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Biomedical subjects

B Fisch

Publications and source records attributed to B Fisch.

At least 73 records · Page 4Linked to original sources
PubMed1993

The impact of D-Trp6 luteinizing hormone-releasing hormone (LH-RH) on carbohydrate metabolism.

BACKGROUND: The population exposed to repeated cycles of gonadotropin-releasing hormone analogue treatment before in vitro fertilization is growing rapidly. Sex steroids have been shown to induce changes in carbohydrate metabolism. In view of the effect of gonadotropin-releasing hormone analogues on sex steroid levels, it seems of interest to investigate carbohydrate metabolism following treatment with these compounds. PURPOSE: Our purpose was to assess possible changes in glucose tolerance following administration of the long-acting gonadotropin-releasing hormone and analogue, D-Trp6 LH-RH. DESIGN: A 3-hr oral glucose tolerance test with 100 g glucose was performed on all patients, before and after 6 weeks of treatment. RESULTS: No significant changes in either glucose tolerance or insulin levels following treatment with D-Trp6 LH-RH were demonstrated in the group of 25 women investigated. CONCLUSION: With respect to carbohydrate metabolism, D-Trp6 LH-RH may safely be administered to healthy women. Further studies are still required to assess the safety of this GnRH analogue when treating potentially diabetic and diabetic patients.

Adult↗
PubMed1993

Operative laparoscopy: a challenge for general gynecology.

Gynecologic laparoscopy has regained popularity since the introduction of video imaging and advanced technologies such as laser and fine mechanical accessories. Gynecology in general is likely to benefit from the recent surge of enthusiasm concerning this method. However, at this stage, when technologic advances are not supported by sufficient clinical data, the classic surgical approaches should not be abandoned.

Female↗
PubMed1993

Dizygotic triplet pregnancy following in-vitro fertilization.

We present a case of dizygotic triplet pregnancy (mono-amniotic twins and a singleton) that, as far as we know, is the first reported one induced by artificial reproductive technology. It ended in the delivery of three healthy normal babies: two monozygotic twin boys and a girl. It appears that zygote splitting is significantly more common in patients treated with ovulation-inducing agents than in the general population. Also, in-vitro conditions of embryonic growth might influence the chances of multifetal gestation and the incidence of identical twinning. This may be due to changes in the physical properties of the zona pellucida and subsequent partial hatching of the pre-embryo. Evaluation of similar cases in the future may shed more light on the mechanism underlying their occurrence following in-vitro fertilization.

Adult↗
PubMed1993

The effect of the hypoestrogenic state, induced by gonadotropin-releasing hormone agonist, on Doppler-derived parameters of aortic flow.

The effect of the hypoestrogenic state, induced by a GnRH agonist (GnRH-a), on cardiac function in healthy young women, was evaluated by Doppler echocardiography performed before treatment and when serum 17 beta-estradiol levels were suppressed by GnRH-a to 36.7 pmol/L. The following parameters of aortic flow were measured: peak flow velocity, ejection time, and acceleration time. Additional parameters calculated were flow velocity integral, cardiac index, and mean acceleration. The study group included 15 menstruating women, aged 25-42 yr (mean, 33 yr), with symptomatic fibroids, endometriosis, or scheduled for in vitro fertilization, who were treated with a GnRH-a. There were significant decreases in peak flow velocity (99 +/- 11 vs. 86 +/- 11 cm/s; P = 0.0004) and cardiac index (3.0 +/- 0.7 vs. 2.5 +/- 0.5 L/min.m2; P = 0.002). A decrease that did not reach statistical significance was noted in flow velocity integral (18.9 +/- 2.7 vs. 16.5 +/- 3.4 cm; P = 0.07). Mean acceleration was decreased significantly (12.6 +/- 2.6 vs. 10.8 +/- 1.8 m/s.s; P = 0.01), but no significant changes in acceleration time (81 +/- 16 vs. 83 +/- 10 ms; P = 0.7) or ejection time (296 +/- 25 vs. 295 +/- 27 ms; P = 0.8) were observed. These results indicate that estrogen deprivation is associated with smaller stroke volume and flow acceleration and might suggest that hypoestrogenism has a direct effect on cardiovascular performance.

Adult↗
PubMed1992

Ultrasound findings in perihepatitis associated with pelvic inflammatory disease.

The width of the right anterior extrarenal tissue was increased on ultrasound examination in 9 patients with perihepatitis (Fitz-Hugh-Curtis syndrome). Normal values were obtained in 72 women without detectable or known disease and were found to be between 1 mm and 5 mm (mean 1.8 mm). The 9 patients with laparoscopically verified perihepatitis who demonstrated this thickening had values ranging from 6 mm to 12 mm, (mean 7.7 mm). Although the incidence of this inflammatory thickening in perihepatitis is not known, its value is that in its ultrasonic demonstration a careful search should be made for inflammatory disease in structures related to the anterior pararenal space.

Chlamydia Infections↗
PubMed1992

Cutaneous graft-versus-host-like reaction after paternal lymphocyte immunization for prevention of recurrent abortion.

We have presented an immunocompetent patient who, after paternal lymphocyte immunization, developed a GVH-like skin reaction; she recovered spontaneously. This complication is rarely seen. This was the only case observed in our series of over 70 patients immunized. A similar phenomenon was not reported in a larger series by Carp and colleagues (1). However, the case deserves special attention because this reaction can be life-threatening. Therefore, we suggest that paternal lymphocyte immunization should be recommended only for those patients who have undergone a thorough work-up and in whom all causes, other than immunological, for recurrent abortion have been excluded. Even then, this treatment should be given with utmost caution. In view of the above described complication, we believe that more data are still required to justify offering such a treatment modality on a routine basis.

Abortion, Habitual↗
PubMed1992

The relationship between sperm ultrastructural features and fertilizing capacity in vitro.

OBJECTIVE: To evaluate the relationship between ultramorphological features of the human sperm and its fertilizing capacity in vitro. DESIGN: The study was performed retrospectively. Ultrastructural features were assessed using scanning and transmission electron microscopes in sperm samples of individuals who underwent an in vitro fertilization (IVF) treatment cycle no more than 6 months before the study. SETTING: Institutional clinical care. PATIENTS: Fifty-six infertile couples in whom mechanical infertility was diagnosed in the female partner. Patients were categorized as fertilizing when fertilization of at least 30% of the oocytes occurred (n = 27) and nonfertilizing when none of the oocytes fertilized in at least two consecutive IVF treatment cycles (n = 29). RESULTS: The two groups differed significantly only in ultramorphological parameters of the sperm head and acrosome (head, F(8,36) = 2.8, P less than 0.02; acrosome, F(4,40) = 2.8, P less than 0.04), and especially in the following malformation patterns: hyperelongated head, acrosome deficiency, and acrosome damage. The suggested score based on these findings was able to predict 90% and 76% of the cases with and without fertilizing potential, respectively. CONCLUSION: The ultrastructural morphology of the sperm head components is a key parameter for assessing the sperm fertilizing capacity in vitro.

Adult↗
PubMed1992

Graves' disease complicating myelopathy.

BACKGROUND: Exophthalmos, supraventricular arrhythmias, and myxedema have been noticed among patients chronically paralysed due to myelopathy. A survey was conducted to document and explain the observation. METHOD: A long term care population of 77 male myelopathy patients aged 59 +/- 14 years (mean +/- 1 standard deviation), paralysed 19 +/- 11 years, were compared by exophthalmometry (Hertel instrument) with 53 male non myelopathy patients and hospital employees, aged 57 +/- 15 years, by review of electrocardiograms (EKGs) of record with 91 male non myelopathy hospital patients, aged 59 +/- 13 years, and by thyroid function tests with standard values. RESULTS: Abnormal ocular protrusion (greater than 22 mm) was found in 9 myelopathy patients (12%) and in none of the controls. Exophthalmos was bilateral in 7. The mean ocular protrusion was 17.2 +/- 3.6 mm for myelopathy patients and 14.9 +/- 3.9 mm for controls (p less than 0.001). Three exophthalmic patients had atrial fibrillation. Arrhythmias had been recorded in 186 of 1390 EKGs in 34 myelopathy subjects and in 63 of 377 EKGs in 25 controls. The ratios of supraventricular to ventricular arrhythmias were 2.8 for myelopathy patients and 0.7 for controls (p less than 0.02). Hypothyroidism was found in 2 of 74 patients tested, 2.7%. CONCLUSION: Exophthalmos, supraventricular arrhythmias, and myxedema are unusually common among chronic myelopathy patients. Preceding Graves' disease with residual effects can be suggested as the explanation.

Adult↗
PubMed1991

Thiol status in human sperm.

The passage of spermatozoa along the epididymis is characterized by a gradual stabilization of intracellular organelles mainly through the oxidation of thiol groups. In this study, we examined the relationship between the thiol-disulfide status of human spermatozoa (using a specific fluorescent probe, monobromobimane) and routine semen analysis parameters. Fluorescence intensity was measured by spectrofluorimeter and its frequency distribution within samples, using a fluorescence-activated cell sorter. The mean proportion of reactive thiols SH/(SS + SH) in 29 semen samples was 29.8% +/- 2.5%. When comparing thiol labeling patterns, oligozoospermic samples differed from normozoospermic ones (P less than 0.05). However, within the normozoospermic group, no correlation was found between thiol-labeling patterns and routine sperm parameters or fertilizing capacity in vitro. No difference in thiol labeling patterns was found between "swim-up" and "whole semen" preparations.

Bridged Bicyclo Compounds↗
PubMed1991

The relationship between in vitro fertilization and naturally occurring antibodies: evidence for increased production of antiphospholipid autoantibodies.

OBJECTIVE: Assessment of possible effects of ovarian stimulation during in vitro fertilization (IVF) treatment cycles on circulating levels of antiphospholipid and antinuclear autoantibodies. DESIGN: The study was performed prospectively. Sera were obtained at three time points along IVF treatment cycle. Levels of autoantibodies directed against nuclear components, mitochondrial antigens, and phospholipids were determined using enzyme-linked immunosorbent assay. PATIENTS: Thirty-five patients, who underwent at least one previous IVF attempt, and 36 age- and sex-matched controls were analyzed. All participants were randomly selected. RESULTS: The mean levels of antiphospholipid (but not antinuclear) autoantibodies in sera from IVF-treated patients were found to be significantly higher than the corresponding values of the control group (for immunoglobulin [Ig]M isotype: anticardiolipin, antiphosphatidyl L-serine; for IgG isotype: anticardiolipin, antiphosphatidyl L-serine, and antiphosphatidylcholine; P less than 0.0001, assessed by Mann-Whitney test). The autoantibody levels remained more or less constant at different time points along the treatment cycle. No correlation with age and number of previous IVF cycles was demonstrated. CONCLUSIONS: Serum levels of antiphospholipid (but not antinuclear) autoantibodies increase after IVF treatment. Based on these preliminary data, it is not yet possible to estimate if the observed changes in autoantibody levels might have any future clinical influence on infertile patients undergoing IVF treatment.

Adult↗
PubMed1990

Endometrial laser ablation in rabbits: a comparative study of three laser types.

Endometrial laser ablation is one of the alternatives to hysterectomy in cases of intractable uterine bleeding. It is currently performed using the Nd:YAG laser at 1.06 microns. The aim of this study was to compare the tissue effect of three types of laser irradiation (Nd:YAG laser at 1.06 and 1.32 microns and holmium laser at 2.12 microns) on the rabbit endometrium. Crater formation, coagulation necrosis, and muscle necrosis were evaluated at the time of ablation, as well as at 1 week and 4 weeks postablation. The results were assessed by determining the depth and width of the affected portion in the uterine wall (lumen to serosa). It was shown that Nd:YAG laser at 1.32 microns caused more generalized and extended effects as compared with the other laser types examined. Endometrial regeneration was faster after ablation by the Nd:YAG laser at 1.06 microns and the holmium laser than by the Nd:YAG laser at 1.32 microns. The widest range of "ablation energy" (defined as that causing ablation without muscle damage) was achieved by applying the holmium laser. Further evaluation of the holmium laser for this indication is recommended.

Animals↗
PubMed1990

The relationship between sperm parameters and fertilizing capacity in vitro: a predictive role for swim-up migration.

The relationship between sperm parameters and fertilizing capacity in vitro was examined retrospectively, with the aim of finding predictive criteria for successful in vitro fertilization. Three hundred thirty semen samples were used to inseminate 1462 oocytes. Conventional parameters of sperm concentration and percentage motility in the ejaculate as well as swim-up migration were analyzed in relation to fertilization rate. It was shown that the probability of fertilizing human oocytes in vitro decreases significantly when (a) the sperm concentration is below 20 x 10(6) spermatozoa/ml ejaculate (P = 0.006), (b) motility is lower than 80% (P = 0.002), or (c) less than 4 x 10(6) motile spermatozoa/ml are concentrated in the swim-up fraction (P less than 0.0001). It was also demonstrated that nonfertilizing sperm could not be distinguished from fertilizing sperm by the conventional criteria but rather by the average concentration of motile spermatozoa in the swim-up fraction [12.5 +/- 1.5 and 22.3 +/- 2.3 x 10(6)/ml for the 0 and the 100% fertilization groups, respectively (mean +/- SE; P less than 0.01)]. Thus, the swim-up migration technique can serve as a predictive test for the in vitro fertilizing capacity of sperm.

Fertilization in Vitro↗
PubMed1990

Physicochemical properties of follicular fluid and their relation to in vitro fertilization (IVF) outcome.

Despite the limited data that are available concerning FF physicochemical properties, the following conclusions can be drawn. (1) FF temperature is lower than ovarian stroma and body temperatures. The physiological significance of this gradient is unknown. (2) Follicular size increases exponentially prior to ovulation. The relationship between FF volume and successful IVF outcome is well established. (3) A highly significant association exists between fertilization (but not embryo cleavage) and FF spectrophotometric absorbance at delta optic density of 455 nm. (4) FF behaves as a non-Newtonian fluid--its viscosity changes at different shear rates. Neither FF viscosity nor its refractive index was found to correlate with the presence of oocytes, their maturation grade, or their fertilizing capacity. (5) FF osmolarity is similar to that of the plasma. There is no information linking variations in FF osmolarity to IVF outcome. (6) FF pH is acidic, probably due to acid mucopolysaccharides. It appears that the intact follicle is capable of buffering any carbon dioxide which diffuses through its wall at the time of intraperitoneal insufflation. The transvaginal aspiration technique eliminates any possible effect of exogenous gas on FF pH. (7) Regarding the intact follicle, it was shown that (a) there is a small potential difference across the follicle wall, and (b) intrafollicular pressure remains steady prior to ovulation. This information may shed some light on mechanisms underlying FF formation and ovulation. No experiments relating these properties to IVF outcome have been performed.

Animals↗