Objective: To determine whether Oxiplex/AP Gel (FzioMed, San Luis Obispo, CA) was safe and preliminarily effective in reducing postsurgical adhesions after adnexal surgery by laparoscopy. Design: Prospective, multicen...Objective: To determine whether Oxiplex/AP Gel (FzioMed, San Luis Obispo, CA) was safe and preliminarily effective in reducing postsurgical adhesions after adnexal surgery by laparoscopy. Design: Prospective, multicenter, double-blind, randomized, U.S. Food and Drug Administration-monitored feasibility study. Setting: University and private clinics. Patient (s): Patients undergoing laparoscopic surgery with pelvic adhesions, tubal occlusion, endometriosis, and/or dermoids were randomized to receive Oxiplex/AP Gel or no further treatment after surgery. Intervention(s): A blinded, parallelgroup design was conducted at six centers. Patients (aged 18-46 years) underwent laparoscopic surgery, with secondlook surgery 6-10 weeks later. Surgeries were videotaped. Oxiplex/AP Gel was used to cover adnexa and adjacent tissue. Main Outcome Measure(s): Blinded reviews of videotapes were quantitated with the American Fertility Society adhesion score (AFS score). Result(s): In 18 treatment patients, surgery was performed on 29 adnexa. Application of Oxiplex/AP Gel required approximately 90 seconds. In 10 control patients, surgery was performed on 18 adnexa. The mean baseline AFS score for each group was 8.0. At second look, treated adnexa had the same score (8.1), whereas in control adnexa the score increased (from 8.0 to 11.6). Thirty-four percent of treated adnexa increased in adhesion score, in contrast to 67%of control adnexa. There were no device-related adverse events. Conclusion(s): In this pilot study, Oxiplex/AP Gel was safe, easy to use with laparoscopy, and produced a reduction in the increase of adnexal adhesion scores.展开更多
Objective: To estimate the expression of haptoglobin (Hp)-βchain isoforms in the peritoneal fluid (PF) and plasma (PL) of women with and without endometrios is. Design: Cross-sectional study. Setting: University hosp...Objective: To estimate the expression of haptoglobin (Hp)-βchain isoforms in the peritoneal fluid (PF) and plasma (PL) of women with and without endometrios is. Design: Cross-sectional study. Setting: University hospital. Patient(s): Se venty-two patients with endometriosis and 35 controls. Intervention(s): Periton eal fluid and PL samples were subjected to two-dimensional gel electrophoresis, silver stained, digitally captured, and compared by semiquantitative computeriz ed analysis. Main Outcome Measure(s): Expression of Hp βchain isoforms. Result( s): No significant difference was observed in the frequency of expression of the Hp βchain isoforms between the two groups. One βchain isoform (HpβE; molecul ar weight, 38.40 ±0.94 kD; and isoelectric point, 5.63 ±0.17) had significantl y higher expression in both the PF and PL of women with endometriosis than in th e PF and PL of controls. No significant difference was observed in HpβE express ion between women with mild (revised American Fertility Society [rAFS], stage I -II) and severe (rAFS, stage III-IV) endometriosis. In the control group, Hpβ E expression was correlated with the phase of the menstrual cycle. Conclusion(s) : Women with endometriosis have higher PF and PL levels of HpβE. Further invest igation should be aimed at producing antibodies against the HpβE-specific epit opes to determine whether its measurement may improve the clinical diagnosis of endometriosis.展开更多
文摘Objective: To determine whether Oxiplex/AP Gel (FzioMed, San Luis Obispo, CA) was safe and preliminarily effective in reducing postsurgical adhesions after adnexal surgery by laparoscopy. Design: Prospective, multicenter, double-blind, randomized, U.S. Food and Drug Administration-monitored feasibility study. Setting: University and private clinics. Patient (s): Patients undergoing laparoscopic surgery with pelvic adhesions, tubal occlusion, endometriosis, and/or dermoids were randomized to receive Oxiplex/AP Gel or no further treatment after surgery. Intervention(s): A blinded, parallelgroup design was conducted at six centers. Patients (aged 18-46 years) underwent laparoscopic surgery, with secondlook surgery 6-10 weeks later. Surgeries were videotaped. Oxiplex/AP Gel was used to cover adnexa and adjacent tissue. Main Outcome Measure(s): Blinded reviews of videotapes were quantitated with the American Fertility Society adhesion score (AFS score). Result(s): In 18 treatment patients, surgery was performed on 29 adnexa. Application of Oxiplex/AP Gel required approximately 90 seconds. In 10 control patients, surgery was performed on 18 adnexa. The mean baseline AFS score for each group was 8.0. At second look, treated adnexa had the same score (8.1), whereas in control adnexa the score increased (from 8.0 to 11.6). Thirty-four percent of treated adnexa increased in adhesion score, in contrast to 67%of control adnexa. There were no device-related adverse events. Conclusion(s): In this pilot study, Oxiplex/AP Gel was safe, easy to use with laparoscopy, and produced a reduction in the increase of adnexal adhesion scores.
文摘Objective: To estimate the expression of haptoglobin (Hp)-βchain isoforms in the peritoneal fluid (PF) and plasma (PL) of women with and without endometrios is. Design: Cross-sectional study. Setting: University hospital. Patient(s): Se venty-two patients with endometriosis and 35 controls. Intervention(s): Periton eal fluid and PL samples were subjected to two-dimensional gel electrophoresis, silver stained, digitally captured, and compared by semiquantitative computeriz ed analysis. Main Outcome Measure(s): Expression of Hp βchain isoforms. Result( s): No significant difference was observed in the frequency of expression of the Hp βchain isoforms between the two groups. One βchain isoform (HpβE; molecul ar weight, 38.40 ±0.94 kD; and isoelectric point, 5.63 ±0.17) had significantl y higher expression in both the PF and PL of women with endometriosis than in th e PF and PL of controls. No significant difference was observed in HpβE express ion between women with mild (revised American Fertility Society [rAFS], stage I -II) and severe (rAFS, stage III-IV) endometriosis. In the control group, Hpβ E expression was correlated with the phase of the menstrual cycle. Conclusion(s) : Women with endometriosis have higher PF and PL levels of HpβE. Further invest igation should be aimed at producing antibodies against the HpβE-specific epit opes to determine whether its measurement may improve the clinical diagnosis of endometriosis.
