RESUMEN
INTRODUCTION: Fallopian tube recanalisation (FTR) for proximal fallopian tube obstruction (PFTO) is considered a good treatment option for tubal infertility. The aim of this study was to assess the safety and the technical and clinical success rates of FTR using a dedicated radiographic tubal assessment set (FluoroSet(®) ) in the angiography suite. METHODS: This study is a retrospective analysis of data prospectively collected between February 2007 and June 2011 at King Abdullah University Hospital, Irbid, Jordan. During this period, 61 patients affected by PFTO underwent FTR using FluoroSet(®) at our institution. The mean age of patients was 34 years (range 20-45 years), and the mean duration of infertility was 4 years (range 2-14 years). The procedure was performed with conscious sedation under fluoroscopic guidance in the angiography suite. The obstructed tube was accessed with a 5-Fr multipurpose catheter, and the obstruction was crossed with a 0.35-Fr hydrophilic guide wire until the wire coiled freely into the peritoneal cavity. Patency of the tube was then confirmed by selective salpingiogram. Technical success rate was recorded, and patients were followed up for evidence of pregnancy over 12 months. RESULTS: The procedure was technically successful in all patients. Minor bleeding and postprocedural pain occurred in most patients; however, there were no major complications encountered. Twenty-five patients (41%) became pregnant. Successful deliveries of full-term infants were reported in 21 patients (84%). Miscarriage was reported in four patients (16%). No ectopic pregnancies were detected, and all deliveries were full-term. The technical success rate was 100% and the clinical success rate was 41%. CONCLUSION: Selective salpingography and FTR using FluoroSet(®) is a safe and effective method. FTR is recommended as the first intervention in patients with PFTO. In experienced hands with dedicated equipment and in an appropriate setting, the success rate is high, and this treatment should be offered to infertile women with PFTO before other, more complex techniques are attempted.
Asunto(s)
Angiografía/instrumentación , Enfermedades de las Trompas Uterinas/diagnóstico por imagen , Enfermedades de las Trompas Uterinas/cirugía , Histerosalpingografía/instrumentación , Infertilidad Femenina/diagnóstico por imagen , Infertilidad Femenina/cirugía , Cirugía Asistida por Computador/instrumentación , Adulto , Angiografía/métodos , Diseño de Equipo , Análisis de Falla de Equipo , Enfermedades de las Trompas Uterinas/complicaciones , Trompas Uterinas , Femenino , Humanos , Histerosalpingografía/métodos , Infertilidad Femenina/etiología , Persona de Mediana Edad , Embarazo , Resultado del Embarazo , Estudios Retrospectivos , Cirugía Asistida por Computador/métodos , Resultado del Tratamiento , Adulto JovenRESUMEN
The Differential Buoyancy method uses Archimedes' principle to non-invasively determine body fat percentage by measuring the subject's weight in breathable high and low densities atmospheres. We currently use both air and helium/oxygen mixtures in our experiments[1]. When the method was tested on rats, an anomaly was observed. As helium/oxygen mixture was admitted to the weighing chamber, while the atmospheric density monotonically decreased, the rat's weight first increased but then after several minutes decreased. Water loss from the rat's body was found to be the main cause of this anomaly. Therefore it was necessary to compensate for this water loss. Consistent with experimental findings the water loss was modeled as a constant rate process, and determined experimentally from weight measurements at the beginning and at the end of the experiment. Making these corrections allowed for accurate predictions of the rat's volume and body fat percentage.
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Composición Corporal , Tejido Adiposo/anatomía & histología , Animales , Ingeniería Biomédica , Humanos , Modelos Biológicos , Ratas , AguaRESUMEN
Measurement of body fat percentage is essential for medical care and research. The "gold standard" method for humans is underwater weighing, which is clearly inappropriate for infants, sick people and non-human animals. The corresponding criterion method for animals is comminution of the carcass followed by extraction of the fat with a volatile solvent such as ether. Our goal has been to develop a method for body composition (fat percentage) for use in animals and humans which is non-invasive and minimally intrusive, independent of variation in body conformation and fat distribution, and reasonable in cost. In one variant, our approach to this problem has been to move Archimedes' principle "on to dry land." The subject's volume is determined by measuring the differential buoyancy in comfortably breathable light (low density) and heavy atmospheres. In another, we use "structured light," in which a pattern of illumination is cast on the patient. The image is acquired using a video camera and the geometrical spatial coordinates of a large number of points on the surface of the subject are acquired. This permits the computation of the surface area and volume of the subject; which, combined with the weight, determines the fat percentage.