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The need for frequent injections and monitoring, the possibility of multiple gestations, and the higher cost compared to clomiphene citrate, prevents many clinicians from using human menopausal gonadotrophin (HMG) for ovulation induction. A sequential medication regimen, in which HMG is taken after clomiphene, overcomes these problems. We retrospectively compared per cycle fecundity and birth rates in 119 cycles of clomiphene-HMG, 524 cycles of clomiphene alone, 57 cycles of HMG alone, and 79 cycles of concurrent HMG and clomiphene in patients receiving intra-uterine insemination (IUI), who were free of endometriosis or tubal disease. Per cycle fecundity for clomiphene-HMG was 22% [95% confidence interval (CI) 12-34%], double that of clomiphene alone (11%) (95% CI 8-14%) (P < 0.01), and equal to HMG alone (18%) (95% CI 7-29%) or HMG and clomiphene together (19%) (95% CI 10-28%). The multiple birth rate for clomiphene-HMG (7/21) equalled that for HMG alone (3/12) and HMG and clomiphene together (3/8). The average number of ampoules of HMG required [follicle stimulating hormone (FSH) 75 mIU, luteinizing hormone (LH) 75 mIU] was decreased by 65% from 24.5 +/- 1.0 for HMG or HMG and clomiphene together to 8.6 +/- 0.3 for clomiphene-HMG (P < 0.001). Per cycle fecundity was identical when one, two or three ampoules of HMG per day were administered after clomiphene. We conclude that ovulation induction with sequential clomiphene-HMG results in fecundity double that of clomiphene alone and equal to HMG alone or concurrent with clomiphene, thereby reducing the requirement for HMG. 相似文献
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BACKGROUND: Noncutaneous psammomatous melanotic schwannoma has recently been reported as an unusual component of Carney's complex (myxomas, spotty pigmentation, and endocrinopathy). The most common locations for this lesion include peripheral nerve roots and the gastrointestinal tract. OBSERVATIONS: A cutaneous psammomatous melanotic schwannoma is reported in a patient with known Carney's complex. This neoplasm was pseudoencapsulated, with epithelioid to spindle-shaped cells and no nuclear atypia. Immunostaining was positive for S100 protein and vimentin, as well for HMB-45 antibody. Electron microscopy showed melanosomes in cytoplasmic processes of cells that were ensheathed by layers of reduplicated basal lamina. CONCLUSIONS: Location in the superficial soft tissues is extremely unusual for psammomatous melanotic schwannomas. Recognition of this new cutaneous marker as a part of this complex may aid in identification of individuals at risk for cardiac myxomas. It is also important that this lesion is not mistaken for melanoma, given the strong HMB-45 positivity. 相似文献
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Prior work has focused on the negative aspects of time-dispersive channels and associated intersymbol interference. The authors show that the inherent diversity introduced by such dispersion is advantageous in reducing the performance-limiting effects of flat fading. This is demonstrated for an indoor QPSK radio link employing a decision-feedback equaliser 相似文献
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Two forms of glutathione synthetase deficiency have been described. While one form is mild, causing hemolytic anemia, the other more severe form causes 5-oxo-prolinuria with secondary neurological involvement. Despite the existence of two deficiency phenotypes, Southern blots hybridized with a glutathione synthetase cDNA suggest that there is a single glutathione synthetase gene in the human genome. Analysis of somatic cell hybrids showed the human glutathione synthetase gene (GSS) to be located on chromosome 20, and this assignment has been refined to subband 20q11.2 using in situ hybridization. 相似文献
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Amjad B. Soulaka William R. Morrison 《Journal of the science of food and agriculture》1985,36(8):709-718
Starches isolated from 23 bread wheats (Triticum aestivum) and 26 durum wheats (T. durum) contained 26.3-30.6% (mean 29.1%) total amylose, 19.3–25.1% (mean 22.9%) apparent amylose and 783–1144mg 100g?1 (mean 977 mg 100g?1) lysophos-pholipids. Gelatinisation temperatures were 57.3–64.9°C (mean 61.8°C) and enthalpies 6.4–11.8 Jg?1 (mean 9.7Jg?1) in excess water, measured by differential scanning calorimetry. There were no correlations between any of these parameters. Starch granule size distributions were determined with a Coulter Counter and 100–channel analyser. A-granule mean volumes were 1235–2585μm3 (av. 1778), modal volumes 863–1804μm3 (av. 1264), mean diameters 13.9–16.0μm (av. 13.99), and specific surface areas 0.236–0.302m2g?1. B-granule mean volumes were 35.4–100.4μm3 (av. 55.9), modal volumes 16.5–54.5μm3 (av. 27.7), mean diameters 3.66–5.07μm (av. 4.09), and specific surface areas 0.684–0.920m2g?1. The B-granule contents of the starches were 12.8–34.6% (av. 27.3) by weight (sedimentation method) and 13.0–37.3% (av. 24.0) by volume (Coulter method), the latter being the more accurate method. 相似文献