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Biomedical subjects

Z Blumenfeld

Publications and source records attributed to Z Blumenfeld.

126 records · Page 7Linked to original sources
PubMed1982

Prevalence of group B streptococci in parturient mothers and their infants.

Eighty pregnant women and their newborn infants were studied for the presence of group B Beta hemolytic streptococci (G.B.S.). G.B.S. were recovered from endocervical cultures in 5 (6.5%) women and 2 (2.5%) had positive throat cultures. Six (7.5%) infants had umbilical and external ear cultures positive for G.B.S. Four infants presented with clinical signs of respiratory distress. All infected infants were treated with penicillin and gentamycin. One case developed fulminant sepsis and died in spite of early diagnosis and treatment. This study shows a high incidence of G.B.S. infection and sepsis with a high mortality rate.

Female↗
PubMed1981

Factors affecting sperm motility. VII. Sperm viability as affected by change of pH and osmolarity of semen and urine specimens.

The effects of pH and osmolarity of semen and urine specimens on motility and velocity of human spermatozoa were studied objectively with the aid of the multiple exposure photography (MEP) method. The pH of fresh ejaculates ranged from 7.2 to 8.2 and specimens were slightly hyperosmotic ranging between 300 to 380 mOsm/kg. Gradually changing the pH and osmolarity to either side of normal values led to progressive loss of sperm motility. However, sperm velocity was slightly increased by mild alkalinization and hyperosmolarity. Spermatozoa that became immobilized by acidification regained their motility shortly after pH was restored to normal values. In the majority of instances spermatozoa lost their motility when mixed with fresh urine specimens. Neutralization of urinary pH could not protect them from this effect unless urine osmolarity was also isotonically adjusted. It is suggested that patients with retrograde ejaculation should adequately increase their fluid intake before recovery of sperm from their bladder for artificial insemination.

Humans↗
PubMed1980

Optimum measurement time for human sperm velocity determination.

The optimal time-duration required by spermatozoa to travel distances from which their average velocity can be accurately determined was investigated. For this purpose, 180 motile spermatozoa, from 12 seminal specimens, were photographed while being illuminated by six light pulses, given at 1-sec intervals. From these photographs, distances traveled by each spermatozoon were measured over identical time periods. Most individual spermatozoa showed slight deviation of their velocity when measured sequentially for 5 sec. Nevertheless, when mean sperm velocity of grouped spermatozoa were determined from 1- or 5-sec measurement time, the results were almost identical. This was attributed to a pure statistical law, that is, the mean deviation decreases as the number of spermatozoa in the sample increases. It was concluded that the sperm velocity of a certain specimen can be determined properly using a 1-sec measurement time. An extended period of time does not seem to contribute to the accuracy of sperm velocity determination.

Humans↗
PubMed1979

Factors affecting sperm motility. II. Human sperm velocity and percentage of motility as influenced by semen dilution.

Spermatozoal velocity and percentage of motility were analyzed objectively with the multiple exposure photography method before and after specimens from fertile and infertile men were diluted in their own seminal plasma or normal saline. No significant change in percentage of motility was found in samples diluted up to 1:6 in both kinds of diluents. However, a significant relative increase (up to 25% of the original velocity) was found when a specimen was diluted with its own seminal plasma, and an even greater increase (up to 37% of the original velocity) was found when it was diluted with saline. Compared with undiluted specimens, there was no delayed effect on spermatozoal motility when semen was diluted with saline after up to 4 hours' incubation time. Contrary to the findings in animal and human semen described by others, there was no deleterious effect on sperm motility with this kind and rate of dilution and duration of time. The assumption that the increase in sperm velocity caused by dilution is not excitatory but is due only to a decrease of seminal fluid viscosity and a reduced number of spermatozoa which interfere with sperm free movement is discussed. We recommend evaluation of spermatozoal motility in diluted specimens in addition to evaluation of the original specimen in any routine semen analysis in order to determine true spermatozoal motility potential under optimal conditions.

Culture Media↗
PubMed1976

Electrocardiographic changes in traumatized patients.

Traumatized patients who sustain a severe physical or psychological insult may develop myocardial ischemic changes, espicially those patients over the age of 40 years. The electrocardiogram (EKG) findings in 34 chest injury patients out of 200 multiple injury cases over a period of two years were studied. Two types of myocardial changes were found: injury pattern (of a permanent character) and ischemic pattern (of a transient nature). The first type was more frequent in the penetrating noncardiac chest injury cases, and the second more common in the blunt chest injury cases. It is necessary to make early and serial EKG tracings on traumatized patients in order to detect myocardial changes.

Adult↗
PubMedDate not supplied

Hair as a sonographic marker of ovarian teratomas: improved identification using transvaginal sonography and simulation model.

An in vitro sonographic model was developed to simulate the transvaginal sonographic appearance of hair-containing cystic teratomas of the ovary. Two groups of patients with ovarian teratomas were compared: group A--consisting of 32 patients scanned before the simulation model was used, and group B--consisting of 25 patients in whom the diagnosis of hair-containing ovarian teratomas was made after the simulation model experience. The positive predictive value of transvaginal sonography in correctly diagnosing this type of tumor was 27/32 (84%) in group A and 25/25 (100%) in group B. By using this simple in vitro simulation model, the preoperative diagnosis of ovarian cystic teratomas by transvaginal sonography was made very accurate, enabling prospective planning of the type of operation and its timing.

Female↗
PubMedDate not supplied

The effect of sera from women with systemic lupus erythematosus and/or antiphospholipid syndrome on rat embryos in culture.

Women with systemic lupus erythematosus (SLE) with or without antiphospholipid antibodies (APLA) suffer from a high rate of recurrent abortions perhaps as a result of specific antibodies that may damage the conceptus. We studied the effects of sera from women with SLE--with or without--APLA and recurrent abortions on 10.5-d-old rat embryos in culture. This was compared to the results of culture on sera from control women and on rat sera. In addition, we studied sera from women with SLE with or without APLA after treatment with low doses of aspirin and glucocorticosteroids. Seventy-three percent of embryos cultured in sera from women with SLE with or without APLA were malformed in comparison to only 10.2% in embryos cultured on control sera and 5.4% in embryos cultured on rat sera. The rate of anomalies was reduced to 37.5% in embryos cultured on sera from women with SLE with or without APLA after treatment, as in 6 of 13 sera, the treatment reduced or prevented the occurrence of embryonic anomalies. When sera were divided in to low- and high-risk sera, the effect of treatment was even more significant, as the average percentage of embryonic anomalies per serum was reduced from 81.7 to 44.7%. Specific ultrastructural changes were found in the yolk sacs of the embryos cultured on the sera from women with SLE with or without APLA by transmission electron microscopy and by scanning electron microscopy. It seems that the rat embryo culture system may be an important clinical diagnostic tool to identify women with recurrent abortions in whom the etiology may be immunologic rejection of the embryo and to assess the efficacy of various treatment modalities.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Ovarian rescue/protection from chemotherapeutic agents.

BACKGROUND: After improved long-term survival in young women with lymphoma and leukemia undergoing chemotherapy, preservation of future fertility has been the focus of recent interest. The investigational endeavors of ovarian cryopreservation await the clinical experience of in vitro maturation of thawed primordial follicles, their in vitro fertilization, and embryo transfer. Although promising, this experience is not yet available. Moreover, the risk of possible reimplantation of malignant stem cells with the thawed cryoperserved ovary has been raised after experimental animal observations. Therefore, until these innovative endeavors prove successful, and in parallel with them, we attempted to minimize the gonadotoxic effect of chemotherapy by the cotreatment with a gonadotropin-releasing hormone (GnRH) agonistic analogue to induce a temporary prepubertal milieu. Whereas inhibin-B concentrations in serum may reflect the ovarian granulosa cell compartment, inhibin-A reflects luteal function. Immunoreactive inhibin-A and -B in these patients before, during, and after gonadotoxic chemotherapy were measured. METHODS: A prospective clinical protocol was undertaken in 44 women with lymphoma, aged 15--40 years, ten with leukemia and eight undergoing chemotherapeutic treatments for nonmalignant diseases such as systemic lupus erythematosus or other autoimmune diseases. A monthly injection of depot D-TRP6-GnRH-a was administered from before the start of chemotherapy until its conclusion, up to a maximum of 6 months. A hormonal profile was taken before starting the GnRH-a/chemotherapy cotreatment, and monthly thereafter until the women resumed spontaneous ovulation. This group was compared with a control group of 55 women who had been treated with similar chemotherapy. Inhibin-A and -B immunoactivity was measured. RESULTS: Whereas all but one (40-year-old) of the surviving patients with GnRH-a/chemotherapy cotreatment group resumed spontaneous ovulation and menses within 6 months, fewer than half of the patients in the control group (chemotherapy without GnRH-A cotreatment) resumed ovarian function and regular cyclic activity (P <.05). The remaining 60% experienced premature ovarian failure (POF). Temporary increased follicle-stimulating hormone (FSH) concentrations were experienced by almost a third of the patients resuming cyclic ovarian function, suggesting a reversible ovarian damage in a larger proportion of women than those experiencing POF. Inhibin-A and -B decreased during GnRH-a/chemotherapy cotreatment but increased to normal levels in patients who resumed regular ovarian cyclicity and/or spontaneously conceived, compared with low levels in those who developed POF. CONCLUSIONS: If these preliminary data are consistent in a larger group of patients, inhibin-A or -B concentrations may serve as prognostic factors to predict the resumption of ovarian function, in addition to the levels of FSH, luteinizing hormone, and estradiol. GnRH-a cotreatment should be considered for every woman of reproductive age who receives chemotherapy, in addition to assisted reproductive technology and the investigational attempts of ovarian cryopreservation for future in vitro maturation.

Adolescent↗
PubMedDate not supplied

Preservation of fertility and ovarian function and minimizing chemotherapy-induced gonadotoxicity in young women.

BACKGROUND: After the improved long-term survival in young women with lymphoma and leukemia undergoing chemotherapy, the preservation of future fertility has been the focus of recent interest. AREAS OF REVIEW: Three major topics are reviewed. They include the following: (1) the role of chemotherapy in the treatment of malignant and nonmalignant disease in young women, the types of chemotherapy and their gonadal effects (differing between ovaries and testes) in both human and other species, and the reasons for differences in the outcomes of various studies; (2) the human experience with GnRH-agonist therapy for minimizing chemotherapy-associated gonadotoxicity; and (3) inhibin measurements in young women treated by chemotherapy and in perimenopausal patients and those with impending premature ovarian failure (POF). Whereas egg retrieval for in vitro fertilization (IVF) and embryo cryopreservation is a valid assisted reproductive technology (ART) for married couples, it may be unacceptable for the young single woman. The investigational endeavors of ovarian cryopreservation awaits the clinical experience of in vitro maturation of thawed primordial follicles, their IVF, and embryo transfer. Although promising, this experience is not yet available. Moreover, the risk of possible reimplantation of malignant stem cells with the thawed cryopreserved ovary has been raised after animal observations. Therefore, until these innovative endeavors prove successful, and in parallel with them, an attempt was made to minimize the gonadotoxic effect of chemotherapy by the cotreatment with a GnRH agonistic analogue (GnRH-a) to induce a temporary prepubertal milieu, because prepubertal ovaries were found more resistant to alkylating agents' effect than the ovaries of older women. To characterize the correlation with ovarian function after gonadotoxic chemotherapy for Hodgkin or non-Hodgkin lymphoma in young women, the immunoreactive inhibin-A concentrations in the sera of these patients were measured before, during, and after the gonadotoxic chemotherapy. CONCLUSIONS: The GnRH-a cotreatment should be considered in every woman in the reproductive age receiving chemotherapy, in addition to ART and the investigational attempts of ovarian cryopreservation for future in vitro maturation or reimplantation. If these preliminary data are confirmed in a larger group of patients, inhibin-A concentrations may serve as a prognostic factor for predicting the resumption of ovarian function in addition to the levels of FSH, LH, and estradiol.

Antineoplastic Agents↗
PubMedDate not supplied

Umbilical and uterine artery flow velocity waveforms in pregnant women with systemic lupus erythematosus treated with aspirin and glucocorticosteroids.

Pregnancy in systemic lupus erythematosus (SLE) is at high risk to the mother and fetus. Impaired utero-placental perfusion may increase fetal loss and intrauterine growth retardation. We assessed the changes in impedance to blood flow in the umbilical and uterine arteries in five patients with SLE treated with low dose aspirin and corticosteroids, using Doppler ultrasound longitudinally throughout pregnancy. Blood flow velocity waveforms of the umbilical and uterine arteries were studied by transabdominal and transvaginal Doppler ultrasound, respectively. Resistance index (RI) was measured every two to four weeks from week 10 to term, and the values obtained were compared to those of normal pregnancies. All five patients delivered uneventfully. One neonate was delivered at 36 weeks (2550 g) and one neonate was growth retarded (1900 g at 38 weeks). Three women delivered at 39 weeks (3585 g, 2850 g, and 2800 g). Most umbilical artery RI values obtained throughout pregnancy were above the 95th percentile of normal pregnancies. The highest values of RI of the umbilical artery were assessed in the case of fetal growth retardation. However, most measurements of RI of the uterine artery were under the 95th percentile of normal. The improved pregnancy outcome in patients with SLE treated with aspirin and corticosteroids seems to correlate with their normal uterine artery flow velocity wave forms.

Abortion, Habitual↗
PubMedDate not supplied

Use of a sealed mini-chamber to investigate human sperm motility in real time under aerobic and anaerobic conditions.

To study the correlation between metabolism and motility, ejaculated human spermatozoa were washed in media containing glucose, pyruvate, and deoxyglucose in various combinations. Spermatozoa suspended in these media were incubated in sealed mini-chambers and subjected to aerobic or anaerobic conditions at 37 degrees C. The effect on the patterns of sperm motility was investigated in real time by direct observation and objective determination with the multiple exposure photography (MEP) method. The motility of spermatozoa incubated in media containing excess of glucose showed similar changes of motility quality with time, whether exposed to aerobic or anaerobic conditions, and in both cases motility lasted about 13 h. Motility of sperm incubated with pyruvate only was of a much lower quality, especially under anaerobic conditions, and in both circumstances lasted about 7 h. When glycolysis of fructose remnants was totally inhibited by deoxyglucose and sperm were incubated with pyruvate only, motility lasted for 2 h under aerobic conditions and only for about 1 h under anaerobic conditions. It is concluded that the main metabolic process that supplies energy for sperm motility is glycolysis, under both aerobic and anaerobic conditions. Oxidative respiration was less efficient as a source of energy for sperm motility. When glycolysis was inhibited and oxidative respiration was eliminated under anaerobic conditions, sperm motility lasted only for about 1 h, probably by using intracellular energy reserves.

Aerobiosis↗
PubMedDate not supplied

Detection of antisperm antibodies: a cytotoxicity immobilization test.

The sera of 110 couples with unexplained infertility were examined for anti-sperm immobilizing antibodies with the aid of multiple-exposure photography. The sera of 10 females and 3 males had immobilizing activity. Eleven pregnancies occurred in 10 female patients in the group without immobilizing antibodies. None of the 13 females in the couples with immobilizing activity conceived. A negative correlation was found between the occurrence of serum immobilizing antibodies and incidence of pregnancy. No such correlation could be found between the occurrence of autoagglutination in the male's ejaculate and the female partner conceiving. In light of detection of anti-sperm antibodies in a patient with habitual abortions, a possible immune mechanism is suggested.

Adult↗
PubMedDate not supplied

Pregnancies following treatment by GnRH-a (Decapeptyl) and myomectomy in infertile women with uterine leiomyomata.

PURPOSE: Uterine leiomyomata alone are an infrequent cause of infertility. We presumed that--since the smaller the uterine size at the time of myomectomy, the greater the chances of subsequent conception--diminishing the preoperative tumor size in infertile patients with large leiomyomata prior to myomectomy should be beneficial. PROCEDURE: Decapeptyl (D-Trp6-LHRH) depot 3.2 mg was administered for a period of 3-6 months to 23 infertile women. No causes of infertility were found in these patients except for uterine leiomyomata. In 10 of the 23 patients conservative myomectomy was added to Decapeptyl treatment. FINDINGS: Following Decapeptyl treatment an average decrease in uterine volume of 57% (range: 22%-86%) was observed in all patients. In ten of the 23 patients conservative myomectomy was added to Decapeptyl treatment resulting in a further 16% decrease in uterine volume. Uterine regrowth following Decapeptyl and myomectomy was found to be significantly lower (P < 0.01) when compared with cases treated with Decapeptyl alone. Five of the ten patients treated by Decapeptyl and myomectomy achieved successful pregnancies and delivered. Among the women treated with Decapeptyl without myomectomy, only one patient conceived. CONCLUSIONS: From these findings it may be concluded that combined GnRH and myomectomy is the treatment of choice for infertile women with large uterine leiomyomata.

Adult↗
PubMedDate not supplied

The role of growth hormone (GH), GH-receptor and GH-binding protein in reproduction and ovulation induction.

In the last decade the potential importance of intraovarian regulators of follicular development has been recognized, and the effects of various growth factors on granulosa cell responses to gonadotropins have been extensively investigated. Ovarian responses to exogenous gonadotropins were improved by adjuvant growth hormone (GH) treatment of GH-deficient patients, and responses to hMG were apparently predicted by estimated GH reserve. However, the results of different studies of GH/hMG cotreatment were equivocal. Therefore, a randomized, prospective, cross-over study protocol between GH/hMG/hCG versus hMG/hCG was undertaken. Whereas 18 pregnancies were achieved in the 32 clonidine negative patients (56%) either in the GH/hMG cycle (13) or in the succeeding one (5), no benefit was detected in 10 clonidine positive patients from the GH/hMG combination. The recently described GH-binding protein (BP) may reflect the GH-receptor. GH-BP levels were evaluated in the sera and follicular fluids (FF) of patients undergoing ovulation induction with either hMG/hCG or GH/hMG/hCG. GH-BP increase in serum correlated with E2 and progesterone (P4) concentrations. The FF GH-BP correlated with serum GH-BP levels and was dose-dependent, highly specific, of high affinity, and low capacity. Lower FF GH-BP levels were measured in older compared to younger women, while increased values were obtained both in patients with elevated E2 concentrations in serum and in FF, and when more than 5 oocytes were retrieved. Longitudinal measurements of GH-BP levels showed an initial sharp increase during early gestation, followed by a gradual decrease from the 2nd trimester to term. The late gestational decrease in GH-BP levels may be attributed to the decreasing hCG concentrations, and/or to the increasing secretions of placental lactogen and GH with advancing gestation. Primary increased GH-BP in unexplained infertility may suggest a new mechanism whereby excessive GH-BP levels may prevent GH from binding to its receptor and thus decrease intraovarian IGF-1 production. Whereas GH-BP significantly increased in correlation with moderately (300-1500 pg/ml, 1100-5500 pmol/l), or with severely increased (> 1500 pg/ml, > 5500 pmol/l) E2 concentrations, the serum IGF-1 levels increased with moderately elevated but decreased at severely increased E2 concentrations, as measured in ovarian hyperstimulation (OHSS). This observation may suggest IGF-1's involvement in a mechanism by which OHSS is detrimental to early conception. The clonidine test may identify patients who may benefit from this combination, during the GH/hMG cycle and possibly also during the succeeding cycle.

Carrier Proteins↗