underwent hysteroscopy between April 2011 and March 2016. All women underwent a routine infertility work-up including transvaginal sonography, hysterosalpingography, and blood tests, and analysis of their husband's semen was performed. The Student t, Mann-Whitney, and Fisher exact tests were used to analyze the data.Results: Hysteroscopy as a routine work-up revealed an abnormal uterine cavity in 141 women (22.1%) and 114 endometrial polyps (80.9%). Endometrial polyps were more frequently observed in those with primary infertility (p<.005) and endometriosis (p<.005) than those without these conditions. Endometrial polyps were rarely observed in those with recurrent pregnancy loss (p<.05).
Conclusion:Hysteroscopy is recommended as a routine work-up before fertility treatment given the prevalence of endometrial polyps, especially for women with endometrioma, and their impacts on embryo implantation failure.
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