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Biomedical subjects

N Gleicher

Publications and source records attributed to N Gleicher.

232 records · Page 13Linked to original sources
PubMed1977

Leukocyte migration in ovarian carcinoma: comparison of inhibitory activity of tumor extracts.

Inhibition of migration of leukocytes from patients with serous cystadenocarcinoma of the ovary was studied by the use of several different types of ovarian carcinoma extract as antigen. KCl extract of an ovarian carconoma was found to be the most effective antigen preparation in comparison with saline, deoxycholate, and perchloric acid extracts. Low concentrations of KCl ovarian carcinoma extract significantly inhibited migration of leukocytes from 11 of 17 patients with ovarian carcinoma (migration index, less than 0.74). Leukocytes from patients with breast, colon, or endometrial carcinoma showed minimal reactivity with ovarian carcinoma KCl extract, and leukocytes from patients with ovarian carcinoma showed minimal reactivity with KCl extracts of breast, colon, and endometrial carcinoma. These results suggested that the 3 M KCl procedure is superior for the isolation of antigens active in the leukocyte migration inhibition test and that this test may be of use for the isolation of tumor-associated antigen and the immunodiagnosis of ovarian carcinoma.

Antibody Specificity↗
PubMedDate not supplied

Parenteral fat emulsions and immune adherence. The effects of triglycerides on red cell and neutrophil immune adherence in vitro and in vivo.

Parenteral fat emulsions may not only exert nutritional effects but may also affect immune adherence phenomena and red cell morphology. Red cell immune adherence (RCIA) was augmented in vitro by 0.05% to 0.1% Intralipid. Similar augmentation of RCIA was observed by peanut oil, corn oil, half-and-half cream, paraffin oil, and human low-density lipoprotein fractions. Neutrophil immune adherence was augmented in vitro by 0.2% to 1.5% of Intralipid. The effects of fat emulsions in vivo were studied in ten patients who received intralipid for nutritional purposes. Red cell immune adherence was augmented in five of ten patients and inhibited in four of ten patients. Neutrophil immune adherence was augmented in two of ten patients. Cytotoxic red cell transformations were evident in five of ten patients. Depression of RCIA in four of five patients was associated with cytotoxic red cell transformations.

Adult↗
PubMedDate not supplied

Rheumatic heart disease diagnosed during pregnancy: a 30-year follow-up.

One hundred one patients originally diagnosed as having rheumatic heart disease (RHD) during the years 1945-1948 were reevaluated in 1975 to determine the natural history of the disease. Twenty patients (19.8%) showed no sign of RHD. Of the patients with confirmed RHD, 56 (70.0%) had their original lesion confirmed, while 23 (28.8%) had developed additional valvular involvement. Pure mitral stenosis resulted in significantly lower mortality than all other valvular lesions, and congestive heart failure was the leading cause of death. Nineteen patients underwent cardiac surgery; the mortality in this group (52.6%) was not significantly higher than that in the overall RHD group (38.8%). False diagnosis of RHD during pregnancy is common. A more thorough evaluation of the "cardiac murmur of pregnancy" is advocated.

Adult↗
PubMedDate not supplied

The assessment of tubal functional status by tubal perfusion pressure measurements.

The measurement of tubal perfusion pressures (TPP) is a recent advance in the field of gynaecoradiology. Measurement of TPP involves a standardized technique using transcervically placed tubal catheters which is reviewed in detail. TPP assesses the functional status of the Fallopian tubes, i.e. their ability to permit pregnancy. Infertile patients with normal TPP demonstrated a higher pregnancy rate (10 out of 23) than patients with elevated TPP (four out of 24, P < 0.05). Analysis of patients who had undergone a laparoscopy as well as measurement of TPP suggest that elevated TPP are highly indicative of tubal endometriosis. Tubal catheterization with wireguides was successful in reducing mildly elevated TPP. The impact of this procedure on pregnancy rates is not known. The use of the gynaecoradiological techniques discussed in this paper has reduced the need for diagnostic laparoscopy at our centre by >60%. This was achieved without compromise in pregnancy rates and has resulted in a considerable reduction in cost.

Fallopian Tube Patency Tests↗
PubMedDate not supplied

Cost-effective infertility care.

Cost-effective healthcare has become a principal paradigm in all areas of medicine. In order to establish cost-effective care, clinical outcomes under various cost conditions have to be examined. Such a process cannot be static since it has to consider ever evolving treatments and outcome results. In infertility, the evaluation of cost-effective care should be simpler than in most other areas of medicine since treatment end-points are easily defined. Nevertheless, the field is lagging in the establishment of cost-effective treatment algorithms. In this review, an effort is made to define the current state of the art of cost effective infertility care, to suggest steps that can be taken to drive the process forward and to encourage the introduction of even limited processes to further the concept of outcome-dependent cost assessment within a practice setting. The limited availability of resources mandates their judicious use throughout medicine. In a field like infertility, by many (rightly or wrongly) perceived as 'elective', the judicious use of resources seems even more necessary since it would permit the treatment of larger patient populations than have currently access to care without further expense to third-party payments.

Cost-Benefit Analysis↗
PubMedDate not supplied

Autoantibodies in normal and abnormal pregnancy.

Abnormal autoimmune function has been associated with reproductive failure for decades. In fact, all medical conditions historically associated with pregnancy loss (and on occasion infertility) are now recognized to have an autoimmune etiology. It is therefore quite surprising that only less than a decade ago a correlation between the presence of abnormal autoantibodies and pregnancy loss was reported for the first time. Since reproductive failure, similar to other abnormal autoimmune states, is not a monoclonal event, we have established that affected patients demonstrate polyclonal autoantibody abnormalities including a variety of nonorganospecific as well as organspecific autoantibody groupings. For example, patients with repeated pregnancy loss will exhibit abnormal levels of anti-phospholipid antibodies (PA). In normal pregnancy natural autoantibodies do not follow the standard immunoglobulin (Ig) pattern, characterized by a decrease in levels despite a probably mild increase in production, which is excessively compensated by the vasodilatation of pregnancy. PA, especially, demonstrate a mild increase during pregnancy, though levels only in the peripartal period may reach abnormally high titers (in comparison to nonpregnant controls). This dichotomy between total Ig and natural autoantibodies is interesting since it suggests that autoantibodies may be under distinct control. In fact, we have suggested that this observed elevation of autoantibodies may be the result of an antigenic stimulus by self-like antigen, represented by the maternal growth of the parasitic fetus. In abnormal pregnancies, especially those associated with maternal hypertension and fetal growth retardation (IUGR), autoantibody levels do reach highly abnormal levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Habitual↗
PubMedDate not supplied

The consumer and provider: pillars of the new health care system.

Managed care has suffered a public backlash, with complaints increasing across the nation from unhappy patients. The physician community despises the current system and is wrestling for control of clinical decision-making. A health care system that is disliked by the public and is despised by the physician community can never succeed. No health care system or reform is possible without willing or even enthusiastic physician participation because only they can control costs, quality of care, and consumer satisfaction. A successful health care system recognizes that only providers can control quality of care and costs--and will create appropriate incentives that allow physicians to do so without losing the public's trust. The author advocates a new system, where consumers choose provider organizations based on disease expertise and purchase insurance through Internet accessible brokers. Provider organizations assume economic risk and have the detailed know-how to treat a specific disease spectrum better and cheaper. Consumers purchase this new "product" in a competitive market and are the principal benefactors of this market-driven, unmanaged care system.

Attitude of Health Personnel↗
PubMedDate not supplied

Transcervical balloon tuboplasty. A multicenter study.

Transcervical balloon tuboplasty represents a noninvasive technique to treat proximal tubal occlusion. In a multicenter study, 77 women with confirmed bilateral proximal tubal occlusion underwent the procedure. In 71 patients (92%), at least one proximally obstructed fallopian tube was recanalized. Concomitant distal bilateral tubal occlusions were diagnosed after successful proximal tubal balloon recanalizations in 13 patients (17%). In the remaining 64 patients, 22 clinical pregnancies (34%) have been confirmed during a median follow-up period of 12 months. Among those, 17 (77%) resulted in normal deliveries and five (23%) resulted in a first-trimester miscarriage. One patient was diagnosed with an ectopic pregnancy. Among 25 patients who had not conceived within 6 months of the procedure, 17 (68%) demonstrated continuing tubal patency on repeated hysterosalpingogram. We conclude that transcervical balloon tuboplasty is a safe outpatient technique that may represent an alternative to in vitro fertilization or microsurgical reanastomosis of fallopian tubes.

Adult↗
PubMedDate not supplied

Effects of progesterone on postoperative adhesion formation in hysterectomized rabbits.

Progesterone has been reported to have an antiinflammatory as well as immunosuppressive effect, and may prevent adhesion formation. In this study, nine treated and seven control rabbits were randomly selected for either pre- and postoperative progesterone treatment or no treatment. All rabbits underwent hysterectomy, focal peritoneal denudation, and intraabdominal instillation of suspended talc. Adhesion formation was evaluated 1 month postoperatively during repeat exploratory laparotomy. Progesterone-treated and control rabbits did not show any significant difference overall in the incidence of adhesion formation. Subgrouping of adhesion formation into adhesions formed by major surgical tissue trauma or minor peritoneal damage revealed a beneficial effect of progesterone in the reduction of only minor adhesion formation.

Animals↗