Summary:or Baltimore groups. [7][8][9] Thus, in this study, examination was made of changes in hemostatic parameters in children with VOD after BMT. Some parameters appeared appliHepatic veno-occlusive disease (VOD) is a major complication after bone marrow transplantation (BMT). Its cable as markers for VOD and the coagulation-fibrinolysis system was shown to possibly contribute to VOD. prediction, diagnosis and treatment remain unclear. Examination was made of changes in hemostatic parameters in patients with or without VOD after BMT.Patients and methods Twenty-seven children were studied following BMT. years). The patients plasmin inhibitor/plasmin complex (PIC), antithrombin III (AT-III), protein C, N-terminal propeptide for typewere diagnosed as ALL (n = 11), AML (n = 3), CML (n = 3), severe aplastic anemia (SAA) (n = 3), neuroblas-III procollagen (P-III-P), were measured weekly from pre-BMT to day 28 after BMT. In VOD patients, t-PA toma (NBL) (n = 2), non-Hodgkin's lymphoma (NHL) (n = 1), juvenile chronic myelogenous leukemia (JCML) and PAI-1 significantly increased (P Ͻ0.05) and FBG significantly fell during the post-transplant period (n = 1), severe combined immunodeficiency (SCID) (n = 1), rhabdomyosarcoma (RMS) (n = 1) and peripheral (P Ͻ0.05). Significantly low AT-III and PLG were also noted before VOD (P Ͻ0.05). There were no changes in neuroectodermal tumor (PNET) (n = 1) ( Table 1). Seven patients received autologous marrow grafts and other hemostatic parameters. t-PA, PAI-1 and FBG would thus appear useful markers for the diagnosis of 20, allogeneic marrow grafts (10 HLA-identical siblings, eight HLA-matched unrelated donors, two HLA-mis-VOD, and AT-III and PLG, predictive markers for VOD. The coagulation-fibrinolysis system following matched families). For the conditioning regimen, total body irradiation endothelial cell damage may contribute to the onset of VOD.(TBI) of 12 Gy + thiotepa (TEPA) 600 mg/m 2 + melphalan (LPAM) 140 mg/m 2 was used for 14 patients. Busulphan Keywords: BMT; VOD; hemostatic parameters (BU) 16 mg/kg + cyclophosphamide (CY) 200 mg/kg was administered to five patients, ifosfamide (IFO) 7.5 g/m 2 + LPAM 210 mg/m 2 to four patients, antithymoHepatic veno-occlusive disease (VOD) is a major compliglobulin (ATG) 10 mg/kg + CY 200 mg/kg to two patients, cation of bone marrow transplantation (BMT). Its fre-BU 16 mg/kg + CY 200 mg/kg + TEPA 300 mg/m 2 to one quency varies greatly from 1 to 54%, 1,2 and its high morpatient and BU 16 mg/kg + LPAM 210 mg/m 2 to one tality (30-50%) has not improved. [3][4][5][6] VOD is characterized patient. by hyperbilirubinemia, painful hepatomegaly and ascitesTen patients who had undergone BMT from HLAafter BMT, following chemo-radiotherapy conditioning.matched siblings received cyclosporin A (CsA) alone VOD may possibly arise from injury or disruption of the and/or methotrexate (MTX) as prophylaxis for acute endothelium lining the sinusoids and pores connected to the GVHD, and 10 patients marrow grafts from HLA-matched hepatic venular lumen. End...

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The purpose of this study was to investigate if the outcome of ICSI was influenced by epididymal sperm motility in frozen-thawed specimens. A total of 18 ICSI treatment cycles using spermatozoa retrieved by microsurgical epididymal sperm aspiration (MESA) were analysed retrospectively. Cryopreservation of epididymal spermatozoa was performed when enough epididymal aspirates were collected. Sixty-nine out of 126 oocytes injected with spermatozoa retrieved by MESA were fertilized, giving a fertilization rate of 54.8%. Out of 18 embryo transfer cycles, 6 (33.3%) achieved pregnancies. Fresh epididymal spermatozoa were used in 5 cycles while frozen-thawed epididymal spermatozoa were used in 13 cycles for ICSI. The fertilization rates were 68.6% (35/51) in the former group and 45.3% (34/75) in the latter group, respectively. There was a significant difference between the two groups (p < 0.05). In ICSI treatments using fresh epididymal spermatozoa, the cells used for injection were all motile. However, motile epididymal spermatozoa could be used in only five ICSI treatment cycles after freeze-thawing. In 6 cycles, only immotile sperm were used for injection of frozen-thawed spermatozoa. The fertilization rate in each group was 68.4% (13/19) and 31.6% (12/38), respectively. There was a significant difference between these groups (p < 0.01). These results indicate that the outcome of ICSI was influenced by sperm motility in frozen-thawed epididymal specimens. When no sperm motility could be recovered after freeze-thawing even with chemical treatments, consideration should be given to retrieving fresh epididymal spermatozoa again to achieve a better fertilization rate in such patients.

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