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Biomedical subjects

V Insler

Publications and source records attributed to V Insler.

At least 73 records · Page 4Linked to original sources
PubMed1991

Management of post-date pregnancy: a case control study.

Post-date pregnancy is associated with higher rates of perinatal mortality and morbidity. The purpose of the present study was to compare the outcome of 200 post-date pregnancies, managed according to our protocol, to a matched control group of 200 healthy pregnant women delivered at term. The management protocol was based mainly on the pelvic score and nonstress test. Higher rates of labor induction, meconium-stained amniotic fluid, fetal distress, instrumental deliveries and cesarean sections were found in post-date pregnancies than in the control group (40% vs. 3% P = 0.0001, 31% vs. 15.5% P = 0.00001, 18.5% vs. 9.5% P = 0.007, 8% vs. 3% P = 0.02, 12.5% vs. 4% P = 0.002 respectively). Neonatal birth weight in the study group was significantly higher than in the control group (3,484.3 +/- 410.7 vs. 3,218.4 +/- 407.8 g P less than 0.001). Despite these differences between the groups, the perinatal morbidity and mortality rates were similar. These results can be partially attributed to the early antenatal monitoring and intensive follow-up.

Apgar Score↗
PubMed1990

Chlamydial IgG and IgA in serum and follicular fluid among patients undergoing in vitro fertilisation.

The point prevalence of IgG and IgA antibodies to Chlamydia was analyzed in serum and follicular fluid in 63 patients undergoing in vitro fertilisation (IVF) in comparison to sera of 298 healthy women by the single serovar (L2) inclusion immunoperoxidase assay (IPA). The presence of specific IgG and IgA to Chlamydia in follicular fluid was demonstrated. No statistical association was found between the presence of specific Chlamydia IgG and IgA in serum and follicular fluid to oocyte fertilization. The positive predictive value for mechanical infertility of Chlamydia IgG at titers of greater than or equal to 128 and IgA titers at greater than or equal to 16 was 91 and 92%, respectively, in this high-risk group for mechanical infertility. Multiple regression analysis singled out Chlamydia IgG levels as a major contributor to the variance between the groups of infertile patients.

Adolescent↗
PubMed1990

Can premature luteinization in superovulation protocols be prevented by aspiration of an ill-timed leading follicle?

In 12 patients stimulated for in vitro fertilization and embryo transfer (IVF-ET), a single leading follicle developed, whereas the other follicles were 6 mm smaller. In 7 patients chosen at random (group A), the leading follicle was aspirated, whereas in the other 5 the leading follicle was allowed to continue growing (group B). Comparison of the hormonal pattern of both groups showed that a premature luteinizing hormone (LH) surge was avoided only in group A, and only in this group a second follicle aspiration for IVF-ET was done, and two pregnancies were achieved. In group B, aspiration for IVF-ET was canceled because of premature LH surge. It is suggested that aspiration of a single leading follicle during ovulation induction may be an efficient method to avoid premature LH surge enabling other follicles to develop up to the preovulatory stage.

Adult↗
PubMed1990

Induction of ovulation: historical aspects.

The cornerstone of the conquest of infertility was laid in the beginning of this century. It took, however, nearly 80 years of work of many scientists from all over the globe to slowly unravel the puzzle of nature's most guarded secret, the control of the reproductive processes. The estimated population size of women between the ages 19 and 34 years in the developed world in 1990 will be about 130 million. If we assume that at least 8% will be infertile, then the pool of the infertile population will be above 10 million, with about 700,000 new patients entering this pool every year between the years 1990 and 1995. In the past only about 40% of infertile patients benefited from ovulation induction regimens. With the advent of assisted reproduction this population increased to about 80%. With the use of gonadotrophins for induction of superovulation in normally ovulating women conceptual changes in treatment regimens and monitoring schemes had to be introduced. It is obvious that the primary task of infertility clinics is to diagnose the main cause (or causes) of infertility in each couple in order to be able to institute appropriate therapy within a reasonable time. We have attempted to review briefly the regulation of follicular development, particularly with regard to new findings demonstrating the potentiating effect of growth hormone and/or various growth factors on ovarian sensitivity to FSH. This new knowledge, as well as availability of potent GnRH analogues, will evidently refine our clinical approach to treatment of functional infertility. Continuous advances in the understanding of mechanisms regulating reproductive processes and the better recognition of underlying causes of infertility will lead to the optimal choice of first-, second- and third-line routine therapies which will apply to the majority of patients. Furthermore, it will become possible to design tailor-made ovulation-inducing protocols for specific patients who do not respond properly to the routine treatment.

Adult↗
PubMed1990

Role of midcycle FSH surge in follicular development.

The present study was undertaken to examine the importance of the proestrous surge of FSH for follicular development during the following cycles in the rat. The midcycle FSH surges were blocked in several consecutive cycles (1-5) by injecting proestrous rats with pentobarbital. The rats were sacrificed on the day of proestrus following the appropriate number of blocked FSH surges and their ovaries were removed for either direct measurements or for histological workout. The number and diameter of follicles were determined in the excised ovaries. Two or three cycles of barbiturate treatment reduced the number and diameter of the follicles. No large follicles (greater than 0.4 mm) were observed in the ovaries of rats in which four or five gonadotropin surges were blocked. A repeat experiment with concomitant supplementary hCG administration yielded the same results. Addition of exogenous FSH canceled the effect of pentobarbital. The cohort observed on ovaries after four cycles of treatment with pentobarbital and FSH resembled that observed in control rats. Histological measurements supported the results obtained with fresh ovaries. It is therefore suggested that in the third cycle preceding the ovulatory one, the midcycle FSH surge determines which follicles will be able to adequately develop in the following three cycles. In the cycle preceding the ovulatory one, the midcycle FSH peak 'rescues' a group of follicles and prepares them for a proper response to the FSH elevation taking place at the beginning of the subsequent ovulatory cycle. This process allows the selection of the dominant follicles which will respond by ovulation to the ensuing LH peak.

Animals↗
PubMed1990

Host defense during pregnancy: monocyte adherence and killing.

Pregnant women are more susceptible to candida infections than nonpregnant women. Since monocytes play a major role in host defense against candida, their association with radiolabeled candida and their capacity for killing candida were compared in sera of pregnant and nonpregnant women. While the basal rate of these monocyte functions was similar in both groups of women, candida opsonized with serum from pregnant women was less effective in enhancing these monocyte activities. Serum from nonpregnant women increased the association about twofold, whereas serum from pregnant women increased it only by about one and a half times in the two groups of women. Pretreatment of candida with serum from pregnant women increased the killing to 28%, whereas the serum from nonpregnant women was more effective, increasing the killing to 40%. The difference between the effect of the sera could not be attributed to the level of serum complement or IgG.

Adult↗
PubMed1989

The association between chlamydial-specific IgG and IgA antibodies and pregnancy outcome in an in vitro fertilization program.

Chlamydial-specific IgG and IgA antibodies were determined by a single serovar (L2) immunoperoxidase assay (IPA) in the serum of all patients that have conceived in an in vitro fertilization and embryo transfer (IVF & ET) program (n = 106) and in a group of patients that went through the program at the same period of time and did not conceive (n = 94). The prevalence rate of elevated IPA IgG (titers greater than or equal to 1:128) and IPA IgA (titers greater than or equal to 1:16) specific to chlamydiae was significantly higher (P less than 0.001) in the IVF & ET pregnancy loss and nonconception groups ("failures") versus the IVF & ET term pregnancy group ("successes") (74 vs 47%, odds ratio = 4.1, and 34 vs 14%, odds ratio = 4.3, respectively). Stepwise discriminant analysis revealed that elevated specific chlamydial IgG had the greatest effect on the variance between successes and failures in this study group. Our study indicates the possible role of past or chronic active chlamydiae infection on the "take-home baby rate" in an IVF & ET program.

Adult↗
PubMed1989

Cervical cancer in Jewish women.

Because of the known low incidence rate of cervical cancer in Jewish women, less than appropriate attention has been focused on this type of malignancy in Jewesses. We have summarized our experience with 144 cases of cervical cancer diagnosed during 25 years in South Israel. In recent years a remarkable, although not statistically significant, increase in the number of patients with cervical cancer could be observed. Only two of ten patients were diagnosed at preinvasive stage. In contrast with previous reports we did not find women of Asian and African origin to be overrepresented, but patients from these origins were more often diagnosed at a higher stage than were patients of European origin. Adenocarcinoma accounts for almost 19% of the cervical cancer in premenopausal women. A very low rate of early detection of cervical cancer and a trend of rising incidence of cervical cancer in Jewish women urgently require a reevaluation of health care policy. Large-scale screening programs, perhaps initially in defined high-risk groups are needed.

Adenocarcinoma↗
PubMed1989

Serum IgG and IgA antibodies to Chlamydia in ectopic pregnancies.

The possible association of Chlamydia trachomatis with ectopic pregnancies was evaluated in a case-control study, comprising 35 women with ectopic pregnancy and 294 apparently healthy women who served as controls. Chlamydia-specific IgG and IgA antibodies were determined by single serovar (L2) inclusion immunoperoxidase assay (IPA). Socio-demographic characteristics, gynecological history and contraceptive methods were also evaluated. An inverse relationship was found between the educational levels and the prevalence of IgG and IgA antibodies to chlamydia. The prevalence rate of elevated IPA IgG (titer greater than or equal to 128) and IPA IgA (titer greater than or equal to 16) specific to chlamydia was significantly higher in women with ectopic pregnancy versus controls (32% vs 8%, respectively, for IgG: odds ratio = 4.9; and 26% vs 4% for IgA: odds ratio = 7.5). Chlamydia trachomatis was not isolated in cell cultures in 10 specimens available from fallopian tubes of women with ectopic pregnancy. Only 9% of the women recall having pelvic inflammatory disease (PID) indicating that most of the infections were asymptomatic. Women who did not use IUD had a higher proportion of chlamydia-specific IgG and IgA seropositives, though not statistically significant, as compared to IUD users. This study further supports the hypothesis that subclinical infection of the tube with C. trachomatis may underlie ectopic pregnancies.

Adolescent↗
PubMed1989

Inhibition of Chlamydia trachomatis growth in endometrial cells by copper: possible relevance for the use of the copper IUD.

There is agreement that the relative risk of developing pelvic inflammatory disease (PID) increases among women who use the intrauterine contraceptive device (IUD). The role of Chlamydia in causing PID among IUD users is not clear. The present study demonstrates that Chlamydia trachomatis growth can be inhibited in cultured human endometrial cells by copper ions at concentrations known to be released by the copper IUDs. More than 98% inhibition was produced with 10(-5) and 10(-6) M of copper. Both C. trachomatis serovar E and a lymphogranuloma venereum Chlamydia serovar L2 (LGV) were inhibited by the copper ions. Although the mechanism of the inhibition is not known, the continuous presence of the copper ions during and after adherence appeared to be necessary for maximal effect. If such inhibition occurs in vivo, it is possible that copper ions released from the copper-containing IUD may partially protect against chlamydial infection.

Cells, Cultured↗
PubMed1989

In utero prenatal diagnosis of Beckwith-Wiedemann syndrome; a case report.

The Beckwith-Wiedemann syndrome is an unusual complex of abnormalities that includes mainly omphalocele, macroglossia, natal and postnatal gigantism, visceromegaly and neonatal hypoglycemia. A case is presented where sonographic prenatal diagnosis of this rare condition was made. Prenatal findings and postnatal management are described.

Beckwith-Wiedemann Syndrome↗
PubMed1989

The combined suppression/stimulation therapy in IVF-ET programmes: expectations and facts.

The benefits of combined pituitary suppression/ovarian stimulation therapy in IVF-ET programmes could be avoiding an untimely LH secretion, synchronization of the ovarian response to stimulation, an increased number of ova obtained and embryos replaced and a higher pregnancy rate. The first two advantages can be considered as direct effects of the combined therapy, while the others result, at least partly, from the more aggressive use of gonadotrophins. The capability of combined GnRH analogue/gonadotrophin treatment to avoid failures due to premature luteinization of follicles seems to be unequivocal. In order to obtain a better synchronized ovarian response to stimulation, new treatment schemes, based on prolonged use of currently available agonists or on application of potent synthetic GnRH antagonists, will have to be developed. Basic studies concerning the presence and the extent of a direct effect of GnRH analogues upon ovarian function would also help in a better understanding and more efficient application of the combined suppression/stimulation therapy in IVF-ET programmes.

Embryo Transfer↗
PubMed1989

Reduction or cessation of fetal movements after steroid administration for enhancement of lung maturation. II: Analysis of blood flow velocimetry.

Reduction or cessation of fetal movements after intra-uterine exposure to pharmacological doses of steroids administered for enhancement of lung maturation has been previously reported. In the present study fetal activity and umbilical and uterine blood flow velocimetry in 18 pregnant patients receiving steroids were evaluated by ultrasonography. Measurements were done before, during and after steroid exposure in an attempt to clarify the possible pathophysiology of this peculiar change in intra-uterine fetal behavior. Even in cases in which mothers ceased to perceive fetal movements, on real-time sonography fetal activity was observed. The possible explanation for this phenomenon may be the influence of large doses of steroids that affected skeletal muscular activity. No changes in blood flow velocimetry in both uterine and umbilical arteries were observed throughout the study period, thereby indicating that the changes in fetal movements did not result from an altered blood supply.

Betamethasone↗
PubMed1988

Gonadotropin-releasing hormone specific binding sites in uterine leiomyomata.

Gonadotropin-releasing hormone (GnRH) analogs can cause regression of uterine leiomyomata. This effect is thought to be mediated by the inhibition of gonadotropin release and steroid synthesis. In the present study we examined the possibility that these analogs may also act directly on uterine leiomyomata. Specific binding sites for GnRH are present in myoma membranes, as 125I-Buserelin binding was displaced with equal efficiency by the superagonists, Buserelin and D-Trp6-GnRH, and by the antagonist Organon 30276, but not by unrelated peptides such as thyrotropin releasing hormone and oxytocin. A nonlinear Scatchard curve obtained for Buserelin specific binding suggests the presence of at least two binding sites, one of which exhibits a relatively high affinity for GnRH analogs (Kd of approximately 10(-8) M). Western blotting with a specific GnRH receptor antibody revealed the presence of a 60 kDa protein in myoma membranes. This protein has a similar molecular weight to the purified pituitary GnRH receptor. These results indicate, for the first time, the presence of specific binding sites for GnRH in uterine leiomyomata, suggesting a direct effect of GnRH analogs on this tissue.

Adult↗