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M Glezerman

Publications and source records attributed to M Glezerman.

At least 19 recordsLinked to original sources
PubMed1997

Uterine sarcoma in the south of Israel: study of 36 cases.

BACKGROUND: Uterine sarcomas are rare, charaterized by rapid clinical progression and poor prognosis, and their management has been a challenge. The purpose of this study was to investigate the clinical and histologic findings, treatment, and outcome of patients with uterine sarcoma in the south of Israel. METHODS: Data from the files of 36 patients with uterine sarcoma who were managed at the Soroka Medical Center between January 1961 and December 1994 were evaluated. RESULTS: The 5-year survival rate was 32% overall; 63% for 9 patients with endometrial stromal sarcoma (ESS). 30% for 14 patients with mixed mesodermal sarcoma (MMS) and 18% for 13 patients with leiomyosarcoma (LMS): 41% for 22 patients with Stage I and 19% for 14 patients with Stages II, III, and IV. Only the difference in the 5-year survival rate between ESS and LMS was statistically significant (P < 0.05). Eleven patients (30.6%) were treated with surgery alone, 4 (11.1%) with surgery followed by pelvic radiotherapy, 11 (30.6%) with surgery followed by chemotherapy, 8 (22.2%) with surgery followed by pelvic radiotherapy and chemotherapy, one (2.8%) with chemotherapy alone, and one (2.8%) had no treatment. CONCLUSIONS: Uterine sarcomas are aggressive tumors with a poor prognosis. The treatment is surgery generally followed by adjuvant pelvic radiotherapy and/or systemic chemotherapy.

Adult↗
PubMed1997

Distinct expression of cytokines and mitogenic inhibitory factors in semen of fertile and infertile men.

PROBLEM: To assess the effect of seminal plasma (SP) of fertile and infertile men on leukocyte mitogenic response, and the capability of sperm cells to produce IL-1. METHODS: This study included four groups: fertile men (donors, normal), infertile men with azoospermia (azoo), oligo-terato-asthenozoospermia (OTA), and OTA with genital infection (OTA-inf). Mouse spleen cell proliferation in response to lipopolysaccharide (LPS) or Concanavalin-A (Con-A) was examined in the presence of SP from the above four groups. Supernatants (sup) and lysates (lys) of sperm cells from fertile and oligoteratoasthenospermic (OTA) men were evaluated for IL-1 bioactivity by specific bioassay. RESULTS: Seminal plasma (SP) of the four groups were shown to inhibit the mitogenic response of mouse spleen cells to LPS and Con-A. SP of fertile men was significantly more inhibitory than SP from infertile men. Sperm cells from fertile and OTA infertile men constitutively produced IL-1. Sperm cells of both groups produced similar levels of IL-1 as examined in the supernatants and lysates. CONCLUSIONS: Seminal plasma of fertile men had more inhibitory mitogenic activity than that of OTA. Sperm cells constitutively produce IL-1. It is possible that the factors involved in this inhibition are not only anti-proliferative immune factors. Cytokines and inhibitory factors of mitogenesis in the seminal plasma may be involved in the physiology and pathophysiology of sperm functions and thus affect male fertility.

Animals↗
PubMed1997

Distinct patterns of expression of interleukin-1 alpha and beta by normal and cancerous human ovarian tissues.

Immunohistochemical staining of normal and cancerous ovarian tissues has demonstrated that both IL-1 alpha and IL-1 beta are more strongly expressed in cancerous than in normal tissues and are secreted mainly by epithelial cells. We have shown by bioassay and immunoassay that cancerous, but not normal ovarian tissues constitutively secrete IL-1 in vitro. Activation of cancerous ovarian tissues by lipopolysaccharide (LPS) increased its capacity to secrete IL-1. Normal ovarian tissues secreted low amounts of IL-1 only after prolonged stimulation (72-96 h) by high doses of LPS (10-100 micrograms/ml). On the other hand, constitutive IL-1 was detected in homogenates of normal ovarian tissues and stimulation by LPS increased its capacity to produce IL-1. IL-1 beta was the main type of IL-1 secreted by cancerous ovarian tissues. IL-1 alpha was detected at lower levels. In contrast, in normal tissues similar amounts of both IL-1 alpha and IL-1 beta were detected in the supernatants. The levels of both types of IL-1, and also the bioactivity of IL-1 were significantly higher in cancerous than in normal ovarian tissues. Established primary cell lines from normal ovarian tissues did not secrete IL-1 into supernatants but did express it at very low levels. Stimulation with LPS did not affect the capacity of these cell lines to secrete IL-1 but it increased their capacity to express it. In contrast, primary established epithelial cell lines from cancerous ovarian tissues did secrete and express high levels of IL-1 and these levels were increased under stimulation with LPS. Cancerous ovarian tissues did not only secrete higher levels of both IL-1 alpha and beta than normal ovarian tissues, but also the mechanism controlling the secretion of these factors in cancerous ovarian tissues seemed to be different from that found in normal ovarian tissues. Our results suggest that paracrine/autocrine factors may be involved in the regulation of both types of IL-1 secreted by ovarian tissues. These cytokines may play a role in regulating the physiological, pathophysiological and oncogenic processes of the ovary.

Cell Line↗
PubMed1996

Adenocarcinoma of the uterine cervix: a study of 37 cases.

In a study of 37 patients diagnosed with cervical adenocarcinoma between 1961 and 1994, clinical and pathologic findings were evaluated. Of the 37 patients, 27 (73%) had a pure adenocarcinoma, five (13.5%) had a collision tumor and five (13.5%) had an adenosquamous carcinoma. Twenty-six patients (70.3%) were diagnosed in Stage I, and 11 (29.7%) patients in Stage II, III, and IV. Two patients (5.4%) were treated with simple hysterectomy alone, nine (24.3%) with simple hysterectomy followed by radiotherapy, eight (21.6%) with radical hysterectomy alone, five (13.5%) with radical hysterectomy followed by radiotherapy, nine (24.3%) with radiotherapy alone, one (2.7%) with radiotherapy followed by simple hysterectomy, and three (8.1%) received no treatment. The actuarial 5-year survival rate was 69%. It is suggested that for patients with small early-stage disease, radical hysterectomy should be primary treatment and postoperative adjuvant radiotherapy would be advocated if high-risk features are histologically demonstrated. For all other patients, radiotherapy should be primary treatment.

Adenocarcinoma↗
PubMed1996

Prolactin concentrations in preterm and term pregnancy and labour.

Maternal plasma and amniotic fluid (AF) were obtained for measurement of prolactin concentrations from: 1) 20 patients with preterm labor and intact membranes who delivered within one week of amniocentesis; 2) 20 patients with preterm labor who responded to tocolysis and delivered at term; 3) 20 women at term who were not in labor and 4) from 20 women in active labor at term. No significant differences were found between: 1) maternal plasma prolactin concentrations in women with preterm labor who delivered prematurely and those who delivered at term (155 ng/ml vs 176.5 ng/ml); 2) patients at term who were not in labor (188 ng/ml) and those who were in labor (155 ng/ml); 3) AF prolactin concentrations in the two preterm labor groups (1987.5 vs 1282.5 ng/ml) and 4) AF prolactin concentration in the two term groups (562 ng/ml vs 701 ng/ml). Prolactin concentrations were generally significantly higher preterm than at term. We concluded that no significant changes in maternal plasma and amniotic fluid prolactin levels were found in preterm and term parturition.

Adult↗
PubMed1996

Maternal plasma and amniotic fluid 17 beta-estradiol, progesterone and cortisol concentrations in women with successfully and unsuccessfully treated preterm labor.

Maternal plasma and amniotic fluid (AF) were obtained for measurement of 17 beta-estradiol, progesterone and cortisol concentrations from 40 patients with preterm labor and intact membranes at 28-32 weeks of gestation: 20 delivered preterm and the remaining 20 patients responded to tocolytic treatment and delivered at term. Maternal plasma and AF concentrations of these hormones were measured with specific commercially available radioimmunoassay kits. Maternal plasma and AF 17 beta-estradiol concentrations were significantly higher in women who delivered preterm than in those who delivered at term, 8.0 ng/ml vs 3.5 ng/ml and 0.85 ng/ml vs. 0.6 ng/ml, respectively. No significant differences were found between groups in maternal plasma and AF progesterone concentrations. Maternal plasma cortisol concentrations were higher in the preterm delivery group than in the term group (235 ng/ml vs. 55 ng/ml, respectively). No significant differences were found in AF cortisol concentrations between groups.

Adolescent↗
PubMed1996

Spreadsheet evaluation of computerized medical records: the impact on quality, time, and money.

Information and communication technologies are presumed to play a critical role in improving effectiveness and efficiency of clinical care. Although the most promising directions of technological development are microcomputer-generated computerized medical record systems, documenting their value has been a major challenge for health care providers. This paper proposes a 15-item spreadsheet instrument for evaluating computerized medical records, and demonstrates how it was experimentally applied to a 6-year long experience at three sites. In conclusion, preliminary implications and guidelines are drawn with regard to practice and research in this area.

Cost-Benefit Analysis↗
PubMed1996

Maternal plasma and amniotic fluid dehydroepiandrosterone-sulfate concentrations in preterm labor and delivery.

The purpose of this study was to determine whether preterm parturition is associated with changes in maternal plasma and amniotic fluid dehydroepian-drosterone-sulfate concentrations. A cross sectional study was constructed according to the gestational age at admission and response to tocolysis. Group 1 consisted of women admitted with preterm labor and intact membranes between 28 and 31 weeks and 6 days gestational age (n = 40). Group 2 included 40 patients with preterm labor between 32 and 36 weeks gestational age. Both groups were classified into two subgroups: preterm delivery within seven days of admission and term delivery. Commercially available immunoassay kits validated for amniotic fluid analysis of DHEA-S, were used to measure maternal plasma and amniotic fluid DHEA-S concentrations. Maternal plasma DHEA-S concentrations were significantly higher in women with preterm labor who delivered preterm than in those who delivered at term. (Group 1: median 800 ng/ml [range 100-1100] vs. median 200 ng/ml [70-800], P < 0.001; Group 2: median 850 ng/ml [300-1700] vs. median 300 ng/ml [90-1100], P < 0.001). In contrast, no significant differences were detected in amniotic fluid DHEA-S concentrations. Our data suggest that the rise in maternal plasma DHEA-S concentrations observed in patients with preterm labor may be related to the effects of stress during labor.

Adult↗
PubMed1996

Intraovarian blood flow during spontaneous and stimulated cycles.

This study was undertaken to investigate intraovarian blood flow during the early follicular, periovulatory and mid-luteal phases, during spontaneous and stimulated ovarian cycles. Transvaginal ultrasonography with colour flow imaging was used to measure the pulsatility index in eight patients with spontaneous cycles, 20 patients undergoing induction of ovulation with clomiphene citrate and 11 patients undergoing controlled ovarian hyperstimulation for in-vitro fertilization (IVF)-embryo transfer with gonadotrophin-releasing hormone analogue, human menopausal gonadotrophin, human chorionic gonadotrophin. All patients were studied during the early follicular, periovulatory and mid-luteal phase. Intraovarian blood flow velocity waveforms were found in 20% of cases at the early follicular phase, in 56% during the periovulatory phase and in 85% during the mid-luteal phase (P < 0.001). Pulsatility index at the early follicular phase was found to be 1.05 +/- 0.22, during the periovulatory phase 0.99 +/- 0.22 and during the mid-luteal phase 0.85 +/- 0.22. The appearance of intraovarian flow velocity waveforms may suggest either ovarian neovascularization or final follicular maturation or luteinization, which can be detected or measured by Doppler technology.

Blood Flow Velocity↗
PubMed1996

Decreased interleukin-2 production by rat uterine artery, aorta and uterine tissues during pregnancy.

Changes in size and function during pregnancy are unique to the uterine artery. The aim of this study was to determine the interleukin (IL)-6 activity of the uterine artery wall tissue in pregnant rats. A total of 18 Charles River white rats (nine virgin and nine in midpregnancy) were used for the study. Bilateral uterine arteries were obtained, together with reference tissues from aorta and uterus. IL-6 production was measured as optical density (OD)/mg protein, in control culture media, and in the presence of stimulants including IL-1, tumour necrosis factor alpha and lipopolysaccharide. Polyclonal rabbit anti-human IL-6 antibodies were used to assess IL-6 activity. In control culture medium, uterine artery tissue samples from virgin rats produced significantly higher concentrations of IL-6 than samples obtained from pregnancy animals (1.8 +/- 0.3 versus 0.9 +/- 0.25 OD/mg protein respectively (mean +/- SE, P = 0.001). Stimulation by lipopolysaccharide increased IL-6 activity of the uterine artery wall. In comparison with the uterine artery, the aorta produced higher activities of IL-6, and its production in virgin animal samples was higher than during pregnancy. Stimulants increased IL-6 production by both aorta and uterus tissues. Neutralization of IL-6 activity was obtained in a range of 77-93% in all samples. The lower level of IL-6 activity during pregnancy in the uterine artery and in reference tissues including aorta and uterus, may be related to acceptance of pregnancy by maternal tissues.

Animals↗
PubMed1996

Maternal plasma and amniotic fluid cortisol and progesterone concentrations between women with and without term labor. A comparison.

OBJECTIVE: The purpose of the present study was to determine the amniotic fluid and maternal plasma concentrations of cortisol and progesterone in nonlaboring women at term and to compare them to those in women with active labor at term. STUDY DESIGN: A prospective, cross-sectional study. Soroka Medical Center of Kupat Holim, Faculty of Health Sciences, Ben-Gurion University of the Negro, Beer-Sheva, Israel. Thirty-five healthy women with normal term pregnancies were classified according to labor status into two groups: group A (16 women with spontaneous, active labor at term) and group B (19 women not in labor). RESULTS: We found a significant increase in the median concentration of plasma cortisol in women at term in active labor in comparison to those not in labor. In addition, the median concentration of cortisol in amniotic fluid in women in labor was also significantly higher than that in women not in labor. In contrast, no significant changes in median maternal plasma or amniotic fluid progesterone concentrations were detected between the groups. CONCLUSION: Human parturition is associated with a significant increase in the concentration of cortisol in both maternal plasma and amniotic fluid. These findings suggest that cortisol plays an important but still-undetermined role in human parturition.

Adult↗
PubMed1996

Distinct expression levels of cytokines and soluble cytokine receptors in seminal plasma of fertile and infertile men.

OBJECTIVE: To compare the levels of interleukin (IL) 1 beta, IL-6, tumor necrosis factor (TNF) alpha, and soluble TNF (sTNF) receptors types I and II, and IL-1 receptor antagonist in seminal plasma of fertile and infertile men. DESIGN: Prospective and comparative study. SETTING: Andrology clinic of a university hospital. PATIENTS: Four groups of normogonadotropic men: group 1, donors with proven fertility (controls, n = 15); group 2, azoospermic men (n = 12); group 3, infertile men with oligoteratoasthenospermia (n = 20); and 11 men with oligoteratoasthenospermia and genital infection (n = 11). INTERVENTIONS: None. MAIN OUTCOME MEASURE: Measurement of cytokines and cytokine-soluble receptors in the semen by specific commercial kits. RESULTS: The levels of IL-1 beta, TNF-alpha, and IL-6 were similar in seminal plasma of controls and infertile men. The mean level of sTNF-I receptor in the seminal plasma of group 4 was 2.4 +/- 0.2 ng/mL, which was significantly lower than observed in seminal plasma of group 1 (3.88 +/- 0.5 ng/mL), the group 3 (4.1 +/- 0.4 ng/mL), or group 2 (3.03 +/- 0.35 ng/mL). The soluble receptor of TNF-II could not be detected in any group. Interleukin 1ra was 120 +/- 10 pg/mL in seminal plasma of group 1, but increased levels were detected in group 2 (420 +/- 180 pg/mL), group 3 (480 +/- 90 pg/mL), and even higher (760 +/- 120 ng/mL) in group 4 patients. CONCLUSIONS: During genital infection cytokines and various soluble receptors of immunoregulatory cytokines are expressed distinctly in seminal plasma. These factors also may be involved in the regulation of sperm cell functions and thus may affect male fertility. Our results may indicate local production of these factors in the secondary sex glands, independently of spermatogenesis.

Cytokines↗
PubMed1995

Malignant germ cell tumors of the ovary: a study of 20 cases.

In a study of 20 patients diagnosed with malignant ovarian germ cell tumors between 1961 and 1993, clinical and pathologic findings were evaluated. Of the 20 patients, seven (35%) had dysgerminoma, two (10%) endodermal sinus tumor, three (15%) malignant teratoma, one (5%) malignant struma ovarii, one (5%) primary ovarian carcinoid, two (10%) benign teratoma with malignant transformation, and four (20%) combination germ cell tumor. Twelve patients (60%) had stage IA, five (25%) stage IC, and three (15%) stage IIIC. Twelve patients (60%) underwent conservative surgery and eight (40%) had at least bilateral salpingo-oophorectomy. At follow-up, 18 patients (90%) were alive free of disease, one (5%) had died of disease, and one (5%) had died of intercurrent disease. The actuarial 5-year survival rate was 93.3%. It is concluded that for young women who wish to preserve child-bearing capacity, regardless of the stage of the tumor, fertility-preserving surgery with complete surgical staging followed, if necessary by cisplatin-based combination chemotherapy is an appropriate and definitive treatment in the absence of involvement of the contralateral ovary and uterus. For patients in whom child-bearing capacity is not an issue, surgery should include total abdominal hysterectomy and bilateral salpingo-oophorectomy with complete staging, followed if necessary by chemotherapy.

Adolescent↗
PubMed1995

Ureaplasma urealyticum cervical colonization as a marker for pregnancy complications.

OBJECTIVES: To determine the clinical significance of cervical colonization with (Ureaplasma urealyticum (Uu) and its possible relationship to pregnancy outcome. METHODS: Cervical cultures for Uu and serum antibodies to Uu were determined in four groups of pregnant women: (1) 117 women who underwent mid-trimester amniocentesis; (2) 47 women with preterm labor and intact membranes; (3) 34 women with preterm premature rupture of membranes; and (4) a control group of 315 healthy women with normal pregnancies. Statistical methods used were the chi-square and Fisher's exact tests. RESULTS: A significant increase in the cervical colonization rate with Uu was detected in all study groups (62%, 77% and 74%, respectively) when compared with the control group (42%). Women at mid-trimester of pregnancy with a positive cervical culture and high levels of antibodies, had a higher rate of pregnancy complications than those with a negative culture and absence of antibodies (62 vs. 28%, respectively; P = 0.0006). CONCLUSION: Cervical colonization with Uu when associated with elevated titers of antibodies to Uu, may serve as a marker for the identification of a subpopulation of women who are at high risk for the development of pregnancy complications.

Adult↗
PubMed1995

Breech presentation and cesarean section in term nulliparous women.

OBJECTIVE: To examine pregnancy outcome in nulliparous women with single term breech presentation. METHODS: Two departments of Obstetrics and Gynecology at the same hospital used different approaches to deliver nulliparous women with singleton breech presentation at term. One department (A) delivered by trial of labor and the other (B) delivered by elective cesarean section. Prospectively and blinded to obstetric condition, parturients were assigned to either department in a systematic alternate fashion. The study period covered 8 years (1985-1992). The pregnancy outcome parameters examined were: Apgar score, intra- and post-partum death and maternal and neonatal morbidity. Neonatal morbidity was classified in three major categories: non-neurological trauma, neurological signs and respiratory problems. RESULTS: The study included 264 women of whom 135 delivered in department A and 129 in department B. Department A had 35 vaginal and 100 cesarean births and department B 10 vaginal and 119 cesarean births. There was no intra-partum death and the only post-partum death occurred among vaginal deliveries. The Apgar score was significantly worse at 1 and 5 min in vaginally delivered babies of department B. Neonatal morbidity was significantly more frequent after vaginal births (P < 0.01). Maternal morbidity was significantly higher following cesarean sections (P < 0.01). Babies of vaginal deliveries had significantly higher non-neurological trauma (P < 0.01) and pathological neurological signs (P < 0.01) than those delivered by the abdominal route. CONCLUSION: The level of risk for mother and child in the nulliparous with term singleton breech, suggests cesarean section as the preferred route of delivery.

Adult↗
PubMed1995

Fetal pelvic kidney: a challenge in prenatal diagnosis?

The objective of this study was to establish ultrasonographic guidelines for the prenatal diagnosis of fetal pelvic kidneys and assess the relationship to clinical outcome. The records of all ultrasonographic diagnoses of a fetal pelvic kidney between 1 January 1991 and 31 December 1993 were reviewed. After review of the sonographic evaluation, the prenatal records were obtained, to assess demographic data as well as the obstetric course and neonatal outcome. If a fetal pelvic kidney was suspected on prenatal ultrasound examination, its precise location and size were recorded and compared with neonatal sonograms. Twenty-six cases of fetal ectopic kidney were diagnosed of which 13 were on the right side and 13 on the left (24/26 cases were diagnosed in the late second trimester). The size of the ectopic kidney did not differ from that of the normal kidney. Except for one case of hydronephrosis, there were no associated structural anomalies. All prenatal diagnoses were confirmed by postnatal sonograms and all neonates had normal renal function. Our conclusions are that prenatal sonographic detection of fetal pelvic kidney is feasible, although in most cases the diagnosis is made beyond 24 weeks' gestation. The importance of prenatal diagnosis is that the parents can be reassured that normal renal function is highly probable and that early neonatal intervention is usually unnecessary.

Adult↗
PubMed1995

Endogenous plasma growth hormone and the occurrence of pregnancies in patients undergoing in-vitro fertilization and embryo transfer with ovarian stimulation.

This study was undertaken to investigate a possible relationship between endogenous secretion of growth hormone (GH) during ovarian stimulation and treatment outcome in patients undergoing in-vitro fertilization (IVF) and embryo transfer. Plasma samples obtained from 19 women who had successfully completed all stages of IVF/embryo transfer were analysed retrospectively. Based on the increase in GH during treatment, 11 GH responders and eight GH non-responders were identified. Mean daily GH concentrations for the GH responders and GH non-responders were 3.5 +/- 1.8 and 1.8 +/- 0.8, 5.4 +/- 2.3 and 0.5 +/- 0.2, and 9.0 +/- 1.9 and 0.7 +/- 0.1 ng/ml (P < 0.05) for days 10, 11 and 12 respectively. Plasma insulin-like growth factor-I slightly increased with treatment in both groups. No significant difference between these groups was found in relation to treatment duration, number of human menopausal gonadotrophin ampoules used, oestradiol peak values, and number of oocytes retrieved or fertilization rate. Seven of the 11 GH responder women conceived in comparison with one pregnancy among eight GH non-responder patients (P < 0.05). In view of the absence of differences in the clinical and laboratory parameters, we suggest that the occurrence of pregnancies among GH responder patients might be related to a positive local effect of GH or its mediators on uterine receptivity at the time of nidation.

Adult↗