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Biomedical subjects

W Boeckx

Publications and source records attributed to W Boeckx.

At least 55 records · Page 3Linked to original sources

The effect of training in microsurgery.

One of the most important and fundamental prerequisites for successful microsurgery is serious and adequate training. This article presents the effect of microsurgical training on the functional end result of reanastomosis in the rabbit fallopian tube and evaluates the appropriate duration of laboratory training. In 50 New Zealand White female rabbits a microsurgical reanastomosis of the fallopian tube in its isthmic portion was performed. The rabbits were divided into five groups. In the first group only 30% of the rabbits conceived on the side operated on. The nidation index was only 0.269 as compared to 0.831 for the control side. Improvement in microsurgical skill following 100 isthmic anastomoses resulted in a 100% pregnancy rate for the last group. The nidation indexes in this group were the same on the side operated on and on the control side, 0.774 and 0.702, respectively. Scanning electron microscopic examination of the anastomosis site revealed a progressive increase in patency rate and in the amount of apposed mucosal folds in the three groups. A training program is recommended, which should bring about a nidation index and pregnancy rate that should not differ from the side operated on to the control side.

Animals↗

Bacteriological effect of cerium-flamazine cream in major burns.

A controlled trial of the use of either 0.05 per cent chlorhexidine for bathing burn wounds or the topical application of a cream containing cerium nitrate and silver sulphadiazine showed that the cerium-flamazine cream significantly reduced the degree of Pseudomonas aeruginosa contamination of the burn wounds of patients with burns covering more than 15 per cent of the body surface area. The adherent eschar produced by treatment with cerium-flamazine provided a satisfactory wound cover until tangential excision could be carried out.

Administration, Topical↗

Training in tubal microsurgery.

The restoration of normal tubo-ovarian function was investigated in a training programme using oviduct anastomosis in the rabbit as an experimental model. Ovulation rate, pregnancy rate, nidation index, implantation failure index and degree of adhesions were used as parameters. More than 100 anastomoses had to be performed to reach a perfect degree of atraumatic, function-restoring surgery. It is concluded that the most difficult aspect in female infertility surgery is not the use of the operating microscope but the experience in applying the principles of atraumatic surgery.

Animals↗

Ciliogenesis following salpingostomy of rabbit hydrosalpinges.

Twenty-five artificially induced hydrosalpinges were studied in New Zealand white rabbits. Hydrosalpinges had been created after 2-16 wk occlusion of both the fimbrial end and the ampullary isthmic junction (A.I.J.), using either Ethilon 8/0 or tantalum clips. Their diameters ranged from 4 to 12 mm, being larger in the clipped oviducts. In hydrosalpinges larger than 6 mm diameter, a salpingostomy was done and ampullary biopsies were taken and prepared for scanning electron microscopy, and 1-micron sections and ultrathin sections for transmission electron microscopy. The changes observed were those found in previous work (Vásquez et al., 1981). Post-salpingostomy biopsies were taken from 10 patent oviducts at different intervals of time, ranging from 2 days to 8 wk. Ciliogenesis was observed between the 2nd and 3rd wk after salpingostomy.

Animals↗

Microsurgery of endometriosis in infertile patients.

From January 1973 to December 1980, 176 infertile women with endometriosis were treated with atraumatic and microsurgical techniques. None of these patients received preoperative or postoperative antigonadotropin therapy. The degree of endometriosis in these patients was classified according to the scaling point system of The American Fertility Society. After 2 years the cumulative pregnancy rate of the severe group (40%) was not different from that of the mild (43%) or moderate group (45%). It is therefore suggested that the use of microsurgical techniques can improve the pregnancy outcome in patients with severe endometriosis.

Adult↗

A scanning electron microscopic study of microvascular anastomoses on irradiated vessels: short-term effect of irradiation.

Experiments were carried out to determine the effect of previous irradiation on microvascular arterial anastomoses. The study focused on regeneration of endothelial cells and thrombus formation. Careful examination with scanning electron microscopy (SEM) showed a difference between irradiated animals and a control group. In the irradiated group one can notice a decreased regeneration, a greater amount of fibrin and platelets, and a higher incidence of microthrombi.

Animals↗

The epithelium of human hydrosalpinges: a light optical and scanning electron microscopic study.

Multiple tubal biopsies from 21 patients with thin-walled dilated hydrosalpinges and from 12 patients with thick-walled fibrous hydrosalpinges were studied. All the biopsies were examined by light microscopy and scanning electron microscopy and the ciliated surface area at multiple locations measured by planimetry. These biopsies were compared with control biopsies taken from 13 normal women at varying stages of the menstrual cycle.

Adult↗

Ovarian transplantation by selective microvascular anastomoses in the rabbit.

Autotransplantation of the ovary by microvascular anastomoses was performed in 42 rabbits by three different procedures: orthotopic replantation with selective end-to-end anastomoses of the ovarian vessels; heterotopic transplantation in the groin area, with anastomosis of the ovarian vessels on the inferior epigastric vessels; heterotopic transplantation in the groin with the ovary included in a peritoneal sac to prevent adhesions. Three weeks later, at day 3 of a pseudo-pregnancy, the grafts were examined and morphology, presence of adhesions and ovulation were compared with those of a control group. The long-term vascular patency rate was 78%. The ovulation rate was 71.5% in the orthotopic group, 50% in the heterotopic group and 83.5% in the heterotopic group with the ovary in a peritoneal sac. Subcutaneous transplantation of the ovary within a peritoneal sac provides a new and useful experimental model for the study of tubo-ovarian function and for recovery of postovulatory oocytes.

Animals↗

The evolution of experimentally induced hydrosalpinges in rabbits.

Damage to fallopian tubes caused by hydrosalpinges is a major reason for persisting infertility. We describe the mucosal changes that occur following induction of experimentally induced hydrosalpinges in 25 rabbits. Ampullary biopsies obtained at varying intervals were examined with light microscopy and scanning and transmission electron microscopy. Mucosal folds showed progressive atrophy. The epithelium was flattened. The population of ciliated cells decreased and, finally, deciliation became generalized. The morphology of nonciliated cells changed from an initial high content of granules of secretion to a final stage of vacuolated cytoplasm. Cell desquamation was common.

Animals↗

[Techniques of vascular microsurgery and gynaecology (author's transl)].

Vascular microsurgery was applied late to gynaecology. The authors evaluate its use in transplantations of the uterus, the ovaries and the tubes and the experimental as well as the clinical angles. The vascular pedicles that can be used in women are studied from the anatomical point of view as well as the functional and technical angles in order that surgical protocols can be worked out logically for transplantation of the tubes and ovaries.

Animals↗

Endometriosis.

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Endometriosis↗

Tubal lesions subsequent to sterilization and their relation to fertility after attempts at reversal.

Tubal biopsy specimens were obtained at the time of tubal anastomosis in 26 previously sterilized women. Scanning electron microscopy showed that half the patients had abnormalities of tubal mucosa, including loss of mucosal folds, deciliation, and polyposis. These pathologic conditions, the morphologic features of which we describe, significantly increase in incidence the longer the time after sterilization. Our evidence suggests that the sooner reversal is performed after sterilization the greater the change of a successful intrauterine pregnancy.

Adult↗