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Biomedical subjects

A Golan

Publications and source records attributed to A Golan.

At least 55 records · Page 3Linked to original sources
PubMed1995

Uterine fluid human decidua-associated protein 200 and implantation after embryo transfer.

Uterine fluid samples from 109 patients undergoing in-vitro fertilization and embryo transfer were obtained so as to examine the relationship between the uterine fluid concentration of human decidua-associated protein (hDP) 200 and the implantation rate. The sampling was performed on the day of embryo transfer with a Wallace catheter, used for the testing of cervical patency before embryo replacement. The implantation rate, as well as the pregnancy rate, demonstrated a significantly positive correlation with the concentration of hDP 200 in the uterine fluid, measured just before embryo transfer. These results indicate that hDP 200, identified as a rheumatoid factor secreted by the endometrium, may be involved in the implantation process.

Decidua↗
PubMed1995

Prevention of post-surgical adhesion formation using aspirin in a rodent model: a preliminary report.

Pelvic adhesions are one of the major factors which significantly and adversely affect surgery outcome due to intra- and postoperative morbidity and reduce future female fertility. Using a rodent model, we evaluated the efficacy of aspirin, a non-steroidal anti-inflammatory drug, in the prevention of adhesion formation. A total of 72 female Wistar rats received a standardized primary traumatic lesion to the right uterine horn. They were randomly divided into eight groups: group I (control) had no treatment and group II received a single pre-operative 0.70 mg aspirin. All the succeeding groups (III-VIII) received aspirin in doses of 0.35, 0.70, or 1.40 mg every 6 h for either 48 or 96 h in addition to the pre-operative aspirin (0.70 mg). All animals were killed 4 weeks later and adhesions were assessed using a modified adhesion scoring scale. The lowest adhesion score was found in the group treated with 0.35 mg of aspirin for 96 h, and the highest was found among the groups treated with either 0.70 or 1.40 mg for 48-96 h respectively (P < 0.05). These results are in line with the hypothesis that administration of a low dose of aspirin selectively inhibits the production of thromboxane A2, whereas basal prostacyclin biosynthesis is preserved. This phenomenon might contribute to reducing postoperative adhesion formation in a rat model. Thus, future studies into the prevention of adhesion formation may require the additional use of a non-steroidal anti-inflammatory drug, for which aspirin deserves further attention, before extrapolation into human therapy.

Animals↗
PubMed1995

The level of human decidua-associated protein hDP-200, in uterine fluid and serum.

Prospective uterine fluid sampling in 140 patients was performed using a Wallace catheter. The levels of human decidua-associated protein (hDP)-200 in the uterine fluid and in the serum, and the total protein concentration in the uterine fluid were determined. Uterine fluid volumes were scored during the hysteroscopy and no correlation was found with the phase of the menstrual cycle. The total protein concentration in the uterine fluid did not vary significantly during the menstrual cycle. The hDP-200 levels in uterine fluid were significantly higher than those in the serum, although considerable individual variation in the level of uterine fluid hDP-200 was found.

Body Fluids↗
PubMed1995

Epidemiological, clinical and microbiological features of shigellosis among hospitalized children in northern Israel.

The epidemiological, clinical, and bacteriological aspects of shigellosis were studied in a population of hospitalized children in northern Israel. During the 6-year period 1987-92, 262 children were hospitalized due to shigella infection. Shigellosis represented 10% of pediatric admissions for diarrhea. Admissions for the disease peaked during the summer and autumn. The median age of the patients was 3 years. Shigella sonnei was isolated in 74% of patients and S. flexneri in 21%, compared with relative frequencies of 87% and 10%, respectively, in the non-hospitalized population of the area, detected during the same period (p < 0.001). Shigella sonnei represented 82% of isolates of hospitalized Jewish patients but only 60% of hospitalized Arab children, many of whom live in poverty and overcrowding (p < 0.001). Shigella flexneri was particularly frequent among hospitalized infants, and was associated with Arab origin, large families and residence in agricultural settlements. Duration of hospitalization was 4.7 +/- 2.3 days for S. sonnei infections and 5.8 +/- 3.6 days for S. flexneri (p < 0.005). No cases of shigella sepsis, hemolytic uremic syndrome, or fatalities were observed. Overall 37% of all shigella isolates from hospitalized children were resistant to ampicillin, 71% to cotrimoxazole, 28% to both and 13% were resistant to > or = 3 different drugs. It is concluded that shigellosis is an important cause of hospitalization in northern Israel. Resistance to antimicrobial drugs is widespread among all Shigella spp. Although S. sonnei is the most common species, S. flexneri is particularly frequent in infants.

Adolescent↗
PubMed1995

Cervical cerclage for the incompetent cervical Os. Improving the fetal salvage rate.

The precerclage and postcerclage term delivery rate (TDR), premature delivery rate (PDR) and late abortion rate (LAR) were evaluated in 260 parturients undergoing elective cerclage at 12-16 weeks' gestation. The TDR increased from 0.49 to 0.78, the PDR dropped from 0.35 to 0.18, and the LAR dropped from 0.16 to 0.04. The rate of early and late complications was acceptable, and the fetal survival rate was significantly improved. The fetal salvage rate increased from 0.73 to 0.92, establishing a fetal salvage ratio of 1.26. Based on this experience, cerclage placement in cases of incompetent cervical os may prolong the duration of pregnancy and improve the outcome.

Abortion, Spontaneous↗
PubMed1994

Investigation of the uterine cavity in recurrent aborters.

To prospectively compare the diagnostic ability of both HSG and diagnostic hysteroscopy in recurrent aborters, an HSG followed by a diagnostic hysteroscopy was performed in 106 patients during an investigation into recurrent abortions. The uterine cavity findings on HSG and at hysteroscopy were compared. Among the 60 abnormal HSG patients, intrauterine pathology was demonstrated in 37 (34.9%). Among the 46 normal HSG patients, a normal uterine cavity was found in 33 (31.3%). The sensitivity of the HSG in revealing intrauterine abnormalities was therefore 79% and its specificity 60%. In 23 pathologic HSG, no abnormalities were seen by hysteroscopy. In 13 cases, hysteroscopy demonstrated mild intrauterine findings overlooked by HSG. The false-positive rate was 38% and the false-negative rate was 28%. Hysterosalpingography showed a high false-positive rate, especially in the intrauterine adhesions group. In view of the low specificity and high false-positive and false-negative rates, we believe that hysteroscopic evaluation of the uterine cavity is superior to HSG in recurrent abortions.

Abortion, Habitual↗
PubMed1994

Development of children born after ovarian superovulation induced by long-acting gonadotropin-releasing hormone agonist and menotropins, and by in vitro fertilization.

The use of a gonodotropin-releasing hormone (Gn-RH) agonist in an in vitro fertilization (IVF) program raises the question of any influence on the physical, neurologic, and mental development of the children. We compared the development of children born after long-acting Gn-RH agonist treatment with that of children born after spontaneous pregnancies. Children from singleton pregnancies and > or = 28 months of age were examined by a pediatric neurologist and a psychologist who did not know to which group the children belonged. The General Cognitive Index test was used. Each group included 30 children. Five children cooperated only partly. Physical and neurologic findings were normal in all children, except that one in the group born after in vitro fertilization had diffuse hypotonia, attention-deficit hyperactivity disorder, and hyperactivity. The General Cognitive Index for the 26 children in the study group and the 29 children in the control group who fully cooperated were 102 +/- 13.3 and 106 +/- 13.5, respectively (p = 0.37). The verbal perception, motor, and memory indexes were not significantly different. We conclude that the long-acting Gn-RH agonist had no clinically identifiable influence on the development of these children.

Adult↗
PubMed1994

Ultrasonic control without hormone determination for ovulation induction in in-vitro fertilization/embryo transfer with gonadotrophin-releasing hormone analogue and human menopausal gonadotrophin.

A total of 114 patients admitted to an in-vitro fertilization-embryo transfer programme for the first time, were randomly assigned to the study group or controls. Gonadotrophin-releasing hormone analogue (GnRHa) and human menopausal gonadotrophin (HMG) were used for ovulation induction. The study patients were followed up merely by ultrasonography and the controls by ultrasonography and serum determinations of oestradiol, progesterone and luteinizing hormone (LH). There was no significant difference in the duration and total amount of HMG used for ovulation induction (10.9 versus 11.5 days and 34.8 versus 37.9 ampoules, respectively). The number of oocytes retrieved (11.7 versus 13.4) and the numbers of embryos replaced (2.6 versus 2.8) and cryopreserved (1.9 versus 3.3) were also similar. Pregnancy rates were similar. Pregnancy rate per ovum retrieval was 22.2 versus 25% and per embryo transfer 27.2 versus 26.5%. Oestradiol patterns were also similar. The rate and severity of ovarian hyperstimulation syndrome were virtually identical. We conclude that 'ultrasound-only' monitoring of ovulation induction in IVF cycles treated by GnRHa-HMG in the long protocol is as effective and safe as the conventional ultrasound and hormone determination, but far simpler, swifter and more cost-effective.

Adult↗
PubMed1994

Human decidua-associated protein 200 levels in uterine fluid at hysteroscopy.

Hysterosocpic intrauterine findings and levels of human decidua-associated protein 200 (hDP 200) in the uterine fluid were recorded in 116 women investigated for infertility or recurrent abortions. The levels of hDP 200 were significantly higher in the presence of submucous myomas or endometrial polyps, and lower in the presence of intrauterine adhesions in comparison to those in normal uterine cavities. hDP 200, an immunoglobin secreted by the endometrium, may be involved in implantation and placentation and its level in the uterine cavity is influenced by the presence of intrauterine pathology.

Abortion, Habitual↗
PubMed1994

Persistence of polyhydramnios during pregnancy--its significance and correlation with maternal and fetal complications.

One hundred and thirteen cases of polyhydramnios diagnosed by repeated ultrasonic examinations in singleton pregnancies were divided into two groups according to the trend of change in the amniotic fluid volume between the first and the second ultrasonic examination. Group A patients (65 cases) showed an increase or no change in amniotic fluid volume, and in group B (48 cases) a reduction in amniotic fluid volume to mild polyhydramnios or to normal amniotic fluid volume was observed. A significantly increased rate (p < 0.05) of maternal complications such as diabetes mellitus, pregnancy-induced hypertension, urinary tract infections, premature rupture of membranes and premature delivery was observed in group A. More abdominal deliveries and an increased rate of fetal anomalies, fetal abnormal presentations, intrauterine fetal death and neonatal death also occurred in this group. Group B patients, most of whom were idiopathic, showed a very favorable outcome.

Diabetes Mellitus↗
PubMed1994

Cervical polyp: evaluation of current treatment.

The removal of a cervical polyp is routinely accompanied by a fractionated dilatation and curettage (D&C) in various institutions. In order to assess the necessity of performing a D&C on all the patients admitted with the diagnosis of a cervical polyp, we reviewed the charts of 362 patients admitted for a cervical polypectomy and D&C during a 5-year period. The procedure was performed on a day clinic basis under general anesthesia. No serious complications were noted. In 218 women (60%) the discovery of the cervical polyp was incidental and in this group no malignant change was found in the polyp or in the endometrium. Six cases of atypical hyperplasia and 2 cases of adenocarcinoma of the endometrium were found in the symptomatic group of patients (40%). Removal of the polyp as an outpatient procedure is recommended of the asymptomatic patient. Hospitalization and removal of the polyp under general anesthesia, accompanied by D&C should be reserved for the symptomatic patients only, or even then, replaced by ambulatory polypectomy and endometrial sampling.

Adult↗
PubMed1994

Oligohydramnios: maternal complications and fetal outcome in 145 cases.

One hundred and forty-five cases of oligohydramnios in the second and third trimester were diagnosed by ultrasonography out of 25,000 obstetrics patients (0.58%). In this group, pregnancy complications included hypertension (22.1%) and bleeding in the second trimester (4.1%). We found a high incidence of meconium-stained amniotic fluid (29.1%), fetal distress (7.9%) and premature placental separation (4.2%). IUGR occurred in 24.5% of cases. Asphyxia during labor occurred in 11.5% and different other perinatal problems in 23.5%. Cesarean section was performed in 35.2% of these pregnancies. Seventeen percent of the cases presented as breech. Intrauterine fetal death occurred in 5.5% of these pregnancies. The gross perinatal mortality was 16% and the corrected perinatal mortality was 10.7%. The overall rate of fetal malformations was 11% and that of lethal malformations 4.8%. The skeletal (7.6%) and urinary system (4.1%) were the predominant systems affected. Oligohydramnios is associated with a higher rate of pregnancy complications and increased fetal morbidity and mortality, and thus termination should be considered when pulmonary maturity is present or in cases of fetal distress.

Abortion, Spontaneous↗
PubMed1994

Transvaginal aspiration of ovarian cysts: prognosis based on outcome over a 12-month period.

The success of transvaginal aspiration of ovarian cysts in terms of cyst dimensions, location, and content and the age of the women was evaluated in 35 women aged 17 to 76 years old. Three parameters proved important in predicting the outcome of aspiration: age of the woman (higher age = poorer prognosis for cure), maximum diameter of the cyst (larger diameter = poorer prognosis), and location (left-sided cysts have a poorer prognosis). Prognosis based on outcome indicates aspiration of large cysts should be avoided in older women.

Adult↗
PubMed1994

Outpatient versus inpatient cervical cerclage.

The outcomes in 125 cases of elective, outpatient cerclage placement were compared to those in 101 cases of elective, inpatient cerclage placement with the same technique at the same institution. There was no difference between the two groups in the rates of early and late complications or in the effect of the procedure on the duration of gestation. As expected, a statistically significantly shorter hospital stay occurred in the outpatient group. The outpatient procedure is as effective as the inpatient one, with no increased risk of early and late complications, and offers patients a shorter absence from home, thus possibly decreasing their anxiety, and considerable financial savings.

Adult↗
PubMed1994

Endometrial carcinoma developing after cervical amputation: the influence of cervical stenosis on prognosis.

The clinical presentation, surgico-pathologic findings and the outcome are described of seven patients with carcinoma of the endometrium, which developed remote after cervical amputation as a treatment for cervical elongation. In six patients, cervical stenosis prevented early uterine bleeding. Four patients when diagnosed, were in advanced surgical stages of the disease (Stages II and III) and all died thereafter. Three patients with surgical Stage I, had no evidence of disease 33, 96, 151 months, after diagnosis and treatment. The role of cervical stenosis in delayed diagnosis and treatment, and therefore poor prognosis is discussed. When cervical stenosis is anticipated, periodic ultrasonographic evaluation of the endometrium is justified, in order to prevent a delay in making a diagnosis of endometrial carcinoma.

Adenocarcinoma↗
PubMed1993

The use of intravenous gammaglobulin, heparin and aspirin in the maintenance of pregnancy of freeze thawed embryo in a patient with lupus-type anticoagulant.

A case of lupus anticoagulant and repeated fetal loss with a successful delivery of a healthy baby after transfer of thawed frozen embryos and intravenous immunoglobulin administration is described. The repeated fetal loss was due to vascular disturbances caused by lupus anticoagulants. Early implantation was not affected. Anticoagulants and/or steroids did not help in further establishing pregnancy. Intravenous immunoglobulin combined with heparin and aspirin led to term pregnancy and the birth of a healthy child.

Adult↗
PubMed1993

Cytogenetic analysis of the oocyte and embryo after removal of the zona pellucida following failed fertilization.

Cytogenetic analysis of the oocyte and embryo after removal of the zona pellucida provides a simple screening method for examining the oocyte and embryo and considering the morphological abnormalities of the zona and adjacent formations, cytoplasm and nucleus. Seventy-one unfertilized oocytes and 27 embryos with poor morphology or cleavage arrest were studied after fixation, staining and mechanical removal of the zona. Fixation was done with a glutaraldehyde solution (1%). The oocytes and embryos were then stained, causing weakening of the zona. A slight pressure on the cover slide led to rupture of the zona and the exposure of the oolema. The oocytes and embryos were analyzed for sperm attachment to and penetration through the zona, appearance of the polar bodies, differentiation of blastomeres from cytoplasmic fragments, nuclear status--pyknotic non-analyzable form, chromosomes or different degenerative appearances of DNA. Peeling of the zona is an easy and reliable screening technique needing only an ordinary light microscope. It provides the advantage of observing the whole structure of the oocyte-embryo, not just the chromosomes as in classical cytogenetic methods.

Female↗