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M Fejgin

Publications and source records attributed to M Fejgin.

At least 55 records · Page 3Linked to original sources
PubMed1994

Laparoscopic Resection of a Cornual Pregnancy: A First Case Report

Laparoscopic surgery is currently the preferred diagnostic and treatment modality for ectopic pregnancy (EP). Cornual pregnancy, a rare and dangerous form of EP, is usually treated by cornual resection or hysterectomy. We report the first case to be treated by laparoscopic surgery. A 27 year old, gravida 3 para 2, was diagnosed with a nine week right cornual pregnancy. Laparoscopy revealed a 3 x 4 cm bulge into the right cornual area. Both fallopian tubes were otherwise normal. The uterus was fixed by a grasping forceps and the right tube and ovarian ligament were coagulated to reduce the blood supply. The gestational area was entered via a 1 cm incision using unipolar scissors and electrocoagulation. The pregnancy contents were suctioned; cavity margins and placental bed were coagulated until hemostasis was secured. The uterus contracted. The posterior leaf of the broad ligament was flapped over the incision site and attached by coagulation points. Postoperative course was uneventful. A hysterosalpingogram performed 4 months post surgery revealed a normal uterine cavity and blocked right tube.

Journal Article↗
PubMed1994

Estrogen replacement in postmenopausal women: are we currently overdosing our patients?

As there are no proven optimal serum estradiol levels, we sought to evaluate the pharmacokinetic profiles of serum estradiol levels following a single oral dose of 2 mg estradiol and 1 mg of estriol (Trisequens) among 26 surgically induced, postmenopausal patients. Their serum estradiol levels were periodically measured over 24 h following oral administration of the drug. They were divided into two groups according to the computed hourly mean estradiol values: group A, < 250 pg/ml/h ( < 918 pmol/l/h) and group B, > 250 pg/ml/h ( > 918 pmol/l/h). The mean peak estradiol concentrations were noted 2 h after drug administration and amounted to 595 +/- 190 pg/ml (2,184 +/- 697 pmol/l) in the entire cohort; 435 +/- 117 pg/ml (1,597 +/- 430 pmol/l) in group A and 712 +/- 142 pg/ml (2,614 +/- 521 pmol/l) in group B (p < 0.001). The mean total area under the curve in group A was 4,887 pg/ml (17,940 pmol/l), which was significantly lower than that of 7,995 +/- 652 pg/ml/24 h (29,350 +/- 2,393 pmol/l/24 h) found for group B (p < 0.001). The mean body mass index showed a significant difference (p < 0.003) between group A and group B (29.4 +/- 0.56 vs. 24.3 +/- 0.24). We found that 57% of our patients were exposed to excessively high levels of estradiol during the 24-hour period following drug ingestion. We advise monitoring estradiol levels and individualizing estrogen replacement therapy, to avoid the long-term exposure of postmenopausal patients to superphysiological estradiol levels.

Adult↗
PubMed1993

In situ hybridization: a simple and sensitive method for detection of trisomy 12 in chronic lymphocytic leukemia.

Chromosome aberrations are detected in only 50% of patients with chronic lymphocytic leukemia (CLL), owing usually to the low mitotic rate exhibited by the neoplastic lymphocytes. Fluorescence in situ hybridization (FISH) is a simple method for identifying numerical abnormalities of the target chromosome in interphase nuclei. Therefore, we used the FISH procedure with chromosome 12-specific a-satellite probe to evaluate 19 patients with CLL. Trisomy 12 was detected in interphase cells of 12 patients (63%). Cytogenetic analysis, performed in nine patients, yielded trisomy 12 in four (44%). FISH detected three patients with trisomy 12 in whom conventional cytogenetic method yielded a normal karyotype. FISH is a simple, reliable, and sensitive method for detection of trisomy 12 in patients with CLL.

Aged↗
PubMed1993

Elevated human chorionic gonadotropin levels in pregnancies with sex chromosome abnormalities.

Numerous reports have dealt with the usefulness of the maternal serum alpha-fetoprotein marker (MsAFP) and human chorionic gonadotropin (MshCG) levels in the detection of Down syndrome (DS) and other autosomal trisomies. Only few reports have discussed the possible association of elevated levels of MshCG and sex chromosome aneuploidy. We wish to report on 3 cases in which this association was found.

Adult↗
PubMed1993

The correlation between the frequency of sister-chromatid exchange and human reproductive hormones.

Different frequencies of sister-chromatid exchanges (SCEs) during various stages of the menstrual cycle have previously been observed. We tested the hypothesis that sex hormones, particularly steroids, influence the frequency of SCEs in women undergoing ovulation induction for in vitro fertilization treatment. These women undergo extreme hormonal changes and therefore serve as a good model for testing the rate of genetic damage due to these changes. As controls, we tested fertile women with regular menstrual cycles who received no hormonal treatment. Peripheral lymphocytes were obtained during different stages of the normal and treated cycles. We examined SCE frequency as related to the different hormones of the reproductive cycle at each of the stages. In general, an increased SCE frequency was observed around ovulation time in the controls, and around the time of human chorionic gonadotropin administration in the group undergoing ovulation induction. However, in the latter group, SCE frequency was significantly higher. SCE frequency was positively correlated with the level of testosterone and FSH in the ovulation induction group, and positively correlated with the estradiol level in both groups.

Adult↗
PubMed1993

Clinical detection of BCR-abl fusion by in situ hybridization in chronic myelogenous leukemia.

We describe the use of the fluorescence in situ hybridization (FISH) technique to detect residual Philadelphia chromosome-positive (Ph+) cells in a patient with blastic phase chronic myelogenous leukemia (CML) after aggressive cytoreductive treatment. The analysis was made in interphase nuclei because of the very small number of recognizable metaphases in leukemic patients. FISH was a reliable tool for the detection of chromosome translocations in interphase nuclei as compared with conventional cytogenetic and polymerase chain reaction (PCR) techniques.

Adult↗
PubMed1993

The inability of preovulatory ovarian scan to predict multifetal pregnancy occurrence in a follow-up of induction of ovulation with menotropins.

OBJECTIVE: To establish the predictive role of preovulatory ovarian ultrasonography in the occurrence of multiple pregnancy after hMG and hCG treatment for anovulatory infertility. DESIGN: Prospective. SETTING: Outpatient Infertility Clinic. PATIENTS: Ninety-five anovulatory women who conceived after gonadotropin therapy. INTERVENTION: Induction of ovulation by hMG and hCG monitored by plasma E2 measurements and ovarian ultrasonography. MAIN OUTCOME MEASURES: All follicles visualized on the day of hCG administration were recorded and divided into the following four groups: group I, 10 to 12 mm; group II, 13 to 15 mm; group III, 16 to 18 mm; and group IV, 19 mm and larger. The sonographic findings were statistically evaluated to 80 singletons and 45 multiple pregnancies. RESULTS: No statistical correlation was found to exist between the number of follicles from the different groups and the number of fetuses. CONCLUSIONS: The number and sizes of follicles visualized on the day of hCG administration have no predictive value regarding the occurrence of a multiple pregnancy.

Adult↗
PubMed1993

Fluorescent in situ hybridization for the detection of t(8:14) in Burkitt's lymphoma.

Burkitt's lymphoma cells exhibit the reciprocal balanced chromosomal translocation t(8:14) in 75% of patients. Cytogenetic analysis is time-consuming, requires in vitro culture with mitogens and enables to analyse a relatively small number of cells. We evaluated the role of multicolor fluorescent in situ hybridization (FISH) in the rapid detection of t(8:14) in Burkitt's lymphoma cells. FISH detected the JH/myc translocation in 100% of the cells of five cell lines carrying the classical t(8:14) and in fresh cells obtained from a newly diagnosed Burkitt's lymphoma patient. In contrast, the translocation was not detected in the Bajb cell line that does not carry t(8:14). We conclude that FISH is a rapid and reliable diagnostic tool for the detection of the JH/myc translocation in Burkitt's lymphoma patients.

Biopsy, Needle↗
PubMed1992

The dilemma of a low rate of chromosomal mosaicism found in fetal blood sampling.

We report a case in which mosaicism of trisomy 13 was detected in 4/10 cells (40 per cent) in amniotic fluid cell cultures, followed by a low rate of mosaicism (1/160 cells) detected in a fetal blood sample. This finding presents a dilemma both for the genetic counsellor and for the parents in determining whether or not to terminate the pregnancy.

Adult↗
PubMed1992

Placental insufficiency as a possible cause of low maternal serum human chorionic gonadotropin and low maternal serum unconjugated estriol levels in triploidy.

We report three cases in which triploidy (69,XXX) was detected by amniocentesis performed for very low maternal serum human chorionic gonadotropin levels. All three cases also had low maternal serum unconjugated estriol levels. We suggest placental insufficiency as the cause of the very low human chorionic gonadotropin because of histologic observations and because a known marker for placental insufficiency, estriol, was also very low.

Abortion, Therapeutic↗
PubMed1991

Screening for Down's syndrome in older women based on maternal serum alpha-fetoprotein levels and age: preliminary results.

We report the results of screening for Down's syndrome (DS) in older women using published rate schedules based on maternal serum alpha-fetoprotein (MSAFP) and age. Five hundred and seventeen patients aged 35 years and older, who were referred for a mid-trimester genetic amniocentesis, were first tested for MSAFP and then underwent an amniocentesis. Individual risks for DS, combining MSAFP and age, were derived using three different published rate schedules. Theoretical selection for amniocentesis was made using the cut-off level of the average collective risk for a 35-year-old woman (1:380 at live birth or 1:270 at amniocentesis). Six affected pregnancies (five with DS and one with trisomy 18), which were diagnosed prenatally, were all found to be at a higher risk than the specified cut-off. These cases would have been diagnosed in any event, using any of the published rate schedules. According to these rate schedules, between 39 and 45 per cent of the patients would be in the lower risk group and therefore would have been counselled not to undergo amniocentesis. Further studies should be conducted in order to reach conclusive screening policies for DS in older women.

Adult↗
PubMed1990

Chromosomal analysis of unfertilized oocytes and morphologically abnormal preimplantation embryos from an in vitro fertilization program.

In vitro fertilization cycles yield a low percentage of pregnancies. Eighty-five to ninety percent of the transferred embryos do not implant, and the abortion rate approaches 30%. Aneuploidy is assumed to be responsible for a major portion of this pregnancy wastage. The purpose of this study was to determine if there was any correlation between morphology and chromosomal content of unfertilized oocytes and rejected embryos. To assess the chromosomal content of oocytes and embryos, we used the method described by Tarkowski in 1966. Sixty oocytes fron 28 women, aged between 27 and 41 years, were analyzed. Sixty-seven percent were aneuploid; of these, 23.35% were hyperhaploid, 23.35% were hypohaploid, 8.35% were hyperdiploid, 3.35% were diploid, and 8.35% showed premature chromosome condensation. Of 20 preimplantation embryos analyzed, 80% were aneuploid, 10% were diploid, 5% were haploid, and 5% showed structural anomaly. Correlation was found between maternal age and aneuploidy in oocytes and between morphology and genetic balance in preimplantation embryos.

Adult↗
PubMed1990

Effect of preovulatory progesterone administration on the endometrial maturation and implantation rate after in vitro fertilization and embryo transfer.

Fifty-two women, who had 62 ovum aspiration cycles, received a progesterone (P) supplementation of 100 mg/day that was initiated 10 hours before human chorionic gonadotropin (hCG) administration and was continued over the following 6 days. Forty-eight women who had 74 ovum pick-ups, but did not get P, served as controls. Forty-four (84.6%) women of the treatment group, and 40 (83.3%) of the controls had ovum fertilization and embryo replacement. The fertilization and cleavage rates and the mean number of replaced embryos per embryo transfer (ET) cycle did not differ between the groups. Endometrial biopsies, from treatment group women with no fertilized eggs, which were taken 48 hours after ovum pick-up, mostly revealed an "advanced endometrial dating," in relation to the "day of hCG." Pregnancy rate per ET cycle for the treatment group was significantly higher than that of the controls; 41.2% versus 23.3%, respectively. It is concluded that the higher pregnancy rate resulted from an improvement in uterine receptivity.

Adult↗