Successful Retrieval Research Articles

Intratesticular Testosterone and Its Precursors among Azoospermic Men: A Pilot Study.

The study aimed to comprehensively analyze testosterone and precursor concentrations in the testicular interstitial fluid (TIF) of men with azoospermia, exploring their significance in the testicular microenvironment and their correlation with testicular sperm retrieval outcomes. We analyzed 37 TIF samples, including 5 from men with obstructive azoospermia (OA) and 32 from men with non-obstructive azoospermia (NOA). Liquid chromatography with tandem mass spectrometry quantified testosterone and precursor levels. Comparative assessments of the outcomes of testicular sperm retrieval were performed between the OA and NOA groups as well as among men with NOA. Men with NOA who had not undergone hormone treatment exhibited significantly higher intratesticular concentrations of testosterone (median 1,528.1 vs. 207.5 ng/mL), androstenedione (median 10.6 vs. 1.9 ng/mL), and 17-OH progesterone (median 13.0 vs. 1.8 ng/mL) than men diagnosed with OA. Notably, in the subgroup of patients with NOA subjected to medical treatment, men with successful sperm retrieval had significantly reduced levels of androstenedione (median androstenedione 5.7 vs. 18.5 ng/mL, p=0.004). Upon a more detailed analysis of these men who underwent hormone manipulation treatment, the testosterone/androstenedione ratio (indicative of HSD17B3 enzyme activity) was markedly increased in men with successful sperm retrieval (median: 365.8 vs. 165.0, p=0.008) compared with individuals with NOA who had unsuccessful sperm recovery. Furthermore, within the subset of men with NOA who did not undergo medical treatment before microdissection testicular sperm extraction but achieved successful sperm retrieval, the ratio of 17-OH progesterone/progesterone (indicative of CYP17A1 activity) was substantially higher. The study suggests distinct testosterone biosynthesis pathways in men with compromised spermatogenesis and those with normal spermatogenesis. Among NOA men with successful retrieval after hormone optimization therapy, there was decreased androstenedione and increased HSD17B3 enzyme activity. These findings have diagnostic and therapeutic implications for the future.

An integrative prediction model of successful sperm retrieval for men with non-obstructive azoospermia.

Microdissection testicular sperm extraction (micro-TESE) is an efficient method for obtaining spermatozoa from patients with non-obstructive azoospermia, but the overall success rate of this surgery is only approximately one-third. This study aimed to construct an integrative prediction model for andrologists to assess the preoperative success retrieval rate. A total of 217 patients diagnosed with non-obstructive azoospermia at the First Affiliated Hospital of Nanjing Medical University were included, in whom sperm was successfully retrieved in 71 patients. We retrospectively analyzed their clinical characteristics and pathological features. Single factor analysis and logistic regression analysis were utilized to validate the predictive performance, and the area under the curve (AUC) analysis was conducted to further assess the clinical diagnostic value of the model. The results showed that a history of Klinefelter syndrome or cryptorchidism, FSH (Follicle Stimulating Hormone) levels, and testicular pathology contributed differently to the nomogram prediction model. Relatively normal FSH levels, a history of Klinefelter syndrome or cryptorchidism, and favorable testicular pathological types were assigned higher scores, with higher scores often accompanying a preferable success rate of sperm retrieval. The integrated model showed good prediction performance, with an AUC (Area Under the Curve) of 0.781 (95% CI (confidence interval) 0.713-0.849). Overall, our integrative model demonstrates excellent prediction performance and may assist andrologists in balancing the benefits of surgery preoperatively.

The wandering ghost: A rare case report dealing with an incarcerated hemodialysis femoral venous catheter and its successful retrieval

Abstract The increasing prevalence of chronic kidney diseases worldwide has eventually increased the demand for dialysis. It is usually achieved by creating an arteriovenous fistula or by the placement of temporary hemodialysis catheters. Without a doubt, the creation of an arteriovenous fistula is the best long-term solution for patients needing frequent dialysis because it carries the least risk of infection. We report a rare case dealing with a fractured and incarcerated single-lumen nontunnel temporary hemodialysis catheter secured in the right femoral vein, and the procedure opted for its successful retrieval from the right external iliac vein.

Investigating discordance between embryologists and histopathologists: analysis of multiple factors in mTESE sperm retrieval outcomes.

The objective of the study is to primarily highlight the consistency between the embryologist and the histopathologist in microdissection testicular sperm extraction and to explore the factors affecting sperm retrieval. The research included 91 patients, aged 20 to 47, who visited our Reproductive Technology center from July 2020 to June 2023. Patient data were collected retrospectively, including demographics, physical exams, lab tests, radiological assessments, genetic analyses, medical histories and histopathological results. Using the Johnsen scoring system for evaluation, the histopathologist identified mature spermatozoa in the specimen in some patients (Johnsen score 8-10); however, the embryologist only declared successful sperm retrieval in 66.6% of them. Overall sperm retrieval rates were lower than expected at 40%. Significant factors influencing sperm retrieval rates included Follicle Stimulating Hormone (p = 0.001), Luteinizing Hormone (p = 0.007), testicular volume (p < 0.001), histopathology (p < 0.001), and alcohol consumption (p = 0.007). A logistic regression model was used to identify the independent predictors of successful sperm retrieval. FSH (p = 0.038), testicular volume (p < 0.001), histopathology (p < 0.001), and alcohol consumption (p = 0.013) emerged as significant predictive factors for the outcome of sperm retrieval. As a result, in addition to patient-related factors, the consistency between the pathologist and embryologist also affects sperm retrieval rates.

Prolegomenon to an "Originary" Politics

Heidegger’s thought presents us with the possibility of, as well as a call for, a “retrieval” (Wiederholung) of what is “unthought” (das Ungedachte) and “unsaid” (das Ungesagte) in the political philosophy of the ancient Greeks. A successful retrieval would lead to an “originary” (ursprünglich) political thinking that enables the “enactment” (Vollzug) of an originary politics, consistent with the possibility of a “second beginning” such as Heidegger deemed necessary and imminent. The task here is to identify “hermeneutic signposts” present in Heidegger’s reading of Plato’s Sophist as a basis for a “prolegomenon” to thinking the unthought. After the signposts are identified, a “Postscript” engages briefly several salient queries that arise from the effort to think about the political with reference to Heidegger’s thought, thus pointing to what remains to be thought beyond the signposting of this prolegomenon.

Retained Inferior Vena Cava Filter Retrieval: Novel Approach Using Tiger Tooth Foreign Body Holding Forceps

Abstract Only about one-third of all inferior vena cava (IVC) filters are successfully retrieved. This is largely due to factors such as IVC occlusion, filter tilt, and caval wall penetration among other reasons. IVC filter retrieval methods currently followed in practice involve the use of standard snares and wires, endobronchial forceps, LASER-tipped sheaths, and even open surgery. However, the success rate of filter retrieval continues to remain low, thereby increasing the risk of complications associated with retained IVC filters. This warrants a need to explore and adopt newer techniques of IVC filter retrieval. In this case report, we describe the novel use of a tiger tooth foreign body holding forceps in the successful retrieval of a retained IVC filter in an elderly man with intracranial hemorrhage.

Rate of testicular histology failure in predicting successful testicular sperm extraction.

The management of Non-Obstructive (NOA) Azoospermia or Obstructive Azoospermia (OA) patients relies on testicular sperm extraction (TESE) followed by intracytoplasmic sperm injection (ICSI). In NOA patients the sperm recovery is successful in only 50% of cases and therefore the ability to predict those patients with a high probability of achieving a successful sperm retrieval would be a great value in counselling the patient and his partner. Several studies tried to suggest predictors of a positive TESE (e.g. FSH concentration), but most concluded that diagnostic testicular biopsy (histology) is best. This is a retrospective analysis of 526 TESE patients. After the extraction of the testis, the resulting sample was immediately given to the embryologist, who examined the tubules for sperm cryopreservation. During the same procedure, a different specimen was destined to the histological analysis. The comparison between the two methodological approaches was carried out through a score. Concordance between TESE and testicular histology outcomes was found in 70,7% of patients; discordance was found in 29,3% of patients. Among the discordance outcomes, in approximately 95% we found at least 1 sperm in the TESE retrieval, while the histology report did not find any spermatozoa or found not enough compared to our evaluation; in only 5% of cases we did not find any spermatozoa or found not enough compared to what was detected in the testicular histology. Based on our experience, to increase diagnostic accuracy, a larger biopsy should be sent to the histopathology laboratory; another option may be to use TESE cell suspension (the same embryologists employ for cryopreservation) for cytological evaluation of spermatogenesis.

Open Surgical Retrieval of a Foreign Body in the Neck: A Case Report

Foreign body retention in the neck may be either traumatic or iatrogenic. Penetrating neck injuries with retained bodies are critical, as the neck serves as a passage for structures essential to life. Therefore, prompt detection and retrieval of the foreign body are paramount in preventing mortality. Here, authors present a case in which a successful surgical retrieval was performed without any postprocedural complications, despite the patient presenting relatively late after the injury. In this case report, a 23-year-old male labourer presented with a right-sided neck swelling two months after a workplace injury involving a shattered metal plate. Imaging confirmed a 15×5 mm hyperdense metallic object penetrating the sternocleidomastoid muscle. Successful open exploration extracted a 1.5 cm metallic shard at the C6 vertebral level, with no major vessel or airway damage. Postoperatively, the patient exhibited no movement restrictions, highlighting the atypical presentation of a retained metallic foreign body and the importance of timely intervention and comprehensive imaging for successful management.

Ethical Considerations in Post-Mortem Sperm Retrieval: A Comprehensive Review.

This comprehensive review delves into the moral and ethical dilemmas surrounding post-mortem sperm retrieval (PMSR) and its implications for creating new individuals. The paper examines the challenges posed by unusual requests for sperm retrieval from the deceased's widow and parents, as well as the broader socio-ethical considerations associated with PMSR. These requests have often been denied due to the absence of established laws and guidelines governing posthumous sperm retrieval and subsequent births, which were once deemed impossible. While some countries have implemented institutional policies to regulate its use to some extent, there remains a lack of standardized rules and procedures for the collection and retrieval of sperm after death. It is essential to introduce institutional guidelines to facilitate requests for assisted reproductive technology (ART) following successful sperm retrieval. Additionally, the development of PMSR legislation is necessary to ensure a proper balance between the moral rights and fundamental rights of the deceased, their family, and any current or future offspring, while providing adequate protection for all parties involved.

Successful Retrieval of Filter Embolic Protection Device Fragment Trapped by a Carotid Stent: A Case Report.

Embolic protection devices are useful for preventing distal embolism during carotid artery stenting (CAS); however, complications have been reported. The successful removal of a filter fragment trapped at the distal edge of a carotid stent during the retrieval procedure is described. CAS was performed for internal carotid artery stenosis in a patient in his 70s, and the carotid stent was successfully placed. During the retrieval procedure, the tip of the filter was trapped at the distal edge of the stent and detached from the filter. Using a snare kit, the filter tip was successfully retrieved, and no postoperative neurological symptoms occurred. The edge of a carotid stent can potentially trap devices. When trapping or fragmentation of a device is suspected, it is necessary to evaluate the situation and cause, and the device should be appropriately retrieved without using force.

Successful retrieval of a retained cerebral protection device using esophageal biopsy forceps

Abstract: Cerebral protection devices (CPDs) often were applied to improve the safety of carotid artery stenting, but the CPD itself may cause fatal complications. We report a case of a retained CPD that was an Emboshield NAV6 device left in situ, which was retrieved successfully with esophageal biopsy forceps.

Reversible bonding in thermoplastic elastomer microfluidic platforms for harvestable 3D microvessel networks.

Transplantable ready-made microvessels have therapeutic potential for tissue regeneration and cell replacement therapy. Inspired by the natural rapid angiogenic sprouting of microvessels in vivo, engineered injectable 3D microvessel networks are created using thermoplastic elastomer (TPE) microfluidic devices. The TPE material used here is flexible, optically transparent, and can be robustly yet reversibly bonded to a variety of plastic substrates, making it a versatile choice for microfluidic device fabrication because it overcomes the weak self-adhesion properties and limited manufacturing options of poly(dimethylsiloxane) (PDMS). By leveraging the reversible bonding characteristics of TPE material templates, we present their utility as an organ-on-a-chip platform for forming and handling microvessel networks, and demonstrate their potential for animal-free tissue generation and transplantation in clinical applications. We first show that TPE-based devices have nearly 6-fold higher bonding strength during the cell culture step compared to PDMS-based devices while simultaneously maintaining a full reversible bond to (PS) culture plates, which are widely used for biological cell studies. We also demonstrate the successful generation of perfusable and interconnected 3D microvessel networks using TPE-PS microfluidic devices on both single and multi-vessel loading platforms. Importantly, after removing the TPE slab, microvessel networks remain intact on the PS substrate without any structural damage and can be effectively harvested following gel digestion. The TPE-based organ-on-a-chip platform offers substantial advantages by facilitating the harvesting procedure and maintaining the integrity of microfluidic-engineered microvessels for transplant. To the best of our knowledge, our TPE-based reversible bonding approach marks the first confirmation of successful retrieval of organ-specific vessel segments from the reversibly-bonded TPE microfluidic platform. We anticipate that the method will find applications in organ-on-a-chip and microphysiological system research, particularly in tissue analysis and vessel engraftment, where flexible and reversible bonding can be utilized.

Combining Contrast-Enhanced Mammography and Radioactive-Free Magnetic Seed Localization of Non-palpable Breast Tumors: A Feasibility Study.

Background: Magnetic seed localization is a novel and reliable technique for perioperative localization of non-palpable breast cancers. However, due to susceptibility artifacts, magnetic seeds cannot be in situ during response monitoring of neoadjuvant chemotherapy with MRI. Contrast-enhanced mammography (CEM) could provide an alternative modality for response monitoring while magnetic seeds are in situ. This feasibility study aimed to investigate whether implanted magnetic seeds cause imaging artifacts in CEM examinations. Methods: A phantom experiment and patient studies were conducted to assess the presence of imaging artifacts caused by magnetic seeds on CEM. Chicken breast filet phantoms containing magnetic seeds were imaged using CEM and MRI. Next, twenty women with non-palpable breast tumors scheduled for breast-conserving surgery were included and received a magnetic marker seed preoperatively. Immediately after seed implantation, postprocedural images were taken using the CEM mode on our mammography units. All images were assessed by two experienced breast radiologists for the presence of artifacts. Descriptive statistics were used to present the study results. Results: The phantom experiment revealed no imaging artifacts on CEM, whereas significant artifacts were present on MRI. This allowed us to continue with the patient studies, in which no imaging artifacts associated with magnetic seeds were observed at all. Surgical outcomes demonstrated successful retrieval of all magnetic seeds and negative surgical margins in 19 out of 20 cases. Conclusion: To the best of our knowledge, this is the first study demonstrating that the combination of CEM and magnetic seeds is feasible and does not cause any significant imaging artifacts.

Successful Retrieval of Rota Burr After Driveshaft Fracture

Rotational atherectomy is an effective procedure for heavily calcified lesions and those that cannot be crossed using conventional percutaneous coronary intervention (PCI) devices. Here, we report a rare case of intracoronary burr entrapment in the coronary artery due to burr disconnection from the driveshaft. A 67‐year‐old man undergoing hemodialysis for nephrosclerosis presented with exertional chest discomfort. Coronary angiography revealed stenotic lesions in the right coronary artery, and PCI was performed using a Rotawire Floppy. During the procedure, the disconnected burr was successfully removed without surgery using the child‐in‐mother technique with a guide extension catheter. Notably, the patient remained hemodynamically stable throughout the procedure and his recovery was uncomplicated. He was discharged on the second postprocedural day. At the 6‐month follow‐up, the patient remained asymptomatic with no evidence of myocardial ischemia. This report informs clinicians of the possibility of burr disconnection and the non‐surgical intervention used for its removal.

Aerosol retrieval over snow using the RemoTAP algorithm

Abstract. In order to conduct accurate aerosol retrieval over snow, the Remote Sensing of Trace Gases and Aerosol Products (RemoTAP) algorithm developed by SRON Netherlands Institute for Space Research is extended with a bi-directional reflection distribution function (BRDF) for snow surfaces. The capability of the extended algorithm is validated with both synthetic measurements and real satellite measurements from the Polarization &amp;amp; Anisotropy of Reflectances for Atmospheric Sciences coupled with Observations from a Lidar (PARASOL), and a comparison has been made to retrievals with the baseline RemoTAP (without a snow kernel). For retrievals with real PARASOL observations, we use pixels over Aerosol Robotic Network (AERONET) stations for validation and we use the MODIS snow cover products to identify pixels over snow. We evaluate the retrieved aerosol optical thickness (AOT) at 550 nm (τ550), single-scattering albedo (SSA) at 550 nm (ω550) and Ångström exponent (AE) for 440–870 nm (AE440−870). The experiments with both synthetic and real data show that the extended RemoTAP maintains capability for snow-free pixels and has obvious advantages in accuracy and the fraction of successful retrievals for retrieval over snow, especially over surfaces with snow cover &gt;75 %. According to the real-data experiment, we find that the retrieval algorithm has difficulty in fitting the PARASOL 1020 nm band, where snow reflectance is significantly lower than that for the visible bands. When we perform a four-band retrieval (490, 565, 670, 865 nm) with the extended RemoTAP, we obtain a good retrieval result for τ550, ω550 and AE440−870. Therefore, the four-band retrieval with the extended RemoTAP is recommended for aerosol retrieval over snow.

AI Model Developed Using Machine Learning for Predicting Sperm Retrieval in Micro-TESE for Nonobstructive Azoospermia Patients

Azoospermia is a severe problem that prevents couples from having their own children through natural pregnancy. In nonobstructive azoospermia (NOA), microdissection testicular sperm extraction (micro-TESE) is required to collect sperm and, at 40%–60%, the sperm retrieval success rate is not very high. Previous studies identified no single clinical finding or investigation that could accurately predict the outcome of sperm retrieval. It would be very valuable to have a factor for predicting the possibility of sperm retrieval in patients with NOA before performing micro-TESE. We retrospectively obtained data from the medical records of 430 patients who underwent micro-TESE from 2011 to 2020. Parameters extracted were age, height, body weight, body mass index, luteal hormone, follicle-stimulating hormone, PRL, total testosterone, E2, T/E2, sperm retrieval, G-band, AZF, medical history, Rt testis, and Lt testis. Prediction One, which does not require coding, was used to create the AI prediction model for sperm retrieval. Prediction One makes the best prediction model using an artificial neural network with internal cross-validation. Prediction One also evaluates the “importance of variables” using a method based on permutation feature importance. The AUC for the AI model was 0.7246, which is acceptable. In addition, among the variables, T/E2 ratios contributed most to predicting whether sperm retrieval was possible or not. However, the difference in T/E2 between successful and unsuccessful sperm retrieval was not statistically significant. In addition, our analysis of data from 20 patients who underwent micro-TESE in 2021 found that in 85%, the actual result matched the result predicted using our novel AI model. We created an AI model for predicting sperm retrieval in patients with NOA before undergoing micro-TESE. In addition, we found that T/E2 ratios contributed most to predicting possibility of sperm retrieval in NOA using machine learning.

Motivation brought to the test: Successful retrieval practice is modulated by mastery goal orientation and external rewards

AbstractWe investigated how learners' motivation impacts the testing effect for complex study materials. High mastery goal orientation was expected to weaken the effect, while external rewards for successful retrieval practice were expected to strengthen it. Two experiments (N = 191) compared restudy, retrieval practice, and retrieval practice with external reward in a between‐subject design. We assessed delayed retention after 1 week. Both experiments revealed a testing effect. Learners' mastery goal orientation moderated the effect in both experiments. It was strong in students with low mastery goal orientation and absent in those with high mastery goal orientation. The external reward failed to enhance the testing effect in Experiment 1, but boosted it in Experiment 2 with more specific criteria for “successful retrieval practice.” In Experiment 2, the reward increased students' retrieval practice effort, improving delayed retention. These results suggest that students' motivation to practice retrieval and to restudy are important boundary conditions for the testing effect.

#85 : Microdissection Testicular Sperm Extraction (Micro-Tese) in Men Non-Obstructive Azoospermia with Very Small Testicular Volume: A Case Series Report

Background and Aims: Testicular atrophy is a common clinical manifestation of NOA, with a rate of 79.1%. The results of sperm retrieval using the mTESE method in a special NOA for testicular atrophy with volume [Formula: see text]5ml are currently inconsistent. As a result, we present the results of sperm retrieval using the mTESE method to patient NOA, who has a bilateral testicular volume [Formula: see text]5ml. Methods: A case series report of NOA with bilateral testicular volume [Formula: see text]5ml that indicated mTESE surgery to collect sperm at the assisted reproductive technology center of Tam Anh Ha Noi General Hospital between January 2022 and December 2022. Results: Four of seven NOA patients (57.1%) had successful sperm retrieval using the mTESE method, with bilateral testicular volume [Formula: see text]5 ml and a mean FSH level of 40,5 ± 21,9 (24,1-87,6) mIU/mL. In which case, 3/4 of patients simply require surgery on the monolateral testicular is sufficient sperm. Conclusions: Testicular atrophy does not appear to impair sperm retrieval results by the mTESE method, even the sperm retrieval rate tends to be higher in NOA patients with bilateral testicular volume [Formula: see text] 5ml.

State-dependent memory retrieval: insights from neural dynamics and behavioral perspectives.

Memory retrieval is strikingly susceptible to external states (environment) and internal states (mood states and alcohol), yet we know little about the underlying mechanisms. We examined how internally generated states influence successful memory retrieval using the functional magnetic resonance imaging (fMRI) of laboratory mice during memory retrieval. Mice exhibited a strong tendency to perform memory retrieval correctly only in the reinstated mammillary body-inhibited state, in which mice were trained to discriminate auditory stimuli in go/no-go tasks. fMRI revealed that distinct auditory cues engaged differential brain regions, which were primed by internal state. Specifically, a cue associated with a reward activated the lateral amygdala, while a cue signaling no reward predominantly activated the postsubiculum. Modifying these internal states significantly altered the neural activity balance between these regions. Optogenetic inhibition of those regions in the precue period blocked the retrieval of type-specific memories. Our findings suggest that memory retrieval is under the control of two interrelated neural circuits underlying the neural basis of state-dependent memory retrieval.

Optical Constituent Concentrations and Uncertainties Obtained for Case 1 and 2 Waters From a Spectral Deconvolution Model Applied to In Situ IOPs and Radiometry

AbstractA spectral deconvolution model (SDM) for inversion of light absorption, a(λ) and backscattering, bb(λ), to estimate concentrations of chlorophyll (CHL), colored dissolved organic material (CDOM) and non‐biogenic mineral suspended solids (MSS) in offshore and shelf waters is presented. This approach exploits the spectral information embedded in the ratio bb(λ)/a(λ), without the need to know each parameter separately. The model has been applied to in situ inherent optical properties (IOPs), a(λ) and bb(λ), and to in situ remote sensing reflectance, rrs(λ). CHL, MSS, and CDOM estimates are provided by propagating uncertainties in input IOPs and material‐specific IOPs using a bootstrapping approach. Application of the SDM to a data set collected in the Ligurian Sea provides Mean Average Errors (MAE) of &lt;0.7 mg m−3 for CHL, &lt;0.02 m−1 for CDOM, and &lt;0.2 g m−3 for MSS. The SDM is found to perform as well as, or in some cases better than, single parameter algorithms and other semi‐analytical algorithms (SAA) for each parameter for the Ligurian Sea data set. The SDM CHL product is tested using the NOMAD, Case 1 dominated, global data set and found to perform consistently with the quasi‐analytical algorithm (Lee et al., 2002, https://doi.org/10.1364/ao.41.005755) but with slightly poorer performance than standard OCx algorithms. However, the additional estimates of CDOM and MSS provided by the SDM suggest that the approach may be particularly useful for Case 2 waters. Successful retrieval of constituent concentrations with uncertainties suggests good potential to adapt this technique for satellite remote sensing.