The objective of this study was to compare the incidence of retained embryos when a full column of media is utilized to expel embryos compared with a column of air. A retrospective analysis of excellent quality fresh embryo transfer results from January 1, 2001 through March 31, 2004. A total of 542 patients underwent fresh embryo transfers. There were no mock or practice embryo transfers performed. All embryo transfers were performed on Day 5 or Day 6 using either a Wallace or Cook catheter with excellent quality embryos. From January 1, 2001 to August 7, 2002, embryos were transferred with approximately 15–20 μl of media and expelled with a column of air. Beginning August 8, 2002, embryos were transferred with approximately 15–20 μl of media and expelled with a full column of media. All embryo transfers were performed with an abdominal ultrasound (5 MHz) and full bladder to aid intrauterine placement of the embryo transfer catheter. *, ** P < .05 (vs. Media Column group using Fisher's Exact) Results indicate no significant difference for retained embryos (P= 1.0) and overall pregnancy rate (P= .7139) between transfers performed when a column of air or a column of media was used to expel embryos. Significant difference was noted for clinical pregnancies compared with the media column group. In addition, there was a significant difference in implantation rate when the two groups were compared.

Commercial donor sperm banks now promote pre-washed frozen sperm. This allows intrauterine inseminations to be performed by physicians without access to a reproductive/andrology laboratory. Many of these banks are discussing, or choosing, to discontinue the use of unwashed (regular/ ICI ready) sperm vials. Additionally, those banks that are still offering a choice between regular and pre-washed (IUI ready) vials are now producing fewer regular vials. Previous data has shown a higher progressive motility and pregnancy rate with the use of regular donor sperm vials. The purpose of this study is to do a follow-up comparison of sperm parameters and cycle outcome in women undergoing intrauterine insemination (IUI) with regular and pre-washed donor sperm vials. Retrospective study comparing women undergoing LH timed, Clomid and FSH stimulated intrauterine insemination with regular or pre-washed frozen donor sperm from February 1, 2001 through December 31, 2003. Patients ordered donor sperm from a commercial bank based on donor characteristics and availability. Pre-washed specimens were centrifuged over a density gradient and re-suspended in a yolk buffer freezing medium to achieve a desired density of motile sperm prior to cryopreservation. These specimens were thawed and analyzed immediately prior to insemination and required no further preparation. Regular specimens were combined with the freezing medium, centrifuged (no density gradient), and re-suspended as necessary to achieve a desired density of motile sperm prior to freezing. These specimens are thawed approximately 1 hour before the insemination, analyzed, and processed via centrifugation over a density gradient. Regular specimens are additionally analyzed following processing and prior to IUI. All specimens were analyzed by computer assisted semen analysis (CASA-IVOS/Hamilton Thorne). Final pre-insemination sperm parameters and cycle outcomes were recorded.RESULTS: Pre-washed specimens do demonstrate a slightly lower progressive motility than regular specimens processed post-thaw. However, the regular vials yielded a slightly lower number of progressive sperm. We found no statistical difference in the pregnancy rates with use of either type of vial. Currently, there seems to be no distinction in the cycle outcome of women using regular or pre-washed donor vials.

There is a linear relationship between potassium removal during haemodialysis and plasma potassium (Kp). Kp falls rapidly during the first hour of dialysis but very little during the last two hours of a five hour dialysis. There is a fairly constant movement of potassium from the intracellular to extracellular space throughout dialysis. Total potassium removal is best predicted by pre-dialysis Kp, but change in Kp is related to the impact of dialysis on acid-base status. The choice of acetate or bicarbonate buffered dialysate does not effect potassium removal during dialysis.

Conference Abstract| January 01 1985 Effect of Dialysate Buffer on Potassium (K) Removal During Haemodialysis (HD) A.J. Williams; A.J. Williams 1Department of Nephrology, The London Hospital, London E1 1BB Search for other works by this author on: This Site PubMed Google Scholar J.N. Barnes; J.N. Barnes 1Department of Nephrology, The London Hospital, London E1 1BB Search for other works by this author on: This Site PubMed Google Scholar J. Cunningham; J. Cunningham 1Department of Nephrology, The London Hospital, London E1 1BB Search for other works by this author on: This Site PubMed Google Scholar F.J. Goodwin; F.J. Goodwin 1Department of Nephrology, The London Hospital, London E1 1BB Search for other works by this author on: This Site PubMed Google Scholar F.P. Marsh F.P. Marsh 1Department of Nephrology, The London Hospital, London E1 1BB Search for other works by this author on: This Site PubMed Google Scholar Clin Sci (Lond) (1985) 68 (s11): 14P. https://doi.org/10.1042/cs068014P Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Citation A.J. Williams, J.N. Barnes, J. Cunningham, F.J. Goodwin, F.P. Marsh; Effect of Dialysate Buffer on Potassium (K) Removal During Haemodialysis (HD). Clin Sci (Lond) 1 January 1985; 68 (s11): 14P. doi: https://doi.org/10.1042/cs068014P Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu nav search search input Search input auto suggest search filter All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. Article PDF first page preview Close Modal You do not currently have access to this content.

Simple tests of verbal reasoning and mental arithmetic, taken under mildly stressful conditions, have been shown to give a reproducible test of intellectual function within groups of normal subjects. Using these tests, in two separate examinations, a double-blind cross-over study was performed on 35 medical students to assess the effects of acute beta-adrenoceptor blockade with propranolol on intellectual function. With placebo treatment, students recorded an average total score of 231.3 marks, with average scores of 108.9 marks on the mental arithmetic paper and 122.4 marks on the verbal reasoning paper. Treatment with propranolol was associated with an improvement in total score of 9.2 +/- 3.9 marks (P less than 0.05), an improvement in mental arithmetic score of 5.6 +/- 2.3 marks (P less than 0.05) and an improvement in verbal reasoning score of 3.6 +/- 2.4 marks (NS). Eighteen out of the 35 students said that they were mildly anxious before one examination and 13 students said they were anxious before both examinations. Those students who admitted anxiety seemed to benefit the most, in terms of improved examination performance, from treatment with propranolol.

1. Eight patients with essential hypertension were challenged with an infusion of 32 mmol of potassium chloride in saline before and after control of their blood pressure by the angiotensin converting-enzyme (ACE) inhibitor enalapril. 2. The potassium infusion was associated with similar increases in plasma aldosterone before and during enalapril treatment, although absolute aldosterone levels were lower after enalapril treatment despite higher plasma potassium levels. 3. The handling of the potassium load was altered by ACE inhibition. The area under the curve of a plot of the increase in plasma potassium above baseline against time was greater during enalapril treatment than during treatment with placebo. 4. These observations contrast with data obtained in the dog and demonstrate that in patients with essential hypertension stimulation of aldosterone secretion by potassium is not abolished by chronic suppression of plasma angiotensin II; and although plasma aldosterone remains at a lower level, the homoeostasis of plasma potassium is only mildly impaired.

The pharmacokinetics of a single oral dose of dihydrocodeine were studied in nine patients with chronic renal failure treated by haemodialysis and nine subjects with normal renal function. In the patients the mean peak plasma dihydrocodeine concentration occurred later and the area under the curve was greater than in the normal subjects. Furthermore, the drug was still detectable after 24 hours in all the patients but only three of the normal subjects. These data, together with those obtained from previously published clinical case reports, contradict the traditional view that the body's ability to cope with opioid drugs is not altered in renal failure.

The effects of a 48 h infusion of arginine vasopressin (AVP) were measured in five separate studies on four normal salt-restricted physicians, in whom fluid retention was prevented. The infusion was associated with an increase in renal sodium excretion which continued during the 24 h after the infusion had been discontinued. During the infusion plasma renin activity (PRA), plasma aldosterone and noradrenaline, and packed cell volume (PCV) fell; glomerular filtration rate, assessed by endogenous creatinine clearance, increased. The findings are best explained by a vasopressin-induced increase in plasma volume, which in the absence of fluid retention is likely to have been due to a redistribution of body water.

Conference Abstract| February 01 1984 Hormonal Changes Associated with Acute Potassium Infusion in Man J. N. Barnes; J. N. Barnes 1Medical Unit, the London Hospital, London El 1BB Search for other works by this author on: This Site PubMed Google Scholar P. J. T. Drew; P. J. T. Drew 1Medical Unit, the London Hospital, London El 1BB Search for other works by this author on: This Site PubMed Google Scholar J. M. P. Holly; J. M. P. Holly 1Medical Unit, the London Hospital, London El 1BB Search for other works by this author on: This Site PubMed Google Scholar F. J. Goodwin F. J. Goodwin 1Medical Unit, the London Hospital, London El 1BB Search for other works by this author on: This Site PubMed Google Scholar Clin Sci (Lond) (1984) 66 (2): 16P. https://doi.org/10.1042/cs066016P_pt2 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Citation J. N. Barnes, P. J. T. Drew, J. M. P. Holly, F. J. Goodwin; Hormonal Changes Associated with Acute Potassium Infusion in Man. Clin Sci (Lond) 1 February 1984; 66 (2): 16P. doi: https://doi.org/10.1042/cs066016P_pt2 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu nav search search input Search input auto suggest search filter All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. © 1984 The Biochemical Society and the Medical Research Society1984 Article PDF first page preview Close Modal You do not currently have access to this content.

Conference Abstract| February 01 1984 Effects of Acute Beta Blockade on Examination Performance P.J.T. Drew; P.J.T. Drew 1Medical Unit, the London Hospital, London E1 1BB Search for other works by this author on: This Site PubMed Google Scholar J.N. Barnes; J.N. Barnes 1Medical Unit, the London Hospital, London E1 1BB Search for other works by this author on: This Site PubMed Google Scholar S.J.W. Evans S.J.W. Evans 1Medical Unit, the London Hospital, London E1 1BB Search for other works by this author on: This Site PubMed Google Scholar Author and article information Publisher: Portland Press Ltd Online ISSN: 1470-8736 Print ISSN: 0143-5221 © 1984 The Biochemical Society and the Medical Research Society1984 Clin Sci (Lond) (1984) 66 (2): 67P–68P. https://doi.org/10.1042/cs066067Pb_pt2 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Citation P.J.T. Drew, J.N. Barnes, S.J.W. Evans; Effects of Acute Beta Blockade on Examination Performance. Clin Sci (Lond) 1 February 1984; 66 (2): 67P–68P. doi: https://doi.org/10.1042/cs066067Pb_pt2 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. © 1984 The Biochemical Society and the Medical Research Society1984 Article PDF first page preview Close Modal You do not currently have access to this content.

A 22 year old woman was referred with an 11-year history of headaches. These had occurred every day apart from during two periods, one when she was 13 and one when she was 16, when she had been free of headaches for three and six months respectively. During the first five years the headaches had lasted for only 15 minutes and had rarely occurred more than once a day, but they had progressively become longer and more frequent. At presentation they were lasting one to two hours each day, during which time she had several attacks of excruciating pain that lasted for five to 10 minutes, with a duller pain between each exacerbation. She therefore had 15-20 attacks each day, a large proportion of which occurred at night. The pattern of the headache was constant. It began as a severe sharp stabbing pain above the left ear and in a few seconds spread to the whole of the left side of the face, left anterior scalp, and occasionally around the left common carotid artery. It occurred at any time and woke her from sleep three or four times each week. It was associated with lacrimation of the left eye, blockage of the left nostril, and left ptosis. It could be precipitated by movements of the neck. There were no abnormal signs on examination apart from bruising of both upper arms where she gripped herself during attacks. When observed during an attack, precipitated by neck flexion, she developed appreciable bradycardia (40 beats/minute, regular) despite being in severe pain. Left ptosis and oedema of the upper eyelid and ipsilateral pupillary constriction developed within two minutes of the start of this pain. She was fully investigated on several occasions. A computed tomogram, skull and sinus x-ray films, and an electroencephalogram were all normal. No dental abnormality had been found, although impacted wisdom teeth had been extracted in 1978 with no change in the frequency or severity of the headaches, which did not respond to any analgesics. She had been treated with many drugs without success. Chronic paroxysmal hemicrania was diagnosed and indomethacin 25 mg thrice daily prescribed. The headaches immediately became much milder and stopped totally after five days. They returned briefly three months later during an episode of severe gastroenteritis,'when presumably the indomethacin was not being absorbed, but were relieved as soon as she recovered. She remained symptom free at follow-up after nine months.

p 1538). The authors refer to the case reports of Collste et all and Farrow et al,2 but they fail to comment on the association with stenosis of the transplant artery in both these reports. We have recently had a case with striking similarities.3 The patient, a 32 year old Filipino with a primary diagnosis of renal failure due to mesangiocapillary glomerulonephritis, received a renal allograft from her sister, who was of identical HLA type. The patient subsequently developed severe hypertension refractory to treatment with combinations of diuretics, beta-blockers, methyldopa, prazosin, and hydralazine. Good control was obtained with minoxidil (10 mg/day), but long term treatment with this drug was considered unacceptable because of the risk of hirsutism. Treatment with captopril on three occasions was associated with a rapid deterioration in renal function, once sufficiently severe to require haemodialysis for hyperkalaemia. It was clearly shown that this was not related to blood pressure reduction per se since minoxidil treatment produced lower pressures without detriment to renal function. Although isotope renal scans were unremarkable, a diagnosis of transplant artery stenosis was suspected clinically and was confirmed angiographically and later at surgery. Review of published work suggests that renal failure after captopril is rare, and the reports of this complication show an association with renal artery stenosis, in most cases after renal transplantation.'-6 The reninangiotensin system is important in the autoregulation of glomerular filtration rate,7 and there is evidence that it mediates the compensatory haemodynamic changes in response to renal artery stenosis. Experiments in which renal artery stenosis has been induced in conscious dogs have shown the unique potential of the renal vascular bed to respond by an increase in resistance, probably at the efferent arteriole, which can be blocked by captopril.8 It would therefore be helpful to know whether transplant artery stenosis was excluded in the present case. J C MASON P J HILTON

We report the results of an observer blind crossover trial in 31 patients with essential hypertension comparing the hypotensive effect of four doses of prazosin and of hydralazine used as the third step of triple therapy and additional data on the efficacy of low dose combinations of these two drugs. Both drugs had an appreciable antihypertensive effect, 1 mg of prazosin being equivalent to 12.5 mg of hydralazine. Increasing the dose of prazosin from 4 to 8 mg twice daily and hydralazine from 50 to 100 mg twice daily did not consistently reduce blood pressure. The combination of the two drugs at low doses resulted in the blood pressure of more patients being controlled (diastolic blood pressure 90 mm Hg or below) than when either drug was used alone at high dose. The symptoms reported by patients were similar for both drugs. The combination did not lead to an increased reporting frequency. The trial demonstrates one of the problems of a crossover study, namely a treatment/period interaction.