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Biomedical subjects

N Rana

Publications and source records attributed to N Rana.

33 records · Page 2Linked to original sources
PubMed1995

Differential expression of VLA beta 1 (CD29) on monocytes from patients with endometriosis.

PROBLEM: Previous studies have established that in vitro proliferation of endometrial cells is enhanced by peripheral blood monocytes (PBM) and suppressed by peritoneal macrophages (PM) from patients with endometriosis but only suppressed by PBM and PM obtained from normal subjects. The functional activity of PBM and PM is influenced by the engagement of numerous cell surface receptors with their respective physiological ligands. METHOD: In this study, PBM and PM from fertile women (Group 1), women with unexplained infertility (Group 2), and women with limited (Group 3) or severe (Group 4) endometriosis were isolated in order to analyze these cells for the expression of CD54, CD58 and HLA-DR (immunoglobulin supergene antigens) CD18 and CD29 (integrins) and CD44 (an addresin). These cell surface antigens are involved in monocyte/macrophage trafficking, activation, signal transduction and/or adhesion. RESULTS: No differences were detected in the percentage of PBM expressing CD18, CD44, CD54, CD58, or HLA-DR among the four groups of subjects. Furthermore, the density of these antigens expressed on PBM was identical in patients and control subjects. In contrast, the percentage of PBM expressing CD29 (also known as VLA beta 1) and the density of CD29 expressed per cell were significantly reduced (P < 0.01) in patients with limited endometriosis compared to controls and patients with severe disease. Interestingly, although the percentage of CD29+ PBM from women with severe endometriosis was not statistically different from the percentage of CD29+ PBM from controls, the density of CD29 expressed per cell was significantly elevated among patients with severe disease. Analysis of PM from the four subject groups revealed no differences in CD29 expression or density. However, the percentage of PM expressing CD18 was significantly decreased in patients with limited (but not severe) endometriosis. CONCLUSION: Since both CD18 and CD29 play a role in cell trafficking and/or adhesion, alterations in their expression among patients with endometriosis suggest that these integrin beta chains may play a role in the pathogenesis of the disease.

Endometriosis↗
PubMed1994

Monocyte-mediated enhancement of endometrial cell proliferation in women with endometriosis.

OBJECTIVE: To investigate the capacity of monocytes from women with endometriosis to influence endometrial cell proliferation. DESIGN: Uterine endometrial cells were cultured in the presence and absence of autologous blood monocytes for 72 hours before assessment of endometrial cell proliferation by thymidine incorporation. SETTING: Patients were tested at initial presentation for evaluation of infertility and/or endometriosis. PATIENTS, PARTICIPANTS: Fertile controls, n = 17; infertile controls, n = 9; untreated endometriosis, n = 29. INTERVENTIONS: None. RESULTS: Endometrial cell proliferation was enhanced significantly by blood monocytes in patients with endometriosis but was suppressed significantly by blood monocytes in fertile controls. Endometrial cell proliferation was not affected significantly by blood monocytes in infertile controls analyzed as a group, but a subset of infertile patients also showed enhancement of endometrial cell proliferation by blood monocytes. CONCLUSIONS: Blood monocytes from patients with endometriosis and a subset of patients with unexplained infertility enhance autologous endometrial cell proliferation, whereas blood monocytes from fertile patients suppress endometrial cell proliferation. The capacity of monocytes to enhance endometrial cell proliferation appears to require both monocyte-derived factors that stimulate endometrial cell proliferation and endometrial cells capable of responding to those stimulatory factors. If either of these factors is absent, monocytes either suppress or have no effect on endometrial cell proliferation.

Adult↗
PubMed1993

Correlation between fetal heart rate, crown-rump length, and beta-human chorionic gonadotropin levels during the first trimester of well-timed conceptions resulting from infertility treatment.

OBJECTIVES: To evaluate sequential changes in fetal heart rate (FHR) during the first trimester of well-timed pregnancies resulting from infertility treatment and to correlate the data with fetal growth curve and beta-hCG levels. DESIGN: Serial measurements of FHR, crown-rump length (CRL) and beta-hCG at weekly intervals throughout the first trimester in 67 consecutive conceptions, resulting from infertility treatment. The day of preovulatory LH surge or of exogenous hCG administration was known in each case. SETTING: Hospital based and private assisted reproductive technology centers. RESULTS: Mean FHR was 108 +/- 12, 26 to 30 days after LH/hCG (5 weeks, 4 days from last menstrual period [LMP]) in embryos 3 +/- 0.3 mm in size; the FHR gradually increased, reaching a peak of 177 +/- 10 on days 51 to 55 (9 weeks from LMP) in embryos of 23 +/- 5.5 mm; it decreased to 156 +/- 5 on days 76 to 80 (12 weeks, 5 days from LMP) in embryos of 62 +/- 5.7 mm. There was, previously not reported, high level correlation between beta-hCG and FHR during the entire first trimester and positive correlation between FHR and CRL during the first 55 days from conception. CONCLUSIONS: During the first trimester of pregnancy, FHR closely follows beta-hCG pattern. Correlation between beta-hCG and FHR is an interesting phenomenon that needs further investigation.

Chorionic Gonadotropin↗
PubMed1993

Experience with laparoscopic hysterectomy.

We conducted laparoscopic hysterectomy on 62 consecutive patients; 12 had laparoscopically assisted vaginal hysterectomy (LAVH), 16 had total laparoscopic hysterectomy (TLH), and 34 had supracervical laparoscopic hysterectomy (SLH). The groups were comparable with regard to age, weight, history of abdominal surgery, number of additional procedures performed, and weight of specimens; 74% had previous abdominal surgery, and 69% had additional procedures at hysterectomy. The mean estimated blood loss associated with LAVH was 2.5 times greater than that with TLH and 3 times greater than with SLH. The length of surgery was influenced by patient selection, surgeon's experience, and equipment malfunction, with a mean of 213 minutes for LAVH, 244 for TLH, and 212 for SLH. The mean hospital stay for LAVH was 1.9 days and less than 1 day for TLH and SLH. There were nine total complications in the series (15%). Twelve (19%) of the specimens showed no abnormalities on pathologic examination. Total and supracervical laparoscopic hysterectomy and LAVH are appropriate operations for selected patients and compare favorably with standard abdominal or vaginal hysterectomy. The procedures demand sophisticated instrumentation and a dedicated endoscopy team to ensure safe and efficient performance.

Adult↗
PubMed1993

Mitogen induced production of polyclonal IgG is decreased in women with severe endometriosis.

PROBLEM: The etiology and/or pathogenesis of endometriosis may involve aspects of both humoral and cellular immunity. METHOD: In this investigation, we analyzed the ability of B lymphocytes from distinct patient groups for production of IgG1, IgG2, and IgG3 following in vitro stimulation with polyclonal B-cell mitogens (pokeweed mitogen and Staphylococcus aureus Cowan strain I) after in vitro stimulation with polyclonal B-cell activators. RESULTS: We observed that the in vitro production of IgG1, IgG2, and IgG3 was identical among fertile controls (no endometriosis; N = 22), infertile women without endometriosis (N = 22), infertile women without endometriosis (N = 20) and patients with stage 1 or 2 endometriosis (N = 31). In contrast, in vitro IgG2 production was significantly reduced among women with stage 3 or 4 endometriosis (N = 11) compared to controls (P < 0.001). CONCLUSION: Since the number of circulating B cells was similar in each patient group studied, the reduced production of IgG2 in patients with stage 3 or 4 disease was not merely due to fewer antibody producing cells in those subjects, and we speculate that the observed decrease in polyclonal IgG2 production among these patients is due to a primary defect. In additional studies, we observed that polyclonal IgG2 production was normal among stage 3 or 4 patients treated with danazol (N = 11), but significantly reduced in patients treated with gonadotropin releasing hormone agonists (N = 8). Although not conclusive, these data suggest that danazol may have the capacity to correct the defective production of polyclonal IgG2 in patients with severe endometriosis.

Antibody Formation↗
PubMed1992

Laparoscopic myomectomy.

Fifty-six patients presenting with infertility (17); bleeding, pain, and pressure symptoms (32); and pelvic mass (seven) associated with leiomyomas were managed with laparoscopic myomectomy. Twenty-four second-look procedures were performed to evaluate healing and adhesion formation. Operative time ranged between 45-443 minutes (mean 157), estimated blood loss varied from 10-400 mL (mean 75), and the mean length of hospital stay was 1 day. Traditional morcellation was used initially but was abandoned because of long operating time; vaginal or abdominal removal (depending on size) proved more satisfactory. Three patients developed subcutaneous emphysema and one had febrile morbidity due to upper respiratory tract infection. There were no other complications. In 24 second-look procedures, adhesions were present in 16 subjects (66%). Twelve of 17 in the infertility group conceived (71%); all 39 patients with other complaints experienced satisfactory relief. There were no reoperations. When myomectomy is indicated, the laparoscopic approach appears to offer an alternative to abdominal surgery in selected patients.

Adult↗
PubMed1992

The development of cytotoxicity in peritoneal macrophages from women with endometriosis.

OBJECTIVE: To assess the activation status of peritoneal macrophages from women with endometriosis. DESIGN: Peritoneal macrophages from patients undergoing laparoscopy were tested for cytotoxic activity against a cultured hepatoma cell line. SETTING: Patients were tested at initial laparoscopy or at the completion of therapy. PATIENTS AND PARTICIPANTS: Fertile controls (n = 27), infertile controls (n = 20), untreated endometriosis (n = 43), danazol-treated endometriosis (n = 22), and gonadotropin-releasing hormone agonist (GnRH-a)-treated endometriosis (n = 13) were tested. INTERVENTIONS: Danazol (800 mg/d) or GnRH-a therapy for 6 months. RESULTS: Cytotoxicity was elevated in stage I and II endometriosis (P less than 0.02) and in infertile controls (P less than 0.05) compared with fertile controls. Cytotoxicity in stage III and IV endometriosis was lower (P less than 0.02) than in stage I and II endometriosis. Indomethacin in vitro increased cytotoxicity (P less than 0.05) in stage III and IV endometriosis but not in the other groups tested. Cytotoxicity in danazol or GnRH-a-treated patients was increased (P less than 0.05 or greater) compared with untreated patients with comparable stage of disease. CONCLUSIONS: Peritoneal macrophage cytotoxicity in women with endometriosis is affected by (1) the extent of endometriosis, (2) prostaglandin metabolism, and (3) treatment with danazol or GnRH-a.

Cytotoxicity, Immunologic↗
PubMed1989

Glass wool-filtered spermatozoa and their oocyte penetrating capacity.

The capacity of glass wool-filtered spermatozoa to penetrate zona-free hamster oocytes was studied. As compared to prefiltered sperm samples, oocyte penetration was significantly increased. A significant increase in the penetration rate for the filtered sperm population was noted even after the sperm motility in the filtrate was adjusted with medium equal to that of the prefiltered sample. However, no significant differences in oocyte penetration were seen between the prefiltered and the filtered sperm population when the filtered sperm samples were diluted with nonviable spermatozoa. These results show that glass wool filtration yields a sperm population with a greater penetrating capacity. It was concluded that motility alone could not account for the improved penetrability and that the removal of nonviable spermatozoa may at least, in part, be responsible for this effect.

Female↗
PubMed1988

Recurrent endometriosis following hysterectomy and oophorectomy: the role of residual ovarian fragments.

Seven women with recurrent endometriosis after definitive surgery were evaluated. Plasma estradiol, FSH and LH indicated that recurrence was stimulated by residual ovarian fragments in six and pseudopregnancy regimen in one. Surgical treatment in two women was followed in one by hypertrophy of another ovarian fragment and reactivation of endometriosis as demonstrated by serial endocrine and ultrasonographic studies. Three patients responded well to hormonal treatment; one required pelvic irradiation. We conclude that: (1) small ovarian fragments may hypertrophy under increased gonadrotropin stimulation, become functional and stimulate recurrence of endometriosis; (2) resection of one such fragment may be followed by reactivation of another.

Adult↗
PubMed1986

Mild endometriosis and ovulatory dysfunction: effect of danazol treatment on success of ovulation induction.

The effectiveness of ovulation induction with clomiphene citrate or human menopausal gonadotropins was evaluated in 52 infertile women with stage I or stage II endometriosis and ovulatory dysfunction: anovulation or luteinized unruptured follicle (LUF) syndrome before (group I) and after (group II) danazol treatment. The incidence of anovulation and LUF in the endometriosis population was 9% and 34%, respectively. In group I, 10 of 36 patients (27.8%) conceived, with an average of 17.6 induction cycles per pregnancy. In group II, 21 of 30 patients (70%) conceived, with an average of 4.5 cycles per pregnancy (difference significant at P less than 0.001). There was no difference in the average number of ovulation induction cycles per patient between groups I and II (4.9 and 3.1, respectively). Of 14 patients who did not conceive in group I and crossed over to group II, 9 (64.3%) conceived (not different from group II). Spontaneous abortion rates were 20% in group I and 14% in group II. These results indicate that mild endometriosis may interfere with conception through mechanisms other than ovulatory dysfunction and that treatment with danazol appears to more than double the fertility rate.

Adult↗
PubMed1986

Evaluation of acrosome on Papanicolaou-stained sperm and its relationship to the in vitro fertilizing capacity of human spermatozoa.

Papanicolaou-stained sperm smears from 1150 ejaculates evaluated from infertility clinic patients and 166 ejaculates in an in vitro fertilization program were studied for the presence of acrosomal abnormalities. Morphologically, a normal acrosome was defined as a sperm having a ratio of 1:1 to 2:1 between the acrosome and postacrosomal part in an oval or round, uniformly shaped head. Acrosomal abnormality was identified in at least a few of the spermatozoa in all the ejaculates (range 8-98%) and appeared to be closely related to normal sperm morphology (r = 0.85). A significantly higher (p less than 0.01) correlation (r = 0.31) was noted between the presence of normal acrosome and in vitro fertilizing capacity of spermatozoa as compared to other standard semen characteristics. Acrosome can be identified on Papanicolaou-stained smears, and since it appears to be related to fertility it may be beneficial to evaluate the acrosome morphologically during routine semen analysis.

Acrosome↗
PubMedDate not supplied

Early endocrine events in induced pregnancies.

Progesterone (P) and human chorionic gonadotropin (beta-hCG) levels were measured randomly or serially in 141 single clinical intrauterine pregnancies resulting from treatment of infertility. Seventy (group I) were conceived during spontaneous cycles, 36 (group II) with clomiphene citrate, and 35 (group III) with menotropins (hMG). Each group was subdivided into subgroup A (normal pregnancies) and B (pregnancies ending in abortion). Thirteen percent of patients in group I aborted, 19% in group II, and 31% in group III (P less than .05). The overall mean (+/- SD) P level in group IA was 25.8 +/- 10.3 ng/mL and in group IB, 16.6 +/- 9.9 ng/mL (significantly lower, P less than .001); in group IIA the mean P level was 37.8 +/- 21.9 ng/mL and in group IIB, 22.9 +/- 17.9 ng/mL, again significantly lower (P less than .01). In subgroups IB and IIB, 11 of 16 patients showed early abnormal beta-hCG patterns; these findings suggest defective embryonic development and/or deficient corpus luteum function as the cause of abortion. There was no significant difference between mean P in group IIIA (71.1 +/- 43.7 ng/mL) and IIIB (75.7 +/- 55.9 ng/mL). In group IIIB, the mean "peak" P level of 101.1 +/- 73.6 ng/mL was followed by a mean "nadir" of 35.4 +/- 24.8 ng/mL at 6-9 weeks. In group IIIB, 7 of 11 patients showed normal beta-hCG patterns. Three patients with precipitous P decline aborted karyotypically normal fetuses in spite of normally rising beta-hCG levels and the presence of fetal cardiac activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Spontaneous↗