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J Masata

Publications and source records attributed to J Masata.

49 records · Page 3Linked to original sources
PubMed1998

[Ultrasonography of pelvic floor muscles in women with urinary stress incontinence].

Ultrasound examinations have become since beginning of the eighties one of the auxiliary examination methods in urogynaecology. Evaluation of the position and mobility of the neck of the urinary bladder practically replaced lateral chain urethrocystography. With the improving differentiating capacity of ultrasound equipment it is possible to visualize some periurethral and paravaginal structures which participate in the support of the urethra and urethrovesical junction by paravaginal and periurethral structures in women (fig. 1). In recent years many papers were published where for visualization nuclear magnetic resonance (NMR) is used [1, 12, 19]. The functional and physiological condition of these tissues is assessed by physical, urodynamic and ultrasonographic examinations and also by cystourethroscopy and manometry [7, 11, 10, 13, 14, 15, 16]. Despite this the greater part of anatomical knowledge of the supporting apparatus is derived from pathological studies and peroperative observations.

Female↗
PubMed1998

[Chlamydia trachomatis and its role in female infertility].

Infertility is a worldwide problem. 15-20% married couples are childless though they want children. The tubal factor is the most frequent cause of female infertility. Chlamydia trachomatis is one of the most frequent pathogenic organisms which cause tubal occlusion. From January 1995 till June 1997 at the 1st Dept. Gynecol. and Obstetric, 1st Fac. of Medicine 327 infertile women were examined divided into three groups (sterile, included in the IVF programme on account of the tubal factor and those included in the programme for other reasons). In all an antigenic examination from the endocervix and serological examination of antichlamydia antibodies was made. In 73 women in the IVF programme by microabrasion of the endometrium material for detection of Chlamydia infection was obtained by PCR. During sampling from the uterine cervix the appearance of the portio uteri, discharge, haemorrhage and pain on examination were evaluated. For statistical evaluation the chi square test was used. In 61% patients anamnestic IGG antibodies were detected suggesting a past or present Chlamydia infection. In women included in the IVF programme on account of the tubal factor there was a significantly higher IgG positivity (92%). Of ten women who suffered from acute chlamydial cervicitis only in one the infection was detected during microabrasion of the endometrium. 65% antigen positive patients had complaints during the examination (discharge, bleeding, pain). The authors discuss the impact of the assembled results from the aspect of impaired fertility of women in the Czech Republic.

Adult↗
PubMed1998

[Treatment of chlamydial urogenital infections].

Chlamydia trachomatis is the most frequent sexually transmitted bacterial pathogen in developed countries [3, 12, 13]. The position is similar in the Czech Republic. Depending on the group of examined women active Chlamydia infection varies between 10 and 23%. The increasing incidence of urogenital Chlamydia infections and improving diagnostic possibilities call for adequate treatment. Correct treatment of urogenital infections caused by Chlamydia trachomatis is very important for the prevention of undesirable sequelae of inflammations of the lesser pelvis, subsequent risk of GEU, sterility, prevention of premature delivery and possible infection of the neonate. When starting treatment, selecting a suitable antibiotic and deciding on the therapeutic strategy it is important to select an antibiotic with regard to its efficacy, the epidemiological situation, regional sensitivity of the infectious agent, toxicity and tolerance of the antibiotic, to its bacteriostatic or bactericide action, and last not least, also its price. Despite selection of a suitable antibiotic sometimes treatment fails. For treatment of urogenital chlamydial infections tetracyclin and macrolid antibiotics are recommended or quinolone chemotherapeutic agents of the third generation. Tetracyclines are broad spectrum antibiotics with bacteriostatic action. As to oral forms doxycycline, tetracycline and oxytetracycline are used. The most frequent undesirable effects during treatment are nausea, vomiting, diarrhoea and abdominal pain. Tetracycline antibiotics are contraindicated in children under 8 years, during pregnancy and lactation and in case of sensitivity to this group of drugs. Macrolids are antibiotics with a medium broad antibacterial spectrum with bacteriostatic action. Macrolids of the first generation have a low antibacterial activity. They have a short biological half-life, not always a good tolerance, and serious clinically important drug interactions may develop. The most frequently used preparations of the first generation include erythromycin, josamycina and spiramycin. Macrolids of the second generation, azitromycin, roxitromycin and claritromycin lack the above negative properties. The most frequent undesirable effects after administration of macrolids include nausea and vomiting. Considerable differences were found in particular between different preparations containing erythromycin. Macrolids of the second generation have only slight undesirable gastrointestinal effects. Macrolid antibiotics are contraindicated in case of sensitization to this group, in severe hepatic disorders and great care must be taken in the treatment of pregnant women. Quinolone chemotherapeutic agents of the third generation, ciprofloxacine, enoxacine, ofloxacine and pefloxacine are synthetic drugs with a broad antibacterial spectrum which act on systemic infections. On oral administration they are rapidly absorbed and the blood and tissue concentrations are sufficiently effective. In the treatment of urogenital Chlamydia infections they are useful in the treatment of chronic infections after failure of previous macrolid and tetracycline therapy. The most frequent undesirable side-effects include nausea, vomiting, meteorism, diarrhoea, tinnitus, headache, changes of mood, allergic skin reaction. They are contraindicated in hypersensitivity to quinolone chemotherapeutic preparations, in children and adolescents under 18 years, during pregnancy and lactation. The objective of the present study was to evaluate different therapeutic patterns, their efficacy and tolerance.

Anti-Bacterial Agents↗
PubMed1998

[Detection of cadmium and zinc in the blood and follicular fluid in women in the IVF and ET program].

Scientific and technical development contributed on the one hand greatly to easier living conditions, on the other hand there is however substantially greater danger threatening not only the life of man but also of nature, of the entire living environment. At present the problem of the possible part played by this phenomenon in reproductive disorders is in the foreground. Via the food chain heavy metals, toxic trace elements and polyhalogenic hydrocarbons penetrate into the organism. They accumulate in the organism and thus also in the reproductive tract and may have an impact on fertility. Some elements with a possible negative impact on reproductive health are in such low concentrations in tissues that only contemporary methods of their detection make it possible to map their presence in the organism. They are called trace elements. Toxic ones comprise cadmium, mercury, lead and arsenic. The mechanism of the negative action of cadmium in the organism is most probably due to its competition with the vitally important trace element--zinc. It was therefore the objective of the present investigation to trace the presence of cadmium and zinc in the organism of 100 sterile women included in an IVF programme: in blood and follicular fluid (i.e. in a medium which surrounds the gamete--the oocyte) and to follow up their concentrations in relation to achievement pregnancy. Cadmium and zinc in blood and follicular fluid were assessed on a mass spectrometer with induction bound plasma as the source of ions (ICP-MS), Varian Co. produced in 1994. The assessed mean levels (microgram/l) of cadmium in blood (2.88 s 2.71) and follicular fluid (1.25 s 0.55) in the group of conception cycles did not differ significantly from mean blood levels (2.82 s 2.22) and follicular levels (1.16 s 0.55) of non-conception cycles. The mean zinc levels in blood and follicular fluid did not differ either in the group of conception and non-conception cycles. Very significant are the differences in the blood and follicular fluid levels, the levels in follicular fluid being significantly lower. We may speak of a protective barrier of the oocyte formed by the follicle (probably the cells of the granulosa) against blood. Thus no relationship was found between the cadmium concentration in blood and follicular fluid of women where pregnancy was achieved and non-pregnant women. The possible cause of fertility disorders in conjunction with toxic elements is probably in damage of the granulosa cells and thus their dysfunction as regards production of steroid hormones with full impact on female fertility (hormone disruptors).

Adult↗
PubMed1998

[Effect of oocyte transportation (IVF transport) on effectiveness of the IVF and ET program].

The programme of in vitro fertilization helps at present an ever increasing number of married couples to resolve successfully the problem of sterility. It is however a method pretentions technically, as regards time, material and in particular funds. This applies above all to embryological laboratories. The transport system of the IVF programme makes possible care of patients indicated for sterility treatment by the IVF method in departments without their own embryological laboratory and thus it is possible to include more patients in the programme and save money. In the author's department the first two stages of the IVF programme are implemented, i.e. stimulation of the ovaries and aspiration of follicular fluid. Then this material is taken in a transport box of the K-system Co., Denmark, type G-81E to a centre with full accreditation where the subsequent stages of the IVF programme take place (selection of the oocyte, fertilization, cultivation of embryos and embryo transfer). The transport system has operated now for three years (1995-1997) and at present the authors evaluate the system. The fertility rate and pregnancy rate in individual years was compared and the following conclusions were reached: The fertility rate is significantly (at the 1% level) lower in the transport centre in 1995 and 1996 (47%, 54%) as compared with the other centre the laboratory of which is used by the authors (57%, 61%). In 1997 the difference is no longer significant (63% x 64%). The difference in the pregnancy rate in centres for aspiration and embryo transfer in both centres is insignificant in the years of investigation. It may thus be stated that the oocyte transport does not have a negative influence on the effectiveness of the IVF + ET programme (same pregnancy rate) and thus makes it possible to include a greater and ever increasing number of patients in the IVF programme by making use of reserve capacities of embryological laboratories and thus reduce the total costs of this programme.

Embryo Transfer↗
PubMed1998

[Ultrasonic imaging of the lower urinary tract in women with urinary stress incontinence and in women after the Burch colpopexy].

The prevalence of urinary incontinence varies from 5% in young to 50% in elderly women. The weak anatomical support of the urethrovesical junction, base of the urinary bladder and proximal urethra lead to its prolapse and hypermobility which is considered the main anatomical basis of stress incontinence. The majority of surgical procedures which resolve this problem describes elevation of the cervix of the urinary bladder. The final step of these operations, i.e. how much the urethrovesical junction should be pulled up, is described only rarely and superficially. The clinical consequence which may develop are complications associated with hypercorrection of the posterior urethrovesicular angle, i.e. problems with micturition-difficult micturition, or stage-wise micturition and symptoms of detrusor instability. The objective of the present investigation was: to analyze ultrasonic parameters of the lower urinary tract in women with stress incontinence (GSU), furthermore in women after colpopexy by Burch's method, and with regard to these results, possibly modify the surgical procedure. In the investigation in the first group 30 women were enlisted with confirmed stress incontinence. The second group was formed by 30 women three to nine months after colpopexy. The ultrasound examination was made by the perineal and introital route with the patient in a supine position, using a Acuson 128 XP 10 apparatus with a convex probe with a frequency of 5 MHz and by means of as vaginal probe with a frequency of 7.0 MHz. Assessment of the site and mobility of the urethrovesical junction was made by the transperineal route by means of a convex probe with a 300 ml filling of the urinary bladder; after micturition assessment of the areas of the urethral sphincter in a vertical and horizontal plane followed. In the vertical plane and anterior surface of the sphincter also the blood flow was measured and the pulsatile index (PI) and resistance index (RI) were assessed. The authors investigated also the thickness of the pelvic floor muscles and in the vertical plane the thickness of the urinary bladder wall on the anterior wall, in the vertex and in the area of the trigon. The authors found significant differences in ultrasound parameters in groups of women with GSI and women after colpopexy as regards the site and mobility of the urethrovesical junction and thickness of the urinary bladder wall (p < 0.01). In women with symptoms of urgency after colpopexy the authors found a mean thickness of the urinary bladder wall of more than 5 mm and mean values of the gamma angle smaller than 40 degrees and they recorded also a reduced mobility of the urethrovesical junction. These findings confirmed their expectations that in women with persisting symptoms of urgency frequently slight hypercorrection of the position of the urethrovesical junction is involved. These findings are important for the correction of the surgical approach and the evaluation of the above mentioned parameters is helpful in the diagnosis of urgency.

Female↗
PubMed1997

[Tolerance and effectiveness of propiverine hydrochloride in 752 patients with symptoms of detrusor hyperactivity and increased sensitivity and irritability of the urinary bladder: results of a study monitoring drug utilization].

In a post-marketing surveillance study of 752 patients suffering from urgent incontinence, mixed urgent-stress incontinence, reflex incontinence, urgency and enuresis were treated with propiverine hydrochloride. Clinical efficacy of propiverine hydrochloride was verified by the improvement of symptoms related to detrusor hyperactivity, hypersensitivity and hyperreflexia during a 12-week surveillance period: daytime and overnight urinary incontinence, as well as the frequency, nocturia, urgency in day time and at night decreased. These results are well demonstrated by decreased pad use and statistically significant decrease of Gaudenz urgency score during treatment, confirming the efficacy of propiverine hydrochloride already proved in clinical trials. The safety profile of propiverine hydrochloride displayed characteristic anticholinergic symptoms (dry mouth, accommodation disorders, constipation, tiredness, dizziness) with decreasing incidence during the 12-week treatment period. The residual urine volume decreased also. Serious adverse events were observed rarely and could be explained by the lack of consideration of contraindications, warnings and interactions with other drugs. The positive risk-benefit relationship of propiverine hydrochloride in the treatment of detrusor hyperactivity, hypersensitivity and hyperreflexia was reconfirmed in this post-marketing drug surveillance study.

Adolescent↗
PubMed1997

[Sactosalpinx, one of the factors affecting the results of in vitro fertilization].

The tubal factor of sterility is nowadays already a classical and also the most frequent indication for including the patient in a programme of in vitro fertilization--embryo transfer (IVF-ET) [3]. Tubal sterility has a multifactorial etiology. The causes include unilateral or bilateral sactosalpinx, distal and proximal obstructions, intraluminal or extramural adhesions. In many patients with damaged oviducts who were included in our IVF programme we recorded repeatedly failures despite an adequate ovarian response to the stimulation by menogonadotropins, uncomplicated collection of oocytes, equal numbers of collected oocytes, similar fertilization and embryo transfer of high standard embrya. In this group of patients sactosalpinx was frequently encountered. Recent investigations assume that the presence of sactosalpinx reduces the implantation rate, pregnancy rate, increases early gestation losses and the incidence of extrauterine pregnancies [12, 5, 14]. In the submitted paper the authors evaluated the possible effect of sactosalpinx on the results of the IVF-ET programme.

Adult↗
PubMed1996

[Ultrasonographic hysterosalpingography].

The objective of the investigation was to compare US hysterosalpingography with methods currently used to examine tubal patency, i.e. hysterosalpingography and laparoscopy with chromoperturbation. The examination was made in 39 women with the diagnosis of primary or secondary sterility. Consistent with data in the literature, the authors proved a high concordance (86.8%) with reference methods. US HSG is an ambulatory minimally-invasive method of examination of the uterine cavity and patency of the oviducts, which is well tolerated by patients.

Adult↗
PubMed1995

[The transport system in the in vitro fertilization program].

The programme of in vitro fertilization helps at present successfully to resolve the problem of sterility in an ever increasing number of married couples. It is, however, a method which is very pretentious from the technical aspect, from the aspect of time and financial demands. Therefore in February 1994 with the Institute for the Care of Mother and Child in Prague-Podolí collaboration in the Transport IVF programme was started. In our clinic the first two stages of the IVF programme are implemented, i.e. stimulation of the ovaries and aspiration of the follicles. The patients of our centre for sterility are included in the programme, if the following indications are present: tubal factor 82%, idiopathic sterility 4%, the remainder being endometriosis, andrological factor and others. The majority of women were in the age group from 30-35 years. Stimulation is most frequently implemented by GnRh analogues and menopausal gonadotropins, aspiration of follicles by the transvaginal route with short analgosedation under so-called semi-ambulatory conditions. The aspirated follicular fluid is immediately stored in a special transport incubator G-812 of K-system Co., Denmark. Within 20 minutes it is taken by the patient's husband to the embryological laboratory of the Institute for the Care of Mother and Child in Prague-Podolí. Between February and December 1994 a total of 69 aspirations in 56 patients were made and 15 pregnancies were achieved. It is 23% pregnancies by transfer.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Cytodiagnosis and premature birth in light of the Bethesda system].

1. Evaluation of cytological cervico-vaginal smears by the Bethesda system enlisted cytodiagnostics among important laboratory methods which can be used also in risk pregnancies. 2. Vaginal cytology makes it possible to test at the same time the hormonal situation during pregnancy, which reflects the placental function, and to evaluate also the vaginal biocenosis. 3. The authors provided evidence that the large number of superficial cells on the cytological smear (more than 10%) is associated with low oestriol and pregnandiol levels which are warning signs of the approaching termination of pregnancy. 4. By the action of microorganisms on the vaginal epithelium typical morphological changes develop in the cell nucleus and in the cytoplasm. By polychromatic staining also the causal agents of inflammations and infections threatening the mother and foetus are apparent. 5. The authors assume that cytological examination and evaluation according to the Bethesda system should be included in the complex of antenatal examinations also in women without clinical symptoms of premature delivery or without signs of vaginal infection.

Cervix Uteri↗
PubMed1993

[Diagnosis and therapy in fetuses at risk in Rh isoimmunization].

The objective of the work was to evaluate the importance of antenatal examination of amniotic fluid and foetal blood in case of suspected Rh isoimmunization of the foetus. In 1991-1992 in 16 patients with a rise of the titre of anti-D antibodies to > 1:8 between the 24th and 36th week of gestation 32 punctures of the umbilicus by means of a 22 gauge needle were made under continual ultrasonic control. In two instances intraumbilical transfusion was indicated. The authors revealed that with the rising titre of anti-D antibodies in maternal blood the foetal haematocrit value in the umbilical blood declines. With the rising bilirubin level the haematocrit declines. In foetuses with a haematocrit of < 31% severe forms of jaundice are encountered more frequently with the necessity of long-term phototherapy and exchange transfusion. The authors did not find a correlation between the haematocrit of foetal blood and the bilirubinoid concentration in amniotic fluid, assessed by Liley's method. Foetuses with a haematocrit higher than 31% are not threatened by severe forms of jaundice and therefore the authors do not use transfusions in these foetuses. Based on hitherto assembled experience, the authors confirmed that cordocentesis is associated with a comparable risk as amniocentesis but provides more accurate information on the state of the foetus.

Amniocentesis↗