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Biomedical subjects

A Brzezinski

Publications and source records attributed to A Brzezinski.

At least 73 records · Page 4Linked to original sources
PubMed1990

Myofibroblastoma of the tunica testis: evolving phase of so-called fibrous pseudotumor?

A collagen-rich stromal tumor attached to the testicular tunica albuginea of a 22-year-old male is reported. Immunocytochemical and ultrastructural characterization revealed a predominant population of myofibroblasts, an as yet unrecognized observation in tumors arising from testicular tunics. The possible relationship with so-called fibrous pseudotumor (nodular fibrous proliferation) is discussed. The myofibroblastic nature of the cell population would support the hypothesis of a reactive contractile process if one accepts this tumor as an evolving phase of fibrous pseudotumor.

Adult↗
PubMed1990

Azathioprine therapy in chronic ulcerative colitis.

We evaluated the efficacy of azathioprine (Az) therapy in chronic ulcerative colitis (CUC) retrospectively in a clinic population from 1977 to 1987. The study was an open one. Sixteen patients were treated with a total of 20 courses of Az. Mean dose of Az was 1.48 mg/kg/d (range 0.98-1.82). All patients were on oral prednisone at the initiation of Az therapy. Indications for Az were: inability to wean off steroids without symptoms of CUC (12/20), poor response to steroids (7/20), and steroid toxicity (1/20). Responses to Az occurred in 15/20 courses (12/16 patients). Two patients had side effects requiring Az discontinuation. The mean duration of follow-up was 52.6 months with no incidence of malignancies. We conclude that the use of Az in selected patients with CUC who are steroid resistant or steroid dependent may be both efficacious and safe.

Adolescent↗
PubMed1990

Precocious puberty following head injury. Case report.

A 6-year-old girl developed secondary sexual characteristics 5 months after severe closed head injury. Endocrinological tests confirmed a pubertal sexual condition; there was also diminution of serum melatonin and disruption of the diurnal pattern. Magnetic resonance imaging demonstrated focal hypothalamic injury; this is believed to be the first time such a posttraumatic lesion has been demonstrated by imaging techniques. The pathophysiology of this condition is discussed.

Brain Stem↗
PubMed1989

Effect of nutrient intake on premenstrual depression.

We examined the occurrence and coincidence of depressed mood and excessive carbohydrate intake in 19 patients who claimed to suffer from severe premenstrual syndrome and in nine control subjects, all as inpatients, during the early follicular and late luteal phases of their menstrual cycles. Mood was assessed with the Hamilton Depression Scale and an addendum that evaluated fatigue, sociability, appetite, and carbohydrate craving. Calorie and nutrient intakes were measured directly. The subjects with premenstrual syndrome significantly increased calorie intake during the late luteal phase (from 1892 +/- 104 to 2395 +/- 93 kcal, mean +/- SEM); carbohydrate intake increased by 24% from meals and by 43% from snacks. Protein intake failed to change, whereas intake of fat, a fixed constituent of all of the test foods, rose in proportion to calorie intake. The Hamilton Depression Scale and addendum scores rose from 2.0 +/- 0.5 to 21.2 +/- 0.8 (Hamilton Scale) and from 0.5 +/- 0.5 to 10.2 +/- 0.6 (addendum) among subjects with premenstrual syndrome during the luteal phase but failed to change among the controls (2.1 +/- 0.8 to 2.4 +/- 0.8, and 0.4 +/- 0.3 to 0.6 +/- 0.3). Consumption of a carbohydrate-rich, protein-poor evening test meal during the late luteal phase of the menstrual cycle improved depression, tension, anger, confusion, sadness, fatigue, alertness, and calmness scores (p less than 0.01) among patients with premenstrual syndrome. No effect of the meal was observed during the follicular phase or among the control subjects during either phase. Because synthesis of brain serotonin, which is known to be involved in mood and appetite, increases after carbohydrate intake, premenstrual syndrome subjects may overconsume carbohydrates in an attempt to improve their dysphoric mood state.

Adult↗
PubMed1988

Risk factors and prognostic variables in the ovarian hyperstimulation syndrome.

This study was undertaken to clarify discriminative roles of multiple epidemiologic, hormonal, and biophysical variables for causation of ovarian hyperstimulation syndrome. Three hundred ninety-six patients with anovulatory infertility had ovulation induction with human menopausal gonadotropin throughout 1822 treatment cycles; 54 cycles (3%) were complicated by ovarian hyperstimulation syndrome. Early follicular serum estradiol and prolactin levels were higher in this group than in controls: 75.5 versus 46.2 pg/ml and 18.5 versus 11.7 ng/ml, respectively (p less than 0.01). On the day of human chorionic gonadotropin administration (day 0) the mean serum estradiol level was 1047 +/- 381 in the group with ovarian hyperstimulation syndrome and 719 +/- 339 pg/ml in controls (p less than 0.0001). In all follicular sizes and in all grades of ovarian hyperstimulation syndrome there was a tendency for more recruited follicles, with significantly more small follicles (12 to 14 mm) present on day 0 in all grades of ovarian hyperstimulation syndrome than in controls. Stepwise logistic regression performed on 22 variables identified a high-risk group for this syndrome; the major features are illustrated by young, lean patients who, after relatively few ampules of human menopausal gonadotropin, develop high estradiol levels and multiple small follicles.

Adult↗
PubMed1988

The circadian rhythm of plasma melatonin during the normal menstrual cycle and in amenorrheic women.

Plasma melatonin, PRL, and LH levels were measured in samples collected every 2 h for 24 h from 14 normally cycling women during the early follicular, periovulatory, and luteal phases of their menstrual cycles. Plasma melatonin levels also were measured in samples collected at the same interval from 7 patients with hypothalamic amenorrhea. A distinct daily rhythm in plasma melatonin was evident in all subjects, with peaks occurring around 0300 h. Each woman's rhythm was remarkably consistent throughout the menstrual cycle (in terms of the phase, amplitude, and total melatonin secreted). Plasma PRL levels also exhibited daily rhythms which did not change during the menstrual cycle; the nocturnal peak plasma PRL level tended to occur 1-2 h after that for melatonin. Among the amenorrheic women, both daytime and nighttime melatonin levels were significantly higher (P less than 0.005) than in the normal women. Their plasma PRL levels were similar to those in the normal women. We conclude that, as for PRL, the circadian rhythm of melatonin secretion does not change significantly during the normal menstrual cycle. The elevated plasma melatonin levels in women with hypothalamic amenorrhea suggest that the hormone may be involved in the neuroendocrine pathology underlying this disorder.

Adult↗
PubMed1987

Periovulatory 17 beta-estradiol pattern in conceptional and nonconceptional cycles during menotropin treatment of anovulatory infertility.

The value of multiple parameters in the prediction of fertile cycles was prospectively evaluated in 52 menotropin-induced cycles. The periovulatory pattern of estradiol (E2) was found to correlate with conceptional cycles. E2 levels greater than 500 pg/ml on the day of human chorionic gonadotropin administration (day 0) with a further increase on day +1 (high ascending pattern--A1) were found to have a 51% predictive value for fertile cycles. Twelve of the 17 fertile cycles had an A1, type of response (71%), whereas the overall incidence of an A1 pattern was 42% (22 of 52). No pregnancies have occurred with preovulatory follicles less than or equal to 14 mm in diameter. The number of preovulatory follicles, E2 level on day 0, and midluteal progesterone had no predictive value for fertile cycles.

Anovulation↗
PubMed1987

Fertility and obstetric history in patients with familial Mediterranean fever on long-term colchicine therapy.

The obstetric histories were examined for 36 women with familial Mediterranean fever (FMF) on long-term colchicine treatment followed for periods ranging between 3 and 12 years. Seven of 28 pregnancies (25%) associated with colchicine therapy ended in miscarriage. Thirteen women (36%) had periods of infertility; these were due to ovulatory dysfunction in six women, to peritoneal adhesions in four and remained unexplained in three women. The rates for miscarriage and infertility are high but are similar to those reported for women with FMF before colchicine therapy was introduced. All 16 infants born to mothers who had taken colchicine during pregnancy were healthy. Currently, we do not advise discontinuation of colchicine before planned pregnancy but recommend amniocentesis for karyotyping and reassurance.

Abortion, Spontaneous↗
PubMed1987

Melatonin in human preovulatory follicular fluid.

Melatonin, the major hormone of the pineal gland, has antigonadotrophic activity in many mammals and may also be involved in human reproduction. Melatonin suppresses steroidogenesis by ovarian granulosa and luteal cells in vitro. To determine if melatonin is present in the human ovary, preovulatory follicular fluids (n = 32) from 15 women were assayed for melatonin by RIA after solvent extraction. The fluids were obtained by laparoscopy or sonographically controlled follicular puncture from infertile women undergoing in vitro fertilization and embryo transfer. All patients had received clomiphene citrate, human menopausal gonadotropin, and hCH to stimulate follicle formation. Blood samples were obtained by venipuncture 30 min or less after follicular aspiration. All of the follicular fluids contained melatonin, in concentrations [36.5 +/- 4.8 (+/- SEM) pg/mL] substantially higher than those in the corresponding serum (10.0 +/- 1.4 pg/mL). A positive correlation was found between follicular fluid and serum melatonin levels in each woman (r = 0.770; P less than 0.001). These observations indicate that preovulatory follicles contain substantial amounts of melatonin that may affect ovarian steroidogenesis.

Chromatography, Thin Layer↗
PubMed1985

Antepartum diagnosis of monoamniotic twin pregnancy.

A case of monoamniotic twin pregnancy complicated by preeclampsia is presented. Early diagnosis was achieved at the 16th gestational age by ultrasonography. The pregnancy was terminated at term by a cesarean section. Both twins survived with excellent outcome. The importance of antepartum diagnosis of this rare condition is discussed.

Amnion↗
PubMed1984

C5a-inhibitor deficiency in peritoneal fluids from patients with familial Mediterranean fever.

Normal peritoneal fluid contains an inhibitor of neutrophil chemotaxis that acts by antagonizing the complement-derived chemotactic anaphyllatoxin C5a. The inhibitor resembles a substance previously described in synovial fluids and is a protein with a molecular weight of approximately 40,000 as determined by gel filtration. In contrast, levels of inhibitory activity in peritoneal fluids from five patients with familial Mediterranean fever were decreased to less than 10 per cent of those found in normal subjects. Gel filtration of peritoneal and synovial fluids from these patients did not yield any fraction with inhibitory activity. We suggest that C5a-inhibitor deficiency in joint and peritoneal fluids from patients with familial Mediterranean fever may have a role in the pathogenesis of the inflammatory attacks characteristic of this disease.

Ascitic Fluid↗
PubMed1984

The use of full-thickness skin grafts in the reconstruction of the male urethra.

Since 1954 full-thickness skin grafts have been used in the repair of a multitude of complex urethral problems. At our institution we have adopted a two team approach utilizing the expertise of both a plastic and a urologic surgeon. We will present our experience with 24 cases of complex urethral strictures. Our results have been very gratifying, with an 80% success rate. The most common complication we have encountered has been restricturing at the proximal or distal anastomotic site. This has been easily overcome with the use of cold knife urethrotomy or regrafting.

Humans↗
PubMed1984

A C5a inhibitor in peritoneal fluid.

Peritoneal fluid was found to contain an inhibitor of neutrophil chemotaxis. The inhibitor was effective only against the chemotactic activity of zymosan-activated serum (including purified C5a) and had no effect when f-met-leu-phe served as chemoattractant. Inhibition was not the result of a direct effect on the neutrophils, since incubation of cells with the peritoneal fluid did not alter their chemotactic response. The inhibitor was found to be a protein with a molecular weight of approximately 40,000 dalton by gel filtration. It resembles the inhibitor previously described by us in synovial fluids, and thus it is proposed to play a role in the regulation of inflammation in serosal tissues.

Ascitic Fluid↗