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Biomedical subjects

N Gleicher

Publications and source records attributed to N Gleicher.

At least 217 records · Page 12Linked to original sources
PubMed1980

Leukocyte migration enhancement as an indicator of immunologic enhancement. I. Pregnancy.

Leukocyte migration studies with amniotic fluid (AF) were performed in 47 pregnant women and 24 control patients. Previous reports about the enhancing effect of AF on leukocyte migration during pregnancy were confirmed (p less than 0.003). No enhancing effect was observed with first-trimester leukocytes. Maximal enhancement occurred during the second trimester (p less than 0.0001). It decreased during the third trimester (p less than 0.01) and lost significance in the postpartum period (p less than 0.072). Fifteen pregnant and control patients were investigated with autologous plasma. Leukocyte migration enhancement (LME) was significant with pregnancy plasma (PL) (p less than 0.03). Again LME was the largest during the second trimester (p less than 0.006). It is concluded that an immunologically active factor is present in AF and PL which in term induces the enhancing activity of a predetermined effector cell subgroup. This process is absent in conjunction with male leukocytes and is lacking in the majority of patients with toxemia of pregnancy.

Amniotic Fluid↗
PubMed1980

Leukocyte migration enhancement as an indicator of immunologic enhancement. III. Common denominators of pregnancy and malignancy.

Leukocyte migration enhancement (LME), a common denominator of pregnancy and malignancy, was investigated in order to determine the immunologic factors and processes involved in this in vitro assay. Reproducibility of results was confirmed by parallel investigations of single patients in an independent laboratory. Preliminary evidence also suggests that the phenomenon of LME is observable not only with the leukocyte migration assay, as performed in the present study, but also with the "indirect" migration inhibitory factor (MIF) assay. Highly significant correlation between results obtained with plasma (PL) and amniotic fluid (AF) was observed (p less than 0.00089). No significant correlation between LME and IgG concentrations as well as complement (C3) concentrations in AF and PL could be detected. C3 concentrations correlated significantly to gravity (p less than 0.007) and parity (p less than 0.003). No immune complexes were detected in either AF or PL samples. An unspecific protein effect as the cause of LME was ruled out in showing no significant correlation between LME and protein concentrations of AF and PL. A highly significant correlation between antigen concentration in PL and migration area was demonstrated (p less than 0.00001). It is suggested that leukocyte migration inhibition (LMI) represents a state of antigen excess, while LME represents antibody excess. Through selective removal of the IgG immunoglobulins LME could be converted into LMI, indicating an IgG subfraction as the responsible immunoglobulin in the phenomenon of LME.

Amniotic Fluid↗
PubMed1980

Leukocyte migration enhancement as an indicator of immunologic enhancement. II. Malignancy.

Leukocyte migration studies were performed on 19 cancer patients and 24 control subjects. Amniotic fluid (AF) as well as autologous plasma (PL) were investigated. No difference in the migration pattern between patients and control subjects was observed with AF, but cancer patients showed significant leukocyte migration enhancement (LME) with PL when compared to control subjects (p less than 0.04). Among 18 cancer patients with persistent disease only three did not show significant LME. All three represented specifically immunodepressed states. None of the untreated group of cancer patients failed to show LME with autologous PL. It is concluded that, as in pregnancy, an immunologic active factor is present in PL of cancer patients which induces a specific subpopulation of leukocytes and thereby LME. The possible mechanism of activation is briefly discussed. Through the detection of LME leukocyte migration may become of importance for the early detection of malignancy and monitoring of treatment success.

Adenocarcinoma↗
PubMed1980

Immune complexes (ICs) and pregnancy. Pregnancy as an IC-state or IC-disease and the influence of IC-diseases on pregnancy.

The immunologic tolerance of the fetoplacental allograft by the maternal immune system is still poorly understood. Recently published studies resulted in a widely publicized controversy on the presence or absence of immune complexes (ICs) in normal and abnormal pregnancies. The present review is an attempt to analyze presently known data critically and to reach subsequently derived conclusions which may be relevant to the understanding of the immunologic phenomenon of pregnancy. Pregnancy may represent an immune complex-state if the presence of ICs represents a physiologic state, or an immune complex-disease if ICs occur under special circumstances only, such as in the EPH-gestosis syndrome. In both of these instances, the presence of ICs may directly influence the maternal immune system, the fetal immune system, or result in very specific effects on associated immune complex-diseases. These effects and the possible influence of immune complex-diseases on normal pregnancy are extensively discussed. It is concluded that a clear definition of pregnancy as a possible IC-state or IC-disease is required. The confirmation of such a concept will necessitate a review of our clinical management protocols for a number of medical conditions.

Antigen-Antibody Complex↗
PubMed1980

A gynecologic presentation of mixed phakomatosis.

The case of a 31-year-old Jamaican woman with mixed phakomatosis is presented whose main complaint, bringing her to medical attention, was intractable vaginal bleeding. A previously undescribed form of uterine pathology, including hypertrophic varicose channels within the endometrium, represented the underlying cause for the patient's bleeding. The histological picture was similar to the vascular pathology in other organ systems. It is suggested that the reproductive organs may be involved in the systemic disease process of phakomatoses in a similar way as other, already recognized, organs. The phakomatoses are a group of poorly understood and underrecognized disorders. As multisystemic processes, myriad signs and symptoms may offer a clue to their diagnosis. The presentation of a mixed phakomatosis as a gynecological disorder, however, has not been reported. The following case illustrates this unusual mode of presentation.

Adult↗
PubMed1980

Sinusoidal fetal heart rate pattern in association with amnionitis.

A case is reported of intrapartum sinusoidal fetal heart rate (FHR) pattern in association with intrapartum amnionitis. Fetal and maternal outcome were excellent. Sinusoidal FHR patterns have been widely associated with severe fetal asphyxia and impending fetal death. In reviewing the published experience with sinusoidal FHR patterns, it is concluded that, although it is alarming, not every sinusoidal FHR pattern is an indication for immediated delivery.

Adult↗
PubMed1980

Intrauterine meconium aspiration syndrome.

A case of presumptive intrauterine meconium aspiration is reported in which the diagnosis was made on the basis of an unexplained intrauterine fetal tachycardia and the presence of severely meconium-stained amniotic fluid. The possible pathophysiology of intrauterine meconium aspiration is discussed with special attention to animal experimentation. The importance of an early diagnosis of this condition is stressed. The clinical management of such cases may change once the antenatal diagnosis of intrauterine meconium aspiration can be made with more certainty. In addition, the legal implications of a confirmed diagnosis of intrauterine meconium aspiration are discussed as meconium aspiration is considered presently to represent a largely preventable neonatal event.

Adolescent↗
PubMed1979

A blocking factor in amniotic fluid causing leukocyte migration enhancement.

Amniotic fluid was found to cause significant leukocyte migration enhancement during the second and third trimester of pregnancy and in the early postpartum period when compared to the migration area obtained with an ovarian tumor homogenate antigen (p less than 0.01), choriocarcinoma spent medium (p less than 0.01), and placental pool homogenate (p less than 0.01). Only borderline significance (p less than 0.1) was obtained when migration enhancement with AF was compared between pregnant and nonpregnant female control patients, indicating minimal unspecific activity of AF. Migration enhancement with autologous amniotic fluid was slightly larger than with homologous amniotic fluid, but the difference did not reach significance (p less than 0.4). None of the control antigens caused migration enhancement; placental pool homogenate in concentrations above 4 mg. per cent caused migration inhibition but did not in lower concentrations. The enhancing effect of AF could be abolished by dilution but not by addition of excessive antibody to estrogen of HCG. It is suggested that a blocking factor is present in AF preventing recognition of fetoplacental antigen by the maternal immune system. Thus in vitro leukocyte migration enhancement may correlate to in vivo graft enhancement.

Amniotic Fluid↗
PubMed1979

Eisenmenger's syndrome and pregnancy.

Two additional cases of successfully managed Eisenmenger's syndrome (ES) during pregnancy are described. A review of the literature on this subject revealed 115 reported cases, of which only 44 (including our two cases) were felt to be adequately documented, representing 70 pregnancies. These formed the material for statistical evaluation. Fifty-two per cent of all patients died in connection with pregnancy. Thirty and three-tenths per cent of all pregnancies results in maternal death. Maternal mortality in first, second, and third pregnancies was not significantly different. A high incidence of maternal death was assoicated with hypovolemia, thromboembolic phenomena and preeclampsia, but mortality was not higher in the toxemia than in the non-toxemia group. Cesarean sections and other operations are associated with extremely high maternal mortality during pregnancy. Thirty-four per cent of all vaginal deliveries, three out of four cesarean sections, and only 1 out of 14 pregnancy interruptions (the only one by hysterotomy) resulted in maternal death. Abortions are significantly safer than any kind of delivery (p less than 0.05). Ventricular septal defect (VSD) is the most frequent underlying shunt defect. Maternal mortality in association with VSD is higher (60%) than in association with atrial septal defect (ASD) (44%) and patent ductus arteriosus (PDA) (41.7%). The majority of maternal deaths occurred during or within the first week after delivery. Only 25.6 per cent of all pregnancies reached term. At least 54.9 per cent of all deliveries occurred prematurely. Thirty and two-tenths per cent of all infants showed intrauterine growth retardation. This represented almost half of all new borns with available information. Perinatal mortality reached 28.3 per cent and was significantly associated with prematurity (p less than 0.001). Pregnancy is contraindicated in patients with ES. Abortion is the treatment of choice, once pregnancy has occurred. Where interruption of pregnancy is refused, utmost care must be taken to assure maternal and fetal survival. A protocol for the management of such pregnancies is discussed on the basis of available information.

Abortion, Therapeutic↗
PubMed1979

Familial malignant melanoma of the female genitalia: a case report and review.

An additional case of familial occurrence of malignant melanoma is presented, involving mother and son. This is the fourth case of familial occurrence of malignant melanoma in the female genitalia and the first occurring in the vagina reported in the literature. We present a review of the literature concerning the hereditary property of malignant melanoma, including a list of all 92 families and 240 patients reported. The importance of a family history of malignant melanoma for the early diagnosis of this disease in relatives at risk is stressed.

Adult↗
PubMed1979

Common aspects of immunologic tolerance in pregnancy and malignancy.

The fetoplacental allograft and the malignant neoplasm represent the only 2 biologic conditions in which antigenic tissue is tolerated by a seemingly intact immune system. Recent investigations in the fields of tumor and pregnancy immunology have resulted in the recognition of a variety of immunologic mechanisms which are common to both systems. These common denominators are reviewed and a thesis suggesting a common mechanism in the nonrejection of pregnancy and malignancy, based on the presence of embryonic antigens in both systems, is presented.

Antibody Formation↗
PubMed1978

An infected ovarian hematoma as the presenting symptom of systemic lupus erythematosus.

A patient with systemic lupus erythematosus (SLE) and an associated coagulation defect presented with the clinical picture of an inflammatory pelvic mass. The laboratory data led to the diagnosis of SLE. A laparotomy revealed an infected hematoma of the left ovary. The SLE-induced coagulation deficit may have caused an intraovarian hematoma at the time of ovulation that became infected secondarily and led to an inflammatory pelvic mass as the first sign of SLE.

Adult↗