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Biomedical subjects

R Frydman

Publications and source records attributed to R Frydman.

At least 361 records · Page 20Linked to original sources
PubMed1985

Multimodal approach to the treatment of stage III ovarian carcinoma: preliminary report of a pilot study and critical review.

In an attempt to improve survival rates in Stage III, grade III-IV ovarian carcinoma (5 years survival rate less than 10%), we have tested the feasibility of a combined modality approach in 10 patients. Five of the 10 patients have been treated with surgery, chemotherapy, second look laparotomy, whole abdominopelvic irradiation and chemotherapy. Three patients are alive without evidence of disease (range 24 to 54 months) after entering the combined programme. We conclude that a combined modality therapy can be safely delivered. The acute toxic effects were not more frequent or more severe than with other therapeutic approaches. These results are compared with published reports in the literature.

Adult↗
PubMed1984

In vitro fertilization and embryo transfer program in Clamart, France.

Our in vitro fertilization and embryo transfer program really began in September 1980. Yet attempts to collect oocytes had been performed since 1978, and the first in vitro fertilizations were obtained in May 1979. The first pregnancy was obtained in April 1981, but it ended on the 12th week by a spontaneous abortion of a 45,X fetus. We have distinguished two periods in our program. The initial phase was from September 1980 until November 1982: ovulation monitoring of 365 cycles, spontaneous or stimulated, 276 laparoscopies, and 121 embryos transfers were performed, and 12 early pregnancies obtained (4.3% per laparoscopy and 9.9% per embryo transfer). Seven normal healthy infants were born (five boys and two girls); four cases were limited to biochemical pregnancies and one spontaneous abortion (yet described) was observed. The second and actual phase, December 1982-June 1983, is described more precisely: ovulation monitoring of 329 cycles, after stimulation protocols with clomiphene citrate and human menopausal gonadotropin, 230 laparoscopies, and 162 embryos transfers have been performed and have led to 34 pregnancies (14.8% per laparoscopy and 20.9% per embryo transfer). Eighteen of these 34 pregnancies are actually in progress (more than 12 weeks), 9 were limited to an increase in plasma human chorionic gonadotropin, and 7 cases ended in spontaneous abortions between 6 and 12 weeks.

Adult↗
PubMed1984

Interrelationship of plasma and urinary luteinizing hormone preovulatory surge.

The only reliable method of predicting spontaneous ovulation relies on the detection of the preovulatory luteinizing hormone (LH) surge in urine or plasma. The efficiency of the detection by means of plasma LH radioimmunoassay, urine LH radioimmunoassay or urine LH agglutination inhibition immunoassay were compared in 33 patients. The detection of the onset of LH surge was simultaneous in plasma and urine in only 11 cases. In two thirds of the patients, the urine LH surge onset is delayed by 3 to 21 h as compared with plasma LH surge onset. In some of these cases the oocyte would probably be missed if the laparoscopy had been scheduled according to urine data.

Adult↗
PubMed1984

Time relationships between basal body temperature and ovulation or plasma progestins.

The basal body temperature (BBT) curve and the estimated time of ovulation, defined by the onset of gonadotropin preovulatory discharge, were analyzed in 38 spontaneous cycles. The BBT nadir was usually located at the beginning of the luteinizing hormone surge, and the first high point was 8 hours after ovulation, which was itself usually at the time when the temperature passed 37 degrees C. This temperature rise was related to the increases in plasma progesterone and 17-hydroxyprogesterone with 24 to 36 hours' delay. The BBT was found to be an unreliable technique for precise ovulation timing but would be of use if the clinical precision required for the diagnosis of ovulation were less.

17-alpha-Hydroxyprogesterone↗
PubMed1984

Delayed appearance of plasmatic chorionic gonadotropin in pregnancies after in vitro fertilization and embryo transfer.

The detection of pregnancy through the rise of human chorionic gonadotropin hormone secretion, on maternal plasma level, has been studied in normally developed pregnancies following in vitro fertilization and embryo transfer (IVF-ET), and compared with two other groups of pregnancies, the first group being pregnancies following artificial insemination with donor semen (AID) in spontaneous cycles ("AID group") and the second group being pregnancies following in vivo fertilization in a stimulated cycle ("stimulated group"). The day of human chorionic gonadotropin detection level significant for pregnancy (Dd) has been first defined and then determined for each pregnancy. Thereafter, mean levels for Dd (Dd) have been compared for each pregnancy group. It has been found that in pregnancies following IVF-ET, Dd is 12.05 +/- 0.8 days after ovulatory stimulus, which is delayed in comparison with spontaneous cycle pregnancies (Dd = 9.5 +/- 1.0) and with stimulated cycle pregnancies (Dd = 8.0 +/- 1.5). The hypothesis to explain this observation is then discussed.

Adult↗
PubMed1984

Human preovulatory follicular fluid: the lipids. Are they the trigger for capacitation?

The lipid content of human follicles within 6 h of ovulation was determined. Levels for triglycerides, phospholipids, and total cholesterol were 1/4 to 1/3 of those in serum. An uncommonly high level of free cholesterol was observed, possibly resulting from a high synthetic rate by the granulosa. Follicular lipids appear to be of serum origin since the relative proportions of the various fatty acids are the same. Arachidonic acid was not found to be present at the high levels reported for "large" porcine follicles, possibly due to its active utilization in the synthesis of prostaglandins necessary for the ovulation process. Precise timing relative to ovulation is clearly essential for follicular classification in order to distinguish between before and after the triggering of the ovulation process. A possible role for lipids in the induction of capacitation is proposed.

Adult↗
PubMed1984

[Primary-purpose peridural analgesia in labor induction].

21 parturients, showing in most of cases either high blood pressure badly controlled or a "real" out of date term, have undergone a peridural analgesia of first intention in labour induction. All these patients were considered to be uninducable according to Bishop score. After an injection of adrenalinized bupivacaïne, either 0.25% or 0.375% rupture depending on state of cervix of membranes occurred in most cases 6 hours after peridural analgesia. The mean between onset of analgesia and delivery was 17 h and the mean time between induction with ocytocin to birth 5 h 37 min. 16 parturients gave birth per vaginam, 9 of which spontaneously 5 have undergone caesarian section because of a non lack of dilatation or foetal distress. Children at birth, at the 2nd and the 24th hour were all healthy.

Anesthesia, Epidural↗
PubMed1984

[Peridural analgesia with 0.375 percent bupivacaine in labor with dystocia].

For dystoctic deliveries peridural analgesia with bupivacaine 0.25% was compared with bupivacaine 0.375%, without adrenalin. Shortening of the delivery time in cases of stagnation of dilatation, was obtained with bupivacaine 0.375%: 181 mn in the average instead of 276 mn with bupivacaine 0.25% (p = 0.05). In the case of a cervical spasm, there was release of the contraction with return of a normal dilatation leading to a shorter labour: 188 mn in the average against 340 mn (p = 0.02) with the 0.25% solution. Apgar scores were similar in both series.

Adult↗
PubMed1983

[Celioscopy under local anesthesia for collecting oocytes for in vitro fertilization].

Since 1960, laparoscopy under local anaesthesia has been gradually abandoned in France and until now oocytes for in vitro fertilization were collected under general anaesthesia, thus increasing the risk of allergic reactions to anaesthesia in these patients who usually undergo several operations. From February to May, 1983, at the Antoine Béclère Maternity, Paris, 50 laparoscopies were performed under local anaesthesia with lidocaine combined with neuroleptanalgesia with diazepam and fentanyl. The procedure was uneventful in 94% of the cases and only 3 women required general anaesthesia. At least one mature oocyte was collected in 46 of these 50 women and 4 pregnancies have already been recorded. Local anaesthesia enables the woman to participate fully in this first stage of in vitro fertilization, increases the out-patient activities of the hospital unit and reduces the cost of in vitro fertilization.

Anesthesia, Local↗
PubMed1983

A study of factors affecting the success of human fertilization in vitro. II. Influence of semen quality and oocyte maturity on fertilization and cleavage.

The incidence of in vitro fertilization was analyzed with respect to the degree of cumulus dissociation (expansion) at the time of oocyte recovery and also the semen quality. Of the oocytes surrounded by perfectly ("++") or moderately ("+") dissociated cumuli, 78.6% and 30.8%, respectively (P less than 0.001), were fertilized when the husband's semen analysis was in the normal range. The proportion of fertilized oocytes was not decreased in cases of polyzoospermia (greater than 130 X 10(6) spermatozoa/ml), but was decreased (P less than 0.05) when the semen analysis revealed other anomalies: oligozoospermia (less than 15 X 10(6) spermatozoa/ml), asthenozoospermia (less than 50% motile cells) or teratozoospermia (greater than 50% abnormal spermatozoa). The proportion of fertilized eggs cleaving in vitro was unaffected by semen quality but was lower when "+" cumulus oocytes were collected than when "++" cumulus oocytes were obtained (58.3% vs. 87.0%, P less than 0.02). In vitro incubation of the oocyte prior to insemination increased the incidence of fertilization by about 28% for both "+" (22.2 to 50.0%) and "++" (65.7 to 93.9%) cumulus oocytes. Finally, 67.6% of "++" cumulus oocytes developed into embryos when the insemination with spermatozoa from normal semen samples was delayed by several hours, compared with only 29.0% when the conditions were suboptimal ("+" cumulus oocyte, abnormal semen analysis or no delay prior to insemination). Eight pregnancies began following the replacement of 38 embryos in 34 patients. Six spontaneous abortions occurred, and chromosomal abnormalities were proven in the two cases analyzed. Two pregnancies continued for more than 3 months, resulting in term deliveries of two normal babies.

Cell Division↗
PubMed1983

[Plasma and intrafollicular hormone profiles in the late preovulatory phase. I. Spontaneous cycles].

The hormone state of development in the late preovulatory phase is described in its relationship to the start of the LH surge which occurs 37-39 hours before ovulation. No precise relationship has been found between the oestradiol (E2) peak in the plasma and that which occurs before ovulation. All the same, the succession of hormone events that have been observed in 77 spontaneous cycles is the following: the level of E2 suddenly rises between 35 and 30 hours before the ovulatory discharge and this rise is immediately followed by a rise in the level of LH. Then the plasma concentration of 17-hydroxyprogesterone (17-OHP) increases 5 hours before the LH surge. In the preovulatory follicle 5 hours after the start of the LH surge, a drop in the level of E2 and a rise in the level of progesterone is noted. Concentrations of androgens only lessen in the last 12 hours before ovulation whereas the level of 17-OHP stays stable. We have thus been able to work out the sequence of plasma hormone phenomena that occur in determining whether a preovulatory gonadotrophic surge will occur. We have described the hormone levels in follicular fluid immediately before spontaneous ovulation. These findings will be able to serve as a reference to evaluate the quality of the late preovulatory phase in abnormal cycles or in cycles that have been induced.

Adult↗
PubMed1982

Minimum time lapse between luteinizing hormone surge or human chorionic gonadotropin administration and follicular rupture.

Occurrence of ovulation was detected by laparoscopy between 22 and 47 hours following the onset of the luteinizing hormone (LH) surge in plasma (61 patients) or human chorionic gonadotropin (hCG) administration (76 patients). None of 22 patients had ovulated before the 34th hour following LH surge or hCG, as compared with 3.4% (3 of 89) and 50.0% (11 of 22) laparoscoped after 34 to 37 hours or 37 to 39 hours, respectively. Whether measured with respect to the initial rise of LH or the injection of hCG, the time lapse before ovulation was comparable. Ovulation was more frequently established at 37 to 39 hours in spontaneous cycles (10/13) than in clomiphene-treated cycles (1/9, P less than 0.01). The onset of the LH rise was found to be a more accurate criterion than the LH peak in determining the time of ovulation.

Adult↗
PubMed1982

Hormonal and histological study of the luteal phase in women following aspiration of the preovulatory follicle.

A hormonal and histologic study of 60 luteal phases was carried out in 40 patients during spontaneous and stimulated cycles before and after follicle puncture for oocyte recovery. The duration of the luteal phase was modified neither by follicle rupture nor by hormonal stimulation. The aspiration of a spontaneous preovulatory follicle caused a temporary deficiency in plasma progesterone (P) (P less than 0.01) on the third day following aspiration, and a higher prolactin (PRL) level (P less than 0.02) on the ninth day. Dystrophia of the endometrium was observed in one-third of the cases, whereas the P level was normal. In cycles stimulated by clomiphene citrate, no P deficiency was observed. When luteinizing hormone (LH) discharge occurred spontaneously, biopsies carried out 3 days following follicle aspiration indicated a normal secretory state of the endometrium, and the P level was higher from, the sixth day following aspiration (P less than 0.05), as compared with the control cycles. This phenomenon was not observed when human chorionic gonadotropin (hCG) was administered.

Androstenedione↗