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Biomedical subjects

V Insler

Publications and source records attributed to V Insler.

At least 91 records · Page 5Linked to original sources
PubMed1988

Chlamydia specific IgG and IgA antibodies in women with obstructive infertility as determined by immunoblotting and immunoperoxidase assays.

The prevalence rate of IgG and IgA antibodies to Chlamydia was analyzed in 50 women with laparoscopy-verified tubal infertility and in 50 age-matched control women by single serovar (L2) inclusion immunoperoxidase assay (IPA) and by immunoblotting technique (IB). Women with tubal infertility had significantly (p less than 0.001) elevated IPA Chlamydia IgG antibody titer greater than or equal to 128 and greater than or equal to 256 than controls (64% vs 16%. Odds ratios = 9.3 and 50% vs 10%, Odds ratio = 9 respectively). The prevalence rate of IPA IgA antibody titer (greater than or equal to 16) to Chlamydia was also significantly higher (p less than 0.001) in women with tubal infertility than controls (48% vs 8%, Odds ratio = 10.6). Antibodies to at least 19 chlamydial structural polypeptides ranging in molecular weight from 30 kD to 204 kD, were detected by the IB technique in the IPA seropositive sera. Antibodies to 57-60 kD were detectable in almost all the IPA IgG and IgA seropositive sera. The prevalence rate of IgG antibody to 57 kD-60 kD was significantly higher in women with obstructive infertility than healthy woman (84% vs. 56% p less than 0.01; Odds ratio = 3.8). More significantly, higher differences to 57-60 kD polypeptide were found in the case of IgA between the infertile women and controls (52% vs. 10%, p less than 0.001; Odds ratio = 9.7). The significance of IPA and IB technique for screening of infertile women is discussed.

Adult↗
PubMed1988

Results of in vitro fertilization in women with antisperm antibodies in serum, cervical mucus, and follicular fluid.

This study was undertaken to investigate the presence of antisperm antibodies (ASA) in serum, cervical mucus, and follicular fluid (FF) of women undergoing in vitro fertilization and embryo transfer (IVF-ET). IgG and IgA ASA directed mostly against sperm head were found at similar concentrations in serum, cervical mucus, and FF of 2 of 34 patients. Ninety-one percent fertilization and 100% cleavage rates, respectively, were observed in one of the two patients. No fertilization occurred in the second patient. In both women, in vitro sperm penetration tests revealed hostile mucus and repeated postcoital tests were poor. It is concluded that the sperm-cervical mucus penetration test and mucus ASA measurements are useful in establishing the diagnosis of immunological infertility.

Adult↗
PubMed1988

Blood supply to the uterus in preeclampsia.

Uterine fundal and low segment arcuate artery velocimetry was studied in normal pregnant women and in severe preeclamptic patients. The waveform velocity of the preeclamptic group revealed large differences between systole and diastole, as well as an increased resistance index. Furthermore, the abnormality was more severe in the fundal than in the low segment arcuate measurement.

Adult↗
PubMed1988

The effect of different LH-RH agonists on the levels of immunoreactive gonadotropins.

The present study compared the effect of D-Ser(tBU)6-des-Gly-LHRH-ethylamide in the form of a nasal spray, D-Trp6-LHRH, which is applied in daily intramuscular injections, and the long-acting preparation, D-Trp6-LHRH, which is given as a monthly intramuscular injection, on the function of the pituitary-ovarian axis. Forty spontaneously menstruating women not belonging to the PCOD group participated in the study, the results of which indicate that the three LH-RH agonists used are similarly effective in their ability to down-regulate the pituitary-ovarian axis. The time required for the appearance of the suppressive effect, as measured by reduced levels of gonadotropins and estradiol as well as by the abolishment of the hypophyseal response to rising estrogens, usually does not exceed 14 days and is never more than 28 days. The immunoreactive LH-reducing effect of the LH-RH agonists was true only if the basic levels of the hormone were higher than 11 mIU/ml. This fact might be particularly significant in patients with polycystic ovarian disease or in perimenopausal women.

Buserelin↗
PubMed1988

Reduction or cessation of fetal movements after administration of steroids for enhancement of lung maturation. I. Clinical evaluation.

Changes in fetal activity ranging from reduction to cessation of fetal movements were observed in patients at the 25th to 34th week of gestation, who were receiving steroids for enhancement of fetal lung maturation. This was a transient phenomenon, and fetal movements returned to normal by 24 h after the last injection of steroids. Concomitantly, during the period of exposure to steroids, we found an increased incidence of nonreactive monitoring patterns on daily analysis of fetal heart monitoring tracing. Although the pathophysiology of these changes is still unclear, we believe that the practical value of this observation is of importance. Reduction or cessation of fetal movements and a nonreactive nonstress test are generally accepted signs of fetal compromise and considered as an indication for termination of pregnancy. In this selective group of patients this is a temporary phenomenon; therefore, conservative management would seem in order.

Betamethasone↗
PubMed1987

Umbilical and uterine flow velocity waveforms in pregnancies complicated by major fetal anomalies.

A continuous wave Doppler unit was used to obtain umbilical and uterine artery flow velocity waveforms in pregnancies complicated by a major fetal abnormality. A total of 139 examinations were performed on 32 women between 26 to 41 weeks' gestation, and the records were reviewed to determine the changes associated with fetal malformation. The systolic/diastolic (A/B) ratio was used as an index of blood flow resistance in the umbilical artery and the systolic minus diastolic divided by systolic (A-B)/A for the branches of the uterine artery. Seventeen out of 32 patients showed high systolic/diastolic ratio in waveforms taken from the umbilical artery. In 30 out of 32 patients the uterine artery waveform was normal (in two patients the results were equivocal). It appears that a fetal mechanism may determine the changes in the umbilical placental circulation resulting in an umbilical artery pattern of high flow resistance in more than half of the patients with congenital anomalies.

Adult↗
PubMed1987

Acid phosphatase levels in follicular fluids following induction of ovulation in in vitro fertilization patients.

Considerable evidence indicates that changes in acid phosphatase (AP) activity at the ovarian level play a role in the process of ovulation. In this study the concentrations of AP were determined in follicular fluids collected from follicles of 52 women at the time of laparoscopy performed in connection with an in vitro fertilization program. In each of the 52 women at least one ovum was harvested. Of the 52 ova, 28 cleaved in vitro, while in 24 ova cleavage was not seen. Levels of AP in follicular fluids of women whose ova did not cleave were significantly lower than those found in follicular fluids of women with at least one ovum undergoing cleavage: 0.45 +/- 0.14 (SE) and 4.78 +/- 0.37 Bess Lowry Units (BLU), respectively. Comparison of AP levels in follicular fluids of women who conceived (5) and women whose ova cleaved, but in whom pregnancy was not achieved (23), did not reveal significant differences: 5.87 +/- 1.29 and 4.55 +/- 0.35 BLU, respectively. Moreover, the enzyme level was typical for a woman and not for a follicle. Fluids of two different follicles of the same woman, when one ovum cleaved and one did not, showed similar AP levels. AP levels were high in all samples follicles of women in whom at least one ovum cleaved. These findings indicate that the presence of certain levels of acid phosphatase represents an important, albeit not the sole, condition for ovum maturation. Moreover, the follicular fluid levels of AP could serve as an indicator of proper timing of the follicular puncture in relation to the human chorionic gonadotropin injection (or the luteinizing hormone peak).

Acid Phosphatase↗
PubMed1987

The effects of contraceptive hormones on the replication of Chlamydia trachomatis in human endometrial cells.

Several recent reports have documented a lower incidence of pelvic inflammatory disease (PID) among oral contraceptive users. The interpretation of this observation is difficult because the action of the contraceptive hormones may be directly by action on a specific host cell-parasite relationship, or indirectly via their action on other systems. In the present study we investigated the susceptibility of cultured human epithelial cells of the endometrium to infection by chlamydia and the influence of contraceptive steroids (ethinyl estradiol, mestranol and medroxyprogesterone acetate) upon replication of chlamydia in these cells. Forty-eight hours post-infection, elementary and reticulate bodies were observed in vacuoles of the infected endometrial cells by electron microscopy. Treatment of chlamydial-infected cells with contraceptive steroids in three different concentrations (10(-5)M, 10(-6)M and 10(-7)M) resulted in no effect on chlamydial replication, as examined by one-step growth curve. These results indicate that contraceptive hormones do not prevent chlamydial infection by direct effect on the replication of the agent.

Chlamydia Infections↗
PubMed1987

Prenatal sonographic detection of fetal facial malformations.

Abnormalities of the fetal face were diagnosed prenatally by ultrasound in six cases. These included four cases of cleft lip and palate, one case of cyclopia with holoprosencephaly, and one case of fetal facial hemangioma. Of the fetuses with cleft lip and palate, one had trisomy 13, and one had Pierre Robin syndrome. Facial anomalies detected by ultrasound may suggest the presence of other accompanying malformations and may sometimes warrant chromosomal studies. Thus, careful imaging of the fetal face is an important part of ultrasound examination when evaluating the fetus at risk.

Cleft Lip↗
PubMed1986

The setting-up of an ambulatory urologic-gynecologic service. Management of patients and results.

An ambulatory set-up is presented which comprises a simple armamentarium for management of women complaining of urinary stress incontinence. Since history appeared to be not sufficiently reliable for management of patients, diagnosis was based mainly on cystomanometry and radiology. Of 58 women who have completed at least six months of follow-up, 11 had been diagnosed as suffering from detrusor instability (DI) and 47 from genuine stress incontinence (SI). Treatment was medical in the former group and surgical in the latter. Significant or complete relief of symptoms was reported in 91% of the former group and in 81% in the latter.

Adult↗
PubMed1986

Evaluation of reliability of history in women complaining of urinary stress incontinence.

It was the aim of this study to evaluate critically the value of history in patients complaining of urinary stress incontinence. Diagnosis was established mainly by radiologic and cystomanometric assessment. History included 21 symptoms subdivided into various items. Only 3 symptoms were proven significant in distinguishing between various diagnostic groups. Assessment of stress incontinence should be regarded as incomplete without other means of evaluation in addition to history.

Adult↗
PubMed1986

Management and outcome of vertex-breech and vertex-vertex presentation in twin gestation: a comparative study.

A comparative study of twin pregnancies with vertex-breech and vertex-vertex presentation was undertaken to evaluate the effect of mode of delivery on perinatal outcome. During the years 1978-1984 there were 89 cases of vertex-breech deliveries at our institution and a control group of 89 cases of vertex-vertex presentation were chosen. The cesarean section rate was 11.2% for both twins in vertex-breech, and 20.2% for the first twin and 23.6% for the second in vertex-vertex presentation. The primary indications for cesarean section were not related to the type of presentation. The perinatal mortality was 22.4/1000 in the study group and 89.8/1000 in the control population. There were no statistically significant differences in 5-min Apgar scores and perinatal morbidity between the two types of presentation. We found that the high perinatal morbidity and mortality of both twins is related to prematurity and intrauterine growth retardation and not associated with the type of presentation of the second twin. Therefore, routine cesarean section for vertex-breech presentation is not necessarily indicated.

Apgar Score↗
PubMed1986

The impact of prenatal care on the outcome of pregnancy.

In a 12-months' prospective project all women delivering at the Soroka Medical Center, Beer-Sheba, Israel, were studied with regard to the type of prenatal care (P.C.) and the outcome of pregnancy. The Soroka Medical Center is the sole medical facility providing obstetric and neonatal services to the 300,000 inhabitants of the region. Prenatal care is delivered by a uniform network of 70 community-based stations. The availability, type and quality of services were uniform for all women and were not altered throughout the study period. The project encompassed 7308 deliveries. 2154 Bedouin women were excluded in order to avoid possible bias due to cultural and genetic characteristics. Data regarding 5154 Jewish women were analysed. Perinatal mortality was inversely proportional to the number of prenatal contacts. The uncorrected mortality rates were 12.7% in women entirely lacking P.C. and 6.2%, 1.9% and 1.0% in patients who had 1-6, 7-10 and 11 or more prenatal contacts respectively. The low-birthweight rate was significantly increased in women lacking prenatal care (22.8%) or having rudimentary care (17.4%) as compared to those who had 11 or more prenatal contacts with medical personnel (5.9%). Prenatal care reduced neonatal morbidity as expressed by the length of hospitalization, the frequency of infants with multiple diagnoses and the incidence of specific pathologies such as respiratory distress syndrome, light for dates and asphyxia. The incidence of some complications of pregnancy (abruptio placentae, premature labor, PROM) was significantly increased in women lacking P.C. or having inadequate P.C. (1-6 prenatal contacts). Moreover, lack of prenatal care was clearly connected with high-risk delivery, thus increasing the danger to the baby. It is suggested that many adverse effects of various socio-economic, genetic and general health factors may be diminished by proper prenatal care coupled with adequate obstetric and neonatal services.

Adult↗
PubMed1986

Thermodynamic properties of erythrocyte Li efflux may facilitate detection of essential hypertension in pregnant women.

Thermodynamic properties of red cell lithium efflux were examined in pregnant women in relation to hypertension. Twenty-two normotensive women, 15 women with essential hypertension, and 27 with pregnancy-induced hypertension were studied. The rates of Li efflux at 37 degrees C in the three groups of pregnant women were similar and nondiscriminatory. The temperature dependence of the Li efflux, known to be uniquely modified in essential hypertension, allowed the differentiation of most (73%) of the pregnant women with essential hypertension as well. Among the women with pregnancy-induced hypertension, 63% showed a temperature-dependence pattern typical for normotensives, and they may be classified as patients with toxemia of pregnancy. The others (37%) showed a thermodynamic pattern of essential hypertension, but a follow-up study is required to ascertain whether they will indeed develop essential hypertension in the future.

Adult↗