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Biomedical subjects

F Lehmann

Publications and source records attributed to F Lehmann.

At least 19 recordsLinked to original sources
PubMed1992

Iron deficiency anemia in 1-year-old children of disadvantaged families in Montreal.

OBJECTIVES: To determine the prevalence of iron deficiency anemia among 1-year-old infants of disadvantaged families in Montreal as well as certain predictors of this condition. DESIGN: Cohort study. SETTING: Five poorest health districts in Montreal. PARTICIPANTS: Infants 10 to 14 months of age were identified from registration lists of births from May 1988 to August 1989. Those whose mother had less than 11 years of schooling and a family income below the government-defined low-income cutoff point were eligible. INTERVENTION: During a home visit capillary blood samples were obtained from the child, and the mother answered a questionnaire about infant-feeding practices. Infants with a serum ferritin level of 10 micrograms/L or less and either a hemoglobin level of 115 g/L or less or a mean corpuscular volume of 72 fL or less were considered as having iron deficiency anemia. RESULTS: Of the 299 mothers who were eligible and could be located 220 (74%) agreed to participate; 218 blood samples were available. Iron deficiency anemia was found in 25% of the infants (95% confidence interval [CI] 19% to 31%). The mean hemoglobin level was 115 (standard deviation 11) g/L. The serum ferritin level, assessed routinely in the last 62 infants, was 10 micrograms/L or less in 37% of the infants. The factors that were found to be predictors of iron deficiency anemia included the use of whole cow's milk before 6 months of age (odds ratio [OR] 3.56 [95% CI 1.07 to 11.26]) and the use of iron-fortified infant cereal for less than 6 months (OR 3.15 [95% CI 1.25 to 7.96]). A low birth weight and the use of iron-fortified formula for less than 6 months were associated with iron deficiency anemia. CONCLUSIONS: Despite a decrease in the prevalence of iron deficiency anemia among children of disadvantaged families in the United States socioeconomically disadvantaged infants in Montreal are at risk. Preventive measures must be taken to ensure adequate iron status in the first year of life.

Anemia, Hypochromic↗
PubMed1992

Precursor frequency analysis of human cytolytic T lymphocytes directed against autologous melanoma cells.

Limiting numbers of peripheral-blood mononuclear cells (PBMC) from melanoma patients were stimulated with irradiated autologous tumor cells in the presence of interleukins-2 and -4 and in the absence of feeder cells. The responder cells were restimulated every week. After 2 to 4 weeks, the microcultures were tested for their lytic activity against the autologous tumor cells. Significant lysis of the tumor cells was observed with a fraction of these microcultures, whereas no lysis was observed with control microcultures seeded without stimulator melanoma cells. Because our aim was to measure the precursor frequency of CTL showing specificity for the tumor, and not that of NK-like effectors that were also capable of lysing the melanoma cells, we used cold-target inhibition with an excess of NK target K562 to inhibit the NK-like activity. Microcultures whose lysis on the tumor cells was not abolished by K562 competition were observed. The specificity of these CTL clones was confirmed by the absence of lytic activity on autologous T-cell blasts. The numbers of microcultures with anti-tumor CTL activity fitted the zero-order of the Poisson distribution equation, indicating that they resulted from the activity of single T-cell clones. The frequency of anti-tumor CTL precursor cells (CTL-P) of 7 melanoma patients ranged from 1/900 to 1/33,000. Frequencies of anti-tumoral CTL-P were higher and NK-like effectors were less frequent when sorted CD8+ T lymphocytes were used as responder cells.

CD4-CD8 Ratio↗
PubMed1991

[Ovarian pregnancy after gamete transfer (gift). A case report].

A case of ovarian pregnancy after gamete transfer (GIFT) is reported in a 33-year old women who, after intensive stimulation therapy, experienced a right tubal pregnancy in one cycle and an ovarian pregnancy on the left side in the next. The incidence of ovarian pregnancies seems to have been increasing during the past years, comprising 3.3% of all extrauterine pregnancies. This may be influenced by the possibilities of sterility therapy today. Clinical presentation, possible pathogenesis, diagnostic steps and preferred management are described. The use of transvaginal sonography has improved the diagnosis of ectopic pregnancies and should be routinely used leading to an early diagnosis and organ-preserving therapy. This case report is intended to assist and promote the sensitivity towards an early diagnosis of this rare form of ectopic pregnancy.

Adult↗
PubMed1988

Ovarian stimulation for in-vitro fertilization: clomiphene and HMG.

Details of the problems and successes obtained after various forms of hormonal stimulation in an IVF programme are presented. The endocrine conditions normally existing in the natural menstrual cycle are discussed first, followed by analyses of the types of responses to clomiphene, clomiphene and HMG, HMG alone and LHRH agonists. Clomiphene produces fewer embryos than other treatments but gives a good control of follicle growth and ovulation. Clomiphene and HMG increases the number of available oocytes, and this raises the chance of pregnancy, but there is a greater heterogeneity in the follicular population. HMG alone is suitable for most conditions except for those with PCO syndrome and gives an average of six oocytes per treatment cycle. The problems associated with premature rises in levels of LH are overcome by using LHRH agonists with HMG, and this results in satisfactory numbers of oocytes but requires endocrine support in the luteal phase. The need for luteal phase support after various therapies remains unclear, and a calculation of the ratios between various steroids may help to clarify the need for it.

Clomiphene↗
PubMed1985

Polyspermy in in vitro fertilization of human oocytes: frequency and possible causes.

In an IVF program a total of 585 oocytes (180 patients) were examined for the presence of pronuclei 16 to 20 hours after the addition of spermatozoa. The overall fertilization rate was 71%, and in 58 (10%) of the fertilized oocytes, three or more pronuclei, indicating a failure of the block to polyspermy, could be observed. The frequency of polyspermy was related to the maturity of the oocyte, determined according to morphologic criteria. Immature oocytes showed a higher percentage of polyspermic fertilization (32%) compared to that of mature oocytes (6%). Preincubation of oocytes (for 0.5-1.5, 2-4, and 5-8 hours) prior to the addition of spermatozoa increased the fertilization rate (to 67%, 70%, and 83%, respectively). The polyspermy rate, however, was not significantly different between the various preincubation intervals (13%, 14%, and 19%, respectively). The polyspermy rate was affected by the number of spermatozoa used for in vitro fertilization. Insemination with 0.5-0.8, 1.0, or 1.5-2.0 X 10(6) spermatozoa/oocyte resulted in a polyspermy rate of 6%, 20%, and 32%, respectively. The appearance of polyspermic fertilization was not related to the age of the patient (which ranged from 20 to 45 years) nor to the method of ovarian stimulation (clomiphene, hMG, or clomiphene/hMG). Because of the high incidence of polyspermy under in vitro conditions it seems to be important to routinely examine the oocytes in the pronuclear stage. Reduction of the number of spermatozoa used for in vitro fertilization and the exact timing of insemination according to the maturity of the oocyte might reduce the occurrence of polyspermic fertilization.

Female↗
PubMed1984

[Performance of laparoscopic follicle puncture and oocyte recovery for in-vitro fertilization].

In-vitro fertilisation of human egg cells and subsequent embryonal transfer offers a possibility to sterile women with oviducts incapable of functioning, to become pregnant after all. This article describes the performance of laparoscopic follicular puncture and extraction of egg cells for in-vitro fertilisation. Laparoscopic follicle puncture as described here was performed from July 1982 to March 1983 on 130 patients at the Gynaecological and Obstetric Hospital in Lübeck. 585 follicles were punctured and 404 egg cells obtained, 210 of which met the criteria of a pre-ovulatory egg cell. Of the 210 pre-ovulatory egg cells, 177 could be fertilised. In 95 patients, embryo transfer was effected in the 2-cell to 8-cell stage. The fertilisation rate obtained was 84%, with an embryo transfer rate of 71%. Since this patient group also included andrological causes of sterility, this figure can be considered quite satisfactory, which is decisively due, among other things, to the puncture technique described here. Pregnancy was attained in 14 cases so far. It is certain that the pregnancy rate can be improved still further.

Female↗
PubMed1984

[Polyploidy occurring during in-vitro fertilization of human oocytes: frequency and possible causes].

In an IVF-program a total of 585 oocytes (180 patients) was examined for the presence of pronuclei 16 to 20 hours after the addition of spermatozoa. The fertilization rate was 71% and in 58 (10%) of the fertilized oocytes three or more pronuclei, indicating a failure of the block to polyspermy with polyspermic fertilization, could be observed. The frequency of polyspermy was related to the maturity of the oocyte, determined according to morphological criteria. Immature oocytes showed a higher percentage of polyspermic fertilization (32%) compared to mature oocytes (6%). Preincubation of oocytes (0-1.5, 2-4, 5-8 hours) prior to the addition of spermatozoa increased the fertilization rate (67%, 70%, 83%, respectively). The polyspermy rate seemed to increase (13%, 14%, 19%). The observed frequency, however, was not significantly different between the various preincubation intervals. The polyspermy rate was affected by the number of spermatozoa used for in-vitro fertilization. Insemination with 0.5-0.8, 1.0 or 1.5 X 10(6) spermatozoa/oocyte resulted in a polyspermy rate of 6%, 20%, 32%, respectively. The appearance of polyspermic fertilization was not related to the age of the patient (20 to 45 years) nor to the method of ovarian stimulation (Clomiphene, hMG, Clomiphene/hMG). Because of the high incidence of polyspermy under in-vitro conditions it seems to be important to examine the oocytes in the pronuclear stage on a routine basis. Reduction of the number of spermatozoa used for in-vitro fertilization and the exact timing of insemination according to the maturity of the oocyte might reduce the occurrence of polyspermic fertilization.

Adult↗
PubMed1984

[Preoperative cervical dilatation in abortion during the 1st trimester with sulprostone].

Retrospectively we have compared the efficacy, the immediate complications, and the side effects during termination of 727 first trimester pregnancies with and without preoperative cervical dilatation by sulprostone. All these patients had been admitted to the Frauenklinik der Medizinischen Hochschule L ubeck for legal abortion; 365 of them got a single intramuscular injection of 500 micrograms sulprostone 8-10 hours prior to vacuum aspiration (failure 4% Hegar less than 6); 81 patients got a single intramuscular-intracervical injection of 25 micrograms sulprostone 8-10 hours prior to vacuum aspiration (failure 16% Hegar less than 6); in 281 patients evacuation of the uterus was carried out in dilating the cervix mechanically. This route without preoperative dilatation by the prostaglandin analogue sulprostone gave the highest rate of complications. Only in regard to a complete evacuation of the uterus a single intramuscular-intracervical injection of sulprostone resulted in a diminution of the complications. However, a single intramuscular injection of 500 micrograms sulprostone prior to vacuum aspiration offered a practical, effective and relatively side-effect free method of cervical dilatation.

Abortifacient Agents↗
PubMed1984

[Echocardiographic diagnosis of fetal heart insufficiency caused by supraventricular tachycardia].

A fetus with hydrops congenitus universalis and congestive heart failure in the 34th week of gestation caused by supraventricular tachycardia was diagnosed by ultrasound. A reanimation in the infant delivery by cesarean section with a heart rate of 360 beats/min was successful. By a weight at birth of 3140 g, pre- and postnatal 930 g edema was found. The postpartal treatment of the supraventricular tachycardia with verapamil, methyldigoxin and propranolol was successful. The child recovered uneventfully.

Echocardiography↗
PubMed1983

[Ovarian stimulation in an in-vitro fertilization programme].

The in-vitro fertilization of human ova and the subsequent transfer of the embryo are a possibility for infertile patients with damaged fallopian tubes to achieve a pregnancy. The results of different methods of ovarian stimulation in an in-vitro fertilization programme are described. The Clomiphen/hCG treatment and the overlapping Clomiphen/hMG/hCG treatment were used. Between July 1982 and March 1983, 130 patients had a laparoscopic aspiration of ovarian follicles at the Department for Obstetrics and Gynaecology in Luebeck. 585 follicles were aspirated and 404 ova retrieved. 210 showed the criteria of a preovulatory ovum. Of these 210, 177 were fertilized. In 95 patients an embryo transfer at the 2-8 cell stage was carried out. Inspite of the good fertilization rate of over 80% and the good embryo transfer rate of over 70%, pregnancy was achieved only in 13 cases. The number of follicles and of the retrieved preovulatory ova as well as the fertilization rate were best in the group which received combined Clomiphen and hMG. The pregnancy rate was not different compared to the other group. The first delivery of a healthy infant following laparoscopic aspiration of a follicle and in-vitro fertilization and embryo transfer in Luebeck occurred in March 1983.

Adult↗
PubMed1983

[Effect of the menstrual cycle on spontaneous and mitogenous lymphocyte transformation].

The spontaneous and the mitogenous lymphocyte transformation by phyt-hemaglutinine P of the peripheral T-cells of healthy women during the menstrual cycle and after the menopause was measured by the 3H thymidine incorporation into DNA. Whereas the transformation of lymphocytes has a uniform pattern after the menopause, the spontaneous transformation in women with menstrual cycles is diminished during the secretory phase of the cycle and periovulatory reduced stimulation by phyt-hemaglutinine P is observed. The formation of spontaneous rosettes was not different.

Adult↗
PubMed1982

[In-vitro fertilization of human eggs and embryo transfer].

This is a first report on experience with in-vitro fertilization of human eggs and embryo transfer. The follicle was aspirated to obtain eggs in 24 patients. A successful fertilization of the oocytes with obvious formation of a pronucleus was observed in 3 cases. In 9 more cases cell divisions were obtained and the embryos were transferred at the 4-cell stage. In spite of the unfavourable female patient population a good fertilisation and embryo transfer rate was achieved.

Adult↗
PubMed1982

Gonadotropin therapy of female infertility. Analysis of results in 416 cases.

This report is based on 416 infertile female patients who were treated for 1,033 cycles with gonadotropins. 28.6% of the patients conceived after hMG/hCG treatment in 79.8% of these pregnancies, healthy children were born. Spontaneous abortion or premature birth occurred in 20.2% of the cases. The twin rate was 28.6%, the triplet rate 5.5%. Most of the abortions occurred in the first trimester (52.2%). No malformations were seen. The pregnancy rate showed striking differences in the various diagnostic groups: hypogonadotropic amenorrhea 44.4%, normogonadotropic amenorrhea 50%, anovulatory cycles 22%, corpus luteum insufficiency 14.8%. The abortion rates for these four groups were as follows: hypogonadotropic amenorrhea 25%, normogonadotropic amenorrhea 14.7%, anovulatory cycles 4.8%, corpus luteum insufficiency 36.3%. A detailed analysis of the treatment cycles is given for the four groups: the number of ampoules of hMG/hCG increased from 21.4 ampoules in patients with corpus luteum insufficiency to 47.7 ampoules in patients with hypogonadotropic amenorrhea. The inactive phase increased from 5.6 days in patients with corpus luteum insufficiency to 8.5 days in patients with hypogonadotropic amenorrhea. Estrogen values around the time of ovulation and in the corpus luteum phase were much lower in patients with spontaneous uterine bleedings. Hyperstimulation syndrome occurred less frequently in these patients. The percentage of pregnancies decreased in patients with corpus luteum insufficiency from 8.1% in the first treatment cycle to 4.8% in the following treatment cycles, whereas it increased from the first to the following cycles in the other diagnostic groups. Patients with anovulatory cycles and corpus luteum insufficiency respond differently to hMG/hCG treatment than patients with normogonadotropic amenorrhea. The inactive and active phase are important parameters for the evaluation of ovulation induction with hMG/hCG, hMG/hCG treatment is of little value in patients with corpus luteum insufficiency.

Amenorrhea↗
PubMed1981

[The antepartum evaluation of pulmonary maturity in high risk pregnancies (author's transl)].

In normal pregnancies the determination of the L/S ratio permits a reliable ante-partum evaluation of fetal maturity. Good correlation between ante-partum determination and the condition of the newborn is obtained. In the 566 L/S ratios obtained from abnormal pregnancies the method was also reliable. There was 217 Rh incompatabilities, 51 pre-eclampsias, 31 diabetic patients, 112 premature labours, 78 placental insufficiencies and 77 premature ruptures of the membranes. In patients with diabetes the ante-partum diagnosis of pulmonary maturity is doubtful. In some patients with diabetes pulmonary maturity appears to be delayed. A difference between the abnormal pregnancies was not recognized. In the different types of high risk pregnancies no acceleration or retardation of pulmonary maturity was detected with statistical significance. However, in some cases of premature rupture of the membranes, premature labour and placental insufficiency, pulmonary maturity appears to be accelerated.

Amniotic Fluid↗