Biomedical subjects

R Paradisi

Publications and source records attributed to R Paradisi.

At least 19 recordsLinked to original sources

PubMed2002

A study of hysteroscopic metroplasty in 141 women with a septate uterus.

141 patients who had a hysteroscopic septum resection of a partial uterine septum (class Vb, American Society for Reproductive Medicine, ASRM) were divided into two groups: Group I (69 patients) presented with infertility and Group II (72 patients) with recurrent abortion. The mean+/-SD post-operative follow up period was 36+/-19.5 months. Thiry-six Group I patients (52.1%) and 38 Group II patients (52.7%) achieved pregnancy, with respective abortion rates of 20% and 25%.

Abortion, Habitual↗

PubMed2001

Human leucocyte antigen I expression in spermatozoa from infertile men.

The expression of class I human leucocyte antigen (HLA) has been investigated by reverse transcription polymerase chain reaction (RT-PCR) and flow cytometry on human purified ejaculated spermatozoa from an infertile population. Similar investigation in a control fertile population has been performed. Among 22 fertile and 20 infertile men, 17 were selected for the study because they showed no contamination with non-sperm cells. HLA I molecules were expressed in four of nine fertile subjects (44.4%) and three of eight infertile subjects (37.5%), with no significant difference between groups. These data demonstrate for the first time the presence of class I HLA antigens on spermatozoa of infertile subjects. In addition, considering that similar results have been obtained in both fertile and infertile populations, the hypothesis that the fertilizing capacity of the spermatozoon is independent of class I HLA-antigen expression on their surface may be advanced.

Histocompatibility Antigens Class I↗

PubMed2001

Low-dose flutamide (125 mg/day) as maintenance therapy in the treatment of hirsutism.

OBJECTIVE: To evaluate the safety and efficacy of a low dose of flutamide (125 mg/day) in maintaining the clinical results already obtained using a higher dose (250 mg/day), in women suffering from hirsutism. METHOD: Forty-three women suffering from hirsutism of varying origin received 250 mg/day of flutamide as an initial treatment for 12 months and, subsequently, 125 mg/day of flutamide for an additional 12 months as a maintenance treatment. Hirsutism was evaluated by the Ferriman-Gallwey score, and hair diameter and hair growth rate were determined by a special image analysis processor. Biochemical, clinical and hormonal parameters were evaluated in basal conditions and every 2-6 months. RESULTS: The significant decrease in the hirsutism score, hair diameter and hair growth rate during the initial treatment period was confirmed at the end of the maintenance treatment period. Androgen levels decreased up to the end of the initial treatment period and partially decreased during the maintenance treatment. During the initial treatment period, 4 subjects showed an increase of aspartate aminotransferase and alanine aminotransferase and dropped out. During the maintenance treatment period, no side effects or complications were observed. CONCLUSION: Satisfactory management of hirsutism with flutamide seems to be represented by an initial treatment period using 250 mg/day to achieve satisfactory results, followed by a long maintenance treatment period using 125 mg/day.

Adult↗

PubMed1999

A prospective randomized trial comparing low dose flutamide, finasteride, ketoconazole, and cyproterone acetate-estrogen regimens in the treatment of hirsutism.

Sixty-six hirsute women were randomized and treated with 1) flutamide (n = 15), 250 mg/day; 2) finasteride (n = 15), 5 mg/day; 3) ketoconazole (n = 16), 300 mg/day; and 4) ethinyl estradiol (EE)-cyproterone acetate (CPA; n = 20), 0.01 mg EE/day for the first week, 0.02 mg EE/day for the second week, and 0.01 mg EE/day for the third week, followed by a pause of 7 days, then 12.5 mg CPA/day added during the first 10 days of every month for 12 months. Hirsutism was evaluated by the Ferriman-Gallwey score, and hair diameter and hair growth rate were determined by a special image analysis processor in basal conditions and after 90, 180, 270, and 360 days of treatment. All treatments produced a significant decrease in the hirsutism score, hair diameter, and daily hair growth rate: flutamide, -55 +/- 13%, -21 +/- 14%, and -37 +/- 18%; finasteride, -44 +/- 13%, -16 +/- 12%, and -27 +/- 14%; ketoconazole, -53 +/- 18%, -14 +/- 12%, and -30 +/- 21%; and EE-CPA, -60 +/- 18%, -20 +/- 11%, and -28 +/- 21%. Some differences existed among treatments with regard to effectiveness; EE-CPA and flutamide seem to be the most efficacious in improving hirsutism. For the hirsutism score, a greater decrease was seen with EE-CPA (-60 +/- 18%) than with finasteride (-44 +/- 13%; P < 0.01) and a greater decrease was seen with flutamide (-58 +/- 18%) than with finasteride (-44 +/- 13%; P < 0.05). Flutamide is the fastest in decreasing hair diameter; EE-CPA is the fastest in slowing down hair growth, even though at the end of the treatment there was a significant difference between flutamide and finasteride only (-41 +/- 18% vs. -27 +/- 14%; P < 0.05). Flutamide, ketoconazole, and EE-CPA induced a significant decrease in total and free testosterone, 5alpha-dihydrotestosterone, dehydroepiandrosterone, dehydroepiandrosterone sulfate, and androstenedione plasma levels. During the EE-CPA treatment, gonadotropins were suppressed, and the sex hormone-binding globulin level increased. Finasteride induced a decrease in dehydroepiandrosterone sulfate and 5alpha-dihydrotestosterone and an increase in testosterone levels. Very few side-effects were observed during treatment with low doses of flutamide, EE-CPA, and particularly finasteride. Flutamide induced a decrease whereas EE-CPA induced an increase in triglycerides and cholesterol, showing higher values within the normal range. Ketoconazole induced several side-effects and complications, and several people dropped out of the study. Despite different modalities of action and significantly different effects on androgen levels, low doses of flutamide, finasteride, and EE-CPA constitute very satisfactory alternative therapeutic regimens in the treatment of hirsutism.

Adult↗

PubMed1999

A histological and immunohistochemical study of neuropeptide containing somatic nerves in the levator ani muscle of women with genitourinary prolapse.

BACKGROUND: To evaluate the changes occurring in the somatic innervation throughout the levator ani muscle in women with genitourinary prolapse and stress urinary incontinence (SUI). METHODS: Thirty-four patients with genital prolapse entered the study and ten subjects with non-malignant pathologies acted as a control group. All patients were evaluated by urodynamic investigation and an electromyographic study of pelvic floor muscles to define the type of urinary incontinence. Biopsy samples were obtained from both groups of patients: the site of muscle biopsies were left and right part of perirectal pubococcygeus muscle. The evaluation of immunoreactivity was semiquantitative and based on staining intensity and distribution. RESULTS: In all cases, S-100 protein and NSE immunoreactivities were found in nerve fascicles running throughout the striated muscle. NPY and VIP positivities were more intense and diffuse, whereas SP immunoreactivity was quite scanty. The different patterns of NPY and VIP expression changed in relation to degree of genital prolapse and to the presence of SUI. CONCLUSIONS: Our immunohistochemical study shows the presence in the pelvic floor of neurons that are able to synthesize neuropeptides. The lower immunoreactivity score of same neuropeptides (VIP, NPY) observed among patients with third degree genital prolapse and with SUI could be related to biochemical damage of the neurons with subsequent lower production of chemical messengers.

Aged↗

PubMed1997

Chronobiologic evolution of luteinizing hormone secretion in adolescence: developmental patterns and speculations on the onset of the polycystic ovary syndrome.

OBJECTIVE: To investigate the long-term evolution of the LH circadian profile in adolescent women with anovulatory cycles and normal or elevated LH levels in the first evaluation. DESIGN: Prospective controlled clinical study. SETTING: Reproductive endocrinology unit of an academic medical center. PATIENT(S): Twelve healthy anovulatory adolescent girls aged 12 to 17 years (5 subjects with high plasma LH level and 7 subjects with normal LH level) and four ovulatory subjects as controls. INTERVENTION(S): Blood samples were drawn every 20 minutes for 24 hours beginning at 10:00 A.M. at early and late gynecologic ages. MAIN OUTCOME MEASURE(S): Luteinizing hormone, FSH, E2, T, androstenedione, ovarian volume. RESULT(S): In the first evaluation, the highest plasma LH levels and greatest pulse amplitude were found early in the morning in the normal-LH group and late in the afternoon in the high-LH group. Controls did not display any significant circadian variation in LH secretion. The second evaluation revealed ovulatory cycles in six of seven subjects (85.7%) in the normal-LH group with the disappearance of the circadian rhythm. Two of five (40%) patients with high LH in the first evaluation became ovulatory with a significant decrease of mean LH levels and the disappearance of the circadian rhythm. Girls of both groups who remained anovulatory still displayed the accentuated circadian profiles that were seen at the first evaluation. CONCLUSION(S): An accentuated 24-hour LH periodicity is typical of puberty but disappears in adulthood. The persistence of these rhythms in persistently anovulatory adolescents may indicate a maturational arrest. In particular, the persistence of the high LH circadian profile with the highest values during the day is very similar to that found in polycystic ovary syndrome.

Adolescent↗

PubMed1997

T-helper 2 type cytokine and soluble interleukin-2 receptor levels in seminal plasma of infertile men.

PROBLEM: The role of cell-mediated immunity (CMI) in unexplained male infertility and impaired sperm function has been explored. METHOD OF STUDY: The presence of cytokines, namely, interleukin-4 (IL-4), interleukin-6 (IL-6), and the soluble interleukin-2 receptor (SIL-2R), was investigated in seminal plasma of 18 fertile and 20 infertile subjects, using specific enzyme-linked immunoadsorbent assays. RESULTS: IL-4 was not detected. SIL-2R was detected, but the concentration difference between the fertile and infertile group was not significant. IL-6 was detected with significantly higher levels in the infertile group compared to the fertile group. IL-6 levels in seminal plasma correlated positively with leukocyte count and negatively with sperm count, motility, and morphology. CONCLUSIONS: These findings show: a) a lack of IL-4 in seminal plasma; b) similar SIL-2R levels in fertile and infertile seminal plasma; c) increased IL-6 secretion in seminal plasma of infertile subjects; and d) specific correlations of IL-6 with the main semen parameters.

Adult↗

PubMed1996

Characterization of human sperm antigens reacting with sperm antibodies from autologous serum and seminal plasma in an infertile population.

Immunoblotting techniques were used to characterize the reactivity of human sperm antigens with sperm antibodies from an infertile population. Sperm antigens of each individual were tested with autologous sperm antibodies present in serum and seminal plasma in order to construct a preliminary map of the antigens of the infertile spermatozoon and to compare the qualitative differences in the antigenic profile between fertile and infertile subjects. A total of 61 infertile males, comprising 51 subjects having poor semen quality and 10 subjects with no abnormalities in semen analysis, entered the study; 55 subjects with proven fertility served as controls. Infertile subjects often showed specific immunoreactivity to 50-, 55-, 57-, 62-, and 72-kDa proteins in serum and to 57- and 62-kDa proteins in seminal plasma. As to comparison of immunoreactivities between fertile and infertile individuals, the sperm antigens may be divided into three groups. Group 1 antigens (50-, 69-, and 72-kDa proteins) were recognized by sperm antibodies present in both populations; group 2 antigens (57- and 62-kDa proteins), by sperm antibodies typical of the infertile population; group 3 antigens (45-, 55-, and 85-kDa proteins), by sperm antibodies typical of the fertile population. This classification shows that the infertile spermatozoon differs substantially at the immunogenic level from the fertile spermatozoon. The group 2 antigens seem to be involved in a relevant step in the reproductive process and hence have been termed "fertility-related antigens."

Autoantibodies↗

PubMed1996

Characterization of human sperm antigens reacting with antisperm antibodies from autologous sera and seminal plasma: comparison among infertile subpopulations.

Immunoblotting techniques were used to characterize the reactivity of human sperm antigens with sperm antibodies from different groups of infertile subjects. Sperm antigens of each subject were tested with autologous sperm antibodies present in serum and seminal plasma in order to assess whether there were qualitative differences in the antigenic structure of spermatozoa among the various infertile groups. Sixty-one infertile males, divided into six groups according to changes in the two main semen parameters (sperm concentration and motility), entered the study. Immunoreactivity to several antigens, in both serum and seminal plasma, was usually demonstrated in infertile subjects. Using a complex statistical package no significant difference was found in the distribution of antigens between groups; this included previously termed "fertility-related antigens' (28, 35, 57 and 62kDa proteins). This suggests that the most relevant sperm antigens involved in reproduction have no particular relationship to sperm concentration and motility.

Antigen-Antibody Reactions↗

PubMed1995

Characterization of human sperm antigens reacting with antisperm antibodies from autologous sera and seminal plasma in a fertile population.

Immunoblotting techniques were used to characterize the reactivity of human sperm antigens with antisperm antibodies from a population of fertile individuals. In particular, sperm antigens of each subject were tested with the same subject's antisperm antibodies present in blood serum and seminal plasma in an attempt to construct a preliminary map of the antigen domains of the normal spermatozoon. Fifty-five fertile males, comprising 22 subjects with a pregnant partner and 33 subjects attending assisted reproductive technology sessions for proven partner's infertility and with normal semen quality entered the study. A high proportion of sera (82%) and seminal plasma (62%) showed antisperm antibodies reacting with one or more sperm antigens. Specific immunoreactivity was often demonstrated to 45-kDa, 50-kDa, 55-kDa, 69-kDa, 72-kDa and 85-kDa proteins in serum and to 59-kDa and 72-kDa proteins in seminal plasma. These proteins are the most frequently involved sperm antigens in the immune responses in fertile subjects. Further studies in an infertile population are necessary to distinguish between these antigens of minor relevance in sperm function from others significantly involved in immunological infertility.

Antibodies↗

PubMed1995

Longitudinal change of sonographic ovarian aspects and endocrine parameters in irregular cycles of adolescence.

We longitudinally studied clinical endocrine and ultrasound parameters of the ovaries in 73 healthy adolescents having persistent menstrual irregularities. After the first examination, they were reexamined after a variable period ranging from 2 to 7 y. During the first examination, three basic features of the ovaries were observed: homogeneous (36%), multifollicular (23%), and polycystic (41%). Polycystic ovaries were most frequent, and they generally exceeded the normal adult range. During the last examination, in the entire group of irregular adolescents, homogeneous ovaries decreased (-14%), polycystic ovaries increased (+18%), and a further higher number of subjects exceeded the normal adult range (+10%). The subjects with enlarged ovaries had the highest values of LH, testosterone, and androstenedione. Fourteen subjects out of 46 (30%), with normal ovarian volume in the first examination, registered an ovarian enlargement in the last examination, exceeding the normal range. Moreover, a change from the homogeneous or multifollicular structure to the polycystic one was observed. Twenty-one subjects out of 27 (78%) with enlarged ovaries in the first examination confirmed the high ovarian volume and the unchanged structure in the last examination, whereas six subjects (22%) showed ovaries within the normal adult range; the polycystic structure was substantially confirmed. These results indicate the following. 1) Homogeneous, multifollicular, and polycystic ovaries can usually be found in the postmenarcheal period. 2) Enlarged ovaries, polycystic structure, hyperandrogenemia, and high LH values are strongly linked, and they are frequent in irregular cycles even in the absence of signs of hyperandrogenism. These characteristics may all persist or in various aggregations become a permanent feature. 3) Only a few subjects may lose ovarian enlargement and show a change in the polycystic structure; however, they frequently maintain hyperandrogenemia. 4) During the postmenarcheal period, normal ovarian characteristics may suddenly change, and the ovaries may take on a polycystic structure and increase in volume. Moreover, some endocrine parameters may reach pathologic levels.

Adolescent↗

PubMed1994

Skeletal maturation and hormonal levels after the menarche.

Skeletal maturity was studied in 82 healthy adolescent girls age between 12 and 19 who had reached the menarche from 0.5 to 5 years previously. 56 subjects (68.2%) had closed epiphyses while they were open in 26 (31.8%). The incidence of open epiphyses was 61% in the first year after the menarche and progressively decreased showing negative correlation with time elapsed since the menarche (r = 0.98, P < 0.0001). The mean +/- SE height increased from 158.7 +/- 1.3 cm in the first year after the menarche, to 162.7 +/- 1.3 cm in the fifth year after the menarche. No significant differences were seen in estradiol, estrone, testosterone, dihydrotestosterone and androstenedione levels between subjects with open or closed epiphyses while dehydroepiandrosterone and its sulfate levels were higher in the closed epiphyses group. Girls with open epiphyses at first evaluation grew about 3.5 cm in the next three years.

Adolescent↗

PubMed1994

Frequency and treatment of ovarian cysts in adolescence.

Ultrasound examination of the ovaries was performed monthly in the follicular phase of 139 healthy adolescents for one year. In 17 girls (12.2%) ovarian cysts spontaneously disappeared within 3 months of first observation. In 6 subjects, treatment with the combined estrogen/progestogen pill was given. The treatment was effective in 4 girls after 2-6 months while 2 subjects required surgical intervention for a cystic teratoma and a simple follicular cyst respectively. A spell of serial sonographic observation of ovarian cysts would seem appropriate in adolescents.

Adolescent↗

PubMed1994

Body fat distribution has weight-independent effects on clinical, hormonal, and metabolic features of women with polycystic ovary syndrome.

This study was performed to investigate whether different patterns of body fat distribution may have distinct effects on the clinical, hormonal, and metabolic features of women with clinical hyperandrogenism such as polycystic ovary syndrome (PCOS). Ninety-seven consecutive women with PCOS were included in the study after assessment of gynecological and obesity history and careful clinical examination. Women were divided into three tertile groups based on the waist to hip ratio (WHR). Those with peripheral body fat distribution (P-BFD) had a WHR of less than 0.80, those with intermediate body fat distribution (I-BFD) had a WHR of 0.81 to 0.90, and those with abdominal body fat distribution (A-BFD) had a WHR exceeding 0.90. Baseline blood and urine samples were obtained for several hormone and lipid determinations, and the response of glucose, insulin, and C-peptide to a glucose oral challenge (75 g) was investigated. In the PCOS group, WHR values were higher than those used to define P-BFD and A-BFD in the normal female population. As WHR values increased, a significantly greater prevalence of obesity and acanthosis nigricans and a lower prevalence of acne was present. No significant differences were present in any of the other clinical features between the three groups. Ovarian morphology and volumes were similar in all groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗

PubMed1993

Immunoreactive dynorphin A-like material in extracted human hypothalamic-hypophysial plasma.

Immunoreactive dynorphin A-like material (ir-dyn A) in human plasma was measured by a validated radioimmunoassay. In peripheral plasma extracts mean concentrations between 20 and 40 fmol/ml were determined in volunteers and in patients with pituitary adenomas. In this latter group superimposable levels were detected three days before and during transsphenoidal microsurgery. Interestingly, ir-dyn A levels evaluated in extracts of hypothalamic-hypophysial plasma obtained during surgery, just after tumor removal, were 4-5 times higher than in peripheral plasma. Reverse-phase high performance liquid chromatography (rp-HPLC) of extracts of peripheral plasma samples revealed two immunoreactive peaks. The major form had the same retention time of dyn A-(1-32); whereas a second, more lipophilic, peak eluted later and was not further characterized. In contrast, rp-HPLC analysis of extracts of plasma collected from the suprapituitary region displayed only one peak eluting in the position of synthetic dyn A-(1-17). The presence of dyn-related peptides in hypothalamic-hypophysial plasma supports the hypothesis that they may play a part in the regulation of hypothalamic and/or pituitary functions in humans.

Adenoma↗

PubMed1993

Insulin and androgen relationships with abdominal body fat distribution in women with and without hyperandrogenism.

This retrospective study was carried out to investigate, in a large group of hyperandrogenized women with polycystic ovary syndrome (PCOS) and nonhyperandrogenized control women, the interrelationships between sex steroids and indices of body fat distribution. Moreover, we investigated the relationships between these parameters and insulin blood levels, since obese women with abdominal pattern of fat distribution (A-BFD), as well as those with PCOS (either obese and nonobese) are characterized by moderate to severe hyperinsulinemia. A sample of 100 women with PCOS and that of 138 women without clinical signs of hyperandrogenism, who served as a control group, were investigated. The waist to hip circumference ratio (WHR) which was used to define different patterns of fat topography was significantly (p < 0.05) higher in PCOS (0.84 +/- 0.10) than in control women (0.81 +/- 0.08). In both groups, women with WHR values lower than or equal to 0.85 were considered as having a peripheral pattern of body fat distribution (P-BFD) whereas those having WHR values higher than 0.85 had A-BFD. Compared to controls, women with PCOS had higher LH, androgen and estrogen concentrations. In both PCOS and controls there were no differences in sex hormone levels between women with different patterns of fat distribution, except androstenedione, which levels were significantly higher in women with A-BFD than with P-BFD. Women with PCOS showed significantly higher insulin levels than controls. Moreover, in both groups fasting and stimulated insulin were significantly higher in women with A-BFD than in those with P-BFD.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗

PubMed1993

Changes in brain catecholamine metabolism during bromocriptine treatment in polycystic ovary syndrome.

The role of dopaminomimetic drugs on the brain catecholamine metabolism in the neuroendocrine regulation of the polycystic ovary syndrome (PCO) was investigated. We measured, besides peptide hormones and sex steroids, urinary dopamine (DA), norepinephrine, epinephrine, vanillylmandelic acid, homovanillic acid (HVA), 3,4-dihydroxyphenylacetic acid (DOPAC) and total 3-methoxy-4-hydroxyphenylglycol (MHPG) levels by high-performance liquid chromatography with electrochemical detector in 10 women with PCO before and during long-term bromocriptine (BRC) administration. HVA and DOPAC concentrations were significantly lower (p < 0.001) in PCO patients compared with 12 control subjects in the early follicular phase, whereas MHPG concentrations were significantly higher (p < 0.01) in PCO patients. During BRC administration, HVA, DOPAC and MHPG levels increased significantly (p < 0.01 for HVA and DOPAC, and p < 0.05) for MHPG), prolactin levels dropped markedly (p < 0.01), whereas luteinizing hormone levels did not change (p = NS). These data show (1) a reduced DA activity in PCO which may be normalizable under BRC treatment, but also (2) no major effects of DA metabolism on the inappropriate gonadotropin secretion of the syndrome.

3,4-Dihydroxyphenylacetic Acid↗

PubMed1993

Adeno-pituitary hormones in human hypothalamic hypophysial blood.

An in vivo technique for collecting blood from the pituitary stalk using transphenoidal microsurgery has recently been developed in men with nonfunctioning pituitary disease. To determine the origin of this blood and the direction of the stream, we measured contemporaneously the levels of LH, FSH, PRL, GH, TSH, and ACTH in hypothalamic-hypophysial blood (HHB) and peripheral blood (PB). Eleven patients with nonfunctioning pituitary adenomas entered the study. The surgical procedure used for collecting HHB consisted of periodically aspirating small amounts of blood using a microsuction apparatus, just after tumor removal, kept in the postero-superior corner of the sella turcica at the junction of the diaphragm with the dursum sellae. The data show clearly the existence of a dramatic concentration gap in HHB vs. PB in all adeno-pituitary hormones (P = 0.003). The HHB/PB ratio varied from 50-600 in the different hormones. The secretion of adeno-pituitary hormones in blood drawn at the pituitary stalk level in man was reported for the first time. The dramatic HHB/PB ratio of the hormone levels has been emphasized. The most likely explanation for the markedly elevated hormone concentration gradient between central and peripheral blood was sampling of peri- and/or suprapituitary blood. To consider the origin and direction of the HHB stream, two hypotheses have been further advanced: 1) a retrograde bloodflow from the pituitary, and 2) a central-hypothalamic secretion.

Adenoma↗