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Biomedical subjects

S Mancuso

Publications and source records attributed to S Mancuso.

At least 415 records · Page 23Linked to original sources
PubMed1987

Induction of ovulation by intermittent intravenous purified follicle-stimulating hormone in polycystic ovarian disease.

IIV FSH was administered to eight women with PCOD to induce ovulation. These patients had been previously treated unsuccessfully with CC or IM gonadotropins. The drug was administered by a pump at 120-minute intervals. Dosage was 1 ampule Metrodin (75 IU of FSH less than 0.11 IU of LH)/day. Eight cycles of treatment were effected. With the IIV regimen, ovulation rate was 75% (six cycles). Two multiple pregnancies and one abortion (mola vescicularis) were observed. Preovulatory E2 plasma levels and the number of follicles recruited per cycle varied from 530 to 3800 pg/ml and from 4 to 15, respectively. Maximal follicular diameter was between 16 and 28 mm. LH levels significantly decreased, while FSH levels were unchanged, resulting in a decrease of LH/FSH ratio. It is concluded that the IIV FSH regimen offers an additional modality for the induction of ovulation in PCOD patients. Further clinical trials with alternative regimens are needed, however, to identify the optimal dosage and frequency of administration of the drug.

Adult↗
PubMed1987

Abnormal fetal cerebral blood flow velocity waveforms as a sign of an aneurysm of the vein of Galen.

A cerebral midline cystic lesion was detected by real-time ultrasound in utero in the absence of other congenital abnormalities. Pulsed Doppler ultrasound assessment of fetal circulation demonstrated normal peripheral and intracardiac hemodynamics associated with decreased cerebral vascular resistance. Furthermore, a markedly turbulent flow pattern was evidenced within the cerebral lesion. The presence of a cerebral arteriovenous malformation with an aneurysm of the vein of Galen was suggested and the provisional diagnosis was later confirmed by computed tomography and carotid angiography performed after birth.

Adult↗
PubMed1987

Development of behavioral states in hydrocephalic fetuses.

Behavioral states observations were carried out in 12 hydrocephalic fetuses by means of a computerized system. Recordings of behavioral parameters, including fetal heart rate, gross body movements, breathing movements and eye movements, were performed at 2-week intervals from 30 weeks of gestation onwards. The hydrocephalic fetuses showed quantitative and qualitative differences in their motor behavior in comparison to healthy fetuses of equivalent gestational age. Similarly the appearance of behavioral states was delayed in hydrocephalic fetuses. Furthermore, an increased discordance between the behavioral parameters was evidenced. The degree of discordance seems to be related to the severity of neonatal outcome suggesting a possible estimation of CNS dysfunction by means of behavioral state analysis.

Brain↗
PubMed1987

Endometrial carcinoma: 128 cases at stages I and II.

The authors have re-examined 146 patients with stage I and II endometrial carcinoma according to pathological findings. An understaging of FIGO classification of 9.8% and 14.2% in stages I and II, respectively, was found. Also evaluated was the influence of some risk factors (histologic grade, myometrial infiltration) on survival rates which was highly significant for both stages I and II. Surgery was the main form of treatment with an operability rate higher than 90%. The bilateral salpingo-oophorectomy appeared to improve the survival at stage I, 85.8% versus 63.6%, while postoperative external radiotherapy (ERT) seemed to be ineffective.

Female↗
PubMed1987

Effects of nifedipine on umbilical artery velocity waveforms in healthy human fetuses.

The purpose of this investigation was to analyze the changes in umbilical artery (UA) velocity waveforms after administration of nifedipine in 30 healthy pregnant women. The effects on fetal and maternal heart rates and maternal arterial pressure were also analyzed. The patients included in this double blind study received sublingually either 10 mg of nifedipine or a placebo. A transient fall of the UA resistance (as expressed by the pulsatility index) occurred 15 min after nifedipine administration, but resistance returned to control values after 90 min. Maternal heart rate increased after nifedipine administration and returned toward the control value by 45 min. Fetal heart rate and maternal mean arterial pressure did not change significantly. These data suggest a possible use of nifedipine to normalize the UA velocity waveform in pregnancies complicated by hypertension and fetal growth retardation.

Blood Flow Velocity↗
PubMed1987

Loss of circadian rhythms of fetal behaviour in a totally adrenalectomized pregnant woman.

Fetal heart rate and fetal movements were recorded over a 24-hour interval in a totally adrenalectomized pregnant woman at term. Cortisol, ACTH, unconjugated estriol and 17 beta-estradiol were contemporaneously measured every 2 h in the maternal peripheral plasma. Owing to the substitution therapy the patient showed a loss of circadian variations of all the hormones investigated. Moreover, the circadian rhythms of fetal heart rate and fetal movements, usually present at term, were no longer evident. We can thus suggest that the circadian variations of plasma maternal cortisol could affect the alternations of fetal behaviour.

Adrenalectomy↗
PubMed1987

Luteal responses to gonadotropin-releasing hormone during the luteal phase: relation to the age of corpus luteum.

The pituitary and luteal responsiveness of GnRH were studied in 20 normal women at different stages of the luteal phase (LP). Blood samples were collected every 15 min for 180 min before and 120 min after the iv injection of 25 micrograms GnRH. The studies were performed in the early LP (ELP; days 2-3 of LP; n = 5), mid-LP (MLP: days 4-8 of LP; n = 11), late LP (LLP; days 9-12 of LP; n = 13), and premenstrual phase (PMP; days 13-14 of LP; n = 3). Plasma LH, FSH, progesterone (P), and estradiol (E) levels were assayed by RIA. The data were analyzed as integrated secretory area before (ISAb) and after GnRH stimulation (ISAs) and in terms of their percent increase with respect to the basal value. In all studies, GnRH elicited increases in plasma LH and FSH (P less than 0.001). On the other hand, in the ELP, GnRH did not alter steroid ISAs compared to their ISAb, while significant increases in plasma P and E levels were found in the MLP (P, P less than 0.01; E, P less than 0.02) and LLP (P and E, P less than 0.01). In the PMP, two women had no increase in steroid secretion; in the remainder of the subjects, both P and E ISAs markedly increased. This different pattern was not related to basal steroid levels. All women who had a blunted steroid response in the ELP or PMP had a normal secretory response of both P and E when studied at the other LP stages of the same cycle. Furthermore, there was a positive linear correlation between plasma P and E for the ISAb and ISAs values, while the secretory patterns of gonadotropins and steroids were not related to each other. In conclusion, the corpus luteum is able to respond to GnRH to GnRH at a well identified period of the LP. This pattern indicates variable dependence of the corpus luteum on the functional activity of the hypothalamic-pituitary axis.

Adult↗
PubMed1987

Successful induction of ovulation and conception with combined gonadotropin-releasing hormone agonist plus highly purified follicle-stimulating hormone in patients with polycystic ovarian disease.

Five women (group A) with polycystic ovarian disease (PCOD) and sterility for at least 3 yr were treated for 1 cycle for ovulation induction with a combined regimen of GnRH agonist (GnRH-A) plus highly purified FSH. The patients received GnRH-A (Buserelin; 200 micrograms, sc, twice a day) for 6 weeks and then GnRH-A combined with FSH highly purified (2 ampules a day; 75 IU FSH and less than 0.11 IU LH in each ampule). Ovarian response was evaluated by plasma estradiol (E2) assay and ultrasound examination, performed daily. Furthermore, plasma FSH and LH levels were assayed 3 times a week. Once a follicle was considered sufficiently developed, the combined regimen was withheld, and 24-48 h later hCG (5000 IU, im) was given. The results are compared with those of 31 ovulatory cycles induced by im FSH highly purified (group B) in PCOD patients with the same FSH administration, clinical, and monitoring protocols. Ovulation was achieved in all cycles treated by GnRH-A plus FSH. Two singleton and a twin pregnancy resulted. Multiple follicular development occurred in all cycles. Plasma E2 levels were generally in the normal range. Echographic and endocrine features in the 2 groups were as follows. 1) basal ovarian volume and ovarian enlargement were similar. 2) Group A had a greater number of follicles than did group B (P less than 0.01), while E2 to number of follicles and E2 to ovarian volume ratios were greater (P less than 0.01) in group B. 3) The linear correlations between plasma E2 levels and ovarian volume were markedly different in groups A and B (P less than 0.01). The regression line for group B had a steeper slope than that for group A. This finding indicates that at a fixed ovarian volume plasma E2 levels were significantly lower in group A than in group B. We conclude that the combined GnRH-A and FSH regimen may constitute an alternative and promising tool for the induction of ovulation in patients with PCOD.

Adult↗
PubMed1987

Fetal blood flow velocity waveforms as predictors of growth retardation.

Seventy-five high-risk pregnancies were studied in order to define the clinical value of the analysis of fetal blood flow velocity waveforms in early screening for growth retardation. Recordings were obtained at 26-28 weeks' gestation, in the absence of ultrasonographic signs of growth retardation, using a pulsed duplex Doppler system. The pulsatility index was evaluated at the level of the umbilical artery, descending aorta, and internal carotid artery. Fetuses (N = 23) who developed growth retardation showed higher values of pulsatility index in the umbilical artery (P less than .001) and descending aorta (P less than .05) than fetuses of normal growth. In the internal carotid artery, the pulsatility index was lower (P less than .001) in the fetuses who developed growth retardation than in those with normal growth. The ratio between the pulsatility indexes of the umbilical and internal carotid arteries proved an accurate predictor of growth retardation (specificity 92.3%; sensitivity 78.2%; positive predictive value 81.8%; negative predictive value 90.5%; accuracy 88%).

Blood Flow Velocity↗
PubMed1987

Squamous cervical cancer at stage IB and II: a ten years experience, analysis of 231 cases.

The authors have reviewed their experience on treatment of carcinoma of the uterine cervix at stage I and II, with a special regard for prognostic factors. The best survival results at 7 years for patients at stage I B and II A were obtained with integrated treatments, while for stage II B patient no treatment proved to be really effective. Lymphnodal infiltration, increasing with the stage, was the most important prognostic factor, but stage must always be taken into account, especially in N- patients. Some considerations are then made on the importance of prognostic factors such as lymphnode status and tumour volume, in order to improve the survival results.

Carcinoma, Squamous Cell↗
PubMed1986

[Assessment of the diagnostic quality of radiography, xerography and computerized bone mineralometry in cases of osteoporosis].

The results of a study conducted on 40 osteoporotic subjects of both sexes aged 40-80 are reported with a comparison of the diagnosis of the nature and degree of the osteoporosis obtained by traditional radiography and xerography and, on the same subjects, by computerised bone mineralometry. The latter technique provided accurate and fairly early diagnosis in all subjects considered and it is therefore indicated as an elective method for the diagnosis of suspected osteoporosis. Xerography proved the most reliable of the traditional techniques. It should also be noted that in terms of protection against radiation, BMC is distinctly preferable to other radiological examination techniques since total radiation dose is very small.

Adult↗
PubMed1986

Estrogen responsive creatine kinase in human breast cancer cells.

The brain type (BB) isoenzyme of creatine kinase (CK) is a very sensitive marker of estrogen action in rat uterus and in experimental mammary tumors. In order to detect useful markers for estrogen dependent human breast cancer cell proliferation we measured CK levels and isoenzyme composition in the CG5 cells, an estrogen supersensitive variant of the MCF-7 human breast cancer cell line. Under basal conditions, CK-BB accounted for 10%-15% of total enzymatic activity, while the MM isoenzyme represented the overwhelming component. In cells cultured in the presence of 5% charcoal-treated fetal calf serum, physiological concentrations (0.1-1 nM) of estradiol increased CK-BB levels in a dose- and time-related fashion. The effect was specific for estrogens and was prevented by antiestrogens. Our results show that CK-BB is estrogen regulated in the CG5 cells and suggest a possible role for this enzyme as an additional marker of the hormonal responsiveness of breast cancer.

Breast Neoplasms↗
PubMed1986

Progesterone and LH variations after LH-RH administration in the luteal phase of the menstrual cycle.

We have investigated the pituitary and luteal responses to LH-RH and their related changes. 11 normal women were studied during the luteal phase (day +4/+11). Blood samples were collected every 15 min for a basal period of 180 and 120 min after the intravenous administration of 25 micrograms of LH-RH. Progesterone (P) and LH were assayed by radioimmunoassay. Data were analyzed as maximum peak and its percent increase (delta max), integrated secretory area (ISA) and percent increase of ISA (delta A) in respect to basal values for both P and LH. LH-RH elicited a secretory response of both hormones in all cases. ISA of LH was significantly greater after LH-RH administration in respect to basal values (p less than 0.001) and delta max accounted to 475 +/- (SE) 36% of the basal concentration. Luteal responsiveness varied from about 115-130% to more marked increments. ISA of P differed from basal to stimulated conditions (p less than 0.05) and delta max was 166 +/- (SE) 14%. The analysis of temporal relationship between P and LH secretion showed that LH promptly rose after LH-RH, while the enhancement of P plasma levels occurred within 31 +/- 19 min after LH rise. Then P levels reached a plateau, values of which were statistically different from those observed before LH-RH administration. In two cases where luteal function was blunted or absent, in spite of marked increments of LH, P secretion did not occur. These data are consistent with the presence of close relationships between hypothalamic, pituitary and luteal functions and strengthen the contention about the usefulness of LH-RH during luteal phase for the lifespan and maintenance of corpus luteum.

Adult↗
PubMed1986

Elevated plasma levels of beta-thromboglobulin in breast cancer.

Beta-thromboglobulin, a platelet-specific protein secreted into the plasma during the release reaction, was measured in 73 women with breast cancer, 10 women with dysplastic disease and 30 healthy female control subjects. 73% of patients with primary operable breast cancer and 65% with metastatic disease had levels above 40 ng/ml (control range 11-38 ng/ml). Among 2-6 months' postoperative patients without evidence of disease at the time of sampling, beta-thromboglobulin was raised in 75% of patients with nodal involvement and in 28% of patients without nodal involvement. Only 1 of 10 patients with benign disease showed abnormal beta-thromboglobulin concentration. Our results show that in a high percentage of breast cancer patients a state of ongoing in vivo platelet activation may be present. Furthermore, beta-thromboglobulin can be regarded as a potential tumor marker in breast cancer.

Adult↗
PubMed1986

Continuous subcutaneous insulin infusion (CSII) in pregnant diabetic women.

Insulin infusion pump treatment (CSII) in pregnancy was compared with conventional therapy (IIT) in 12 pregnant diabetic women. In patients poorly controlled on IIT a plasma glucose equilibrium was achieved with CSII (mean of: glucose levels = 84 vs 137 mg/dl; SD = 36 vs 63 mg/dl; MAGE = 65 vs 112 mg/dl). In patients well controlled on IIT, CSII led to a reduction in the variation of glucose excursions (SD = 29 vs 36 mg/dl; MAGE = 48 vs 76 mg/dl). CSII generally led to a reduction of 20-37% of daily insulin dose but in 3 cases there was an increase of dose with the achievement of glycaemic control. A significant relation between bolus/basal ratio of insulin daily dose and the quality of glycaemic control was also found during CSII. All infants were born at or near to term and none were macrosomic or had neonatal complications. It is concluded that CSII is highly efficient in pregnancy not only in type I but also in type II or gestational diabetes.

Adult↗
PubMed1986

Early hemostatic disorders in patients with gynecologic tumors.

One hundred and seventeen female subjects were studied: 23 patients with cervical carcinoma; 25 with endometrial carcinoma; 29 with benign uterine diseases; 14 with ovarian carcinoma; 26 patients with benign ovarian tumors. These patients, together with 25 healthy female control subjects, underwent several coagulation tests including Beta-Thromboglobulin (Beta-TG) and Platelet Factor 4 (PF4) plasma levels. Among all Beta-TG and PF4 exhibited the most interesting results. They were increased in four groups of patients: those with malignant 92.2% (13/14) and benign 50% (13/26) ovarian tumors and those with endometrial 64% (16/25) and cervical carcinoma 69.5% (16/23). Our study showed a high incidence of abnormalities of Beta-TG and PF4, early signs of hemostatic disorders, in gynecological malignancies especially in ovarian carcinoma. These data suggest a possible value of these tests as tumor-markers and in order to detect the patients who develop thrombo-embolic accidents.

Adult↗
PubMed1986

Evaluation of circulating immune complexes (C.I.C.) in endometrial cancer.

We evaluated the presence of CIC in 32 patients with histological proven cancer of endometrium: 23 stage IA or IB (i.e. localized disease), 9 in stage II or III (i.e. advanced disease). The determination of CIC was done at the time of the diagnosis before the patients underwent any surgical or medical therapy. The presence of CIC was demonstrated in 17% (4/23) of the patients with localized disease and in 56% (9/9) of the patients with more advanced disease. Our findings indicate that the presence of CIC is higher in patients with advanced endometrial carcinoma (stage II, III), than in those suffering of a more limited disease (stage IA, IB) and this seems could be consistent with a possible role in modulating the immune response against tumour itself.

Adult↗