68 research outputs found

    Intrauterine insemination: evaluation of the results according to the woman's age, sperm quality, total sperm count per insemination and life table analysis

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    We report on 332 infertile couples who underwent 1115 cycles of intrauterine insemination (IUI) with washed husband's semen. The indication for IUI was an abnormal post-coital test due to either a male or cervical infertility factor. The mean number of IUI cycles per patient was 3.4, the overall pregnancy rate 18, 7%, and the pregnancy rate per cycle 5.6%. The cumulative pregnancy rate calculated by life table analysis showed that 16.0% of pregnancies occurred in the first three treatment cycles, while the cumulative pregnancy rate was 26.9% by the sixth cycle. The outcome of the therapy was adversely affected if the woman's age was >39 years and/or total motile sperm count per insemination was <1X106. No pregnancy occurred in women older than 44 years or in cases with a total motile sperm count before semen preparation of <1X10

    Appropriateness of Upper Gastrointestinal Endoscopy: Comparison of American and Swiss Criteria

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    Objective: Examine the reproducibility of the RAND method for developing criteria for the appropriateness of medical procedures. Design: Comparison of two sets of explicit criteria for appropriateness of upper gastrointestinal (UGI) endoscopy, developed by separate expert panels from two countries.Setting: United States, Switzerland. Study participants: National experts from different medical specialties involved in the referral or application of UGI endoscopy.Interventions: Each panel was presented with about 500clinical scenarios (indications)that were rated on a nine-point scale as to the appropriateness of performing UGI endoscopy for a patient with that clinical presentation. Main outcome measurer: (1) distribution of appropriateness ratings and intrapanel agreement categories between the two panels, (2)between-panel agreement of assigning appropriateness for comparable indications and, (3) percentage of indications with major between-panel differences. Results: Ratings for 2/3 of indications could be compared. The Swiss panel showed higher intrapanel agreement (54.6% versus 46.2% p=0.002). Seventy-eight percent of comparable Indications were assigned to indentical categories of appropriateness by both panels (kappa=0.76,P <0.001). For 93% of the 376 comparable indications, there were no major interpanel differences. Conclusion: Separate expert panels in different countries, using a standardized methodology, produce criteria for appropriatenesof medical procedures that are similar. Given the resources being invested throught the world in devilping criteria and guidelines, international collaboration in seeking optimal use of limited health care resources should be intensifled. © 1997 Elsevier Science Ltd. All rights reserve

    Adéquation de l'oeso-gastro-duodénoscopie en pratique ambulatoire

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    QM/MM calculations on a newly synthesised oxyluciferin substrate: new insights into the conformational effect

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    International audienceIn this publication we conduct calculations on a newly synthesised red-shifted emitter of luciferin in order to understand what are the main contributions to the colour-shifting emission. Indeed the bioluminescent system, especially from fireflies, is one of the main resources for medical imaging but its efficiency greatly depends on the wavelength of the emission. We performed classical molecular dynamics followed by quantum mechanics/molecular mechanics (QM/MM) calculations, with either density functional theory or multiconfigurational reference second-order perturbation theory on different emitters to obtain bioluminescence emission. We analysed the calculations and investigated the effects which play a non-negligible role in the emission, like the effect of the surroundings or the effect of the conformation of the emitter. Finally, in the absence of crystallographic structures, we proposed the most likely conformation for the emitter in the bioluminescence process

    QM/MM calculation on a red emitter of firefly oxyluciferin

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    QM/MM Calculation on a red emitter of firefly oxyluciferin

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    QM/MM calculations of light emission in firefly

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    International audienceIn this presentation, I will show how the theoretical studies can be used to give information on the bioluminescent system luciferase/oxyluciferin in fireflies. In simulation of such system, very accurate quantum chemistry has to be used in order to understand the electronic transition that lead to the photons emission. The modulation of the light emission is due to the protein environment. In order to take into account this environment, the surrounding is described with lower accuracy than for the emitter. The coupling of the two methods is called QM/MM (quantum mechanic/molecular mechanic).QM/MM studies will be presented for firefly oxyluciferin/luciferase[1,2] as long as for a new firefly luciferin analogue. This last molecule, synthetized and tested by experimental team[3], gives a red emission with better in vivo tissue penetration and signal quantification in bioluminescence imaging. Figure: oxyluciferin analogue (QM: sticks and balls) and luciferase (MM: ribbon) [1] I. Navizet, Y.-J. Liu, N. Ferré, H.-Y. Xiao, W.-H. Fang, R. Lindh, J. Am. Chem. Soc. 2010 132, 706.[2] I. Navizet, L. Yue, Y-J Liu, D. Roca-Sanjuan, N. Ferré, and R. Lindh, Photochemistry and Photobiology 2013, 89(2), 319-25.[3] A. P. Jathoul, H. Grounds, J.C Anderson and M. A. Pule, Angew.Chem.Int.Ed. 2014 53, 13059 –1306
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