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Biomedical subjects

G Ragni

Publications and source records attributed to G Ragni.

At least 37 records · Page 2Linked to original sources
PubMed1997

Semen parameters and conception rates after intraperitoneal insemination.

OBJECTIVE: To analyze the reproductive outcome in infertile couples which underwent intraperitoneal insemination (IPI). METHODS: We analyzed a series of 216 couples who underwent IPI. Indications for treatment were unexplained infertility in 51 couples and male factor in 165. The 51 couples with unexplained infertility underwent a total of 71 cycles (20 couples underwent a second IPI cycle). The 165 couples with male factor underwent 243 cycles (165 first cycles and 78 second cycles). RESULTS: Out of the 314 cycles performed, a total of 41 clinical pregnancies were observed, with a corresponding conception rate of 13.1%. The values of conception rates for unexplained and male factor infertility were 21.1 (based on 15 pregnancies) and 10.7% (based on 26 pregnancies), respectively. Out of the 41 pregnant women, 26 gave birth to a child, thus the overall livebirth rate was 8.3% (12.7 and 7.0%, respectively, for unexplained infertility and male factor diagnostic subgroups). Considering the couples with unexplained infertility, the conception rates were 9.0, 30.8 and 20.0% for strata of < 5, 5-10 and > or = 10 millions of inseminated spermatozoa. The corresponding values were 6.8, 12.5 and 18.5%, respectively, in couples with male factor infertility (chi(2)1 trend p < 0.05). CONCLUSION: In conclusion, this series provides quantitative estimates of pregnancy rates after IPI in Italian couples with unexplained infertility or male infertility and suggested that the number of motile sperm inseminated is a determinant of pregnancy with this technique.

Female↗
PubMed1997

Intercellular adhesion molecule-1 is expressed on human granulosa cells and mediates their binding to lymphoid cells.

Some immune cellular components have been recently demonstrated to play a critical role in ovarian physiology. Resident ovarian white blood cells are known to produce cytokines that modulate granulosa cell (GC) functions and differentiation. Moreover, it has been postulated that, during the formation of the corpus luteum and luteolysis, human luteal cells are able to interact with lymphocytes and macrophages through some adhesion molecules. This study was designed to examine, at messenger RNA and protein levels, whether intercellular adhesion molecule (ICAM)-1, known to be involved in leukocyte-cell binding, is expressed by human GCs. Furthermore, we also investigated whether this molecule could be involved in the complex events that allow the interaction between the ovary and the immune system. GCs, obtained from women undergoing in vitro fertilization procedures, were enzymatically dispersed with collagenase and cultured for different time periods. To assess the presence of ICAM-1 messenger RNA, total RNA obtained from freshly aspirated GCs and GCs luteinized in culture was reverse transcribed and then amplified using two oligonucleotide primers specific for the human ICAM-1 gene. A single major DNA band of the expected size (943 bp) was obtained. The identity of this material with the human ICAM-1 sequence was further confirmed by restriction enzyme analysis. Surface ICAM-1 protein was detected by flow cytometric analysis on luteinized GCs cultured for 7 and 15 days. Finally, to evaluate a possible functional activity of ICAM-1, a 51Cr-release-binding assay between peripheral blood lymphocytes and luteinized GCs was performed in the presence and absence of a monoclonal antibody against ICAM-1. As a result, lymphocyte adhesion to GC monolayers was significantly, but not completely, inhibited by the anti-ICAM-1 monoclonal antibody. These findings demonstrate that intercellular interactions between GCs and the immune system are, at least in part, mediated by the adhesion molecule ICAM-1. Based on this data, we might speculate that this molecule could participate in the remodeling processes of the ovarian endocrine compartment.

Antibodies, Monoclonal↗
PubMed1996

Effect of galanin on growth hormone (GH) response to thyrotropin releasing hormone of rat pituitary GH-secreting adenomatous cells (GH1) in culture.

The growth hormone (GH) releasing effect of thyrotropin-releasing hormone (TRH) and galanin, a 29-amino acid peptide widely distributed in mammalian CNS, alone or in combination was investigated in cultured rat pituitary tumor cells (GH1). TRH stimulated GH secretion in GH1 cells (maximal stimulation at the dose of 0.1 microM). Galanin alone had a significant GH inhibitory effect in GH1 cells at all the doses used. When the two peptides were administered in combination, no significant changes as compared to baseline levels were observed. The results of this study indicate that galanin has potent direct inhibitory effects on baseline and TRH-stimulated GH release from rat tumor cells.

Adenoma↗
PubMed1994

Anthropometric indicators and response to gonadotrophin for ovulation induction.

A total of 111 women with no ultrasonographic findings of polycystic ovarian syndrome were observed between January 1989 and December 1991 in an in-vitro fertilization (IVF) programme. The treatment schedule involved ovulation induction after treatment with a gonadotrophin-releasing hormone (GnRH) agonist, using standard doses of human menopausal gonadotrophin (HMG) for 4 days, and further stepwise increments in dosage as required. Response to the treatment was defined as: (i) presence/absence of one or more follicles > or = 10 mm diameter after 4 days of treatment, and (ii) oocyte retrieval. Three indices of body mass were considered: weight (W) in kg/height (H)2 in metres (Quetelet's index), W/H1.5 (the National Health and Nutrition Examination Survey anthropometric index for women), W0.30/H (ponderal index). Surface area was computed as 0.0235 (H in cm0.422) (W in kg0.515). Women in the upper tertiles of the range of anthropometric indicators more frequently tended to present no follicle > or = 10 mm on day 7. Likewise, oocytes were retrieved less frequently in subjects in the higher tertile than in those in the lower. The odds ratio of a negative response both on day 7 and at the end of treatment increased with the tertiles of body mass indices or surface areas. This study suggests that response to ovulation induction treatment is inversely related to body mass index.

Adult↗
PubMed1994

A modified technique for correction of the complete septate uterus.

When correcting a complete uterine septum, it is recommended that one should spare the cervical portion to avoid the possible risk of cervical incompetence. However, it may be difficult to create a communication between the uterine cavities above the internal os. In seven patients with complete septate uterus we incised the cervical portion with Metzenbaum scissors and the corporal portion with microscissors under hysteroscopic guidance. The operating times were shorter and the distension fluid deficit smaller compared with nine historical controls in whom the cervical septum was spared. No intraoperative or obstetric complications were associated with cervical septal section. This modified technique is simple, rapid, safe, inexpensive, and may be considered among the alternative treatments to correct a complete septate uterus.

Abortion, Habitual↗
PubMed1993

Does contraception modify the risk of endometriosis?

Long episodes of regular, prolonged, abundant menstrual flows are generally agreed to increase the risk of endometriosis. Since oral oestrogen-progestogen combinations reduce and intra-uterine contraceptive devices increase menstrual flow, an effect on the risk of development of endometriosis in women utilizing these forms of contraception could be expected. Analysis of the most recent epidemiological observations shows no consensus on a possible relationship between use of cyclic oral contraceptives and endometriosis, with an increase, a decrease, and no effect on the risk of developing the disease all being reported. A lower relative risk of endometriosis in previous users of the intrauterine contraceptive device was only found in two series, most of the other data suggesting a rise in risk or no effect. Further studies on the relationship between type of contraception and endometriosis are needed to demonstrate whether the risk of development of the disease could be influenced, and whether well tolerated, relatively inexpensive, long-term treatment might be available for symptomatic patients not desiring offspring.

Contraceptives, Oral↗
PubMed1993

Morphology and nuclear contents in IVF embryos.

Human pre-embryos, at 2-8 cells, with different morphology have been examined for chromosome constitution. Concerning the informative pre-embryos (23/65), 11 showed a normal karyotype and in 12 an abnormal karyotype was observed; there was not a complete correspondence between pronucleation and chromosome set. Also in the interphasic pre-embryos the presence of chromatin masses at different sizes was revealed. The observation of polyploid and/or polynucleated blastomeres can suggest a failure of synchronization between cytoplasmatic and nuclear division. Mosaicism, polyploidy and polynucleation are phenomena that could be caused by in vitro culture conditions or dependent upon the genetic anomaly of the zygote.

Blastocyst↗
PubMed1993

Adenomyosis: a déjà vu?

Adenomyosis is a relatively frequent finding in series of hysterectomies performed for menorrhagia and dysmenorrhea. Evident selection biases of the available studies on adenomyosis have always limited the possibilities of defining the real clinical importance of the condition. Until now the only certain diagnoses have been made by histopathologists on uteri removed at surgery, but recently various sufficiently accurate techniques have been suggested which allow diagnosis on the uterus in situ. With the these methods it might be possible to obtain correct information on the epidemiologic characteristics of adenomyosis and to clarify whether it has a pathogenic role in unexplained ovulatory menorrhagia and juvenile dysmenorrhea. Furthermore, resectoscopic treatment has been proposed in some mild forms of adenomyosis to avoid hysterectomy, whereas it seems improbable that medical treatment can offer a definitive solution. The adoption of standard histologic criteria for adenomyosis seems important. Until this is done, it will be difficult to establish whether adenomyosis is really a disease or merely a paraphysiologic condition.

Adult↗
PubMed1993

Abnormal uterine bleeding associated with iron-deficiency anemia. Etiology and role of hysteroscopy.

We reviewed the clinical and histologic records of 61 consecutive premenopausal women with abnormal uterine bleeding and moderate to severe iron-deficiency anemia investigated in a tertiary care and referral center. Excessive bleeding was caused by benign lesions in 67% of the cases and by anovulation in 25% and was unexplained in 8%. Hysteroscopy revealed an organic intrauterine lesion (submucous myomas in 38%, endometrial polyps in 13%, submucous adenomyomas in 3%) that could be treated endoscopically in more than half the patients. In populations without nutritional deficiencies, a woman of reproductive age with sideropenic anemia and no other evident cause of blood loss or systemic disease should be considered menorrhagic until proven otherwise. Hysteroscopy should be included in evaluations of abnormal uterine bleeding.

Adenomyoma↗
PubMed1991

Testicular dysfunction in Hodgkin's disease before and after treatment.

Over a 7-year period, semen analysis was performed in 92 male patients with Hodgkin's disease prior to therapy. In 67% of patients semen revealed a decreased chance for fertility (i.e. oligozoospermia, asthenozoospermia and/or teratozoospermia). The mean basal levels of follicle-stimulating hormone (FSH), luteinising hormone, testosterone and prolactin were in the normal range. In 77 patients in complete remission after alternating MOPP/ABVD (mechlorethamine, vincristine, procarbazine, prednisone; doxorubicin, bleomycin, vinblastine, dacarbazine), testicular function was assessed. 87% of patients were azoospermic, 9% had semen abnormalities and only 4% were normospermic. Recovery of spermatogenesis was documented in only 17 of 42 (40%) reassessed patients after a median time of 27 months and was generally not affected by pretreatment sperm quality. After chemotherapy, the mean value of FSH [20.45 (S.E. 1.7) mUI/ml] was significantly superior compared with that of the mean pretreatment values. No difference was documented in the mean testosterone and prolactin values tested before and after treatment. Our findings indicate that, of patients with Hodgkin's disease, about half are affected by hypogonadism before starting chemotherapy. By utilising alternating MOPP/ABVD, persistent testicular dysfunction was documented in half of the patients.

Adolescent↗
PubMed1991

Human prolactin release induced by follicle stimulating hormone, luteinizing hormone and human chorionic gonadotrophin.

Plasma prolactin levels rise in stimulated cycles. To clarify the effects of gonadotrophin on the lactotrophs, three studies were performed. First, plasma concentrations of prolactin during clomiphene citrate (CC)-human menopausal gonadotrophin (HMG)-human chorionic gonadotrophin (HCG) treatment of women enrolled for in-vitro fertilization (IVF) were compared with those during HMG-HCG administration while under pituitary suppression with a gonadotrophin releasing hormone (GnRH) analogue (buserelin). Women suppressed with buserelin had higher basal levels of PRL in plasma (14.4 +/- 4.3 ng/ml versus 6.9 +/- 1.4 ng/ml, P less than 0.001). Only buserelin-suppressed women showed a significant rise in plasma prolactin before HCG administration, while both patient groups had marked prolactin peaks after HCG injection. This peak was higher in the buserelin group (71.9 +/- 50.7 ng/ml versus 52.6 +/- 29.7 ng/ml). The second study showed that plasma levels of prolactin of 6 post-menopausal women were significantly increased 48 h after an injection of 5000 IU HCG, i.m. (24.9 +/- 17.4 ng/ml versus 12.4 +/- 6.2 ng/ml P less than 0.05). Third, plasma prolactin was studied in 5 women over 30 days after surgical castration. An upward trend was observed similar to that of endogenous gonadotrophin, with the change in prolactin values closely correlating with the change in concentrations of follicle stimulating hormone (P less than 0.005). All these findings suggest that human gonadotrophins stimulate lactotrophs.

Buserelin↗
PubMed1991

Role of blood pressure in the natriuretic response to acute calcium channel blockade in humans.

Glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and renal excretion of sodium and lithium were measured before and after acute oral administration of 20 mg nifedipine in 19 essential hypertensive patients. In 10 of them, with a diastolic pressure less than 105 mm Hg, nifedipine resulted in a decrease in mean blood pressure toward normal (109 +/- 2 to 97 +/- 2, p less than 0.001), a 27% increase in ERPF (p less than 0.001), no change in GFR, and an increase in fractional sodium excretion (28%, p less than 0.001). In nine subjects with a diastolic pressure greater than or equal to 105 mm Hg, nifedipine produced a decrease in mean blood pressure (133 +/- 6 to 117 +/- 4, p less than 0.001), which however remained higher than in mild hypertensives (p less than 0.001). ERPF rose by 29% (p less than 0.001), GFR remained unchanged, and fractional sodium excretion definitely increased more than in mild hypertensives (126%, p less than 0.001), as did fractional lithium excretion, used as an estimate of proximal tubular sodium handling. Acute nifedipine produces renal vasodilation in hypertensives, but with a greater natriuretic response in those subjects whose blood pressure remains elevated. Thus, acute natriuresis following nifedipine administration is largely dependent on the interaction between changes in arterial pressure and renal hemodynamics.

Blood Pressure↗
PubMed1991

Intraperitoneal insemination in the treatment of male and unexplained infertility.

For couples with unexplained or male infertility, intraperitoneal (IP) insemination in induced cycles is a method that increases the chance of fertilization. Seventy-seven couples with male subfertility were subjected to 120 IP insemination cycles and 31 with unexplained sterility to 44 cycles. As a consequence of the treatment, 23 pregnancies were obtained, with pregnancy rates of 23% per cycle and 32% per patient for unexplained infertility and 11% and 17% for male subfertility. Pregnancy loss rate was quite elevated: 9 clinical abortions and 1 ectopic. Intraperitoneal insemination appears to be a relatively noninvasive way to deal with unexplained or male factor infertility, well worth trying before moving on to more invasive and costly approaches, such as gamete intrafallopian transfer or in vitro fertilization.

Abortion, Spontaneous↗
PubMed1990

Computerized slow-staged freezing of semen from men with testicular tumors or Hodgkin's disease preserves sperm better than standard vapor freezing.

Two methods of freezing semen taken from patients with testicular tumors or Hodgkin's disease before treatment were compared. Many patients already have semen abnormalities, so an optimal method is extremely important. Ejaculates from 8 patients with testicular tumors and 20 with Hodgkin's disease were frozen by fast-freezing or by slow-staged freezing. Effects of motility, viability, and swelling after thawing were significantly impaired with both methods. However, cryosurvival was better after slow- than fast-freezing: motility 24% +/- 12.4% versus 15% +/- 11.2%; viability 24.1% +/- 11.4% versus 17.3% +/- 10.4%, swelling 33.3% +/- 11% versus 27.6% +/- 12.8%. The effects were equal for normal and abnormal sperm. Sperm from tumor patients should be frozen by slow-staged freezing method in spite of the higher cost and longer time.

Computers↗
PubMed1990

Dopaminergic modulation of acute renal effects of nicardipine.

In order to investigate whether dopamine receptors are involved in the acute natriuretic effects of calcium channel blockade, experiments were carried out in humans with uncomplicated essential hypertension. In 8 hypertensives 5 mg intravenous nicardipine produced a large decrease in blood pressure and renal vascular resistance, a slight but significant increase in glomerular filtration rate (GFR) and marked natriuresis. When a second identical experiment was performed in the same subjects with the addition of 10 mg metoclopramide as dopamine blocker, changes in sodium excretion and vascular resistance were the same, but GFR did not increase during nicardipine. In a second set of experiments (n = 5) the same design was used, but nicardipine was infused at a dose of 0.01 mg/kg, ie, seven times less than in previous experiments. Under these conditions, blood pressure, renal vascular resistance and GFR did not change, but significant natriuresis occurred. Natriuresis was almost completely prevented by metoclopramide. In 5 additional hypertensives, metoclopramide alone was infused and 0.01 mg/kg nicardipine was added to the infusion. No change in any parameter was observed. Our findings suggest that the dopaminergic system participates in maintaining or increasing GFR during blood pressure reduction by calcium antagonists, although renal vasodilation and natriuresis are largely independent of dopamine receptor activity. In addition, when low doses of calcium antagonists produce natriuresis in the absence of renal or systemic hemodynamic changes (direct tubular effect), dopamine blockade is able to blunt this effect. This indicates a modulation by dopaminergic receptors of the direct tubular action of calcium antagonists.

Blood Pressure↗
PubMed1990

Pregnancy after direct intraperitoneal insemination of spermatozoa from a man with severe infertility, after unsuccessful application of other methods of assisted fertilization.

Direct intraperitoneal insemination (DIPI) is one of the least invasive strategies of assisted reproduction. Unexplained infertility and male sub-fertility are the major indications for DIPI. It is otherwise well known that assisted procreation gives poor results in severe male infertility. This is a report of a pregnancy that occurred as a result of a direct intraperitoneal insemination of prepared spermatozoa characterized by a particularly severe astheno-teratozoospermia in a couple unsuccessfully treated with other, more invasive methods of assisted fertilization.

Adult↗