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Biomedical subjects

A Herman

Publications and source records attributed to A Herman.

At least 109 records · Page 6Linked to original sources
PubMed1994

Differential replication of plasmids during stringent and relaxed response of Escherichia coli.

Stringent control of DNA replication has been demonstrated for a few replicons like oriC, pBR322, and plasmids derived from coliphage lambda. In this study we investigated the replication of other plasmids harboring a well defined origin (orip15A, oripSC101, and oriRK2 = oriV) in amino-acid-starved stringent and relaxed strains of Escherichia coli. We found differential replication of plasmids during stringent and relaxed response. Inhibition of DNA synthesis or amplification of plasmid DNA in amino acid-starved relA+ and relA- cells depends on the kind of replicon and, surprisingly, on the nature of deprived amino acid. We conclude that there are no general rules for stringent control of DNA replication and each replicon must be considered separately. There are, however, possible explanations for the differences shown between replicons in their response to stringent and relaxed conditions.

Amino Acids↗
PubMed1994

Development of children born after ovarian superovulation induced by long-acting gonadotropin-releasing hormone agonist and menotropins, and by in vitro fertilization.

The use of a gonodotropin-releasing hormone (Gn-RH) agonist in an in vitro fertilization (IVF) program raises the question of any influence on the physical, neurologic, and mental development of the children. We compared the development of children born after long-acting Gn-RH agonist treatment with that of children born after spontaneous pregnancies. Children from singleton pregnancies and > or = 28 months of age were examined by a pediatric neurologist and a psychologist who did not know to which group the children belonged. The General Cognitive Index test was used. Each group included 30 children. Five children cooperated only partly. Physical and neurologic findings were normal in all children, except that one in the group born after in vitro fertilization had diffuse hypotonia, attention-deficit hyperactivity disorder, and hyperactivity. The General Cognitive Index for the 26 children in the study group and the 29 children in the control group who fully cooperated were 102 +/- 13.3 and 106 +/- 13.5, respectively (p = 0.37). The verbal perception, motor, and memory indexes were not significantly different. We conclude that the long-acting Gn-RH agonist had no clinically identifiable influence on the development of these children.

Adult↗
PubMed1994

Ultrasonic control without hormone determination for ovulation induction in in-vitro fertilization/embryo transfer with gonadotrophin-releasing hormone analogue and human menopausal gonadotrophin.

A total of 114 patients admitted to an in-vitro fertilization-embryo transfer programme for the first time, were randomly assigned to the study group or controls. Gonadotrophin-releasing hormone analogue (GnRHa) and human menopausal gonadotrophin (HMG) were used for ovulation induction. The study patients were followed up merely by ultrasonography and the controls by ultrasonography and serum determinations of oestradiol, progesterone and luteinizing hormone (LH). There was no significant difference in the duration and total amount of HMG used for ovulation induction (10.9 versus 11.5 days and 34.8 versus 37.9 ampoules, respectively). The number of oocytes retrieved (11.7 versus 13.4) and the numbers of embryos replaced (2.6 versus 2.8) and cryopreserved (1.9 versus 3.3) were also similar. Pregnancy rates were similar. Pregnancy rate per ovum retrieval was 22.2 versus 25% and per embryo transfer 27.2 versus 26.5%. Oestradiol patterns were also similar. The rate and severity of ovarian hyperstimulation syndrome were virtually identical. We conclude that 'ultrasound-only' monitoring of ovulation induction in IVF cycles treated by GnRHa-HMG in the long protocol is as effective and safe as the conventional ultrasound and hormone determination, but far simpler, swifter and more cost-effective.

Adult↗
PubMed1994

Critically ill obstetrical patients: outcome and predictability.

OBJECTIVE: To determine the applicability of the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system in predicting outcome in a subgroup of critically ill obstetrical patients. DESIGN: Retrospective data collection. SETTING: A multidisciplinary intensive care unit (ICU) in a university hospital. PATIENTS: All patients (n = 1,670) admitted for > 24 hrs to the ICU during an 8-yr period, of whom 58 were obstetrical patients and 120 were nonobstetrical young women. MEASUREMENTS AND MAIN RESULTS: The mean APACHE II score in the obstetrical group was 11, with a mortality risk of 16.6%. In this group, the mortality ratio, which is the ratio between actual and predicted mortality rate, was low (0.416) and significantly (p = .021) different from the expected mortality ratio of 1. The mean APACHE II score in the group of nonobstetrical young women was 10, with a mortality risk of 10.17%. In all nonobstetrical ICU patients including all the admitted patients excluding the obstetrical patients, the mean APACHE II score was 15, with a mortality risk of 24.18%. The mortality ratio in the nonobstetrical young women group and in the nonobstetrical ICU patient group was 0.986 and 1.006, respectively, which was nonsignificantly different from the expected mortality ratio. CONCLUSIONS: Obstetrical patients requiring intensive care in our ICU had a better outcome than predicted, as expressed by a low mortality ratio. Various explanations that may be applicable to any subgroup of critically ill patients with a different mortality ratio are presented. The subgroup itself may be uniquely different, similar to our obstetrical patients with their physiologic changes of pregnancy. Another explanation may relate to an improvement in care of the subgroup and therefore a better outcome.

Critical Illness↗
PubMed1994

Human decidua-associated protein 200 levels in uterine fluid at hysteroscopy.

Hysterosocpic intrauterine findings and levels of human decidua-associated protein 200 (hDP 200) in the uterine fluid were recorded in 116 women investigated for infertility or recurrent abortions. The levels of hDP 200 were significantly higher in the presence of submucous myomas or endometrial polyps, and lower in the presence of intrauterine adhesions in comparison to those in normal uterine cavities. hDP 200, an immunoglobin secreted by the endometrium, may be involved in implantation and placentation and its level in the uterine cavity is influenced by the presence of intrauterine pathology.

Abortion, Habitual↗
PubMed1994

Memory impairment in patients with stereotaxic lesions to the hippocampus and amygdala.

The study aimed at testing: (1) whether stereotaxic damage to the hippocampus and amygdala results in a memory deficit, (2) whether the memory functions subserved by the hippocampus are lateralized and (3) whether time limited storage of sensory information is impaired after focal hippocampal and amygdalar lesions. Seven patients with unilateral stereotaxic damage to the anterior part of hippocampus and unilateral or bilateral damage to the medial part of amygdala and 11 control subjects with no brain damage participated in the research. They were presented with memory tests that required either remembering a spatial arrangement of simultaneously presented verbal vs nonverbal stimuli or a temporal order of sequentially presented items. Moreover, a sensory information storage test was used. The results indicate that even small damage limited to the anterior part of the hippocampus and medial part of the amygdala results in a mild memory deficit. Memory impairment was not related to the side of hippocampal lesion. This suggests that memory function subserved by the hippocampus is not lateralized. Differential effects of left and right lobectomies found in previous studies were, thus, probably due to the damage to temporal cortex. The results showed, however, that sensory information storage limited to 3 s is not impaired after focal damage to the hippocampus and amygdala. A clear lateralization effect showing right hemisphere advantage in that function was found.

Amygdala↗
PubMed1994

Prenatal care access and pregnancy outcomes in Missouri.

Women's access to prenatal care and perception of barriers to obtaining care were acquired from data derived from the 1990 NICHD/Missouri Maternal and Infant Health Survey. Maternal surveys were available for 479 fetal deaths, 902 VLBW, 802 MLBW, and 919 normal birth weight infants. Very low birth weight mothers were less likely to receive prenatal care, perceived more barriers to obtaining prenatal care, and were more unhappy about their pregnancy than were the mothers of normal weight infants.

Female↗
PubMed1994

Individual differences in the functional asymmetry of the human brain.

Standard models of hemispheric asymmetry assume the dychotomous division of functional competence between the two hemispheres. Individual subjects, however, often do not fit such prototypical patterns and show great variation with respect to the functional differentiation of their hemispheres. The present paper reviews the results of some of our investigations on the effect of various subject related factors on brain lateralization. Among these individual experience, gender and handedness seem to be of most significance.

Dominance, Cerebral↗
PubMed1993

The use of intravenous gammaglobulin, heparin and aspirin in the maintenance of pregnancy of freeze thawed embryo in a patient with lupus-type anticoagulant.

A case of lupus anticoagulant and repeated fetal loss with a successful delivery of a healthy baby after transfer of thawed frozen embryos and intravenous immunoglobulin administration is described. The repeated fetal loss was due to vascular disturbances caused by lupus anticoagulants. Early implantation was not affected. Anticoagulants and/or steroids did not help in further establishing pregnancy. Intravenous immunoglobulin combined with heparin and aspirin led to term pregnancy and the birth of a healthy child.

Adult↗
PubMed1993

Cytogenetic analysis of the oocyte and embryo after removal of the zona pellucida following failed fertilization.

Cytogenetic analysis of the oocyte and embryo after removal of the zona pellucida provides a simple screening method for examining the oocyte and embryo and considering the morphological abnormalities of the zona and adjacent formations, cytoplasm and nucleus. Seventy-one unfertilized oocytes and 27 embryos with poor morphology or cleavage arrest were studied after fixation, staining and mechanical removal of the zona. Fixation was done with a glutaraldehyde solution (1%). The oocytes and embryos were then stained, causing weakening of the zona. A slight pressure on the cover slide led to rupture of the zona and the exposure of the oolema. The oocytes and embryos were analyzed for sperm attachment to and penetration through the zona, appearance of the polar bodies, differentiation of blastomeres from cytoplasmic fragments, nuclear status--pyknotic non-analyzable form, chromosomes or different degenerative appearances of DNA. Peeling of the zona is an easy and reliable screening technique needing only an ordinary light microscope. It provides the advantage of observing the whole structure of the oocyte-embryo, not just the chromosomes as in classical cytogenetic methods.

Female↗
PubMed1993

Dynamic ultrasonographic imaging of the third stage of labor: new perspectives into third-stage mechanisms.

OBJECTIVE: Dynamic ultrasonographic imaging of the third stage of labor was performed to document ultrasonographic findings and to present new perspectives into third-stage mechanisms. STUDY DESIGN: Twenty-five normal deliveries and five with prolonged third-stage labor were studied. RESULTS: Normal third-stage labor could be divided into four phases: (1) latent phase, characterized by thick, placenta-free wall and thin, placenta-site wall; (2) contraction phase, with thickening of placenta-site wall (from < 1 cm to > 2 cm); (3) detachment phase, in which the placenta completes its separation and detaches; and (4) expulsion phase, with a sliding movement of the placenta. Although oxytocic agents were routinely used, they do not seem to influence the findings. In five cases with retained placenta the placenta-site wall was initially thin. In four of them it became thick, and the placenta was removed by traction of the cord, whereas in the fifth case the placenta-site wall remained thin and the placenta had to be removed manually. CONCLUSION: Shearing forces seem to tear the decidual septae and thereby separate the placenta. This process is completed only when the placenta-site wall attains full thickness. In cases of prolonged third-stage labor, traction of the cord should be applied only when this phase is completed and the actual sliding movement of the placenta is observed.

Female↗
PubMed1993

Overstimulated cycles under low-dose gonadotrophins in patients with polycystic ovary syndrome: characterization and management.

Among 30 patients with polycystic ovary syndrome, treated with low-dose gonadotrophins, 75 cycles were analysed in order to characterize overstimulated cycles that were at increased risk of developing ovarian hyperstimulation. Optimal response (one or two follicles > or = 14 mm diameter) was observed in 59 cycles (79%). The remaining 16 cycles (21%) exhibited an overstimulated response characterized either by growing more than two follicles or having an oestradiol level > 850 pg/ml (2 SD above the mean observed in optimal cycles). Six of the latter were handled prospectively when oestradiol levels were found to be too high according to the size of the leading follicle. This stage was termed as developing overstimulation and its identification was based on objective criteria obtained from the optimal group. Following the withholding of gonadotrophin, the follicles continued to grow; however, the final oestradiol level was lower compared with six other matched overstimulated cycles. Overall, 14 patients conceived (47%) of whom three (21%) had multiple pregnancies. Mild or moderate ovarian hyperstimulation syndrome occurred in three cases; all of which involved overstimulated cycles. Low-dose gonadotrophin treatment is associated with a substantial degree of overstimulated response. All cycles should be monitored carefully in order to recognize the overstimulated response, which deserves cautious management.

Dose-Response Relationship, Drug↗
PubMed1993

Human chorionic gonadotrophin is a better luteal support than progesterone in ultrashort gonadotrophin-releasing hormone agonist/menotrophin in-vitro fertilization cycles.

In an attempt to determine the best luteal support in in-vitro fertilization (IVF) cycles treated with gonadotrophin-releasing hormone agonist (GnRHa) and human menopausal gonadotrophin (HMG) by the ultrashort protocol, 60 patients were prospectively randomized for either i.m. progesterone or human chorionic gonadotrophin (HCG) luteal support. The two groups did not differ in the mean number of oocytes retrieved and embryos replaced, nor in the mean age of the patients and the amount of HMG used. HCG maintained higher levels of oestradiol and progesterone during the luteal phase. Conception rate was significantly higher in the HCG group. We conclude that HCG is superior to i.m. progesterone as luteal support in IVF cycles in which GnRHa is used in the ultrashort protocol.

Adult↗
PubMed1993

A simplified preinduction scoring method for the prediction of successful vaginal delivery based on multivariate analysis of pelvic and other obstetrical factors.

Most of the popular preinduction scoring methods were created three decades ago, applied to selected populations and based on analysis of each factor separately. In order to overcome these limitations and to try and create a simple and reliable scoring method, 401 inductions of labor were analyzed. Failure was defined as delivery by cesarean section, regardless the indication. Results of multivariate analysis demonstrated that only two of the five factors used by Bishop's method were included (cervical dilatation and fetal head station). Gestational age and parity also constituted important factors and thus the new method incorporates these four factors. The variables among each factor were scored according to their relative risk, obtained from the analysis; dilatation 3 cm or more = 2, dilatation 1-2 cm = 1, fetal head station -1 cm or lower = 1, multiparity = 1, term delivery = 1, closed cervix = 0, station -2 cm or higher = 0, primiparity = 0 and non-term delivery = 0. Comparison of the suggested scoring method and Bishop's method demonstrated that in the low score category our method predicted more accurately cesarean section rate (44.7% and 27.6%, respectively). No difference was noted among the middle or high score groups. More studies among other populations may clarify whether our proposed method really overcomes other methods concerning simplicity, universality and predictability.

Birth Weight↗
PubMed1993

Brain lateralization and severity of stuttering in children.

Cerebral lateralization in visual perception was investigated in 9 severe stuttering, 11 mild stuttering and 48 fluent speakers. The subjects were asked to identify words presented in the left or right visual field for 20 ms. Children responded by pointing to the exposed test word on a response card which contained four different words. Errors committed in the left and right visual fields were analyzed. The data showed a left hemisphere superiority in the processing of words in both the mild stutterers and the fluent speakers, but a right hemisphere advantage in the severe stutterers. The results suggest a close relationship between the severity of stuttering and functional brain organization.

Child↗