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Sperm Banking
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Rakesh Sharma, Alyssa M. Giroski, Ashok Agarwal
Experimental options are available for fertility preservation in prepubertal boys as spermatogenesis has not resulted in the formation of spermatids or spermatozoa. Testicular tissue and germ cell preservation in young patients with cancer is an experimental option. Spermatogonial stem-cell transplantation is a novel method where there is ongoing research for fertility preservation in both prepubertal and adult males. Spermatogonial germ cells are present in prepubertal testicular tissue and can be isolated and successfully cryopreserved [49]. These stem cells have the potential to be transplanted autologously into the testis where they are expected to recolonize the seminiferous tubules and initiate spermatogenesis. Autotransplantation is not recommended in cases where the potential for occult metastasis is high. In such situations, transplantation of human spermatogonial cells into animals can be performed (xeno-transplantation) under experimental conditions [50,51]. However, the risk of introducing animal infectious retroviruses into the human germ line is a possibility when these cells are used for conception [52]. Ischemic damage to transplanted testicular tissue, in vitro enrichment of stem-cell spermatogonia, and noninvasive transfer of germ cell suspension into the rete testis are some other challenges associated with this technology.
Bilateral Parathyroid Exploration
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
R. James A. England, Nick McIvor
In the study, the practice of autotransplantation (AT) is extremely variable: 40.7% perform immediate AT while 36% do not. Smaller percentages tailor their practice to ioPTH results or dialysis techniques. The forearm is the implantation site of choice in 72.7% and the sternocleidomastoid in 16.4%. Graft function is assessed with serum PTH monitoring from grafted versus non-grafted forearms in 62.9% of cases, with 13.6% (n = 5) performing a temporary implantectomy (‘Casanova test’) and one using sestamibi scintigraphy (2.6%).
The pancreas
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
The role of surgery is to overcome obstruction and remove mass lesions. Some patients have a mass in the head of the pancreas, for which either a pancreatoduodenectomy or a Beger procedure (duodenum-preserving resection of the pancreatic head) is appropriate. If the duct is markedly dilated, then a longitudinal pancreatojejunostomy or Frey procedure can be of value (Figure68.31). The natural evolution of the disease may not be altered significantly, but around half the patients get long-term pain relief. The rare patient with disease limited to the tail will be cured by a distal pancreatectomy. Patients with intractable pain and diffuse disease may plead for a total pancreatectomy in the expectation that removing the offending organ will relieve their pain. However, one should keep in mind that pancreatic function and quality of life are significantly impaired after this procedure, and the operative mortality rate is not trivial. Moreover, there is no guarantee of pain relief (approximately a third of patients get resolution, a third show some benefit, and a third see no benefit at all). Total pancreatectomy and islet autotransplantation has been reported in selected patients, but it is difficult to demonstrate any overall benefit.
The Sysmex XN series hematopoietic progenitor cell (XN-HPC) as a predictive marker of stem cell enumeration and products: a systemic review and meta-analysis
Published in Hematology, 2022
Lunhui Huang, Guoqing Zhu, Yueyi Mu, Yonghui Xia
The authors (LH and YX) independently extracted relevant information from each study, including the first author, country, year of publication, male ratio, sample size, number of allogeneic transplantation donors, average age of allogeneic transplantation donors, diseases of autotransplantation patients, number of patients, mean age of patients, CD34 counting guidelines, HPC model, sample type, mobilization scheme, and True Positive (TP), True Negative (TN), False Negative (FN), and False Positive (FP). The extracted information was checked by a third author (GZ). Both authors re-examined the differences to ensure the accuracy of the database. The quality of the included study was assessed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool, to estimate the risk of bias and applicability.
Strategies for overcoming oncological treatment-related ovarian dysfunction – literature review
Published in Gynecological Endocrinology, 2017
Katarzyna Pankiewicz, Grzegorz Szewczyk, Tomasz Mikołaj Maciejewski, Dariusz Szukiewicz
This method involves the removal of ovarian cortical tissue during laparoscopic surgery. Obtained tissue is cryopreserved and after the completion of oncological treatment is then autotransplanted. There are two types of autotransplantation: orthotopic, which includes ovarian fossa or pelvic cavity and heterotopic, which includes such locations as forearm or abdominal wall. It is the only method for fertility preservation in prepubertal girls. The patient does not require ovarian stimulation and there is also no need for a partner or using a sperm donor. However, this technique is still considered experimental. The first ovarian tissue transplantation was performed in 1999 with the first pregnancy not being reported until 2004 [24–28]. Until 2014 there were only 24 live births after more than 60 orthotopic transplantations and no live births after heterotopic transplantation reported [29,30].