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Biomedical subjects

R Marana

Publications and source records attributed to R Marana.

At least 55 records · Page 3Linked to original sources
PubMed1993

[The role of laparoscopy in the evaluation of chronic pelvic pain].

Chronic pelvic pain, defined as cyclic or acyclic pain reported for a minimum of six months, is one of the most common gynecological symptoms and one of the most important in terms of social costs. From January 1987 to December 1991, 127 patients suffering from chronic pelvic pain were submitted to diagnostic laparoscopy at the Department of Obstetrics and Gynecology of the Università Cattolica del Sacro Cuore in Rome. The mean age of the patients was 30 years, ranging from 14 to 46. All patients were submitted to bimanual pelvic examination upon hospital admission, and most of them (No. = 99, 78%) to pelvic ultrasonographic examination. In 117 patients (92%) samples for the isolation of Chlamydia trachomatis in 5-iodo-2-deoxiuridine treated McCoy cell cultures were obtained from the cervix, the endometrium and the cul-de-sac peritoneal fluid. At laparoscopy, in 25 patients (20%) the exam showed normal pelvic anatomy, whereas in 102 patients (80%) some pelvic pathology was found. The most frequent conditions observed were: pelvic adhesions in 55% (No. = 70), endometriosis in 29% of the cases (No. = 37), and other pathologies (non-endometriotic ovarian cysts, hydrosalpinges, myomas, etc.) in 25% of the cases (No. = 32). At the comparison of bimanual examination and laparoscopic findings, out of 71 patients with normal findings at bimanual examination, 75% (No. = 53) were found to have abnormal findings at laparoscopy; out of 55 patients with abnormal bimanual examination, 11% (No. = 6) were found to have normal laparoscopic findings.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Chlamydial genital infections and laparoscopic findings in infertile women.

Several studies have shown that previous chlamydial genital infection, reflected by serological markers, is strongly associated with tubal damage leading to tubal infertility. In 105 women undergoing laparoscopy, multiple samples were collected from the lower (urethra and cervix) and upper (endometrium, peritoneal fluid, tubal lumen) genital tract, in order to isolate Chlamydia trachomatis in cell culture. Chlamydia trachomatis was isolated from at least one site in 13 (30.9%) of 42 infertile women with tubal infertility, in 5 (12.1%) of 41 women with unexplained infertility, in 1 of 4 women affected by acute salpingitis and in 1 (5.5%) of 18 women with endometriosis or uterine malformations. The latter group was the control group. Thirteen (65%) of the 20 positive women harboured Chlamydia trachomatis in their upper genital tract alone and 16 women were positive in one or both tubes. Only one of the positive women showed laparoscopic signs of acute pelvic infection. Four of the 5 positive women with unexplained infertility harboured Chlamydia trachomatis in the tubal lumen. This study confirms that chlamydial infection is strongly associated with tubal damage. It suggests that cervical cultures are inadequate for excluding a tubal infection and that chlamydial colonization of the tubal mucosa is possible in the absence of symptoms and laparoscopic signs of active infection.

Adult↗
PubMed1992

[Salpingoscopy: a new method for the evaluation of the tubal factors in sterility].

Salpingoscopy is a new endoscopic procedure that allows the direct vision of the tubal mucosa. Therefore, it is able to identify and evaluate intraluminal lesions not detected by hysterosalpingography or laparoscopy. The endoscopic evaluation of the tubal mucosa can predict the possibility of an intrauterine pregnancy or laparoscopic tubal surgery, permitting the selection of patients with the most favourable prognosis. This technique may also have a role in identifying patients at risk for a repeat ectopic pregnancy and patients with silent endosalpingitis.

Endoscopy↗
PubMed1991

Salpingoscopy in patients with contralateral ectopic pregnancy.

Patients who experience a tubal pregnancy have a poor prognosis in terms of reproductive potential and are at increased risk of a repeat EP. Salpingoscopy is a new endoscopic technique that allows the detection of abnormalities of the tubal mucosa. In seven patients with a follow-up longer than 6 months, an IUP occurred only in patients with a normal ampullary mucosa, whereas a recurrent tubal pregnancy occurred in the patient that conceived with an abnormal tubal mucosa. These preliminary results suggest that salpingoscopy may constitute an important prognostic factor in these patients.

Adult↗
PubMed1991

Ovarian function after incision of the ovary by scalpel, CO2 laser, and microelectrode.

OBJECTIVE: The objective was to evaluate the relative effects of a standardized surgical incision performed with scalpel, CO2 laser, or microelectrode on ovarian tissue and function. DESIGN: Thirty sexually mature female rabbits were randomly assigned to one of three surgical groups. The injury consisted of a linear incision along the long axis of both ovaries, from the cortex to the hilum, followed by immediate unilateral oophorectomy for evaluation of the acute tissue damage. The opposite ovary was left in situ to evaluate subsequent healing, steroidogenesis, folliculogenesis, and ovulation. RESULTS: Minimal damage was observed after surgery with either laser or microelectrode. The ovarian stroma and follicles adjacent to the surgical site appeared normal both immediately and 15 days after all surgeries. Steroidogenesis, folliculogenesis, and luteinization were similar among the three groups. The number of ovulated oocytes after human chorionic gonadotropin was significantly reduced after scalpel and laser surgery compared with microelectrode (P less than 0.05). The former groups appeared to have a higher incidence of unruptured luteinized follicles with untrapped oocytes, which were often covered with a cellular fibrous membrane. CONCLUSIONS: These findings suggest that surgical trauma is well tolerated by the ovaries and does not impair subsequent ovarian function. However, rupture of the preovulatory follicle and its release of the oocyte may be influenced by the presence of ovarian adhesions and/or surgical trauma.

Analysis of Variance↗
PubMed1991

Reproductive outcome after ovarian surgery: suturing versus nonsuturing of the ovarian cortex.

The purpose of this study was to ascertain if microsurgical approximation of the ovarian edges after ovarian surgery alters postoperative results, as determined by both adhesion formation and reproductive outcome. Sixteen female white New Zealand rabbits were anesthetized, and the ovaries were exposed. Each ovary was longitudinally bivalved with a scalpel, but only one ovary was reconstructed microsurgically, whereas the contralateral ovary was left open. Four weeks after surgery, the rabbits were mated, and two weeks later, a laparotomy was performed to evaluate postoperative adhesions, the number of corpora lutea in each ovary, and the number of embryos in each uterine horn. The nidation index was calculated. No significant differences were found between the microsurgically sutured and the nonsutured ovaries for all the parameters evaluated. Our data suggest that not closing the ovarian incision does not alter either postoperative adhesion formation or reproductive outcome.

Animals↗
PubMed1991

Reproductive outcome after ovarian surgery: microsurgery versus CO 2 laser.

The present study was undertaken to compare CO 2 laser vs microsurgery in ovarian surgery, evaluating both postoperative adhesion formation and reproductive outcome. Eighteen female white New Zealand rabbits were anesthetized, and the ovaries were exposed. At random, one ovary was longitudinally bivalved with a scalpel and then reconstructed by microsurgery. The contralateral ovary was similarly cut, but with a CO 2 laser set at a superpulsed mode. Four weeks after surgery, the rabbits were mated, and two weeks later, the animals were evaluated for extent of postoperative adhesion formation, number of corpora lutea in each ovary, and number of embryos in each uterine horn. The nidation index was calculated. The present study shows no difference in postoperative adhesion formation or reproductive function following ovarian surgery by microsurgery or CO 2 laser.

Animals↗
PubMed1991

Serum CA-125 levels in the diagnosis and management of endometriosis.

The value of CA-125 for the diagnosis and management of endometriosis (EN) was investigated by assaying the marker in the serum and peritoneal fluid (PF) from patients with the disease in comparison with control subjects. Of women who underwent 270 consecutive laparoscopies, 81 with various stages of EN (18 stage I, 13 stage II, 35 stage III and 15 stage IV) and 38 with normal pelvic findings were studied. CA-125 serum values increased progressively in relation to the severity of the disease. The levels in stages III and IV EN were significantly higher (P less than .01) than in stages I and II or control patients. The latter two groups did not differ from each other. High CA-125 PF values were found in all the patients investigated. Twenty-two patients with EN were treated with a gonadotropin releasing hormone agonist for six months before second-look laparoscopy or laparotomy. CA-125 values decreased significantly after one month of medical treatment and remained unchanged during the course of therapy. No significant relationship was found in the outcome after therapy.

Adult↗
PubMed1990

High prevalence of silent chlamydia colonization of the tubal mucosa in infertile women.

Thirty-four asymptomatic infertile patients without distal tubal occlusion were prospectively evaluated at laparoscopy for C. trachomatis infection. Samples were collected from the urethra, the cervical canal, the endometrium, the cul-de-sac peritoneal fluid and the endosalpinx. In 8 patients (24%), C. trachomatis was isolated from at least one site. In 6 patients C. trachomatis was isolated from at least one tube, demonstrating the possibility of silent chlamydial colonization of the tubal mucosa in the absence of signs of active pelvic infection.

Chlamydia Infections↗
PubMed1990

Gonadotrophin releasing hormone agonist (buserelin) in the treatment of endometriosis: changes in the extent of the disease and in CA 125 serum levels after 6-month therapy.

Twenty-two women with endometriosis were treated with the luteinizing hormone-releasing hormone (LHRH) agonist buserelin for 6 months. At second-look laparoscopy the mean score of endometriosis had decreased from 23.1 (SD 17.0) to 17.2 (SD 20.2) (P less than 0.05). CA 125 serum levels decreased from 38.4 (SD 32.2) U/ml at diagnosis to 15.5 (SD 7.0) at second look (P less than 0.005). CA 125 levels correlated at diagnosis with total score of endometriosis (P less than 0.05) and with active score of endometriosis (P less than 0.05), but not with the adhesion score. CA 125 levels were not correlated with endometriosis scores at second look laparoscopy, thus suggesting that mechanisms other than the change in the extent of the disease may be involved in the CA 125 decrease during therapy. CA 125 levels may therefore not be a reliable indicator for monitoring the efficacy of LHRH agonist treatment of endometriosis.

Adult↗
PubMed1980

Adrenocortical and gonadal steroids during sleep deprivation.

Twelve healthy males were exposed to 48 hr of sleep deprivation under conditions of strictly controlled activity and of food and drink intake. During the experiment the subjects were isolated from external time cures, i.e. no daylight, clocks, etc. Plasma samples were obtained before and at the end of the vigil, as well as after 5 days of recovery. Samples were analyzed for adrenal and gonadal steroid hormones and for follicle-stimulating (FSH) and luteinizing hormones (LH). The levels of all unconjugated steroids studied (cortisol, 17-hydroxypregnenolone, 17-hydroxyprogesterone, androstenedione, dihydrotestosterone) were significantly lower at the end of the sleep deprivation period. Self-ratings of fatigue were significantly higher at the end of the deprivation period. After recovery, all values returned to base line. No changes were observed in the levels of FSH, LH, or most conjugated steroids. It was concluded that the results were not consistent with the view that sleep deprivation induces an emergency reaction with increased activation, but rather that it results in lower levels of both psychological and physiological activation.

17-alpha-Hydroxypregnenolone↗
PubMed1979

A sensitive and specific in vitro bioassay method for the measurement of follicle-stimulating hormone activity.

An in vitro bioassay method for hFSH is presented. The method is based on the principles previously described by Dorrington et al. (1976b) and involves the assay of oestradiol produced from 19-hydroxyandrostenedione by dispersed Sertoli cells of 10-day old rats when cultured in the presence of graded doses of FSH. Using the 1st International Reference Preparation for human pituitary gonadotrophins (FSH and LH/ICSH) for bioassay (code no. 69/104) as standard, the useful range of the method is from 0.5 to 32 mIU/chamber (2 to 128 mIU/ml). The sensitivity of the method is 0.5 mIU/chamger. The mean index of precision (lambda) obtained from 16 multiple assays over 2 or 3 dose levels was 0.084. Parallelism was obtained between the 69/104 preparation and all preparations under study. The practicability of the proposed assay method is such that 15 preparations at 3 dose levels can be assayed by one person in 3 days. The specificity of the assay was investigated by determining the FSH activity in the following preparations: hFSH alpha- and beta-subunits, hLH, hCG, hTSH, ACTH, human growth hormone (hGH) human prolactin (hPRL) and luteinizing hormone-releasing hormone (LH-RH). The ACTH, hGH, hPRL and LH-RH preparations studied showed no detectable FSH activity in the assay. In the remaining preparations very low levels of FSH activity were found, corresponding to 0.004 to 0.6% of the weight of these preparations when compared with a highly purified hFSH preparation, suggesting that the method is specific for FSH. The possible synergistic or antagonistic influence of the above preparations when assayed in the presence of the 69/104 preparation was also assessed. No evidence of a synergistic or antogonistic effect was found. The assay of the hFSH potencies of a limited number of hFSH preparations of varying purity by the proposed in vitro bioassay, an hFSH radioreceptor method and an hFSH specific radioimmunoassay technique revealed that - although the relationship of the various potencies obtained with each method showed a close agreement - the bioassays yielded the highest potency estimates, and the radioimmunoassays the lowest ones. Since the proposed bioassay method is sensitive and considered to be specific for hFSH activity, it provides a suitable basis for the assessment of the specificity of other in vitro methods (radioreceptor and radioimmunoassay) currently used for detecting low levels of FSH activity.

Age Factors↗
PubMed1979

Influence of the purity of the iodinated tracer on the specificity of the radioimmunoassay of human follicle-stimulating hormone.

The objective of this study was to establish whether [125I]hFSH subunits are formed during iodination of hFsh by a mild (lactoperoxidase) technique, and if so which fractionation procedure provides the best separation of [125I]hFSH from its subunits. In addition, the effect of the 125I subunits on the specificity of the hFSH radioimmunoassay technique was examined. The products of iodination of hFSH were fractionated by a number of techniques consisting of low and high resolution gel filtration procedures and adsorption on either cellulose of Concanavalin A coupled to Sepharose. The efficacy of the adsorption methods was assessed by a subsequent high resolution gel filtration procedure (Ultrogel AcA 54). Radioreceptor and radioimmunoassay methods were used to monitor the profiles of hFSH, hFSH alpha and hFSH beta subunits and to assess the recoveries of radioreceptor-active hFSH obtained by the different procedures. Iodination of a highly purified hFSH preparation invariably resulted in the formation of both [125I]hFSH subunits. The proportion of radioactivity associated with the 125I subunit peak to that of the [125I]hFSH peak was 10% when the iodination products after low resolution gel filtration were fractionated by a high resolution gel filtration procedure. The corresponding amount of subunits obtained by adsorption on cellulose and Concanavalin A was 71% and 6%, respectively. Thus in comparison with low resolution gel filtration there was a partial separation of [125I]hFSH from [125I]hFSH subunits on Concanavalin A while no separation was effected on cellulose. In fact, the results suggest that 125I subunits were formed during fractionation on cellulose. The recoveries of hFSH activity following fractionation on cellulose and Concanavalin A were significantly lower (27% and 65%) than those obtained by either low or high resolution gel filtration techniques. A marked reduction ;n the specificity of the RIA of hFSH was found when [125I]hFSH subunits rather than [125I]hFSH were used as tracer in the assay. It is concluded that the presence of 125I subunits in [125I]hFSH preparations used as tracer in the RIA of hFSH can diminish the specificity of the assay. The routine employment of a high resolution gel filtration procedure which provides a complete separation of 125I subunits from the intact hormone, is suitable for the elimination of this source of assay invalidity while the other fractionation procedures tested (cellulose adsorption or Concanavalin A) are not.

Adsorption↗