[Hemolytic disease of the newborn due to Kell sensitization].
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Biomedical subjects
Publications and source records attributed to Z Palti.
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Dextran is widely used in order to prevent intraperitoneal adhesions during pelvic surgery. Of 25 women who underwent laparotomy and in whom dextran was instilled intraperitoneally, almost half developed pleural effusions. These were generally mild and required no treatment. None of a control group of 20 women developed a pleural effusion. The mechanism of this type of effusion is discussed.
Thirty-one patients who underwent retropubic prostatectomy under epidural anesthesia for benign hypertrophy of the prostate were checked for serum prolactin levels before and during operation. A significant increase in serum prolactin levels was noted during operation after the removal of the prostate, as compared with levels just prior to its removal. This difference suggests high concentration of prolactin in the prostatic tissue, part of which was released into the bloodstream during the traumatic squeezing of the prostate.
Twenty-eight severely oligospermic and azoospermic men aged 20 to 42 years were challenged with luteinizing hormone (LH)-releasing hormone (LHRH), thyrotrophin-releasing hormone (TRH), and the dopaminergic antagonist, metoclopramide, given at 30-minute intervals. According to basal gonadotropin levels, the patients were subdivided into three groups: those with severe testicular failure (basal LH > 20 mIU/ml and FSH > 14 mIU/ml); those with moderate testicular failure with predominant seminiferous tubule involvement (LH < 20 mIU/ml and FSH > 14 mIU/ml) and those with mild testicular failure (LH < 20 mIU/ml and FSH < 14 mIU/ml. With one exception, mean basal prolactin (PRL) levels were normal in all patients. In all three groups, however, there was an exaggerated PRL response to TRH, the response in severe and moderate testicular failure being greater than that in mild testicular failure. The response to metoclopramide was increased only in the first two groups, not in the group with mild testicular failure. When individual patients and control subjects were considered together, the peak PRL response to TRH correlated with both basal and peak gonadotropin responses to LHRH. However, the PRL responses did not correlate with 17 beta-estradiol, estrone, testosterone, or the estradiol-testosterone ratio. It is concluded that oligospermic and azoospermic subjects with the most severe testicular failure and the highest gonadotropin levels have the greatest PRL increases after TRH and metoclopramide, indicating that the PRL response is related to the degree of testicular failure.
Amniotic fluid rT3 levels were measured during pregnancy in two women who previously gave birth to infants suffering from neonatal hypothyroidism. In the first case, hypothyroidism was strongly suspected because of repeated low levels of rT3 in the amniotic fluid (20-64 ng/dl) at 16 and 31 weeks of gestation. A normal infant was delivered. He is now 10 months old and taking no treatment; he has no clinical or laboratory signs of hypothyroidism. In the second case, amniotic rT3 levels (140-180 ng/dl) were well within the normal range for 15-19 weeks of pregnancy, but an affected hypothyroid infant was born. These data suggest that amniotic fluid rT3 levels may not be a reliable tool in diagnosing intrauterine hypothyroidism.
The glycogen concentration and the activities of glycogen synthetase and phosphorylase were assayed in endometrial tissue obtained during curettage. Tissues were obtained during different phases of the menstrual cycle from women investigated because of menometrorrhagia or sterility. The glycogen concentration was less than 2 mg/g wet wt in specimens from days 1-15 and increased 10-fold during the early secretory phase. The total activities of glycogen synthetase and phosphorylase were increased 1.5- and 2-fold, respectively, during the secretory phase compared to those during the first half of the cycle. The activities of the active forms (a form) of these enzymes did not show significant changes during the menstrual cycle. The largest difference between the proliferative and secretory phases was in the activity of glycogen synthetase phosphatase, which was virtually inactive in tissues obtained on days 1-15 and increased almost 20-fold during the secretory part of the cycle. In tissues obtained from cases of sterility, the activities of glycogen synthetase and phosphorylase were significantly reduced only during the early secretory phase. Glycogen concentration throughout the menstrual cycle and enzyme activities during the midsecretory and premenstrual phase were similar in cases of sterility and other pathologies.
In 25 oligospermic patients who had negative postcoital tests, artificial inseminations were performed with the whole semen and split ejaculates. After 30 minutes, a sample of cervical mucus was obtained and examined microscopically for the presence of motile spermatozoa. There was a significant improvement of 64% using the split ejaculate, as compared with 44% using whole semen. We found a significantly higher sperm count and progressive motility in the split ejaculate (18 patients, 72%).
A case of Eosinophilic Granuloma of the vulva, associated with Diabetes Insipidus, is presented. There is neither specific nor adequate treatment for the vulval lesions. Treatment with local steroids should first be tried, if this does not help Roentgen-ray irradiation should be given. Simple vulvectomy is a last resort with poor results.
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In 15 women with suspected ectopic pregnancy considerable amounts of beta-subunit of human chorionic gonadotropin (hCG) were detected in the serum by the radioimmunoassay technique. The diagnosis was proved by laparotomy. In another 25 suspected cases beta-hCG values were less than 1 mU/ml, and in those cases the diagnosis was excluded. The detection of the beta-subunit of hCG in the serum was found to be an excellent tool for the early diagnosis of ectopic pregnancy, thus helping to prevent the dangerous sequelae which follow in the late diagnosis of this condition. The advantage of detecting the beta-subunit of hCG rather than hCG is discussed.
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Determination of human chorionic gonadotropin (HCG) values in the serum by the radioimmunoassay technique, was performed in 23 women with suspected ectopic pregnancies. In 16 cases the values of HCG were high and the diagnosis of ectopic pregnancy was verified by laparoscopy and laparotomy. In 7 cases low HCG values were found and ectopic pregnancy was excluded. The detection of HCG in the serum was found to be an excellent tool for the early diagnosis of ectopic pregnancy, thus helping to prevent the dangerous sequelae which follow the late diagnosis of this condition.
Testicular biopsy specimens taken from seven patients with azoospermia were studied by electron microscopy. We considered the possibility of a relationship between the annulate lamellae in the Sertoli cells and azoospermia. In the Leydig cells, we observed intranuclear and intracytoplasmic paracrystalline inclusions and considered their relationship with the Reinke crystalloid.
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It is assumed that one function of hCG is to preserve the developing corpus luteum and maintain pregnancy by producing progesterone and thus preventing menstrual shedding. In 8 of 17 cases of ectopic pregnancy, progesterone values were in the range of the proliferative phase of a normal cycle (0.1-1ng/ml), whereas the levels of hCG were 299-1600 mIU/ml. In 8 cases the progesterone levels were in the range of the secretory phase (2.3-6.9 ng/ml), and the hCG level was 182-5500 mIU/ml. In 1 case only was the progesterone level 15.0 ng/ml with an hCG level of 325 mIU/ml. In normal pregnancies of the same gestational age, the values of progesterone were 3.8-18.7 ng/ml, and the levels of hCG were 260-1300 mIU/ml. It seems that in addition to the level of hCG, a normal fetoplacental unit is needed for the preservation of the function of the corpus luteum.
High levels of serotonin and 5-HIAA were found in the urine of a group of 102 oligospermic and azoospermic men. These levels were significantly higher than those of normal fertile men.
A suspension of fine carbon particles was added to cord blood of healthy premature and full-term infants, and the mixture was incubated for 3 h, after which the uptake of carbon particles by blood leukocytes was examined. The results were compared with those from the blood of adults. A gradient of phagocytic activity was observed. The most active uptake of carbon was by the leukocytes of premature infants, the least active by leukocytes of adults. In cord blood and blood of adults, phagocytic activity was evident in both monocytes and neutrophils. In addition, two types of what have been termed 'lymphocytoid' phagocytes were seen. These resemble lymphocytes in their morphology. One type possesses basophilic cytoplasm, and has been found only in premature cord blood. The presence of lymphocytoid phagocytes affords a further indication of the differences between the circulating lymphocyte population in the prenatal and perinatal period as compared with the adult.