Biomedical subjects

G Jakiel

Publications and source records attributed to G Jakiel.

At least 19 recordsLinked to original sources

PubMed2006

Successful outcome of twin gestation after endoscopic metroplasty of complete septate uterus.

The successful outcome of twin gestation after the endoscopic metroplasty of uterus septus class Va was described. Authors described and discussed the technical details of diagnosis and treatment of this rare malformation. Five months after treatment the patient spontaneously became pregnant. The pregnancy was determined as dizygotic twins. The cesarean section was performed in the 36th week of gestation because of growth arrest of one fetus and two healthy newborns were delivered.

Adult↗

PubMed2001

[Treatment of intracranial aneurysms during pregnancy].

Aneurysmal subarachnoid hemorrhage (SAH) during pregnancy is rare but serious obstetric complication. SAH occurs more often in primiparae and in the third trimester of pregnancy. The hemodynamic and endocrine changes play an important role in the growth and rupture of aneurysms. There are no differences in the clinical course of SAH among pregnant and non-pregnant patients. Subarachnoid hemorrhage during pregnancy may be confused with eclampsia. The confirmation of the diagnosis is made by computed tomography (CT) or lumbar puncture and cerebral angiography. Ruptured intracranial aneurysms should be treated as they would be in patients who are not pregnant. When the aneurysm is successfully clipped, the pregnancy can be allowed to progress to term. In these cases the vaginal delivery is preferred by most clinicians. Caesarean section would be indicated in several circumstances: when the clinical state of mother is severe (coma, brain stem damage), if the aneurysm is diagnosed at term of labour, if the interval between the neurosurgical treatment of aneurysm and labour is less than 8 days.

Adult↗

PubMed2001

[Two years experience of laparoscopic management of the deep posterior vaginal endometriosis].

Our three year experiences of laparoscopic operations recto-vaginal endometriosis is presented here. We treated 15 patients. The main symptom was severe dyspaurenia. Laparoscopic (n = 14) and laparotomic (n = 1) excision of endometriotic nodules resulted in considerable pain relief. The surgical techniques was excision with scissors and bipolar coagulation. In all the procedures the anterior rectum was freed to the loose areolar tissue of the recto-vaginal septum, prior to excising deep fibrotic endometriosis. Operation time was average 135 minutes and intraoperative blood loss was minimal. Postoperative hospital stay was average 4.8 days. Fourteen patients were free from the preoperative symptoms at six month follow-up. Laparoscopic surgery for deep recto-vaginal endometriosis is an effective treatment and offers significant symptom relief.

Adult↗

PubMed2001

[Comparison of the efficacy of treatment by two laparoscopic techniques combined with medical treatment of endometriosis stage three and four].

20 patients were treated for endometriosis with combined treatment, we have divided prospectively our patients on the 2 groups. One group was operated by laparoscopic marsupialisation of endometrial cyst and coagulation. The second group was operated by stripping of lining. Second-look laparoscopy was performed after six month medical treatment. Two techniques laparoscopic was very efficacy (decrease of AFS score). The difference between them wasn't significant.

Adult↗

PubMed2001

[Family labor from the father's point of view].

Family labor becomes increasingly popular in our country. The aim of the study was answering the question: what the main motive for the men attending to labor was, whether fathers were satisfied of their participation and what the main reason of their satisfaction was. The study was performed in the district and local hospitals in south-eastern Poland during 7 months. 110 fathers were in the study group, 78 (70.9%) of urban population, and 32 (29.1%) of rural. The obtained results indicate firm acceptance of such a way of labor among majority of fathers. It was supported by the fact that almost all of them were satisfied of their participation in labor, and wished to attend the next one. The main reason for inclining them for the participation in labor was the granting of the partners' request, and internal willing. The source of satisfaction from sharing of the labor was providing the safety for the partner and setting up early contact with the baby. Significant influence of the labor schools on the feeling of readiness for delivery and the level of father's satisfaction were not evident.

Adaptation, Psychological↗

PubMed2001

[Biophysical characteristics of cervical mucus after stimulation of ovulation by clomiphene citrate and HMG].

OBJECTIVES: Characteristics of cervical mucus during monofollicular stimulation of ovulation by clomiphene citrate and by clomiphene citrate with HMG was evaluated. MATERIALS AND METHODS: 226 women of couples treated for male factor infertility or idiopathic infertility were studied. Favourable parameters of cervical mucus in women treated by clomiphene citrate with HMG were found although they were worse than observed in spontaneous ovulatory cycle. RESULTS AND CONCLUSIONS: The E2/follicle index was used for evaluating efficiency of stimulation. It was the highest during cycles were CC and HMG were used, although they did not reflect the risk of hyperstimulation. Authors discuss the importance of their findings in cases when techniques of ART can not be applied.

Adult↗

PubMed2001

[Changes in carbohydrate metabolism of PCOS patients in cycle stimulated by rFSH].

UNLABELLED: 24 patients with clomiphene citrate-resistant PCOS were enrolled in the study. We used low-dose step up protocol of recombinant FSH administration. Ovulation induction by rFSH injection was commenced on 3 day of cycle, at a dose of 50 IU for 7 days initially. The dose was continued at 50 IU, and ultrasonographic scans were performed daily until a dominant follicle had developed to a size of at least 18-20 mm, at which point 5,000 IU of hCG was administrated. If no response was noted after 7 days, the dose was increased by 50 IU for a further 7 days. Insulin and glucose serum levels were determined 7 times: in days 3, 5, 8 of a cycle and later when diameter of ovarian follicle was 10, 12, 16 mm and in the day of hCG injection. Estradiol serum level was determined in 8 day of cycle and when diameter of ovarian follicle was 10, 12, 16 mm and in the day of hCG injection. BMI and WHR was determined in the day of admission to hospital. RESULTS: The correlation between mean insulin level in the examined cycle and BMI and as well as the correlation between mean insulin level and WHR were determined. Mean level of serum glucose increased as the level of estradiol raised. No influence of growth level on insulin level was detected.

Adult↗

PubMed2001

[Hysteroscopic correction of uterine malformations by small diameter hysteroscope with flexible needle].

The series of 14 hysteroscopic surgery procedures in case of septum uteri were analyzed. All women enrolled into the study were infertile. The malformations were diagnosed by hysterosalpingography and intravaginal ultrasound. The laparoscopic examination of intrauterine serosal surface and operative hysteroscopy were performed in the same time. The 8 mm diameter hysteroscopy with flexible needle was used. The uterine cavity solution was distended by sorbitol and mannitol. The patients left the hospital on the second postoperative day. There was one complication in this study: intravasation of distended fluid. After one month from surgery the pelvis was controlled by HSG. In 12 cases the uterine cavity was restored to a normal shape, in 2 cases the residual uterine septum of less than one centimeter was determined. We concluded that correcting the septum uteri by the small diameter hysteroscope (8 mm) with flexible needle is an effective and safety method for the uterine septum treatment.

Adult↗

PubMed2001

[Menopausal medicine of the threshold of the third millennium].

The paper reviews most important trends in hormonal replacement therapy which have appeared in recent years. The tailored approach to HRT, introduction of new drugs and modification of established treatment regimes are the most probable directions in which menopausal medicine would develop in the years to come.

Female↗

PubMed2001

[Men's acceptance of continuous hormone therapy].

The aim of the study was the assessment of males' willingness to long-term administration of hormonal drugs in substitutive and contraceptive means. Eighty males in their third and fifth decade were inquired a questionnaire. The patients were divided according to age into two groups: A (20-30 yrs of age) 55 males, and B (41-50 yrs of age) 25 males. University education was a condition required to be enrolled into the study. The results was statistically analyzed with Chi 2 test. 65.5% of males in their third decade would not accept hormonal contraception. 40% of males declared their acceptance for hormonal substitutive therapy and they were also aware of the necessity of prophylactic examinations, 7.3% accepted the therapy but without regular follow-ups, 16.3% did not accept the therapy and 36.4% did not consider it as necessary. 56% of the respondents from group B would accept an administration of contraceptive pill. 44% would not accept hormonal substitutive therapy, 24% did not see the necessity of the therapy, 16% would accept the therapy and the necessity of regular prophylaxis, and the last 16% would accept the therapy, however without control examining.

Adult↗

PubMed2001

[Seventh caesarean section with the same woman--case report].

Seventh caesarean section in the same pregnant woman was described. Pregnancy was terminated in 36 week of gestation cause of preterm uterine activity, after getting pulmonary maturation and estimating ultrasound fetal weight over three kilograms. The caesarean section and postoperative period were uncomplicated. There is little literature about multiple repeat caesarean sections. The authors discuss changes in outcomes and complications of multiple caesarean sections through last three decades.

Adult↗

PubMed2001

Diagnostic value of US and CT in the assessment of ovarian teratomas and their qualifications for surgical treatment with laparoscopic method.

In the group of 17 women after surgery with histopathologically confirmed diagnosis of teratomas diagnostic usefulness of US and CT was analysed. Differentiated echostructure of tumours was correlated with different densities of pathologic tissues in CT examination, also after their contrast enhancement. In 2 patients teratomas of both ovaries were recognised, in the remaining 15 women tumours were unilateral. In total morphologic pictures of 19 teratomas were assessed, 9 times tumours with prevailing liquid component had the picture of a thick-walled cyst, 7 times these were hyperechogenic fatty foci and in 3 cases had the character of solid tumours. Teratomas had different morphologic pictures, but it was possible to show the prevalence of one element and classify the tumour to one of the three types of teratomas. It was found that US examination, due to its high frequency, lets early diagnose teratomas before they are accessible in the clinical exam, in the symptomless period or when they give indirect symptoms, usually dysuric ones. CT examination, due to its high sensitivity in recognising fatty tissue and calcifications, is necessary before laparoscopic operation requiring fragmentation of big tumours to determine their character.

Adolescent↗

PubMed1998

[The effect of various methods of luteal phase supplementation on serum progesterone level].

OBJECTIVES: Examined was the effect of luteal phase supplementation on serum progesterone level with the use of two methods: oral administration of 10 mg dydrogesterone twice daily since the detection of corpus luteum till the menstruation and intramuscular HCG administration in the dose 1500 IU every 4 days and 10 mg dydrogesterone twice daily in the same period. DESIGN: A randomized study, controlled by placebo. PATIENTS AND METHODS: 56 infertile women, with luteal phase deficiency assessed on the basis of basal body temperature (decrease shortly after the peak the luteal phase shorter than 11 days) and ovulation determined sonographically. Progesterone was evaluated by an EIA method, on the 3rd, 7th and 11th day since the corpus luteum occurred. RESULTS: The peak of progesterone concentration was assessed in the midluteal phase (7th day) in both supplemented groups, significantly higher than in the placebo group, also in group with dydrogesterone and HCG it was higher than in group with dydrogesterone alone. Progesterone concentration decrease on the 11th day after the ovulation to the values comparable with the placebo group. CONCLUSION: It has been found that both methods increase serum progesterone level in the time of an assumed implantation but they do not affect the premenstrual period if conception is not achieved.

Adult↗

PubMed1998

[Correlation of pituitary hormones in serum of male patients with fertility problems].

UNLABELLED: FSH, LH and prolactin serum levels estimations are the part of the most diagnostic procedures in andrology but there is their prediction value under discussion all the time. AIM: To judge the sensitivity of pituitary hormones serum levels estimation as the diagnostic method in male subfertility and to investigate the correlation between FSH, LH and PRL depending on their physiological or pathological ranges. MATERIAL AND METHODS: FSH, LH and PRL serum levels were estimated in 36 males with azoospermia or severe oligozoospermia (density below 5 mln sperm per milliliter) by EIA. The percentage of pathologic values for every hormones was counted. The statistic analyzes (for p. < 0.05) of correlation factor between every couple of hormones were performed in full investigated group and in subgroups which were formed in following way: A-12 men with pathologic FSH serum levels, B-9 men with pathologic LH serum levels and C-24 men with both physiologic gonadotropins serum levels. RESULTS: The percentage of FSH, LH and PRL pathologic values was in all subfertile men: 33%, 25% and 19.4% respectively. The correlation factor for FSH and LH was high in whole group (0.9484), it was the highest in both groups with FSH and LH pathologic levels (almost 1.0). In the group with physiological FSH and LH serum levels this positive correlation was significantly weak but also present (0.4107). The prolactin is completely independent without the correlation with any gonadotropins in any groups. CONCLUSIONS: 1. The sensitivity of the investigations of pituitary hormones during the diagnostic procedures of male fertility disturbances is poor. 2. Gonadotropins and prolactin infertile male serum levels are completely independent. 3. Positive correlation between FSH and LH increases in the pathological range of their values.

Follicle Stimulating Hormone↗

PubMed1998

Zinc levels in seminal plasma and sperm density.

Zinc levels in seminal plasma were measured. The study was done on 122, random selected males from infertile couples. The atomic absorption spectrophotometer was used. Sperm density of ejaculate was also determined. These parameters were compared in subgroups: normospermic and oligospermic and in classes of variable oligospermic severity. Semen serum zinc levels in normospermic men was significantly increased as compared to oligospermic men. There were no significant differences in zinc levels between the different classes of oligospermia.

Adult↗

PubMed1998

Ectopic pregnancy diagnosis in very high risk patients.

The authors analyse the effectiveness of ectopic pregnancy diagnosis in women with clinical history and high psychological motivation for treatment. The effectiveness of the diagnostic algorithm was studied in 21 women with previous history of infertility treatment (including 15 who had undergone tube surgery). The diagnostic process was begun between 20th and 25th days after the suspected conception. The only clinical symptom that the patients complained of was spotting (7 cases). The algorithm used serum HCG determination (EIA); in cases of HCG ranging between 2 mIU/ml and 1500 mIU/ml (or clinical uncertainty)-transvaginal sonography (with colour Doppler) was used. If ectopic pregnancy was suspected, laparoscopy was done. It was found that in 15 cases laparoscopic images agreed with diagnostic results; in 5 cases, the image obtained was false negative; in 1 case it was false positive. The diagnostic efficiency of sonography alone was higher than if it was correlated with HCG, but it, too, did not secure against false positive and false negative results. The conclusion was drawn that despite very high sensitivity (70%) and specificity (93%) of the diagnostic procedures used, in high-risk patients the diagnosis should be verified by laparoscopy.

Adult↗

PubMed1997

[Endometrial changes in the ovaries during full-term pregnancy: a case report].

The authors described case of 27 years old female patient treated due to infertility of unknown etiology. The female was pregnant after series of intrauterine insemination. During caesarean section due to pelvic longitudinal lie the chocolate cyst and endometriosis of the ovary were found. The authors did not find any information in the literature about coincidence of endometriosis of female reproductive organs and full-term pregnancy.

Adult↗

PubMed1994

[Seasonal changes in results of semen analysis from male members of an infertile married couple].

Analysis of 200 semen samples of men from childless couples was performed in order to evaluate the sperm characteristics during the year. Estimated were following features: semen volume, sperm density, motility and percentage of pathological forms. The sperm estimation data obtained from 4 seasons of the year was statistically evaluated. Statistically significant changes were found only in the percentage of pathological sperm forms. During the spring period the observed values were significantly higher than during summer and winter. From the correlation tables it appears that together with the increase of sperm density the percentage of pathological forms decreases. Whereas increase in density is correlated with the increase of sperm motility. It was also revealed that together with the increase of the percentage of pathological forms the motility decreases. Analogical results were obtained in all seasons of the year which indicates that there is a clear regularity existing. The least apparent dependencies were found in winter period.

Adult↗