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Biomedical subjects

E Caspi

Publications and source records attributed to E Caspi.

At least 163 records · Page 9Linked to original sources
PubMed1983

Sterilization at the time of cesarean section: tubal ligation or hysterectomy?

The operative, postoperative and subsequent course of 86 patients who underwent cesarean hysterectomy (C.H.) during the years 1970-1979 are compared to an equal number of cesarean sections with tubal ligation (C.S.L.). Both groups are similar regarding age, gravidity, parity, number of living children and indications for abdominal delivery. Operative and postpartum complications of both groups were all minor, although significantly (p less than 0.05) more frequent in the C.S.L. group. More patients of the C.H. group required blood transfusions than the C.S.L. group (p less than 0.01). The mean period of hospitalization was similar in both groups. Two pregnancies occurred after tubal sterilization, a failure rate of 1:43. During the follow-up period, 49 surgical gynecological procedures were performed in the C.S.L. group compared to 1 in the C.H. group. Ten patients of the C.S.L. group subsequently underwent abdominal hysterectomy. Hysterectomy is the procedure of choice for permanent sterilization and prevention of many subsequent gynecological problems. Consideration must be given to coexisting gynecological conditions while considering sterilization at elective C.S. and C.H. should be offered to those patients.

Adult↗
PubMed1983

Biological activities of 4-fluoro estrogen analogues.

As part of a study on the biological activity of gamma-emitting estradiol analogues, a series of fluorinated and/or brominated analogues of estradiol were synthesized. 4-Fluoro-1,3,5(10-estratrien-3,17 beta-diol (4-fluoro-estradiol) and 16 alpha-bromo-1,3,5(10)-estratrien-3,17 beta-diol (16 alpha-bromo-estradiol) had relative binding affinities (RBA) for the rabbit uterine cytosol receptor which were comparable to those of estradiol. However, while 4-fluoro-estradiol stimulated the increase in uterine weight of immature mice to the same amount as estradiol, 16 alpha-bromo-estradiol was less effective in this assay indicating that its metabolism is probably more rapid than that of estradiol. 16 beta-Bromo-1,3,5(10)-estratrien-3,17 beta-diol had a low RBA and was ineffective in stimulating uterine weight at the doses used. 4-Fluoro-16 alpha-bromo-estradiol had a lower RBA than either the 4-fluoro- or 16 alpha-bromo-estradiol and all the 4-fluoro-seleno-estrogens tested possessed low RBA's.

Animals↗
PubMed1983

Spermatic vein ligation in varicocele: prognosis and associated male and female infertility factors.

The fertility outcome of 129 spermatic vein ligations with good postoperative anatomic results is analyzed. For each couple, specific attention was also directed to other infertility factors. The study analyzes four groups: group I, 55 patients with varicocele only; group II, 16 patients with varicocele and prostatovesiculitis; group III, 16 patients with varicocele and a severe degree of testicular failure; and group IV, 42 patients with a varicocele only and associated female infertility factors. In each group, the pregnancy rate within 6 to 24 months after the operation was recorded. The control subjects were 36 patients with varicocele only who had declined or postponed intervention for 6 months. The best results were obtained in group I. Sperm motility improved following ligation and was associated with a greater percentage of pregnancies within a shorter period: 51% and 62% within 6 and 12 months, respectively, as compared with the control group (14% within 6 months). The prostatic disease required additional treatment for a longer period, but results similar to those of group I were eventually obtained (50% pregnancy rate). With testicular failure or female infertility factors, the prognosis worsened (31% overall pregnancy rate).

Female↗
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↗
PubMed1983

Prediction of respiratory distress syndrome by the fetal lung maturity analyzer microviscosimeter on newborn gastric aspirate.

To predict the development of respiratory distress syndrome (RDS), the authors determined the fluorescent polarization values on gastric aspirates obtained from 67 premature infants within 30 minutes of birth. In 29 cases these results were also compared with the fluorescent polarization values measured on the corresponding amniotic fluid samples. Measurements for microviscosity were made by fetal lung maturity analyzer. Among 15 of 67 premature infants who developed RDS, the fluorescent value measured on gastric aspirates in all 15 infants was greater than 0.320. The fluorescent polarization values were less than 0.320 in all 52 infants in whom RDS did not develop, a predictability of 100%. Direct comparison found fluorescent polarization values measured on gastric aspirates to be somewhat lower than the corresponding amniotic fluid fluorescent polarization values. The results indicate that gastric aspirate obtained within 30 minutes of birth contains swallowed amniotic fluid. In cases where amniotic fluid samples were not available for surfactant evaluation prenatally, the determination of fluorescent polarization values on the newborn's gastric aspirate may accurately predict the development of RDS. The use of the fetal lung maturity analyzer microviscosimeter provides a simple, reliable, and rapid (45 minutes) method for assessment of surfactant in premature infants.

Amniotic Fluid↗
PubMed1983

Unexpected cardiac pathology in pregnant women treated with beta-adrenergic agents (ritodrine).

Premature uterine contractions were treated by intravenous beta-mimetics in 190 patients during a 2-year period. History and physical examination were directed toward identification of patients with cardiac problems. Unexpected cardiac pathology was discovered in 14 patients, all of whom exhibited severe and continuous nausea, retrosternal pain, or dyspnea during beta-mimetic administration. Treatment was immediately discontinued in the presence of S-T depression, supraventricular tachycardia, nonspecific T wave changes, and sinus tachycardia with right axis deviation. Further investigation revealed obstructive cardiac myopathy in one case and atrial septal defect in another. Such changes might be identified earlier by more extensive screening procedures (such as electrocardiogram) before drug administration. Administration of beta-mimetic agents may uncover previously unexpected cardiac pathology. Continuation of ritodrine in such cases is contraindicated and potentially hazardous.

Adult↗
PubMed1983

Prolapse of the cord: reduction of perinatal mortality by bladder instillation and cesarean section.

The fetal outcome in 135 cases of cord prolapse seen during the period 1970-79 was studied. The fetus was alive at diagnosis in 127 cases. In 88 (69.3%) of the cases, the cord prolapsed during the first stage of labor and they were managed by Vago's method of rapid instillation of saline into the bladder to relieve cord pressure during preparation for cesarean section (CS). In the remaining 39 cases, the cord prolapsed during the second stage of labor and the patients were delivered vaginally. The overall perinatal mortality rate was 8.1%. The perinatal mortality rate among cases with a live fetus at diagnosis was 2.4%. In spite of a long diagnosis-delivery interval, no fetal deaths occurred in the 88 cases managed by bladder instillation and CS. Vaginal delivery of footling presentations was associated with a fetal mortality of 18.2%. The infant depression rate was significantly higher in breech vaginal deliveries than in CSs (P less than 0.001). Fetal bradycardia at the time of diagnosis was associated with an increased infant depression rate following vaginal delivery (39%) as compared with CS (10%). The CS rate in this series is the highest and the perinatal mortality among the lowest yet reported.

Cesarean Section↗
PubMed1982

Improved fertility following ectopic pregnancy.

The reproductive performance subsequent to operative removal of ectopic pregnancy was examined in 154 women. They represent 64% of 242 women admitted for ectopic pregnancy between 1969 and 1979. The follow-up period averaged 4.2 years. The patients at risk had a conception rate of 81%, with a repeat ectopic pregnancy incidence of 7.8%, and 65% had at least one live birth. Postoperative infertility was significantly associated with (1) previous sterility, (2) coexistent periadnexal adhesions and/or tubual disease, (3) rupture of the ectopic pregnancy, and (4) older age. A statistically significant advantage of conservative over radical treatment, as regards future fertility, was demonstrated only in 53 patients with either history or findings suggestive of previously impaired fertility. Early, prerupture diagnosis and treatment, coupled with conservative and restorative measures, might account for the improved reproductive performance.

Adolescent↗
PubMed1982

Conservative surgery for tubal pregnancy.

Fifty-seven conservative surgical procedures for unruptured tubal pregnancy were performed on 54 patients. Salpingotomy was performed in 44 cases and fimbrial expression of the ectopic gestation was performed in 13 cases. In this patient group, 80% of the patients (39 of 49) experienced intrauterine pregnancy following surgery and 71% (35 of 49) had a live birth. The recurrence rate of tubal pregnancy was 12%. Ninety percent of the patients with a normal contralateral tube had an intrauterine pregnancy following surgery and a 7% recurrence rate of tubal pregnancy, a ratio of 1:15. It is suggested that the indications for the conservative surgical management in patients with unruptured tubal pregnancy should be broadened to all patients interested in future pregnancies and should also be considered in those cases with normal contralateral tube.

Fallopian Tubes↗
PubMed1982

Modulation of endometrial lymphocyte response in menstrual cycle of fertile women.

Endometrial lymphocytes were isolated in two groups of fertile women, 17 of them normal and seven with various clinical problems. In order to study their immunological properties, endometrial and blood lymphocytes were cultured with either phytohemagglutinin (PHA), concanavalin A (Con A), pokeweed (PW), or purified protein derivative (PPD). Lymphocyte response was assayed by tritiated thymidine incorporation. The percent of T cells was estimated by E-rosette formation. In the normal fertile group, endometrial lymphocyte response to PHA and to Con A was found to correlate with the days of menstrual cycle, rising in a linear fashion between days 9 and 24. In the group with clinical problems, no correlation was noted. In neither group were endometrial lymphocyte responses to PW or PPD or percent of endometrial lymphocyte rosette formation influenced by the menstrual cycle. The modulation of endometrial lymphocyte response to PHA or to Con A stimulation in normal fertile women during the menstrual cycle seems unrelated to the number of T cells.

Adult↗
PubMed1982

The biologic activity of selenoestrogens.

For differential imaging of mammary tumors with estrogen receptors and without estrogen receptors we required gamma-emitting estrogen analogues. In this paper we report on the binding properties of 7 alpha-, 16 alpha-, and 17 alpha-methylselenoestrogens and 17 alpha-phenylselenoestrogens relative to the binding properties of estradiol. The selenium-containing estrogens retained the ability to displace [3H]estradiol from the estrogen receptor of rabbit uterine cytosol, although in most instances the displacement was small (3-7% compared to estradiol). The most active compounds were 16 alpha-phenylselenoestrone, 16 alpha-methylselenoestradiol, and 17 alpha-methylselenomethyl-estradiol which had relative binding of 23, 27, and 31%, respectively, compared with that of estradiol. 16 alpha-Methylselenoestradiol was able to translocate the estrogen cytosol receptor to the nucleus, in vitro, but was not able to increase the uterine weight when administered to mice in vivo.

Animals↗