Biomedical subjects
Publications and source records attributed to J Rotman.
An acardiac fetus is an extremely rare anomaly occurring only in twin pregnancies and its etiology is still controverted. Sonography must permit an early diagnosis, in order to anticipate the risks of the pregnancy and the delivery, as well as the future of the second twin.
The effects of a single im injection of 10,000 IU of hCG on testicular steroid secretions were studied in 15 normal men and 54 patients with varicocele. Plasma levels of the following steroids were determined by radioimmunoassay: T, DHT, A, DHA, 5Adiol, E1, E2, 5P, 170H5P, 170HP, E1S, E2S, TE1, TE2, DHAS, 5AdiolS and hCG as well as FSH and LH in baseline samples. In normal men, peripheral venous blood was collected at 0, 1, 2, 4, 6, 8, 24, 36, 48, 72 and 96 h after hCG. Three types of steroid response were observed. The first, biphasic with an early peak within 2 h and a delayed one after 24 h, was shown by T, its unconjugated precursors and DHT. The second with an early rise plateauing for 6 h and followed by a 36 h peak characterized the estrogen pattern. Finally DHAS did not demonstrate a significant increase but 5AdiolS fluctuated at higher levels than the baseline ones. A significant correlation was only observed between hCG maximum value and E2 and TE1 maximum relative responses. In the patient group, peripheral blood was collected at 0, 1, 1.5, 2, 4, 6, 8, 10, 24 and 48 h after hCG. Baseline levels of all steroids were similar in the two groups. After hCG the same delayed pattern was observed as in the controls. The early relative response was low for T while A, DHT, E2 and E1S levels decreased. Conversely 170HP was higher until 24 h. Spermatic vein blood was collected before and at 1.5, 24 and 48 h after hCG. Steroid baseline levels in the varicocele side were similar to the other. After hCG, despite very large variations, general steroid patterns were comparable to those observed in peripheral vein blood. The important fall at 24 h of T/170HP and T/170H5P concomitant with that of T/E2 might be related to an inhibition of C17-20 lyase activity. The testicular secretion of all the measured steroids, including E1S, could be demonstrated except for DHAS. From our findings, a biogenetic defect evidenced by the fast response to hCG administration might exist in varicocele patients. In view of these results, the protocol of the hCG test should be improved using more frequent blood sampling and determining, besides T, its precursors and estrogen conjugates.
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Fourteen tubo-uterin implantations for endometriosis of the horn and infertility have been carried out. They have been made with microsugery with a reversed transcornual T access. The setting of a retractor pushing off the edges of the uterin muscle allows the removing of the pathological zone, allows also not to hurt the vascularisation during the dissection of the nodule, and allows also to suture edge to edge the tube to the uterus under microsurgical control. This original process allows a new setting up of the continuity (Ten permeabilities cheked with hysterography 2 pregnancies and 2 obstructions among 14 cases after a passing of less than 1 year).
65 salpingostomies were carried out using microsurgical techniques between 1976 and 1978. The patency rate was 89 p. 100. There were 30 p. 100 intra-uterine pregnancies and 4 p. 100 ectopic pregnancies. The authors emphasize the prognosis that can be obtained from hysterosalpingography, laparoscopy and histological examination of the tissues and the very poor results that are obtained even using these methods when a second operation is undertaken.
We report a histological study of a microsurgical tubo-tubal anastomosis undertaken to restore patency after ligation. It confirms the good level of tissue tolerance of the suture material employed. It emphasizes the difficulty of anastomosis in the ampulloisthmial region because of the discrepancy in size of the parts that have to be brought together. From this we can emphasize the need for carrying out sterilizations only on a limited lenght of the isthmus.
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The levels of oestradiol and of testosterone were estimated in the spermatic and in the perpheral veins in two series of 13 subjects. The one was a control group and the other stimulated with 10,000 International Units of chorionic gonadontrophir (II.C.G). The follwing conclusions can be drawn. --the first is that the testis secretes simultaneously testosterone and oestradiol 17 beta --the second is that the level of oestradiol is significantly raised after the administration of II.C.G. whereas the level of testosterone hardly alters. This leads on to the supposition that oestradiol does not arise from the same source in the testis as testosterone.
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After they had analysed 50 cases of varicocoele the authors decided to put in writing some of their ideas. They conclude that varicocoele is often sub-clinical, localised to the right side, bilateral only in a number of cases. Although neither the sperm count nor the histology of the testes show specific pathological features, treatment of the condition brings worthwhile rewards. About 40% of patients father pregnancies.
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The most typical disorder encountered during the menopause is the sudden flush, but the etiopathogenicity of these disorders is still a matter of hypotheses only. Increased levels of FSH and LH have been evoked ; recent cutaneous temperature studies have demonstrated a significant increase in LH but not of FSH, E1, and E2, during sudden flushes. The degree and rapidity of estradiol level variations have also been suggested as relevant factors. Current opinion conduces to be favoured with the involvement of gonadotropins, catecholamines, and indolamines, and perhaps prostaglandins at the hypothalamic level. Whatever the cause may be, vasomotor flushes are present in 55 to 75 % of menopausal women, and may be accompanied with sudoral crises, palpitations, or lipothymia. Women with a harmonious family life are better able to endure these disorders, treatment being most necessary when they result from a greatest disorder. Therapy is essentially estrogen therapy (after exclusion of cancer), progestogens, or veralipride, a non hormonal agent which produces 80 % of positive results, without apparently the disadvantage of estrogen therapy.