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Biomedical subjects

M Sigman

Publications and source records attributed to M Sigman.

At least 55 records · Page 3Linked to original sources
PubMed1995

Delayed appearance of sperm after end-to-side vasoepididymostomy.

The frequency and timing of the delayed appearance of sperm following an end-to-side vasoepididymostomy were determined in 89 patients. The surgical patency rate, defined as greater than 1 million sperm in the ejaculate, was 56% (50 of 89 consecutive patients). None of the 7 patients without sperm in the epididymal fluid at the anastomosis had sperm in the ejaculate postoperatively. Of the remaining 82 patients 31 had sperm on initial semen analysis within 3 months postoperatively. Seven of the 51 patients whose initial postoperative semen sample revealed azoospermia were lost to followup. Among the remaining 44 patients 18 (41%) had delayed appearance of sperm in the ejaculate (mean delay 6 months, range 3 to 15). The ultimate mean sperm count and motility in the patients with initially positive postoperative semen samples were not significantly different from those in patients with delayed appearance of sperm. In addition, the delayed anastomotic obstruction for both groups was the same (10% and 11%, respectively). Our results demonstrate that delayed appearance of sperm after end-to-side vasoepididymostomy is common and that the prognosis for patients with delayed appearance of sperm is not significantly worse than that for patients with sperm on the initial semen analysis.

Adult↗
PubMed1994

Comparison between diagnostic instruments for identifying high-functioning children with autism.

Two instruments for identifying autism in children and adolescents with intellectual abilities in the normal range were compared. Diagnostic tools consisted of the Autism Behavior Checklist (ABC) and the Autism Diagnostic Interview (ADI). The sample was composed of 18 children who were all diagnosed as having either infantile autism or infantile autism, residual state based on DSM-III criteria by a clinical team using observations, parental interviews, and interactions with the children. Only 4 of the children met diagnostic cutoffs for autism on the current ABC but all met criteria for diagnosis on the ABC using parental recall of the child's behavior at 3-5 years of age. The ADI had somewhat greater specificity in that 3 children did not meet criteria for diagnosis although 2 of these children also received ABC scores based on parental recollection that were in the borderline range.

Adolescent↗
PubMed1994

Laparoscopic versus subinguinal varicocelectomy: a comparative study.

OBJECTIVE: To determine the relative advantages of the laparoscopic approach to varicocelectomy, postoperative morbidity and pain in patients undergoing subinguinal varicocelectomies were compared with that of patients undergoing laparoscopic varicocele repairs. DESIGN: Retrospective study of concurrent groups of patients undergoing laparoscopic or open subinguinal varicocele repairs. SETTING: Tertiary teaching hospital. PATIENTS: Forty-seven patients with primary or secondary infertility. INTERVENTIONS: Patients were offered a choice between a laparoscopic or open subinguinal varicocele repair. MAIN OUTCOME MEASURES: The total number of pain pills used, the number of days of analgesics, and the number of days off from work after surgery were recorded. RESULTS: Fourteen patients underwent laparoscopic varicocelectomies, and 33 patients underwent subinguinal varicocelectomies. Analgesic use by the laparoscopic patients was no different from that of the subinguinal patients. The length of time off from work was significantly longer for the laparoscopic patients (6.4 days) as compared with the time off from work for the patients who underwent subinguinal varicocele repairs (2.6 days). CONCLUSION: The subinguinal varicocele repair performed with local anesthesia is a safe, low morbid technique offering a quicker recovery period than laparoscopic approaches. Although laparoscopic repairs may offer a shorter recovery period when compared with standard inguinal varicocelectomies, this is not the case when compared with subinguinal approaches.

Adult↗
PubMed1994

Attention to people and toys during social and object mastery in children with Down syndrome.

Attention to people versus objects by children with Down syndrome was examined. Subjects were presented with situations in which the primary focus alternated between an object stimulus (a toy) and a social stimulus (a singing experimenter). The children with Down syndrome monitored their environment in the same manner as did MA-matched typically developing children during object mastery and had a more focused attention style during social mastery. Reasons for this difference in attention across the two situations were discussed.

Attention↗
PubMed1994

Impact of a temporary food shortage on children and their mothers.

Kenya experienced a severe drought and temporary food shortage during a study on mild malnutrition. Effects of the temporary food shortage on energy intake, weight, and behaviors were evaluated in schoolchildren and in toddlers and their mothers. Schoolchildren were seriously affected, showing significant declines in their energy intake, age-corrected weight, activity on the playground, and classroom attention. Toddlers appear to have been somewhat protected since their energy intake, weight, and play and language behaviors were stable. Maternal caregiving of toddlers declined for the group as a whole, but individually those mothers who maintained family food levels delegated responsibility for toddlers to other caregivers. While the food shortage affected poorer families more than those of higher SES, declines in the behaviors of schoolchildren occurred regardless of SES and previous level of nutrition, suggesting that food shortages can have behavioral consequences for schoolchildren in all communities.

Child↗
PubMed1994

Assisted reproductive techniques and male infertility.

For couples in whom improvement in spermatogenesis is not possible or is unsuccessful in producing conception, ARTs offer much promise. For mild to moderate male factor couples, IUI combined with superovulation is often the initial procedure employed. If unsuccessful, IVF or one of its variations should be considered. With severe male factor cases, couples should proceed directly to IVF or one of its variations in which specific techniques may be used to improve the chances of fertilization. Currently both specialized semen-processing techniques and micromanipulation are used either singly or in combination. More experience is needed to determine which couples will benefit from which techniques. Although the urologist may not actively participate in all the actual ART procedures, it is important that the urologist have a thorough understanding of the procedures and their indications. This allows for accurate counseling of the male factor couple.

Humans↗
PubMed1994

Object mastery motivation of children with Down syndrome.

Mastery motivation of children with Down syndrome and MA-matched typically developing children was examined. The two groups performed similarly with respect to the quality of their play but differed in level of task engagement and causality pleasure. The children with Down syndrome appeared to be less engaged in the task than were the typically developing group as indicated by shorter sequences of goal-directed behavior and higher rates of toy rejection. In addition, the children with Down syndrome displayed less causality pleasure with object exploration than did the typically developing children.

Affect↗
PubMed1993

Laboratory testing in the evaluation of male infertility. A rational approach.

Laboratory testing is an integral component of the evaluation of the infertile man. This testing must be appropriate and specific for the individual couple. As there are many tests that evaluate various aspects of infertility, the urologist must understand what information the tests can offer as well as the limitations of each assay. The semen analysis remains the cornerstone of the evaluation but is not a functional assay. Other assays such as sperm-cervical mucus tests, hemizona assays, and the sperm-penetration assay are functional tests. Through the appropriate use of these and other tests, the urologist will be capable of better and more accurately counseling the infertile couple.

Follicle Stimulating Hormone↗
PubMed1993

The correlation between round cells and white blood cells in the semen.

It is generally recognized that white blood cells in semen are detrimental to sperm function and fertility. Traditionally, pyospermia has been suspected if greater than 10 round cells per high power field or more than 1 million round cells per ml. were identified in the semen. Since immature germ cells and white blood cells appear as round cells under wet mount light microscopy, the relationship between increased numbers of round cells in semen and true pyospermia was examined. Semen analyses were performed on specimens from 627 infertility patients. The numbers of round cells per high power field and the number of round cells per ml. of semen were recorded. Specimens from 57 patients (9%) persistently demonstrated greater than 10 round cells per high power field or more than 1 million round cells per ml. and they were subjected to immunohistochemical staining against white blood cell surface antigens. Greater than 1 million white blood cells per ml. were identified in only 20 patients (35%) and only 8 samples demonstrated more than 3 million white blood cells per ml. Of the patients with greater than 1 million white blood cells per ml. 65% had motilities of less than 60% compared to 49% of the patients with less than this amount of pyospermia. This difference was not statistically significant. Round cells counted on a per milliliter basis correlated better with results of immunohistochemical staining than did round cells counted on a per high power field basis. These data demonstrate that the majority of patients with excess round cells in the semen do not have pyospermia and, therefore, empiric antibiotic therapy without further testing will likely be unproductive.

Humans↗
PubMed1993

Parental perception of emotional expressiveness in children with autism.

Parents' perceptions of their children's emotional expressiveness, and possible bases for these perceptions, were investigated in a study comparing older, nonretarded autistic and normal children and in another study comparing young autistic, mentally retarded, and normal children. Both groups of autistic children were perceived as showing more negative emotion and less positive emotion than comparison children. In the younger sample, parental perceptions correlated with the children's attention and responsiveness to others' displays of emotion in 2 laboratory situations. Findings contradict the view that autism involves the "absence of emotional reaction" (American Psychiatric Association, 1987, p. 35).

Affective Symptoms↗
PubMed1993

Parent reports of behavioral and emotional problems among children in Kenya, Thailand, and the United States.

The behavioral and emotional problems children develop may differ from one cultural context to another. We explored this possibility, comparing 11-15-year-old Embu children in Kenya, Thai children, African-American children, and Caucasian-American children. Standardized parent reports on 118 problems revealed 62 significant (p < .01) culture effects. Caucasian-Americans were rated particularly high on undercontrolled problems (e.g., arguing, disobedient at home, cruel to others). Embu children were rated particularly high on overcontrolled problems (e.g., fears, feels guilty, somatic concerns), largely because of the numerous somatic problems reported. The findings may relate to the strict emphasis on compliance and obedience among the Embu, as opposed to the greater independence permitted in the United States. But alternative interpretations are discussed as well, including the effects of parent sensitivities and Third World living conditions.

Adolescent↗
PubMed1993

Hemispherectomy for intractable seizures: presurgical cerebral glucose metabolism and post-surgical non-verbal communication.

This study examined the presurgical 2-deoxy-2[18F]-fluoro-D-glucose positron emission tomography (PET) patterns of regional cerebral glucose metabolism in the non-resected hemisphere of 13 children who underwent hemispherectomy for early-onset intractable seizures. These patterns were compared with the rate of change in the children's non-verbal communication scores, measured before and after surgery. Irrespective of the side of surgery, the pre-operative glucose metabolism in the non-resected prefrontal cortex correlated significantly with the postoperative rate of change in the children's ability to focus the attention of an adult on an object or event (joint attention). These preliminary findings suggest that pre-operative PET patterns might be associated with certain aspects of the developmental outcome of children undergoing hemispherectomy.

Brain↗
PubMed1993

Varicoceles: postoperative prevalence--a prospective study with color Doppler US.

To define the ultrasound (US) prevalence of varicoceles after surgical repair, 28 postoperative patients underwent color Doppler US. A group of 26 control subjects also underwent color Doppler US to establish the prevalence of varicoceles in the healthy population. Eighteen of 28 (64%) patients who underwent color Doppler US scanning 16.4 months, on average, after varicocele repair had evidence of a varicocele, a number similar to that reported in other series for infertile men before surgery. Dominant veins in the postoperative patients were larger (P < .01) than those in the control subjects. Postoperative improvements in sperm parameters and conception rate in our subjects were 58% and 43%, respectively, consistent with findings reported in the literature. The prevalence of varicoceles detected at color Doppler US in our healthy population was 42% (11 of 26). Physical examination after surgery failed to show a varicocele in 20 of 22 (91%) patients examined. The discrepancy between sperm parameters and the results of color Doppler US and physical examination raises questions about the utility of US as a means of evaluation in the postvaricocelectomy patient.

Adult↗
PubMed1992

Understanding of simple and complex emotions in non-retarded children with autism.

Non-retarded autistic children are compared to normal controls on measures of emotion expression and recognition. In general, autistic subjects recounted appropriate examples of simple and complex emotions, and accurately labeled relatively ambiguous affect expression in pictures. Autistic children manifested some difficulty talking about socially derived emotions, pride and embarrassment. They required more time and more prompts, their responses were more tentative and "scripted", and they displayed limited understanding of the salience of others in embarrassing situations. Results are discussed in relation to theory of mind impairment and compensation strategies in autism.

Adolescent↗
PubMed1992

Non-verbal communication skills of surgically treated children with infantile spasms.

The authors present preliminary findings on the effects of surgery on the development of early non-verbal social communication skills in eight children with intractable infantile spasms. After a mean follow-up of 15.2 months, there was no statistically significant change in the post-surgical non-verbal communication behavior of these children beyond the expected developmental change. Implications of these findings for the developmental impairment associated with infantile spasms are discussed.

Cerebral Cortex↗
PubMed1992

Early onset intractable seizures: nonverbal communication after hemispherectomy.

The nonverbal communication skills of 10 children (mean age = 44.2 months) who underwent hemispherectomy for early onset intractable seizures were tested before and after surgery. A within-group analysis suggests that the 10 seizure-free children used more nonverbal communication after a mean follow-up period of 11.2 months than before surgery. Young normal language age matches were available for the 4 older and higher functioning subjects in the sample. Before surgery, the surgical subjects used less requesting gestures than did the normal children. After surgery, these differences were no longer apparent. The patients also employed more gestures to focus an adult's attention on objects and events than language-age-matched normal children. The children who underwent left or right hemispherectomy used similar nonverbal communication behaviors. The study's findings suggest that children with early onset intractable seizures have impaired early social communication that improves to some extent after hemispherectomy.

Child, Preschool↗