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Biomedical subjects

A Herman

Publications and source records attributed to A Herman.

At least 163 records · Page 9Linked to original sources
PubMed1990

Binovular human ovarian follicles associated with in vitro fertilization: incidence and outcome.

Binovular follicles were found in 15 (0.3%) of 4,695 follicles containing oocytes. These binovular follicles were either with adjacent cumulus complexes (9 cases), or separate corona radiata and common cumulus mass (1 case), or two oocytes within a single zona pellucida (5 cases). In each of the latter form, there was a smaller and a larger oocyte. All the smaller oocytes and two larger ones possessed a germinal vesicle, whereas the remaining three larger oocytes were mature and developed normally. Though being exposed to the same intrafollicular milieu, there can be a difference in the maturity of the nucleus and characteristics of the cytoplasm of both oocytes.

Adult↗
PubMed1990

High-output left ventricular failure after dextran use in an operative hysteroscopy.

High-output left ventricular failure occurred in a patient after a difficult case of hysteroscopic lysis of adhesions using dextran as a distension medium. The excessive dissection in the uterine wall, the long duration of the operation, and the large volumes of dextran probably caused intravasation of dextran into the systemic circulation inducing a significant shift of fluids from the third space. This was possibly assisted by the large volume of fluids given intravenously in a 45-kg patient initiating the reported sequence of events.

Adult↗
PubMed1990

Fetal outcome following inadvertant administration of long-acting DTRP6 GnRH microcapsules during pregnancy: a case report.

Early follicular use of long-acting analogues of gonadotrophin releasing hormone (GnRH) in IVF programmes has caused some concern with respect to its teratogenic potential. In the case reported here, an injection of DTRP6 GnRH microcapsules was given in the 5th week of a spontaneous unsuspected pregnancy. No deleterious effect or teratogenesis of the embryo could be demonstrated at birth or 18 months later.

Adult↗
PubMed1990

Ovarian response in repetitive cycles induced by menotrophin alone or combined with gonadotrophin releasing hormone analogue.

The number of oocytes retrieved for in-vitro fertilization (IVF) has a major influence on the number of embryos developed and pregnancy success. This study was designed to investigate the ovarian response in the same patient under the same and different stimulation protocols. In group A, 19 patients underwent two consecutive cycles, both stimulated with human menopausal gonadotrophin (HMG). Group B comprised 27 patients who experienced two successive cycles treated with the combination of long-acting gonadotrophin releasing hormone analogue (GnRHa) and HMG. Group C included 27 patients whose first cycle was stimulated with HMG alone, and their second with a GnRHa/HMG combination. The mean number of HMG ampoules administered and the duration of treatment were similar in both cycles of group A and B patients while in group C, both the amount and duration of HMG administration were significantly higher and longer in the combined protocol compared to HMG alone. This study demonstrates an identical ovarian response using the same mode of stimulation in repeated cycles, and a significantly improved response with the GnRHa/HMG combination compared with HMG alone in the same patient.

Chorionic Gonadotropin↗
PubMed1990

Platelet counts in maternal and umbilical venous blood at the time of delivery.

Platelet count in 38 paired maternal venous and umbilical venous specimens were determined at delivery. Umbilical values were significantly higher than simultaneous maternal values (p = 0.004), and a significant relationship was demonstrated between umbilical values and maternal values (r = 0.54, p = 0.0004). Associations between platelet counts and acid-base variables were found to be insignificant in the mother and the umbilical cord.

Adolescent↗
PubMed1990

A method of macro-auditing and assessing the preventability of infant mortality using large volume computerized files.

We present a method for auditing and evaluating infant mortality with the aid of a preventability grading system, based on national computerized files of livebirths and infant deaths. Diagnostic categories and specific causes of deaths were classified into one of the following three preventability grades: Preventable (P), Possibly Preventable (PP) and Non Preventable (NP). This classification was then applied to two different scales: Preventability of Condition (PC) and Preventability of Death (PD) from which a third scale--Preventability of Mortality (PM)--was derived. The method was then applied to matched records of 39,786 livebirth and 452 infant death certificates between 1977 and 1984, in a semi-urban region in Israel encompassing 220,000 inhabitants. Comparison of mortality rates, according to the proposed preventability scores, demonstrated that higher infant mortality rate in non-Jewish population, or in Jewish mothers with a lower educational, was present only in the preventable categories (P or PP), while death rates due to non preventable causes were identical for all groups. The suggested macro-auditing method facilitates the assessment of large scale infant mortality rates in terms of preventability.

Congenital Abnormalities↗
PubMed1990

Working while breast feeding among coloured women.

The influence of a wide variety of factors on infants' feeding patterns has frequently been reported. Of growing interest is the role played by economic issues in determining the duration of breast feeding. The present study describes the attitudes toward, beliefs about, and practices in relation to working while breast feeding amongst 220 'Coloured' (of mixed ethnic origin) women. Breast feeding rates are initially high but drop rapidly about the time mothers return to work. Approximately two-thirds of the women studied returned to work in the post partum period. Most report that breast feeding and working are incompatible.

Adult↗
PubMed1990

Polymicrobial infections of the female low genital tract.

A complete microbiologic analysis of nine infectious agents causing low genital tract infection (LGTI) was obtained in 240 young women, of whom 193 were symptomatic for LGTI and 47 were asymptomatic (control group). The polymicrobial nature of LGTI was demonstrated by both the increased frequency of different microorganisms (1.77 +/- 1.09 SD in symptomatic vs. 1.08 +/- 0.98 in asymptomatic patients) and the increased total number of agents (0 agents 8.3 and 36.2%, 1-2 agents 67.4 and 55.3%, greater than or equal to 3 agents 24.3 and 8.5%, in symptomatic and asymptomatic patients respectively). There was a mutual association between Ureaplasma urealyticum and Mycoplasma hominis, where the presence of one nearly doubled the frequency of the other. Of 74 symptomatic patients with a single infectious agent, Chlamydia trachomatis was isolated most frequently, suggesting an important role of this agent in infections of the female low genital tract.

Adolescent↗
PubMed1989

The V beta-specific superantigen staphylococcal enterotoxin B: stimulation of mature T cells and clonal deletion in neonatal mice.

Staphylococcal enterotoxin B is known to be a powerful T cell stimulant in mouse and man. In this paper we show that, for mice, this is because the protein in association with major histocompatibility complex class II molecules stimulates virtually all T cells bearing V beta 3 and V beta 8.1, 8.2, and 8.3, and few others. Neonatal mice given the enterotoxin eliminate all mature, and some immature, T cells bearing these V beta s, demonstrating that tolerance to exogenously administered antigen can be caused by clonal deletion of reactive T cells. The enterotoxin shares these "superantigenic" properties with known self-antigens in mice, Mls-1a and Mls-2a, and a B cell-derived product, a shared property that is unlikely to be coincidental or inconsequential.

Animals↗
PubMed1989

Results of in vitro fertilization and embryo transfer by combined long-acting gonadotropin-releasing hormone analog D-Trp-6-luteinizing hormone-releasing hormone and gonadotropins.

To avoid cancellation of in vitro fertilization (IVF) because of early luteinization, pituitary suppression by gonadotropin-releasing hormone (GnRH) was carried out in 111 cycles. D-Trp-6-luteinizing hormone-releasing hormone (LH-RH) microcapsules were administered intramuscularly at menstruation and menotropin (hMG) stimulation was started 19 days (mean) later. In 3 cycles (2.7%), only early luteinization occurred. The mean number of oocytes per cycle was 6.7, with a fertilization and cleavage rate of 50 and 95%, respectively. A mean of 3.4 embryos were transferred per cycle. The 111 cycles resulted in 34 clinical pregnancies, 41% per cycle with embryo transfer. The early abortion, multiple pregnancy, and ovarian hyperstimulation rates were 24, 18, and 11%, respectively. It is concluded that D-Trp-6-LH-RH/hMG cycles are associated with a very low occurrence of early luteinization, high number of oocytes and embryos, and a substantial incidence of ovarian hyperstimulation syndrome.

Adult↗
PubMed1989

The effect of chronic gonadotropin-releasing hormone analog (D-Trp-6) treatment on elevated and normal serum prolactin levels.

A long-acting GnRHa (D-Trp-6 microcapsules) proved capable of lowering serum PRL levels in a young hyperprolactinemic patient treated for a large myomatous uterus. No similar inhibitory effect was found in normoprolactinemia. Chronic GnRHa therapy may constitute an alternative to the existing forms of treatment for hyperprolactinemia and pituitary adenomas.

Adult↗
PubMed1989

Early, late, and sequential embryo transfer in in vitro fertilization program: a preliminary report.

The timing of ET was evaluated by transferring four embryos at 44 to 48 hours, 68 to 72 hours, or equally dividing and sequentially transferring at 44 to 48 and 68 to 72 hours after insemination. Fifty-one patients were randomly allocated to one of the above protocols. The mean number of blastomeres of embryos transferred at 68 to 72 hours after insemination was significantly (P less than 0.0001) higher than those transferred at 44 to 48 hours. The number of embryos with good morphology was similar in all study groups. The pregnancy rate was similar in the three protocol groups, 53% at 44 to 48 hours, 59% at 64 to 72 hours, and 47% by sequential transfer. There probably is no advantage in delaying the transfer or dividing the embryos into two sequential transfers. It seems that sequential transfer is not associated with any harmful effect.

Adult↗
PubMed1989

D-Trp-6-luteinizing hormone-releasing hormone microcapsules in the treatment of uterine leiomyomas.

Long acting D-Trp-6-luteinizing hormone-releasing hormone (LH-RH) microcapsules, 3.2 mg were given monthly, intramuscularly for a period of 6 months to 26 menstruating patients with symptomatic leiomyomas. The patients ages were 22 to 52 years. Five patients (20%) were infertile. Patient evaluation before initiation of treatment included endometrial biopsy, ultrasonic measurements of uterine and tumor volumes, and bone-mineral density. The patients were periodically followed hormonally and ultrasonographically. A statistically significant reduction in uterine and tumor volumes (maximal after 4 months of treatment) was observed in all the patients except one. Two patients discontinued the treatment after 2 months, preferring surgery. A nonsignificant decrease in the mean bone-mineral density was noted after completion of therapy. Minor side effects such as hot flushes, vaginal dryness, backache, vaginal spotting, and nervousness, were encountered frequently, disappearing within 6 weeks after the last injection. A significant increase in uterine and myoma volume was noted in all the patients at 3 months after treatment.

Adult↗
PubMed1989

Low multiple pregnancy rate in combined clomiphene citrate--human menopausal gonadotrophin treatment for ovulation induction or enhancement.

Sixty-five infertile women, 37 with anovulation, eight with ovulatory disturbances and 20 with unexplained infertility were treated by a combination of clomiphene citrate (CC) from cycle day 5 (or 3) and human menopausal gonadotrophin (HMG) begun 3 days later for induction or enhancement of ovulation. Monitoring was carried out by measuring preovulatory 17-beta-oestradiol (E2) and progesterone (P) concentrations in blood samples and by follicle measurements using ultrasound. Forty-seven pregnancies resulted with a multiple pregnancy rate of 7.7% for those completed. This incidence is very low and within the range found for CC induction and might result from the later commencement of stimulation compared with many other protocols. These results were achieved with a low incidence of ovarian hyperstimulation syndrome (2.6% per cycle). The HMG doses given were low in comparison with those found in other forms of induction. The deleterious effects of this combined mode of induction on cervical mucus and the occurrence of premature spontaneous ovulation were much less than in the sequential mode of treatment. These results suggest that combined induction treatment by CC and HMG as described offers a means of achieving low rates of multiple pregnancies a known complication in the induction of ovulation.

Adult↗
PubMed1989

Ripening the highly unfavorable cervix with extra-amniotic saline instillation or vaginal prostaglandin E2 application.

Extra-amniotic saline instillation using a 26-gauge Foley catheter and vaginal application of prostaglandin E2 (PGE2) were compared. Among 52 cases treated with extra-amniotic saline instillation, the mean Bishop score increased from 1.7 to 7.8 in a mean of 2.8 hours. In all cases but one, an increase of the Bishop score of three or more points occurred during a 6-hour period. Prostaglandin E2 tablets (3 mg) applied in the posterior vaginal fornix (once or twice) resulted in an increase in the Bishop score of three or more points in 39 of 54 cases during the 12-hour study period. The mean Bishop score in these "successful" ripenings using PGE2 increased from 1.9 to 5.6 points during a mean time of 8.5 hours. No severe side effects were registered in either procedure.

Administration, Intravaginal↗