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Biomedical subjects

A Herman

Publications and source records attributed to A Herman.

At least 199 records · Page 11Linked to original sources
PubMed1988

The value of simultaneous hysterectomy during Burch colposuspension for urinary stress incontinence.

The effect of concomitant hysterectomy during colposuspension on the cure rate of genuine stress incontinence was evaluated prospectively in 45 patients. Twenty-two women underwent a colposuspension only (no-hysterectomy group) and 23 had a concomitant abdominal hysterectomy and cul-de-sac obliteration (hysterectomy group). Twenty-five months postoperatively, no differences were found in the cure rate for urinary stress incontinence between the two groups (95.5 and 95.7% for the no-hysterectomy and the hysterectomy group, respectively). In the no-hysterectomy group, three patients (13.6%) had enterocele formation after surgery; this complication did not occur in any of the patients in the hysterectomy group.

Female↗
PubMed1988

Detrusor instability following colposuspension for urinary stress incontinence.

Sixty-two patients with genuine stress incontinence (group A) and 30 women with combined detrusor instability and genuine stress incontinence (group B) had a colposuspension operation. The proportion with symptoms of detrusor instability was significantly reduced from 24% before operation to 9% after operation in group A and from 73% to 33% in group B. Urodynamically, detrusor instability developed after surgery in 17 of the 62 patients (27%) in group A whereas only 12 of the 30 women (40%) in group B had detrusor instability after surgery. No urodynamic explanation was found to explain the effect of colposuspension in relieving the symptoms of detrusor instability in some and causing them in others. Nevertheless, it is suggested that colposuspension is helpful for most patients with combined detrusor instability and genuine stress incontinence.

Adult↗
PubMed1987

Reproductive outcome after fimbrial evacuation of tubal pregnancy.

Thirty-one ectopic pregnancies were manually expressed (i.e., "milked out") by the tubal fimbria during a 13-year period. Reproductive histories and operative findings were unremarkable when compared with the general population with ectopic gestation. The subsequent reproductive performance was evaluated in 27 patients who attempted conception. Twenty-five (92%) of the 27 patients subsequently conceived, 23 (85%) had at least one successful term pregnancy, and the remaining 2 (7%) had abortions only. There was no repeat ectopic pregnancy. Average follow-up time was 38.5 months. Previous experience with this technique has been disappointing with low postoperative rates of successful term pregnancies. Favorable outcomes after fimbrial expression have been reported only in small numbers of patients. It is suggested that the procedure is appropriate for distal tubal gestations that are loosely adherent within the tubal lumen; these are usually expressed with minimal efforts. However, if the gestational mass does not yield to gentle milking of the tube or evacuation has been incomplete, the surgeon can always use a linear salpingotomy. More experience is obviously needed to verify these preliminary results, suggesting that fimbrial evacuation is simple, safe, and advantageous in properly selected cases.

Adult↗
PubMed1987

Fertility following conservative surgery for tubal pregnancy.

Eighty seven conservative surgical interventions for unruptured tubal pregnancy were performed on 83 patients. Salpingotomy was performed in 66 cases and expression of tubal pregnancy in 21 cases. In this patient group, 76.7% (56 out of 73) experienced intra-uterine pregnancy following surgery and 71.2% (52 out of 73) had a live birth. The recurrence rate of tubal pregnancy was 12.3%. Of the 42 patients with a normal contralateral tube, 36 (85.7%) had an intra-uterine pregnancy, 80.9% had a live birth and 7.1% had a recurrent tubal pregnancy. Sixty percent of the patients who underwent operation on their single tube, had a live birth and 66.6% had an intra-uterine pregnancy; the recurrence of tubal pregnancy in this group was 26.6%. No recurrence of tubal pregnancy was found in the group of patients who underwent expression of tubal gestation. It is suggested that the expression of tubal gestation (milking) is a safe procedure for conserving future fertility, and that the indications for conservative surgical management in patients with unruptured tubal gestation should be broadened to include all patients interested in future pregnancies, regardless of the current state of the contralateral tube.

Adolescent↗
PubMed1987

Influence of vasoactive substances on early toxic acute renal failure in the dog.

The influence of different vasoactive substances on the evolution of HgCl2-induced acute renal failure (ARF) was evaluated in the dog. HgCl2 alone caused a progressive fall in both glomerular filtration (GFR) and renal blood flow (RBF) during the first 3 h of the mercury administration (delta after 3 h: -44% and -39%) and provoked a concomitant stimulation of the renin-angiotensin (RAS) and thromboxane systems. The administration of the thromboxane inhibitor dazoxiben (2 mg/kg i.v. every 2 h) adequately inhibited the activation of the thromboxane system after HgCl2, but could not prevent the fall in GFR and RBF. The continuous intrarenal administration of the Ca2+ entry blocker verapamil (0.005 mg/kg per min) into the left kidney resulted in the prevention of the postmercurial fall in GFR and RBF at the perfusion site. This beneficial effect was immediately lost when the verapamil administration was stopped. Finally, the administration of the converting enzyme inhibitor captopril (300 micrograms/kg every 2 h) resulted in an effective inhibition of the renin-angiotensin system, the prevention of the postmercurial fall in RBF, and the partial attenuation of the fall in GFR. This beneficial effect was immediately lost after the intravenous administration of indomethacin (2 mg/kg). These results indicate that the fall in GFR after HgCl2 can be prevented by vasoactive agents such as captopril and verapamil and point at least in part to a pathophysiological role of the renin-angiotensin system or of an alteration in the equilibrium between renin-angiotensin and prostaglandins. The thromboxane system is seemingly of no major importance.

Acute Kidney Injury↗
PubMed1986

Correlates of early disability in Huntington's disease.

Functional disability in Huntington's disease usually results from a combination of the movement disorder, intellectual decline, and psychopathological changes, but the unique contribution of each element has never been investigated. The Shoulson-Fahn functional capacity rating scale measures independence in such daily activities as eating, dressing, and managing personal finances, and is used to stage the illness and follow its progression. To determine which problems contribute most to reduced functional capacity as the disease evolves, we reviewed the records of 48 consecutive patients who were evaluated for intellectual and emotional status and motor disability. Each patient was staged and rated for functional capacity at the time of the examinations. Thirty-three of these patients were followed over several years with repeat evaluations at 6-month intervals. Intellectual impairment and depression correlated significantly with reduced functional capacity. However, when the somatic symptoms of depression were eliminated from the analysis, its relationship to functional capacity was no longer significant. Duration of illness, motor disability, and age at onset also had little impact. Neuropsychological test performance and functional capacity deteriorated over time. Our data suggest that intellectual impairment is a major factor in reducing functional capacity in the early stages of Huntington's disease.

Activities of Daily Living↗
PubMed1986

AIDS risk-reduction guidelines: a review and analysis.

Until an effective treatment or vaccine for AIDS is developed, the principal strategy for controlling its spread will remain persuading at-risk and diseased populations to modify behaviors implicated in the transmission of the disease. In the case of homosexual and bisexual men the "risk-reduction" or "safe-sex" brochure has emerged as the most widely used public health intervention modality. While there has been a proliferation of such brochures, to date no systematic analysis of the content or potential efficacy of these materials has been undertaken. The authors carry out two kinds of analyses of a sample of risk-reduction brochures. First, these materials are characterized in terms of 13 characteristics related to their content, and style. Second, the extent to which they incorporate the elements of a standard model of health communication is assessed. Limitations of existing brochures are identified and the implications of the findings for the development of future materials are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Electrolyte changes in mesothelioma.

Little has been reported concerning electrolyte changes among patients with mesothelioma. Two studies have suggested that hyponatraemia is particularly common among them and should lead to suspicion of inappropriate secretion of antidiuretic hormone in those patients (Perks et al. 1979; Siafakas et al. 1984). We reviewed serum electrolyte changes in three groups of patients: 48 cases of pleural mesothelioma, 89 of peritoneal mesothelioma, associated with asbestos exposure, and 149 of asbestosis. Five of 48 (10.4%) patients with pleural mesothelioma, 17 of 89 (19.1%) with peritoneal mesothelioma, and 23 of 149 (15.4%) patients with asbestosis without mesothelioma, had hyponatraemia. No statistically significant difference among the groups was found. These findings do not support the proposal that hyponatraemia is unusually common when mesothelioma is present, at least not among patients whose neoplasms are related to asbestos exposure.

Asbestosis↗
PubMed1986

Prostacyclin, thromboxane and prostaglandin F2 alpha; plasma levels in breast cancer.

In this study, 6-keto-prostaglandin F1 alpha, TXB2, and 15-keto-13,14-dihydro-prostaglandin F2 alpha plasma levels (i.e., theprostacyclin, thromboxane, and PGF2 alpha-metabolites, respectively) were determined, using a radioimmunoassay, in 32 breast cancer patients (21 without evidence of disease and 11 with metastases), and in a control group of 16 patients. Neither group of breast cancer patients showed an increased plasma level of any of these products compared with the control group. This study suggests that the increased 6-keto-prostaglandin F1 alpha, TXB2 and prostaglandin F2 alpha levels which have been observed in breast cancer tissues are not detectable in the plasma.

Breast Neoplasms↗
PubMed1985

Prevalence of low genital tract infectious agents in young Israeli women.

Low genital tract infectious agents were examined 411 times in 386 young women. Each examination included anamnesis, physical examination and broad-spectrum microbiologic analysis for the detection of: Ureaplasma urealyticum, Chlamydia trachomatis, Trichomonas vaginalis, Candida species, Mycoplasma hominis, Streptococcus beta hemolyticus Group B, Hemophilus vaginalis, Neisseria gonorrhoeae and syphilis serology. Three hundred and six patients were symptomatic for low genital tract infection and 80 were asymptomatic. Most patients were young, 19.6 +/- 1.7 (SD) years old, single (84.7%) and sexually active (87.4%). U. urealyticum and C. trachomatis were the most common agents recovered in 43.9 and 40.8% of symptomatic patients, respectively. All agents were isolated more frequently in the symptomatic group, but statistically significant group comparisons were obtained only for Candida sp. (P less than 0.001), T. vaginalis (P less than 0.005) and M. hominis (P less than 0.05). N. gonorrhoeae was isolated in only one case (0.3%), which may reflect technical difficulties or a true very low prevalence of this agent. Clinical diagnoses of candidiasis and trichomoniasis in symptomatic patients were confirmed by laboratory results in only 34.9 and 54.9%, whereas negative clinical diagnoses were confirmed in 83.9 and 73.2%, respectively.

Adolescent↗
PubMed1985

Perinatal outcome following physicians' strike of 1983.

Organized public medical services were profoundly disturbed during the 4 months of the physicians' strike in 1983. An unknown proportion of patients were referred to private services, but only a minority of them attended the alternative centers. The findings during the strike and the following 6 months were compared with those of the year 1982. The incidence of high-risk cases and of multiple and premature deliveries were unchanged. There was a significant rise (P less than 0.01) in the rate of cesarean sections during the strike, 10.8%, compared with 7.8% in 1982. Also, a significant reduction in instrumental deliveries and labor inductions was observed during the strike and for 4 months afterwards. There was no change in the perinatal mortality (total and corrected) or in Apgar scores. This indicates that good perinatal results were achieved despite drastic disturbances in organized perinatal care.

Apgar Score↗
PubMed1983

Recognition by xenogeneic cytotoxic T lymphocytes of cells expressing HLA-A2 or HLA-B7 after DNA-mediated gene transfer.

Murine L cells expressing HLA-A2 or -B7 antigens were isolated after cotransformation of thymidine kinase-negative cells with the herpes simplex virus thymidine kinase gene and the genomic clones containing either the HLA-A2 or -B7 genes. Monoclonal antibody binding analyses demonstrated the stable cell surface expression of HLA antigens by these cells at levels of up to 40% of the amount expressed by the human B lymphoblastoid cell line, JY. The HLA-A2 and -B7 antigens expressed by the L cells retained all of the antibody-defined, heavy-chain-associated antigenic determinants but lacked those determinants associated with human beta 2-microglobulin. These HLA transformants were capable of functioning as targets for monoclonal cytotoxic T lymphocytes (CTL) that specifically recognize the HLA-B7 or -A2 antigens expressed by JY cells. However, the efficiency of lysis, relative to the JY cell line, was 50-99% for individual CTL. In addition, not all of these CTL were capable of lysing the appropriate transformants. Because the antigens appear by serological criteria to be structurally intact and expressed at high levels, these results suggest that the complementation of the HLA heavy chains with mouse, rather than human, beta 2-microglobulin may alter the antigenic determinants that are important for CTL recognition.

Animals↗
PubMed1983

"Milking"--a conservative surgical technique for a tubal gestation.

Milking technique was utilized in 13 patients with tubal pregnancies. Following this procedure there were we intrauterine pregnancies in nine women and 10 live births in eight women. No ectopic pregnancies recurred in this group. These results suggest that the milking procedure, whenever possible, may represent a valuable method for conservative surgical treatment of tubal gestation.

Fallopian Tubes↗