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Biomedical subjects

I Zalud

Publications and source records attributed to I Zalud.

At least 37 records · Page 2Linked to original sources
PubMed1991

Transvaginal color flow Doppler in the assessment of ovarian and uterine blood flow in infertile women.

OBJECTIVE: To measure the flow velocity of the uterine and ovarian arteries through the menstrual cycle to determine there are changes. DESIGN: Serial measurements throughout the menstrual cycle in women attending an infertility clinic, compared with volunteers coming for annual examinations. Transvaginal ultrasound-color flow Doppler was the investigative tool. SETTING: A University Hospital ambulatory care center. PATIENTS: One hundred infertile women compared with 150 women attending the clinic for annual checkups. MAIN OUTCOME MEASURES: Changes in the resistance index of flow velocity waveforms of the uterine and ovarian arteries. RESULTS: Uterine flow velocity has a resistance index of 0.88 +/- 0.04 (2 SE) in the proliferative phase and starts to decrease the day before ovulation. A nadir of 0.84 +/- 0.04 is reached on day 18 and remains at that level for the rest of the cycle. In anovulatory cycles, these changes do not occur. A subgroup of 12 women who lacked end diastolic flow in the uterine arteries during the secretory phase were identified. Eleven of these women were infertile, 8 of whom with primary infertility. Ovarian artery flow velocity is usually detected when the dominant follicle reaches 12 to 15 mm. The resistance index is 0.54 +/- 0.04 and also declines on the day before ovulation. A nadir of 0.44 +/- 0.04 is reached 4 to 5 days later and slowly rises to 0.050 +/- 0.04 before menstruation. CONCLUSIONS: There are changes in the flow velocity patterns of the uterine and ovarian arteries during the normal ovulatory menstrual cycle. Because these changes in flow velocity begin before ovulation, it can be suspected that they may involve angiogenesis as well as hormonal factors. The changes noted in these studies are statistically significant but may be too small to be used as a diagnostic tool in the study of infertility problems.

Adult↗
PubMed1991

Transvaginal color Doppler in the assessment of abnormal early pregnancy.

The study groups comprised 61 pregnant women whose gestational age ranged from 7 to 12 weeks from the last menstrual period. All patients apparently had a normal developing pregnancy; there were no clinical symptoms of pathology e.g. bleeding in early pregnancy. Eighty-two patients with a clinically and ultrasonographically normal pregnancy whose gestational age ranged from 7 to 12 weeks, served as a control group. When the anatomical position of investigated area have been obtained clearly, pulsed wave Doppler sample volume was placed on the structures of interest: the both uterine arteries and intervillous space. There is no statistically significant difference between the Resistance Index (RI) in the left or right uterine artery (P greater than 0.01) and among investigated groups of patients (P greater than 0.01). The intervillous blood flow RI in the case of molar pregnancy was 0.38 with SD +/- 0.03; in blighted ovum 0.43 with SD +/- 0.03, and in missed abortion 0.43 with SD +/- 0.02. It should be stressed that in nine (31%) cases of blighted ova and in five (26%) cases of missed abortion, intervillous space flow could not be detected. In the control group, intervillous blood flow was always visualized and the mean RI was 0.45 with SD - 0.04. Statistical analysis showed significantly higher RI in control group in comparison with other groups of patients (P less than 0.01), and significantly lower RI in molar pregnancy in comparison with other groups of patients (P less than 0.01). There was no difference in RI between blighted ova and missed abortions (P greater than 0.01).

Abortion, Missed↗
PubMed1991

Ectopic pregnancy: transvaginal color Doppler of trophoblastic flow in questionable adnexa.

The purpose of this study was to see if color flow Doppler measurements could aid in the positive diagnosis of ectopic pregnancy when no gestational sac can be seen in the adnexa. We examined 148 women with abdominal pain and suspected ectopic pregnancy by abdominal ultrasonography, followed by vaginal ultrasonography and color Doppler when the diagnosis was still uncertain. Seventy-three patients proved to have ectopic pregnancies. Color flow with low resistance and high velocity vascular signals were observed in complex adnexal masses and in some of the corpora lutea. The resistance index for ectopic trophoblast was 0.36 +/- 0.02 SD. Color Doppler had both positive and negative discrimination of adnexal masses (P = 10(-15). The resistance index for the corpora lutea was 0.48 +/- 0.04. A cutoff value of 0.40 or less is proposed as a diagnostic index for suspected trophoblast in the adnexa. In nine cases of ectopic pregnancy, no color flow was noted. In these women, the beta-human chorionic gonadotropin level was less than 1000 mIU/ml. The clinical operative suspicion in these cases was tubal abortion. Sensitivity and specificity were 88% and 97%, respectively, in this highly selective series. Positive and negative predictive values were 97% and 89%. Color Doppler appears to be useful for the positive diagnosis of ectopic pregnancy with ultrasonography when no adnexal gestational sac is observed. Prospective randomized trials will determine the ultimate clinical value of these findings.

Adnexa Uteri↗
PubMed1991

Evaluation of adnexal masses with transvaginal color ultrasound.

We evaluated 14,317 asymptomatic or minimally symptomatic women for ovarian carcinoma with transvaginal color Doppler ultrasound. The resistance index was calculated for at least five separate cardiac cycles in each case, and the mean was calculated. We discovered 624 benign adnexal masses: in every case except one the resistance index was greater than 0.40. There were 56 malignant adnexal masses, 16 of which were stage I ovarian cancers. Neovascularization was found in six of the seven stage I primary neoplasms and in all of the nine stage I secondary ovarian cancers. In all, the RI was less than or equal to 0.40. There were 40 advanced ovarian cancers revealed (stage III or IV); 39 showed abnormal color-flow pattern with the resistance index less than 0.04.

Adult↗
PubMed1990

Transvaginal color Doppler imaging.

Transvaginal color Doppler was used to assess circulation in pelvic vessels in a group of 64 patients including 15 patients with fertility problems, 18 patients with pelvic tumors, 2 cases of suspected ectopic pregnancy, and 29 pregnant patients with fetuses between 6 weeks and 10 weeks, menstrual age. Blood flow was successfully displayed by color Doppler in the external and internal iliac arteries, and the uterine arteries, but flow in ovarian arteries could not be visualized. In the subgroup of patients with pelvic tumors, neovascularization of tumor tissue was documented in 6 out of 10 cases of uterine fibroma and in 2 cases of ovarian cancer. In 6 cases involving benign ovarian pathology, no abnormal blood supply was observed. A comparison between the characteristics of blood flow within uterine fibromas and ovarian malignancies showed lower impedance and higher blood velocity in cases of malignancy. In early pregnancy blood flow in the umbilical artery could be visualized by color Doppler starting from the 6th week and flow in the aorta from the 8th week. Flow in the trophoblasts was observed with an overall success rate of 59% and successfully demonstrated in 1 out of 2 cases of ectopic pregnancy.

Blood Flow Velocity↗
PubMed1990

Analysis of T cell subsets after induction of experimental autoimmune encephalomyelitis in susceptible and resistant strains of rats.

T cell subsets in the peripheral blood, draining lymph node (DLN) and spinal cord lesions were analysed after the induction of experimental autoimmune encephalomyelitis (EAE) in susceptible (DA) and relatively resistant (AO) rats. In DA rats, a significantly higher number of CD4+ cells were generated in the DLN, in response to both nervous tissue antigens and complete Freund's adjuvant (CFA), compared to AO rats. In the peripheral blood of DA rats, the percentage as well as absolute number of CD4+ cells increased in the preclinical phase of EAE, but declined as the disease developed. The percentage of CD8+ cells decreased in both these phases of EAE. In resistant AO rats, however, there were no significant changes in the T lymphocyte subset percentages after EAE induction, although the absolute number of peripheral blood CD4+ cells again increased in the preclinical stage of EAE. In the CFA-treated control DA rats, the absolute number of CD4+ cells was increased in the preclinical phase. However, no decline comparable to that seen in diseased animals followed. It is concluded that the generation of CD4+ cells in response to this antigen is strain specific and, since the cells are released into the circulation, will affect the balance between the T cell subsets in the peripheral blood during the development of EAE.

Animals↗
PubMed1990

The assessment of abnormal pelvic blood flow by transvaginal color and pulsed Doppler.

Transvaginal color Doppler was used to analyze a group of 19 healthy, 48 infertile and 8 postmenopausal women; 67 patients with uterine and 151 patients with adnexal masses, and 19 patients with a suspected ectopic pregnancy. The ultrasonographer had not been informed of other clinical findings and indications for operative treatment. A 5 MHz transvaginal color Doppler probe was used to visualize the pelvic anatomy and blood flow. Each arterial blood flow velocity was classified into either of two types. In the normal flow pattern, the diastolic flow component was absent or small and the value of resistance index (RI) was greater than 0.50. In the abnormal flow pattern, a large diastolic flow component was evident and the value of RI was less than 0.50. Transvaginal color and pulsed Doppler studies in confirmed malignant uterine masses had moderate accuracy (90.2%), with a sensitivity (55.6%) and specificity (100%); and in confirmed malignant adnexal masses high accuracy (100%), sensitivity (100%) and specificity (100%). Comparison of blood flow characteristics within benign and malignant tumor tissue revealed less impedance and higher velocity in cases of malignancy. Blood flow studies in both uterine arterias have not shown clinically important values. This method can be also used in the diagnosis of ectopic pregnancy.

Blood Flow Velocity↗
PubMed1990

[Transvaginal color Doppler for evaluating gynecologic pathology of the pelvis].

Transvaginal colour Doppler Sonography was used to assess circulation in pelvic vessels in a group of 611 non-pregnant and 88 pregnant patients. A 5 MHz transvaginal probe was used to visualize the pelvic anatomy and blood flow. Further analysis was made by pulsed Doppler where flow velocity waveforms were recorded and analysed by calculation of resistance index (RI). In the normal flow pattern, the diastolic flow component was absent or small and the value of RI was greater than 0.50. In the abnormal flow pattern, the large diastolic flow component was evident and the value of RI was less than 0.50. The transvaginal colour Doppler assessment of tumour vascularity can be used for better non-invasive characterisation of adnexal tumour and may be potentially useful as a screening test for ovarian malignancy. Because of its high sensitivity, specificity and accuracy, transvaginal colour Doppler Sonography is the imaging of choice, in diagnostic procedure of early pregnancy failure and ectopic pregnancy. The guidance of a pulsed Doppler beam by colour flow mapping helps to locate areas of the most abundant flow and makes examination more reproducible, faster and easier.

Abortion, Induced↗
PubMed1990

The assessment of luteal blood flow in pregnant and non-pregnant women by transvaginal color Doppler.

Transvaginal color Doppler of luteal flow was performed on 58 patients with normal early pregnancy before artificial abortion, 73 patients with proven ectopic pregnancy and 75 non-gravid patients in luteal part of menstrual cycle. The equipment used were Aloka Color Doppler SSD-350 and SSD-680 with a 5 MHz transvaginal probe. Obtained color flow from ovarian tissue was explored with pulsed Doppler and the Pourcelot resistance index was calculated. Typical luteal low-impedance flow was detected in 82.8% cases of early pregnancy, 80.8% cases of ectopic pregnancy and 69.3% cases of non-pregnant women. The lowest resistance index (RI = 0.42 +/- 9.12) of luteal flow was found in cases of non-pregnant women, and the highest resistance index (RI = 0.53 +/- 0.09) was obtained in cases of early normotopic pregnancy. RI in cases of ectopic pregnancy was 0.48 +/- 0.07. Statistical analysis has shown significantly different RI in each of 3 groups of patients (P greater than 0.001). Corpus luteum was seen as early as a few days after ovulation in non-pregnant women and was present until about the 11th week of amenorrhea in pregnant women. In 86.4% patients with proven ectopic pregnancy, luteal flow was detected on the same side as the ectopic pregnancy. Our results have shown different RI value of corpus luteum flow in different groups of patients. Such findings could help to exclude pregnancy, specially with non-specific B-mode ultrasound features. Corpus luteum flow could be used as a guide for searching for ectopic pregnancy.

Corpus Luteum↗
PubMed1990

Tissue characterization by transvaginal colour Doppler for the evaluation of gynaecological tumours. 2. Clinical experiences.

Transvaginal colour Doppler was used to evaluate the blood flow patterns in pelvic vessels in a group of 315 patients including 168 with uterine tumours and 147 with adnexal masses. Neovascularization of malignant tumour tissue was successfully displayed by colour Doppler in the vases of endometrial and ovarian cancers but no abnormal blood supply was observed in the cases of early cervical cancers. A comparison between the characteristics of blood flow within benign and malignant lesions showed lower resistance index in cases of malignancy. The sensitivity, specifity, positive predictive value, negative predictive value and the diagnostic accuracy of this new method in the recognition of endometrial and ovarian cancers are higher than 95%. By the help of transvaginal colour Doppler (together with the classical methods as colposcopy, cytology etc.) it will be possible to establish of complex screening programmes for all types of gynaecological cancers.

Adnexal Diseases↗
PubMed1990

Conventional B-mode and transvaginal color Doppler in ultrasound assessment of ectopic pregnancy.

The study was arranged in two parts. In the first part, 43 of the clinically suspected ectopic pregnancies were sent for a transvaginal color Doppler examination. Both cystic and complex adnexal masses were carefully scanned for their Doppler flow characteristics. The Pourcelot index (RI) was calculated and the RI 0.40 was used as a cut-off point to differentiate the trophoblastic (RI less than 0.40) and the normal blood flow (RI greater than 0.40). The diagnosis was confirmed by the beta hCG serum test. Three false-negative and one false-positive findings were obtained. The transvaginal color and pulsed Doppler study of the flow within ectopic pregnancy has a high degree of sensitivity (87.5%), specificity (94.7%) and accuracy (90.7%). Pelvic sonograms of another 110 patients with proven ectopic pregnancy were reviewed retrospectively. The ectopic gestational sac with the alive embryo was documented in 11.8% cases and without the embryo in 30.4% cases. A mixed, solid or cystic adnexal mass was detected in 57.8% patients. Intrauterine findings showed a pseudogestational sac in 13.6% cases, a cluster configuration in 18.6% cases and a linear configuration in 67.8% cases. Criteria for the ultrasound diagnosis of ectopic pregnancy influencing its specificity, sensitivity and accuracy are discussed.

Female↗
PubMed1989

Accuracy of routine flow-cytometric bitmap selection for three leukocyte populations.

A double-blind study was performed with peripheral blood of 41 human subjects to check the accuracy of determination of lymphocyte, monocyte, and granulocyte windows with which every flow cytometric analysis of leukocyte markers starts. White blood cell suspensions were prepared according to the whole blood method and analyzed on an EPICS-C flow cytometer using the two-parameter 90 degrees light scatter vs. forward angle light scatter (granularity vs. cell size) data distribution. Windows (bitmaps) for lymphocytes, monocytes, and granulocytes were drawn and numbers of cells determined in each. The proportions of lymphocytes, monocytes, and granulocytes were calculated in relation to total cell number, counted and in relation to the sum of cells in three bitmaps, and then compared with proportions determined by microscopic whole blood cell (WBC) differential and a WBC differential determined in an automated hematology analyzer. Average proportions of lymphocytes obtained by the flow cytometer were significantly lower than those obtained by either microscopic or automated differential, suggesting that some of the relevant cells were not included in the bitmaps. Granulocyte proportion related to total cell number was lower and that related to bitmap cell number higher than that obtained by microscopic and automatic differentials, suggesting that nongranulocytic cells were included in the granulocyte bitmaps. Proportions of lymphocytes and granulocytes obtained by the flow cytometer correlated well with those obtained by both microscopic and automatic differential. In contrast, the proportions of monocytes showed a poor correlation, which is probably due to their low number and delicate position in the distribution, and which makes them difficult to delineate.

Antigens, Differentiation↗
PubMed1989

Ultrasound diagnosis and evaluation of fetal tumors.

Fetal tumors represent a rare and heterogeneous group of abnormalities. A significant proportion of them can now be diagnosed by using modern high resolution ultrasonic equipment. During 15 years there were 57 fetal tumours detected prenatally. Hygroma colli is the most frequent fetal tumor. It should be emphasized that cystic hygroma generally carries poor prognosis, and after an early diagnosis, termination of pregnancy is most logical approach. Contrary to the general opinion our own experience showed that there are cases in which prognosis could be much better as illustrated with our 4 cases. All of the treated fetuses, after surgical resection, had normal development and are now on the age of 5, 4, 3 and 2 years of life. An ovarian cyst can be suspected if a fluid-filled structure is visualized next to a fetal kidney and female external genitalia are recognizable. The ultrasound finding suggestive of an ovarian cyst is that of a pelvic cystic or complex mass in a female fetus with normal kidneys and urinary bladder and a normal gastrointestinal tract. In most cases, the normal course of fetal ovarian cyst is a spontaneous intrauterine or postnatal involution. Prenatal diagnosis improves neonatal outcome by allowing an appropriate choice of the optimal time, mode and place of delivery in order to avoid accidental and unexpected intrapartum and postnatal complications. The management of a fetus affected by an ovarian cyst depends on the size and on the echo-pattern of the cyst. It remains unclear whether in utero puncture of the cyst and evacuation of its content should be justified in cases of particularly large ovarian cyst. In our opinion intrauterine procedure can be attempted in the presence of large cyst fulfilling the fetal abdomen. We have treated actively two cases of large ovarian cysts by ultrasonically guided puncture before delivery and both fetuses underwent surgery later without complications. If properly performed puncture of the cyst seems to be a low risk procedure in comparison to potential problems that cyst may cause to the fetus or by causing dystocia. Sacrococcygeal teratoma represents the most frequent tumor in the fetuses and newborns. Prenatal diagnosis is usually simple and based on the visualization of tumor of variable size and internal structure. Tumors may appear as completely cystic, mixed or predominantly solid with obvious calcifications. Cystic and calcified tumors are most likely to be benign. Obstetrical management of sacrococcygeal teratoma depends on numerous parameters which include size and texture of the tumor, and gestational age.(ABSTRACT TRUNCATED AT 400 WORDS)

Female↗
PubMed1989

Transvaginal color Doppler for the assessment of pelvic circulation.

Transvaginal color Doppler was used to analyse a group of 56 patients including 41 with proven pelvic masses and 15 infertility patients with normal pelvic anatomy. All patients were examined by ultrasound before laparoscopy or/and laparotomy. The ultrasonographer had not been informed of other clinical findings and indications for operative treatment. Comparison of blood flow characteristics within uterine fibromas and ovarian malignancies revealed less impedance and higher blood velocity in cases of malignancy. When predicting the malignant nature of pelvic tumors, no false-negative results were encountered, and only one false positive diagnosis of malignancy.

Color↗
PubMed1989

Lymphocyte subsets in normal human bone marrow harvested for routine clinical transplantation.

Bone marrow and peripheral blood of 25 healthy bone marrow donors from our allogeneic bone marrow transplantation program were assessed for cell subsets bearing T11(CD2), T4(CD4), T8(CD8), B1(CD20) J5(CALLA, CD10), Mo1(CD11b), MY7(CD13). Mo2(CD14), MY9(CD33) and NKH-1 antigens. Bone marrow cell samples were taken for analysis at the start or at the end of the harvesting procedure of aspiration from the iliac crest. All samples were analysed on a flow cytometer at the lymphocyte window as obtained on the two-parameter (L90oLSxFALS) scatter diagram. There were no differences in the lymphocyte subset composition of bone marrow samples taken at the start or at the end of the harvesting procedure. In contrast to the majority of literature data, a high CD4/CD8 ratio was detected in bone marrow samples: it did not differ from that in the peripheral blood. The proportions of CD2 and CD4 T cell markers in the bone marrow correlated with those in the peripheral blood, thus further documenting a substantial bone marrow contamination with peripheral blood cells. A relatively large aspirate volume (4-5 ml) obtained from individual aspiration sites was identified as the only factor possibly accounting for the high-level contamination of bone marrow samples with peripheral blood. This conclusion was corroborated by low T cell proportions and low CD4/CD8 ratios found in the bone marrow washed from bone fragments and in bone marrow samples aspirated at first bone puncture in a volume of 1.0 ml. Taken together, these findings imply that less vigorous suction may decrease the number of T lymphocytes in bone marrow harvested for transplantation purposes.

Antigens, Differentiation↗