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Biomedical subjects

I Brosens

Publications and source records attributed to I Brosens.

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

Diagnosis of endometriosis.

The diagnosis of endometriosis is based on the presence of endometrial-like tissue outside the uterine cavity and direct or indirect evidence of cyclic bleeding. Clinically three entities can be distinguished: the peritoneal implant, the endometrial cyst and the deep-nodular lesion. Laparoscopy and biopsy remain the gold standard for diagnosis, but in addition attention should be paid to the detection of functional activity, such as bleeding, by non-invasive techniques.

CA-125 Antigen↗
PubMed1996

Analysis of the karyotype and desoxyribonucleic acid content of uterine myomas in premenopausal, menopausal, and gonadotropin-releasing hormone agonist-treated females.

OBJECTIVE: To correlate the cytogenetics and the DNA content in uterine myomas. DESIGN: Prospective study in treated and untreated females. SETTING: Tertiary University Center. PATIENTS: Premenopausal, menopausal, and GnRH-agonist (GnRH-a)-treated patients. INTERVENTION: Myomectomy or hysterectomy. MAIN OUTCOME MEASURE: Karyotype analysis and the DNA content measured by microfluorescence technique and expressed in fluorescence units. RESULTS: The mean DNA content in cells from karyotypically normal and karyotypically abnormal myomas, respectively, was 37.4 +/- 6.9 and 30.4 +/- 1.8 fluorescence units in premenopausal females, 30.3 +/- 5.3 and 28.7 +/- 0.9 fluorescence units in menopausal females, and 31.6 +/- 2.7 and 32.9 +/- 5.8 fluorescence units in GnRH-a-treated females. CONCLUSIONS: Forty percent of the myomas evaluated demonstrated an abnormal karyotype and had a significantly lower DNA content than the chromosomally normal myomas. After GnRH-agonist treatment, the DNA content was decreased in the euploid myoma group only.

Biopsy↗
PubMed1995

A new cytogenetic subgroup in uterine leiomyoma is characterized by a deletion of the long arm of chromosome 3.

Our cytogenetic findings in 175 uterine leiomyomas revealed 52 tumors with clonal chromosome abnormalities, eight of which did not belong to any well-delineated cytogenetic abnormal subgroup. However, an interstitial deletion of the long arm of chromosome 3 was found, as the sole chromosome abnormality, in three cases. We believe that this involvement of 3q is significant enough to consider it as a new cytogenetic subgroup of uterine leiomyoma.

Adult↗
PubMed1995

No correlation between peritubal and mucosal adhesions in hydrosalpinges.

OBJECTIVE: To correlate the presence and extent of peritubal and mucosal adhesions in hydrosalpinges. DESIGN: Comparative study. SETTING: Tertiary centers with experience in tubal microsurgery. PATIENTS: Infertile women with complete distal tubal block. INTERVENTION: Salpingoneostomy. MAIN OUTCOME MEASURE: Presence and extent of adhesions. RESULTS: Peritubal adhesions occur more frequently than mucosal adhesions in hydrosalpinges. Of 7 hydrosalpinges without peritubal adhesions, 1 showed mucosal adhesions but of 83 hydrosalpinges with peritubal adhesions, 31 (37%) showed no mucosal adhesions. CONCLUSION: Accurate endoscopic assessment of the ampullary mucosa is recommended in hydrosalpinx to select the appropriate patient for surgery.

Body Fluids↗
PubMed1995

Reflections on the way to conduct an investigation of subfertility.

Infertility is a worldwide issue in reproductive health. In view of the World Health Organization's definition of health, the psychological and social consequences of infertility simply cannot be ignored. Prevention of infertility is difficult and does not help the couple seeking medical advice for infertility, whereas efficient treatment for infertility is time consuming, expensive and often unsuccessful. This article reflects on a shortened, yet full investigation of both partners' fertility before any treatment whatsoever, which is indispensable once the decision to help the couple medically has been made. By optimizing the use of modern gynaecological endoscopy within the woman's cycle, an exhaustive infertility investigation can be conducted within the span of two couple-physician contacts, thereby responding to the couple's concern, avoiding loss of time and energy due to inappropriate therapies, and directing the subfertility treatment correctly from the start. Trained gynaecologists can easily conduct this investigation in fertility centres in developed countries, as well as in centres for family planning in developing countries. The investigation can be employed either with an emphasis on diagnosis alone (and then even under local anaesthesia) or, if the necessary infrastructure is available, in combination with operative endoscopy under general anaesthesia where indicated.

Adult↗
PubMed1995

Prospective study of tubal mucosal lesions and fertility in hydrosalpinges.

The relationship of abnormalities of the Fallopian tubes in patients with tubal infertility due to hydrosalpinges and fertility outcome after salpingoneostomy was studied in a prospective multicentric project. Hydrosalpinges of infertile patients were evaluated macroscopically and microscopically at the time of salpingoneostomy and the results were analysed with regard to the fertility outcome. Peritubal adhesions, the diameter and the quality of the mucosa were scored at the time of surgery and biopsies from representative areas were evaluated by scanning electron and light microscopy in 50 patients with bilateral hydrosalpinges or a hydrosalpinx of a single tube. Analysis of the different factors for fertility outcome was performed using the Cox proportional hazards model. No intrauterine pregnancy occurred in the thick-walled hydrosalpinges group (n = 13). In the thin-walled hydrosalpinx group (n = 37), 15 intrauterine and two tubal pregnancies occurred. The aspect of the mucosa as evaluated by an operating microscope was the most important factor in determining the fertility outcome; > 50% abnormal mucosa was associated with an intrauterine pregnancy rate of 7% which increased significantly to 50 and 69% when the mucosa was > 50 and 75% normal respectively. The pregnancy rate was not influenced by the presence or extent of peritubal adhesions but small sized (< 1 cm) hydrosalpinx had a better prognosis than medium (1-2 cm) and large sized (> 2 cm) hydrosalpinx. When mucosal adhesions were present (n = 19), the intrauterine pregnancy rate was 22% which increased significantly to 58% when adhesions were absent (n = 18). Both tubal pregnancies occurred in tubes with mucosal adhesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Experimental model for neoangiogenesis in adhesion formation.

This study presents an animal model for the observation of adhesion formation, from a vascular viewpoint. In 60 Wistar rats, a 4 cm midline incision was made and a 0.5 cm square piece of silastic 0.2 mm thick was fixed on the right side of the peritoneum with two separate angular stitches of nylon 9/0. The rats were randomized in six groups of 10 animals and were operated on again on days 2, 4, 6, 8, 10 and 12 respectively. Biopsies for scanning electron microscopy were obtained by resecting a 2 x 2 cm square of parietal peritoneum around and covering the silastic patch. Foreign body reaction induced by the silastic patch and ischaemia caused by stitching are the stimuli for adhesion formation. The results showed a gradual progression in the type and tenacity of adhesion formation. The maximal degree of peritoneal reactive angiogenesis was noted between days 8 and 12, together with a decrease and a redistribution in the extent of adhesions. In the early stages, vascularization is part of the organization of adhesions while their extent is limited. Two parallel mechanisms take part in trauma healing: while omento-parietal adhesions are vascularized, new peritoneal tissue with its vascular network develops and covers the silastic surface and the traumatized area. This theory is supported by the presence of fibroblasts differentiating into mesothelial cells on day 8. Theoretically, a valid treatment in preventing adhesion formation should increase the peritoneal neoangiogenesis and the repair of peritoneal lesions, but at the same time prevent the vascularization of adhesions. The present model offers the possibility of testing the effect of any treatment or device for preventing post-operative adhesions in a relatively short time.

Animals↗
PubMed1994

A meta-analysis of the therapeutic role of oil soluble contrast media at hysterosalpingography: a surprising result?

OBJECTIVE: To evaluate the therapeutic effect of oil-soluble contrast media compared with water-soluble contrast media after hysterosalpingography (HSG) in infertile couples. DESIGN: Meta-analysis of four randomized clinical trials (RCTs) and six nonrandomized controlled studies evaluating pregnancy rates after the use of oil- or water-soluble contrast media during HSG. SETTING: Institute of Epidemiology and Health Services Research, Leeds, United Kingdom. PATIENTS: Four identified RCTs studied 800 patients and six nonrandomized studies comprised an additional 1,806 patients, all experiencing primary or secondary infertility. INTERVENTION: Hysterosalpingography as part of infertility investigation. MAIN OUTCOME MEASURE: Pregnancy rates after HSG. RESULTS: Pregnancy rates were significantly higher in the oil-soluble contrast media group compared with the water-soluble contrast media group in the RCTs. Inclusion of the six nonrandomized studies did not alter this conclusion. This apparent benefit was greatest for patients with unexplained infertility. CONCLUSIONS: Oil-soluble contrast media have a therapeutic effect compared with water-soluble media and this effect is greatest for patients who have been diagnosed as having unexplained infertility. New techniques for the evaluation of tubal patency support the hypothesis that tubal "plugs" may be involved in proximal tubal blockage.

Clinical Trials as Topic↗
PubMed1993

Sexual behavior, contraception and the risk of contracting HIV.

Recently, concern has been expressed on a possible association between the use of oral contraceptive pills (OCs) and an increased risk of contracting the HIV infection. As a consequence it has been postulated that a low prevalence of condom use due to widespread utilization of oral contraceptive pills would result in an acceleration of the spread of AIDS. The International Committee for Research in Reproduction (ICRR) a group of eleven experts in the field of gynecology, endocrinology and contraception, wishes to comment on the concerns raised about OC use and AIDS.

Acquired Immunodeficiency Syndrome↗