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J Bontis

Publications and source records attributed to J Bontis.

At least 37 records · Page 2Linked to original sources

Factor V Leiden and prothrombin G20210A mutations in pregnancies with adverse outcome.

BACKGROUND: Inherited thrombophilia has been associated with obstetric complications through mechanisms that are not yet fully elucidated. The aim of this study was to investigate the relationship between specific obstetric adverse outcomes and factor V Leiden and prothrombin G20210A mutations. METHODS: Forty-five women with adverse pregnancy outcome defined as severe pre-eclampsia, abruptio placentae, intrauterine growth restriction and stillbirth, were tested for factor V Leiden and prothrombin G20210A mutations. The control group comprised 100 women with at least one normal pregnancy and no history of thrombosis. RESULTS: Overall, 13 women with one or more of the above-mentioned pregnancy complications (28%) had either thrombophilic mutation, as compared with six in the control group (6%) (p < 0.001, odds ratio (OR) 6.1; 95% confidence interval (CI) 1.9-20). The factor V Leiden mutation was detected in ten of the women with complicated pregnancies (22%) and in four of the controls (4%) (p < 0.001, OR 6.6; 95% CI 1.7-27.2). The prothrombin G20210A mutation was detected in three women in the group with complications (6%) and in two of the controls (2%) (p = 0.17, OR 3.4; 95% CI 0.4-30.5). Compared to controls, the prevalence of the factor V Leiden mutation was significantly higher in the subgroups of severe pre-eclampsia, abruptio placentae and fetal growth restriction. The prevalence of the prothrombin G20210A mutation does not appear to be significantly different from that in the controls in any of the groups studied. CONCLUSIONS: Our data suggest that inherited thrombophilia, and specifically the factor V Leiden mutation, may be associated with adverse pregnancy outcome. The role of the prothrombin G20210A mutation remains to be elucidated.

Abruptio Placentae↗

Congenital obstructive azoospermia in a man with Marfan syndrome.

OBJECTIVE: To present a case of Marfan syndrome and concurrent congenital obstructive azoospermia. DESIGN: Case report. SETTING: Tertiary-care academic hospital. PATIENT(S): A man with Marfan syndrome and obstructive azoospermia. INTERVENTION(S): The patient was evaluated for azoospermia that was proved to be due to congenital absence of large segments of vas deferens and epididymis bilaterally. MAIN OUTCOME MEASURE(S): Evaluation for testicular sperm extraction and ICSI procedure. RESULT(S): The patient is a candidate for testicular sperm extraction and ICSI. CONCLUSION(S): The Marfan syndrome and azoospermia may be associated in sporadic cases.

Adult↗

Factor V leiden and prothrombin G20210A mutations, but not methylenetetrahydrofolate reductase C677T, are associated with recurrent miscarriages.

The aim of this study was to investigate the relationship between recurrent miscarriages and factor V Leiden, prothrombin G20210A and C677T methylenetetrahydrofolate reductase (MTHFR) mutations. In this case-control study the prevalence of factor V Leiden, prothrombin G20210A and C677T methylenetetrahydrofolate reductase mutations was determined in a consecutive series of 80 recurrent miscarriage patients and 100 controls. Fifteen of 80 recurrent miscarriage patients and four out of 100 controls carried the factor V Leiden mutation (19 versus 4%, P = 0.003, odds ratio 5.5, 95% confidence interval (CI): 1.7-17). Seven of 80 recurrent miscarriage patients and two of 100 controls were carriers of the prothrombin G20210A mutation (9 versus 2%, P = 0.038, odds ratio 4.6, 95% CI: 0.9-23.2). Six of 80 recurrent miscarriage women and 15 of 100 controls were homozygotes for the C677T MTHFR mutation (8 versus 15%, P = 0.134, odds ratio: 0.4, 95% CI: 0.1-1.2). Our results suggest that the presence of factor V Leiden and prothrombin G20210A polymorphism, but not MTHFR C677T homozygosity, could be additional risk factors for recurrent miscarriages. Furthermore, it was suggested that the prevalence of factor V Leiden and prothrombin G20210A mutations is more prominent in second trimester, primary fetal losses and it is independent of the existence of additional pathology predisposing to recurrent fetal losses.

Abortion, Habitual↗

Growth hormone response to oral glucose tolerance and insulin tolerance tests in patients with PCOS.

Polycystic ovary syndrome (PCOS) is characterized by its heterogeneity. This is the reason for the diversity in the clinical manifestations and laboratory findings. In this study we examined the serum levels of growth hormone (GH) in 15 women with PCOS and 5 healthy volunteers following oral administration of 75 gr glucose (OGTT) and intravenous administration of insulin (ITT). The OGTT produced no significant difference between the two groups of women, in the ITT there was a difference between the GH response of the women with PCOS and that of the healthy women. The group with PCOS showed a later, more prolonged, higher response, indicating that the hypothalamus is probably involved in PCOS.

Adult↗

Cytokines in the human ovary: presence in follicular fluid and correlation with leukotriene B4.

PURPOSE: This study was undertaken to correlate the follicular levels of interleukin (IL)-1 alpha, IL-2, tumor necrosis factor-alpha (TNF-alpha), and leukotriene (LT) B4 with oocyte maturity, fertilization, and achievement of pregnancy. METHODS: The material was obtained from 22 women undergoing IVF, 8 of whom became pregnant and 14 of whom did not. RESULTS: All of the studied cytokines and LT B4 were found in follicular fluids, but there were no significant differences according to oocyte maturity, fertilization, embryo quality, and achievement of pregnancy. On the other hand, a significant positive correlation was found between IL-1 alpha and TNF-alpha, IL-1 alpha, and LT B4 as well as between TNF-alpha and LT B4 in follicular fluids with subsequently fertilized oocytes. CONCLUSIONS: It seems that IL-1 alpha, TNF-alpha and LT B4 may take part in the process of follicle wall degradation, and their follicular correlations may suggest more optimal follicular and oocyte development and maturation.

Adult↗

Treatment of endometrial hyperplasias with gonadotropin-releasing hormone agonists: pathological, clinical, morphometric, and DNA-cytometric data.

On the basis of the recently reported observation that gonadotropin-releasing hormone agonists (GnRH-a) can affect endometrial cell proliferation, both indirectly, through the hormonal axis, and directly, by acting on the GnRH-a receptors, we investigated how far GnRH-a can be used as a new treatment mode for endometrial hyperplasias. Forty-two women, aged 28-60 years, with histologically confirmed simple (n = 30) or complex (n = 12, 2 with atypias) hyperplasia of the endometrium were involved in the study. According to the protocol they were treated for 6 months with GnRH-a (leuprolide acetate or triptorelin), and each patient underwent uterine curettage in the third and the sixth month of treatment, and 6 and at least 12 months after cessation of the treatment, for histological examination and morphometric and DNA-cytometric evaluation of the endometrium (mean pathological follow-up, 19.2 months; mean clinical follow-up, 30.7 months). During treatment, most of the women first revealed endometrial atrophy, and, after cessation of the treatment, again an atrophic or mainly functional endometrium; in 7 women, all with initial diagnosis of simple hyperplasia, the endometrial hyperplasia reappeared, which led in all 7 cases to hysterectomy. The mean values of almost all morphometric and DNA-cytometric parameters during and after treatment showed statistically significant changes in relation to pretreatment values, indicating a decrease in the proliferative activity of the endometrial cells; the GnRH-a antiproliferative effect was still active for a long time after cessation of the therapy. Our results, based for the first time not only on histological but also on serial nuclear morphometric and DNA-cytometric examinations of the endometrial cells and on the longest follow-up time, support the view that in cases of endometrial hyperplasia, especially of complex type, the use of GnRH agonists, which decrease the proliferative tendency of endometrial cells, could represent an alternative conservative therapeutic approach, which, however, requires close monitoring of the endometrium.

Adult↗

Therapeutic approach of immotile cilia syndrome by intracytoplasmic sperm injection: a case report.

OBJECTIVE: To present a case of immotile cilia syndrome, a very rare cause of male infertility and to evaluate the role of the recently suggested treatment by intracytoplasmic sperm injection (ICSI). DESIGN: Case report. SETTING: Tertiary-care academic hospital. PATIENT(S): One man with immotile cilia syndrome, showing no motile spermatozoa despite normal morphology and viability. INTERVENTION(S): The patient's partner underwent two cycles with IVF of the oocytes achieved by ICSI. MAIN OUTCOME MEASURE(S): Evaluation of ICSI procedure in cases of immotile cilia syndrome. RESULT(S): Thirty-three percent of the oocytes were fertilized and subsequently divided enabling ET in both cycles. CONCLUSION(S): Intracytoplasmic sperm injection seems to represent a promising approach to the problem of infertility in men with immotile cilia syndrome.

Adult↗

The effect of transdermal estradiol on the conjunctiva in postmenopausal women.

OBJECTIVE: To evaluate the effect of hormonal replacement therapy on the conjunctiva in postmenopausal women. STUDY DESIGN: A prospective clinical study in the setting of a tertiary-care university hospital. Eleven postmenopausal women received hormonal replacement therapy (transdermal estradiol or transdermal estradiol plus medroxyprogesterone acetate) for 4 months. Serum estradiol levels as well as vaginal and conjunctival maturation value (a cytological parameter) were measured before and after the treatment. Data were analysed using the Wilcoxon matched pairs signed-Rank test. RESULTS: A significant increase of serum estradiol levels (P < 0.01) and of vaginal maturation value (P < 0.01) were found. Cytological maturation changes in conjunctival epithelium were also observed. These changes, although mild, were statistically significant (P < 0.01). CONCLUSION: These data support the view that the hormonal replacement therapy induces cytological maturation changes in conjunctival epithelium in postmenopausal women.

Administration, Cutaneous↗

Intrafollicular ovarian pregnancy after ovulation induction/intrauterine insemination: pathophysiological aspects and diagnostic problems.

Ovarian pregnancy is a rare variant of ectopic implantation. A case of an intrafollicular ovarian pregnancy after ovulation induction/intrauterine insemination is presented. The woman had primary infertility of 4 years. Diagnostic laparoscopy revealed endometriosis and adhesions. After adhesiolysis and laser vaporization of endometriotic implants, the patient underwent ovulation induction with artificial insemination by husband/intrauterine insemination; she conceived at her second attempt. The pregnancy proved to be an ovarian intrafollicular one. She was treated by right partial ovariectomy. Three months later she conceived spontaneously with an intrauterine pregnancy which is still ongoing. The diagnostic problems resulting from the coexistence of ovarian hyperstimulation and the intrafollicular development of pregnancy are discussed. A re-evaluation of the criteria for the diagnosis of ovarian pregnancy based on the currently available diagnostic methods is proposed. Moreover, the pathophysiology of ovarian and especially intrafollicular implantation is reviewed.

Adult↗

Adenomyosis at hysterectomy: prevalence and relationship to operative findings and reproductive and menstrual factors.

In order to estimate the frequency and risk factors for adenomyosis, the clinical records of 594 women undergoing hysterectomy were retrieved. Data were collected on indications for the intervention, age at surgery, age at menarche, parity, abortions, mode of delivery, abnormal uterine bleeding, dysmenorrhea, and menopausal status at surgery. Adenomyosis was found in 116 of the 594 patients (19.5%). A pathologic condition was present in 63 patients with fibroids (20.5%), 11 with genital prolapse (25.6%), 11 with benign ovarian tumors (17.8%), six with endometrial hyperplasia (13.6%), two with cervical cancer (18.2%), ten with endometrial cancer (16.1%), and 13 with ovarian cancer (21.3%). No relationship was found between adenomyosis and endometriosis. On the contrary, a strong relationship was found between adenomyosis and parity, cesarean section, induced abortions, dysmenorrhea, abnormal uterine bleeding, and late age at menarche. These results show that adenomyosis is a common pathologic finding, significantly related to reproductive and menstrual characteristics of the patients.

Abortion, Induced↗

Lead concentrations in early human milk of urban and rural mothers.

The aim of this study was to determine and compare lead concentrations in breast milk between urban and rural women. Colostrum from 51 women living in the city of Thessaloniki (exposed to increased air lead concentration, 0.54 micrograms/m3) and from 40 women living in rural areas (exposed to significantly lower air lead concentrations) was analyzed by atomic absorption spectrometry. Urban women showed slightly higher lead concentrations (mean +/- SD: 0.090 +/- 0.029 micrograms/ml) than rural women (mean +/- SD: 0.084 +/- 0.024 micrograms/ml). This difference was not statistically significant. These results suggest that the lead content of human milk is not influenced by the concentrations of this environmental pollutant in the air.

Adolescent↗

Application of image analysis cytometry in follicular fluid cells obtained from in-vitro fertilization cycles: relationships to patient's age, oocyte maturity, fertilizability and in-vitro fertilization outcome.

In an in-vitro fertilization (IVF)/embryo transfer programme granulosa cells obtained from 59 individual preovulatory follicles were analysed using multiparameter image analysis cytometry, in an attempt to determine whether their morphometric and DNA-cytometric parameters could prove useful in assessing follicle and oocyte maturity and in predicting fertilizability and outcome of these IVF cycles. Almost all morphometric and DNA-cytometric parameters were not correlated with either the patient's age or oocyte maturity, and did not predict oocyte fertilization or occurrence of a clinical pregnancy. The only possible relevant parameter which, despite its inverse correlation to total luteinizing hormone administration, also proved to be inversely correlated to pregnancy outcome (in the seven cases in which a pregnancy occurred), was the percentage of granulosa cell nuclei with increased DNA content (> 5c). Finally, if granulosa cells do not reveal euploid polyploidization in spontaneous or induced ovulatory cycles, the detected cells with increased DNA content should be interpreted as aneuploid, i.e. with chromosomal aberrations, and so their presence could also be discussed in connection with the hypothetical risk of prospective neoplastic transformation of the tissue.

Adult↗

Pituitary-testicular axis in men with beta-thalassaemia major.

Delayed puberty and hypogonadism are frequently observed in patients with homozygous beta-thalassaemia. We evaluated the pituitary-testicular axis in 30 thalassaemic men, aged from 17 to 35 years who were regularly transfused and underwent chelation therapy, while emphasis was given to pituitary reserves of gonadotrophins and the correlation of hormones with serum ferritin (SF). The investigation included endocrinological examination, evaluation of serum basal levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), free testosterone and gonadotrophin-releasing hormone (GnRH) test and also spermiograms. According to the results, patients were divided into three groups: group A, which included 18 eugonadal patients with moderately elevated SF, group B which included six patients who had hypogonadotrophic hypogonadism and excessive elevation of SF, and group C, which included six patients characterized as intermediate, with regard to sexual maturation and SF levels. In conclusion, beta-thalassaemia major leads to variable pituitary iron overload and thus hypophyseal damage. This endocrine disturbance is becoming less frequent nowadays with early and intensive chelation therapy.

Adolescent↗

Squamous cell carcinoma arising from mature cystic teratoma: a report of three cases.

Cases of squamous cell carcinoma arising from mature cystic teratomas of the left ovary are presented. Two of the carcinomas occurred in postmenopausal women 54 and 71 years old and the third in a menstruating woman 42 years old. The two women with well-differentiated squamous cell carcinomas, who had extra ovarian extension of the tumor, died four and eight months postoperatively. The third woman with a poorly-differentiated squamous cell carcinoma, which was confined to the ovary, was alive two years after the operation. The special importance in the prognosis and spreading of tumors is emphasized.

Adult↗

Histopathological findings of the endometrium in patients with dysfunctional uterine bleeding.

The histopathological examination of the endometrium in cases of abnormal functional uterine bleeding frequently reveals the type of functional disturbance and assists correct treatment. On this basis, 7,000 endometrial curettages from patients with abnormal uterine bleeding were studied. The 1,282 cases with no endometrium in phase, organic changes, or systemic disorders were defined as dysfunctional uterine bleeding; the endometrial lesions were then classified and the histological findings correlated with the patients' ages. The endometrial curettages revealed an anovulatory cycle in 984 (77%) of the patients, and an ovulatory cycle in 298 (23%). Of the cases with an anovulatory cycle, 446 patients (47.5%) showed endometrial hyperplasia, 412 (41.86%) showed abnormal endometrial proliferation due to prolonged persistence of a follicle, while 106 (10.77%) showed deficient endometrial proliferation. Three hundred and thirty four cases (71.67%) of endometrial hyperplasia were (simple) cystic hyperplasias, 124 (26.60%) were (complex) adenomatous hyperplasia, and 8 (1.71%) were atypical hyperplasia. Of the cases with an ovulatory cycle, 252 (84.56%) showed deficient endometrial secretion due to a prolonged proliferative phase, while the other 46 (15.43%) showed deficient secretion due to luteal phase defect. Seven hundred and thirty six patients with an anovulatory cycle and 212 with an ovulatory cycle-i.e. 948 (74%) of the 1282 patients studied-were at the climacteric. The conclusions may be summarised as follows. i) Dysfunctional abnormal uterine bleeding was found more often at the climacteric and chiefly in the form of an anovulatory endometrium; ii) 88.14% of cases (1130 patients) presented histological signs of oestrogen influence in the form of either an anovulatory endometrium or an ovulatory endometrium; iii) Cystic (simple) hyperplasia was the most common form of endometrial hyperplasia.

Animals↗

Postmenopausal virilization due to ovarian hyperthecosis.

A case of a 66-year-old obese woman with type II diabetes mellitus and a 4 year history of virilism is presented. After removal of the ovaries the raised testosterone levels returned to normal and signs of virilism gradually receded. The histological finding of nodular hyperthecosis of the ovaries is discussed in relation to hyperinsulinaemia.

Aged↗

Maternal plasma level of thrombomodulin is increased in mild preeclampsia.

The purpose of this study was to determine if plasma thrombomodulin levels, a glycoprotein found on the surface of the endothelial cell, are elevated in pregnant women with mild preeclampsia and if these levels correlated with other features of disease severity. Parameters were compared in three groups of women: (I) 30 pregnant women with mild preeclampsia, (II) 30 normotensive pregnant women of similar lengths of gestation, and (III) 30 normotensive healthy young women. Thrombomodulin levels were significantly elevated in women with preeclampsia as compared with those of gestation-matched pregnant and non-pregnant controls. There was no correlation between plasma thrombomodulin levels and creatinine and uric acid blood levels. It is thus suggested that plasma thrombomodulin levels are elevated in preeclampsia, even in its mild stage, reflecting a vascular endothelial damage.

Adult↗