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J Rabinovici

Publications and source records attributed to J Rabinovici.

At least 55 records · Page 3Linked to original sources
PubMed1990

Human recombinant activin-A inhibits proliferation of human fetal adrenal cells in vitro.

Activins and inhibins are dimeric peptides which are structurally and functionally related to transforming growth factor-beta (TGF-beta). The mRNA for the activin and inhibin subunits is expressed in the adrenal gland. Because members of the TGF-beta superfamily have effects on mitogenesis, we examined the effect of recombinant human activin-A (rh-activin-A) on proliferation of midgestation human fetal adrenal cells in vitro. Dose-dependent growth inhibition by rh-activin-A was obtained, with an ED50 of 1 ng/ml. Rh-activin-A inhibited basal and epidermal growth factor (EGF)-stimulated fetal zone cell proliferation, but did not alter basic fibroblast growth factor (bFGF)-stimulated growth. TGF-beta combined with rh-activin-A demonstrated additive inhibition of fetal adrenal growth. These findings suggest a potential autocrine or paracrine role for activin-A in modulating the growth and/or subsequent involution of the human fetal adrenal gland.

Activins↗
PubMed1989

Transcervical chorionic villi sampling: a comparison between the silver cannula and the Portex catheter.

The Portex catheter and the silver cannula are two of the most widely used biopsy devices for chorionic villus sampling. In a prospective randomized study we used these two devices alternatively in 168 women. Significantly more trophoblastic tissue was obtained with the silver cannula than with the Portex catheter (p less than 0.05) while significantly more failures to obtain villus tissue were recorded with the Portex cannula (8/84 with the silver cannula vs. 19/84 with the Portex cannula; p less than 0.05). In 27 cases where use of the device met with failure to obtain chorionic villi after three attempts the other instrument was then used in the same patient (combined group). Four pregnancies aborted spontaneously after the procedure (2.4%). Significantly more complications occurred in the 'combined' group (4/27 vs. 4/168, p less than 0.05). A higher yield of trophoblastic tissue is possible with the silver cannula than with the Portex catheter.

Catheterization↗
PubMed1989

In vitro fertilization and primary embryonic cleavage are possible in 17 alpha-hydroxylase deficiency despite extremely low intrafollicular 17 beta-estradiol.

Congenital adrenal hyperplasia due to 17 alpha-hydroxylase deficiency in genotypic females is characterized by primary amenorrhea and the absence of sexual maturation due to inadequate biosynthesis of ovarian androgens and estrogens. We induced ovarian follicular development in a woman with this syndrome. Ovum pick-up, in vitro fertilization, and primary embryonic development were achieved despite undetectable plasma estradiol and extremely low ovarian androgen concentrations and minute concentrations of these hormones in the ovarian follicular fluid.

Adrenal Hyperplasia, Congenital↗
PubMed1989

Ciliary ultrastructure of respiratory and fallopian tube epithelium in a sterile woman with Kartagener's syndrome. A quantitative estimation.

Ciliary ultrastructure was studied and quantitatively estimated in a 27-year-old sterile woman suffering from complete KS. Ciliated epithelium was obtained from both nasal mucosa and a fallopian tube. Cilia from both locations were devoid of DA. Various MT abnormalities were found in 16 percent of respiratory epithelial and 21 percent of fallopian tube ciliary cross-sections. The abnormality related to radial spoke defect was frequently seen. The findings in the fallopian tubes were compared to three normal control cases. In these, DA were visible, and MT defects were mainly of excess or missing microtubules. The relevance of these findings to fertility is not clear.

Adult↗
PubMed1988

Iatrogenic mechanical ileus due to over-distended uterus.

The combination of an over-distended uterus caused by a multiple-fetus pregnancy with therapeutic bed-rest may cause mechanical ileus. Iatrogenic triggering of a pathological consequence of events is presented in purpose to highlight the simplicity of its prevention.

Adult↗
PubMed1988

Internal podalic version with unruptured membranes for the second twin in transverse lie.

Internal podalic version of the second twin in transverse lie has usually been performed after first rupturing the membranes of the second amniotic sac. In a prospective study on internal podalic version with unruptured amniotic membranes, 11 second-born twins in transverse lie were successfully delivered, with good neonatal outcome and without birth injuries. From our experience, it appears that this modified technique, when used within the presented guidelines, offers a reasonable alternative for the safe delivery of the second twin.

Apgar Score↗
PubMed1987

Randomized management of the second nonvertex twin: vaginal delivery or cesarean section.

Sixty twin deliveries after the thirty-fifth gestational week with vertex-breech and vertex-transverse presentations were managed according to a randomization protocol. Thirty-three parturient women (21 vertex-breech and 12 vertex-transverse presentations) were allocated for vaginal delivery and 27 for cesarean section (18 vertex-breech and nine vertex-transverse). Six pairs of twins in the vaginal delivery group were delivered in a different mode than requested by the protocol (two women underwent cesarean section; in four cases the second twin spontaneously changed to vertex presentation). There were no significant differences between 1- and 5-minute Apgar scores and incidence of neonatal morbidity between the second-born twins in both study groups. Firstborn twins had higher 1-minute Apgar scores than the second-born infants irrespective of route of delivery (p less than 0.05). No case of birth trauma or neonatal death was recorded. Maternal febrile morbidity was significantly higher in the cesarean section group than in the vaginal delivery group (40.7% versus 11.1%, p less than 0.05). These results suggest that in twins with vertex-breech or vertex-transverse presentations after the thirty-fifth week of gestational age the neonatal outcome of the second twin was not significantly influenced by the route of delivery.

Apgar Score↗
PubMed1987

Fetal heart rate changes following external cephalic version under tocolysis near term.

Fifty eight gravidas near-term underwent external cephalic version using tocolytic treatment and continuous fetal monitoring by cardiotocograph and real-time ultrasound. No unfavorable maternal or fetal effects were recorded. Fetal heart rates showed a significant decline at 10 and 30 min after the procedure with complete recovery at 1 h after external version, but no pathologic tracing was recorded. No uniform heart rate patterns due to external cephalic version could be found.

Breech Presentation↗
PubMed1987

Breast stimulation test and oxytocin challenge test in fetal surveillance: a prospective randomized study.

Fifty healthy gravidas with uncomplicated singleton pregnancies at a gestational age of 35 to 42 weeks were assigned at random for the performance of either a breast stimulation test or an oxytocin challenge test after a nonreactive nonstress test. A satisfactory contraction stress test was achieved in 21 of 25 women in the breast stimulation test group and in 24 of 25 women in the oxytocin challenge test group (nonsignificant difference). Significant differences were found in the cumulative rate of achieved contraction stress tests: in the breast stimulation test group 17 of 21 after 20 minutes and 21 of 21 at 50 minutes whereas in the oxytocin challenge test group only four of 24 at 20 minutes, eight of 24 at 50 minutes, and 21 of 24 at 150 minutes. The mean duration for the achievement of a contraction stress test was 20.9 +/- 11.5 minutes for the breast stimulation test group and 81.3 +/- 48.4 minutes in the oxytocin challenge test group. Uterine hyperstimulation occurred once in each group. No gravida went into labor within 24 hours. Breast stimulation test is a satisfactory alternative to the oxytocin challenge test, is less time-consuming, and is simpler to perform.

Adult↗
PubMed1987

Ovarian hyperstimulation syndrome: prediction by number and size of preovulatory ovarian follicles.

Monitoring of human menopausal gonadotropin (hMG) treatment for induction of ovulation according to either preovulatory estrogen levels or the presence of a dominant ovarian follicle was found insufficient to prevent ovarian hyperstimulation syndrome (OHS). In 65 infertile patients treated with hMG and human chorionic gonadotropin (hCG), a possible correlation between the number and size of all ovarian follicles on the day of assumed ovulation and the occurrence of OHS was evaluated in order to assess the value of ultrasonography in predicting OHS. It was found that patients with OHS had significantly more follicles at the time of hCG than patients without OHS. Mild OHS was characterized by the presence of eight to nine follicles, 68.7% of which were of intermediate size (9 to 15 mm). In moderate to severe OHS 95% of the preovulatory follicles were less than 16 mm, most of them (54.7%) less than 9 mm in diameter. It can be concluded that a specific preovulatory follicular configuration characterizes mild and severe hyperstimulation. This is important information before hCG administration and emphasizes the value of ovarian ultrasonography in predicting OHS.

Chorionic Gonadotropin↗
PubMed1987

Rescue of menotrophin cycles prone to develop ovarian hyperstimulation.

In an attempt to prevent the loss of 'overstimulated cycles' associated with human menopausal gonadotrophin (hMG)-induced ovulation, oestradiol levels and ovarian follicular state were monitored in 12 women with 'overstimulated cycles' after withholding hMG for several days. Human chorionic gonadotrophin (hCG) was administered when oestradiol levels were less than or equal to 1700 pg/ml and the leading follicles between 17 and 22 mm in diameter. During the withholding period follicular growth continued in all patients, while oestradiol levels declined in all but three. These three patients conceived. Ovulation was observed in six additional women. Ovarian hyperstimulation did not occur in any of the 12 patients. We conclude that a rescue of 'overstimulated cycles' is sometimes possible. Conception seems to depend on a continuing rise of E2 levels and early detection of 'overstimulation'.

Chorionic Gonadotropin↗
PubMed1987

Changes in plasma norepinephrine in normal labor following isometric contraction.

Changes in norepinephrine following a bimanual handgrip contraction test were used to evaluate the contribution of static physical effort exerted by the parturient on the rise in adrenergic stimulation observed during ongoing labor. Noradrenaline baseline values were 306.71 +/- (SE) 21.5 pg/ml); and after a maximal effort handgrip contraction test rose to 345.07 +/- 29.11 pg/ml (p = 0.11). This increase was less pronounced than found generally in nonpregnant subjects under similar test conditions and suggests a protection of the maternal organism from excessive adrenergic output during labor.

Female↗
PubMed1987

Changing pituitary reactivity to follicle-stimulating hormone and luteinizing hormone-releasing hormone after induced ovulatory cycles and after anovulation in patients with polycystic ovarian disease.

Pituitary reactivity to GnRH, characteristic of polycystic ovarian disease (PCOD), has been attributed both to a primary ovarian cause and to hypothalamic-pituitary dysfunction. If the heightened pituitary reactivity characteristic of PCOD patients is secondary to chronic anovulation, ovulatory cycles should produce changes in the LH to FSH ratio and reduce the augmented response to GnRH. In a randomized cross-over study of 10 women with PCOD, GnRH (100 micrograms) was injected iv on the fifth day of 2 consecutive cycles, 1 of them following anovulation and progesterone withdrawal bleeding and the other following an induced ovulatory cycle. Mean basal plasma 17 beta-estradiol, progesterone, and FSH levels were similar after ovulatory and anovulatory cycles. However, mean basal serum testosterone (P less than 0.05) and LH (P less than 0.01) levels were significantly lower, as were LH levels 30, 60, and 90 min (P less than 0.01) and FSH levels 60 and 90 min (P less than 0.05) after GnRH injection, after an ovulatory cycle than after an anovulatory cycle. The pituitary response to GnRH in those PCOD patients, therefore, was more normal after an ovulatory cycle than after an anovulatory cycle. We conclude that the heightened pituitary reactivity characteristic of PCOD patients is associated with chronic anovulation.

Adult↗
PubMed1986

Impact of a protocol for external cephalic version under tocolysis at term.

We present our experience with 60 trials of external cephalic version under tocolysis (EVT) performed on 58 women with uncomplicated (low-risk) pregnancies at term (37 to 42 weeks) during a 10-month period. Version was successful in 67.2% of the subjects (70.7% of trials). Fetal well-being was monitored before, during and after the procedure by cardiotocography and real-time ultrasound (RTUS). No analgetic or anesthetic medication was administered. Transient fetal bradycardia was recorded in 18 women. No major complications were noted. Compared with the period preceding the protocol, the breech rate declined during the study period by 1.02% (P less than 0.02) with a parallel decline of 1.12% (P less than 0.001) in the low-risk breech group affected by the protocol. The cesarean section rate for low-risk breeches fell from 1.85 to 0.89% (P less than 0.001), while the overall cesarean section rate decreased from 10.15 to 9.1% (not significant). We conclude from our experience and previous studies that EVT/RTUS is a reasonable alternative in the management of pathological presentations near term, provided that only low-risk pregnancies are included, and analgesia or anesthesia for external version under tocolysis is avoided.

Breech Presentation↗