Biomedical subjects
H Zuckerman
Publications and source records attributed to H Zuckerman.
[Torsion of the uterus during labor].
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Pelvic inflammatory pseudotumor (xanthogranuloma).
A case is presented of a patient with xanthogranulomatous pseudotumor in the pelvic region. The pseudotumor was probably the result of inflammatory reaction in both tubes and in the uterine cavity, with pyometra. The condition is very rare and only 5 cases could be found in the literature.
Correlation between estradiol and progesterone in cycles with luteal phase deficiency.
Many studies have been published on luteal phase deficiency, and the emphasis in most of them is on progesterone deficiency. In this study 144 patients (455 cycles) with infertility were studied. The patients were divided into four groups. Group 1 consisted of patients with high estradiol and high progesterone levels in the midluteal phase. Group 2 consisted of patients with high estradiol and low progesterone levels. Group 3 consisted of patients with low estradiol and low progesterone levels. Group 4 consisted of patients with low estradiol and high progesterone levels. As expected, patients in groups 2 and 3 showed a low conception rate with outphased endometrial biopsy. However, group 4, in spite of the normal progesterone levels, had a low conception rate with an outphased endometrium. We conclude that estradiol deficiency during the luteal phase is a major factor in infertility, and replacement therapy with progesterone alone in these patients may not improve fertility.
Ultrasound determination of fetal sex.
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Hypophyseal gonadotropin insufficiency in a young woman with idiopathic hemochromatosis.
A 24-year-old women suffering from primary sterility was diagnosed in 1971 as having idiopathic hemochromatosis (IH). The diagnosis was made on the basis of high serum iron and high transferrin saturation, ferrokinetic studies, including iron absorption, liver biopsy showing heavy deposits of iron in the parenchymatous cells, and a family history. Except for slight elevations in the serum transaminases, there were no clinical or laboratory findings of liver pancreatic, myocardial, or dermal involvement by hemochromatosis. Endocrine evaluation revealed gonadotropin insufficiency as the cause of sterility. The patient was treated with periodic phlebotomies for seven years, and the mount of iron withdrawn during that time was calculated to be approximately 27 g. A repeat liver biopsy showed complete disappearance of the iron excess of the fibrotic changes that had been present in 1971. Repeated relevant clinical and laboratory studies did not reveal any pathological findings consistent with hemochromatosis. A complete endocrine evaluation, including stimulatory tests (luteinizing hormone releasing hormone, thyrotropin-releasing hormone, insulin, and metyrapone), disclosed only findings consistent with hypophyseal gonadotropin insufficiency, and these were attributed to iron deposition. It can be assumed that the prolonged treatment with phlebotomies prevented the development of liver, pancreatic, myocardial, or other clinical endocrine disease, but had no effect on the already damaged pituitary. The patient's clinical course followed the pattern recently described in other young patients with IH.
Compulsive water drinking in pregnancy.
A case report of a pregnant woman with primary polydipsia is presented. The workup, including an investigation of the disturbance and the implications for fetal outcome, is described. The terms primary and secondary polydipsia are defined, and the differential diagnosis is discussed. Compulsive water drinking was finally diagnosed following psychiatric evaluation. A brief review of the literature concerning compulsive water drinking is presented.
[Indomethacin and prostaglandins in labor].
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[Diagnosis of meconial amniotic fluid by determination of maternal serum alkaline phosphatase].
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Further developed device for human sperm freezing by the twenty-minute method.
A further developed, practical device for human sperm freezing is described by which the preparation of sperm and the freezing process are reduced to a simple procedure requiring about 20 minutes. The instrument is based on the principle of evaporation of liquid nitrogen, which acts as a refrigerant for the freezing plate under the control of a thermostat. Rapid-rate freezing can be performed for pellet production and slow-rat freezing for paillettes; a high degree of isolation of samples is maintained by easily interchangeable freezing plates. Typical stages of freezing are accomplished at temperatures of +5 degrees C and--80 degrees C, with storage at--196 degrees C. The recovery index is 50% to 70%. The treatment was applied to 56 patients, resulting in 19 normal deliveries, 3 abortions, and 9 current pregnancies.
Prostaglandin F2alpha human blood during labor.
Plasma prostaglandin F2alpha (PGF2alpha) concentrations were determined by radioimmunoassay in serial samples during labor and the early postpartum period. PGF2alpha was also measured during and between contractions every 20 to 30 seconds. The highest levels of PGF2alpha were found during expulsion of the fetus and placenta with an additional rise half an hour after delivery and a decrease 2 hours after delivery to the levels of first stage of labor. PGF2alpha values from cord blood were higher than in maternal peripheral blood in labor. The maximum PGF2alpha concentration occurred between 100 to 120 seconds after the peak uterine contraction and between 40 and 60 seconds prior to peak of the next contraction. The possible explanation is that PGF2alpha initiates uterine contractions and plays a role in the maintenance of labor, in the expulsion of the fetus and the placenta, and in the involution after delivery.
Effect of caffeine on increasing the motility of frozen human sperm.
A preliminary report on the effect of the addition of caffeine to 45 frozen sperm samples, in order to restore the effectiveness and motility of frozen stored human sperm, is presented. The addition of 7.2 mM caffeine proved optimal and resulted in 40% to 80% increased sperm motility after 30 days of frozen storage. The use of rapid-rate freezing to produce frozen sperm pellets and the addition of one frozen pellet of buffered caffeine (7.2 mM) to five sperm pellets before thawing are recommonded. For slow-rate freezing in paillettes, the addition of a caffeine solution (final concentration, 7.2 mM) to the sperm and protective medium is recommended. With these methods, frozen storage of hypomotile sperm, which previously could not be preserved by freezing, is now practical.
The effect of indomethacin on plasma levels of prostaglandin F2alpha in women in labour.
Prostaglandin F2alpha was measured by means of radiommunoassay in the serum of women in the active phase of term labour before and after rectal indomethacin administration. Samples of blood were collected every 20 or 30 seconds, between and during contractions. There was a significant decrease of the level of PGF2alpha in plasma 30 to 30 minutes after indomethacin administration, but the pattern of rapid short-term fluctuations in prostaglandin levels was unaltered.
High maternal serum alkaline phosphatase as an index of meconial amniotic fluid.
High level of maternal serum alkaline phosphatase (AP) (above 4 Bessey-Lowry units) was found to be indicative of meconium-stained amniotic fluid (AF). Simultaneous maternal serum AP and AF AP were measured in two groups: group A, the study group (78 cases), parturients with meconium-stained AF, and group B (29 cases), the control group, parturients with clear AF. A positive significant correlation was found between the level of AP in the AF and the level of AP in the parturient's serum, when meconium was present. It is our feeling that the high level of AP in the maternal serum is due to transfer of heat-labile AP from the meconium-stained AF, meconium being rich in AP. The mechanism has as yet to be elucidated.
The effect of indomethacin in labour at term.
The effect of indomethacin as an antagonist to prostaglandin was evaluated on a series of 16 women during spontaneous labour in the ninth month of pregnancy. The evaluation of the effect of indomethacin on the progression of labour was determined by the deviation from the normal curve of Friedman. In 8 cases there was complete cessation of labour from 3 to 192 hours and in 8 additional cases there was protraction of the active phase from 3 to 17 hours. In 2 cases there was no effect. Seven births terminated spontaneously and in 9 cases it was necessary to administer pitocin intravenously to strengthen or renew contractions in order to terminate the pregnancy. There is no correlation between the obstetric state (the degree of cervical dilation, or effacement or rupture of membranes) at the time of indomethacin administration and the uterine response, or the speed of return to the normal curve of Friedman. The effect of indomethacin, as an antagonist to prostaglandin, at the time of labour was studied.
Unilateral renal agenesis associated with multiple skeletal abnormalities.
Two cases are presented in which an association between unilateral renal agenesis and multiple skeletal abnormalities is found. The pathologic agents responsible for the URA act similarily on other organ systems, including the skeleton. The skeletal abnormality can be diagnosed easily and promptly and may be an indicator for anomalies in other systems as well, especially the urogenital system.
[Indomethacin as an inhibitor of premature labor].
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Antibacterial activity of human cervical mucus.
The antimicrobial property of human uterine cervical mucus was tested in three groups of women. Healthy women, using no contraception, women using an intrauterine device and women receiving hormonal treatment for contraception. Cervical mucus was taken on the 10th, 14th, 18th and 22nd day of the menstrual cycle. Cervical mucus had a strong inhibitory effect on the growth of Micrococcus lysodeicticus in all three groups. The strength of the inhibitory effect on the other microorganisms were in the following order: Staphylococcus albus, Staphylococcus aureus, Proteus mirabilis, Escherichia coli, Candida albicans, Streptococcus haemolyticus, Streptococcus faecalis. Use of an intrauterine device did not affect the antimicrobial effect of cervical mucus. The use of hormonal contraceptive canceled the antimicrobial effect on the series of microorganisms, with the exception of M. lysodeicticus. The maximum inhibitory effect occurred on the 14th day and declined toward the end of the menstrual cycle.