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Biomedical subjects

M Vignali

Publications and source records attributed to M Vignali.

At least 73 records · Page 4Linked to original sources
PubMed1996

Intrauterine adhesions: detection with transvaginal US.

PURPOSE: To evaluate the reliability of transvaginal ultrasonography (US) in the diagnosis of uterine adhesions. MATERIALS AND METHODS: Transvaginal US was performed before hysteroscopy as part of the routine diagnostic work-up in 77 women who had repeated spontaneous abortions. The sensitivity, specificity, and positive and negative predictive values were calculated for transvaginal US in the diagnosis of uterine adhesions. Hysteroscopic findings were considered the reference. RESULTS: Uterine adhesions were correctly identified with transvaginal US in 10 of 11 women in whom this finding was subsequently confirmed at hysteroscopy. The adhesions were minimal in 10 instances and moderate in one. The sensitivity of transvaginal US was 91%, the specificity was 100%, the positive predictive value was 100%, and the negative predictive value was 98.5%. CONCLUSION: Transvaginal US, which is a noninvasive and relatively inexpensive procedure, seems to be effective in screening for uterine adhesions in a population at risk.

Abortion, Spontaneous↗
PubMed1996

Success in inducing ovulation in a case of premature ovarian failure using growth hormone-releasing hormone.

Ovulation was obtained in a 29-year-old woman affected by premature ovarian failure who had previously failed to respond to two attempts performed administering human menopausal gonadotropin or follicle-stimulating hormone after the spontaneous gonadotropin production was suppressed using a gonadotropin-releasing hormone analog (buserelin). Induction of ovulation succeeded when 1000 mg/day growth hormone-releasing hormone was added to the induction scheme. Five mature follicles were obtained after 27 days therapy and the serum level of 17 beta-estradiol was 975 pg/ml (195 pg/ml per follicle) at the time of human chorionic gonadotropin administration.

Adult↗
PubMed1996

Urinary tract anomalies associated with unicornuate uterus.

PURPOSE: We investigated the association between the various subclasses of the unicornuate uterus and urinary tract anomalies. MATERIALS AND METHODS: We studied the urinary tract of 37 patients with a unicornuate uterus by urography and/or ultrasonography. Unicornuate uterus was diagnosed at laparoscopy or laparotomy. RESULTS: A total of 15 patients (40.5%) had urinary tract anomalies, including ectopic kidney in 4, renal agenesis in 6, double renal pelvis in 2, horseshoe kidneys in 2 and unilateral medullary sponge kidney in 1. No differences were observed in the frequency of urinary anomalies among the various subclasses of unicornuate uterus. CONCLUSIONS: Our results indicate the need to suspect a urinary tract anomaly, particularly of the kidney, in all women with a unicornuate uterus.

Abnormalities, Multiple↗
PubMed1996

Use of growth hormone-releasing factor in ovulation induction in poor responders.

OBJECTIVE: To evaluate the effect of growth hormone-releasing factor (GRF), given in addition to follicle-stimulating hormone (FSH), after pituitary down-regulation, on follicular development in poor responders. GRF was added in a prospective, randomized manner to an existing stimulation protocol. STUDY DESIGN: Forty-two women, demonstrated to be poor responders in previous attempts at induction of ovulation, were included in the study. Follicular stimulation with FSH was started after pituitary downregulation obtained using gonadotropin-releasing hormone agonist (GnRH-a). GRF, 1,000 mg/day, was given in addition to FSH to 22 patients randomly chosen until human chorionic gonadotropin administration. RESULTS: The number of ampules of FSH needed to obtain follicular growth was significantly reduced in the group of women who received GRF. Also, the number of follicles obtained was higher and the days of treatment generally reduced. However, a greatly beneficial effect for some women was observed, while a second subgroup did not have any. No differences were observed in follicular steroid and insulin growth factor 1 (IGF-1) between GRF patients and controls or in serum IGF-1 between the two subgroups of patients who received GRF. CONCLUSION: In vivo administration of GRF with FSH after pituitary down-regulation may be beneficial for some poor responders, although prognostic criteria could not be established. However, the use of GRF does not seem to influence the chance of obtaining pregnancy; it remains low in these patients.

Adult↗
PubMed1995

Basic fibroblast growth factor messenger ribonucleic acid levels in eutopic and ectopic human endometrial stromal cells as assessed by competitive polymerase chain reaction amplification.

Previous studies have localized basic fibroblast growth factor (bFGF) and its mRNA in normal and neoplastic endometrium but the expression of bGFG mRNA in endometriosis cells is virtually unknown. Our purpose was to investigate the presence of bFGF and its receptor mRNAs in highly purified primary cultures of stromal cells isolated from six eutopic endometrial samples obtained from patients without evidence of endometriosis and five endometriosis cyst linings. Using reverse transcriptase-polymerase chain reaction (RT-PCR), single major DNA bands of the expected sizes for bFGF and its receptor (354 and 661 bp, respectively) were detected in both endometrial and endometriosis samples. A competitive RT-PCR, that uses coprimer extension and amplification of a bovine RNA as an internal standard, was developed for semiquantitative estimation of bFGF gene expression. The target to standard mean ratios +/- SEM in six normal endometrial samples and in five endometriosis cultures were 26.7 +/- 10.7 and 9.2 +/- 3.0, respectively. Furthermore, when data were analyzed according to the cyst diameter, levels of bFGF mRNA resulted statistically higher (P < 0.05) in bigger cysts when compared to those detected in smaller ones (16 +/- 2.7 and 4.7 +/- 1.8, respectively). These results demonstrate that the genes coding for bFGF and its receptor are expressed in endometriosis cells, but levels of bFGF mRNA are generally lower than those detected in their eutopic counterpart. Moreover, they indicate that endometriosis cells derived from large cysts have increased bFGF mRNA levels. Thus, bFGF could be one of the factors responsible for a more or less active behavior of the endometnotic lesion.

Base Sequence↗
PubMed1995

Separation and quantitation of reverse transcriptase polymerase chain reaction fragments of basic fibroblast growth factor by capillary electrophoresis in polymer networks.

In human ovarian carcinomas (epithelial and endometrial tumors) the presence of mRNA coding for the basic fibroblast growth factor (bFGF) was previously demonstrated by reverse transcription-polymerase chain reaction (PCR). For quantitation purposes, competitive PCR is adopted, using a competing fragment a sequence of a highly homologous bovine bFGF. However, separation and detection of the PCR products by slab gel electrophoresis and ethidium bromide staining gives poor quantitative data due to the nonstoichiometric binding of the dye. Thus, the only possible quantitation that can be obtained is via autoradiography with 32P-labeled primers. We report here a capillary electrophoresis protocol, in 6% linear, liquid polyacrylamide as a sieving system, able to fully resolve and quantify the undigested (354 bp) bovine and the digested (295 bp and 59 bp) human fragments, with peak ratios in good agreement with the autoradiographic data.

Adrenal Cortex↗
PubMed1995

Effects on bone mineral density of 12-month goserelin treatment in over 40-year-old women with uterine myomas.

We evaluated the effects on bone mineral density (BMD) of a 12-month treatment with goserelin depot, a gonadotropin-releasing hormone agonist, in a group of women with symptomatic uterine myomas requiring hysterectomy. Sixteen women, mean age 45.6 +/- 5.0, reporting menorrhagia associated with uterine myomas, candidates for hysterectomy, were scheduled to be treated with goserelin depot for 12 months. BMD was measured at the vertebral (L2-L4) and proximal femur level (femoral neck and trochanter) at the start of therapy and 6, 12, and 18 months later using dual energy X-ray absorptiometry (Hologic QDR 1000/W). The patients were followed for a minimum of 6 months after the end of treatment. Thirteen of the 16 women enrolled completed the treatment and three suspended it after 5, 6, and 7 months, respectively, because of side effects (hot flashes, insomnia, depression). Of the 13 women who completed the treatment, three underwent hysterectomy because of myoma regrowth and the recurrence of symptoms 3-18 months later; four reached the menopause 5-16 months later, and six were all menstruating normally with a follow-up varying from 6 to 18 months. After 12 months of therapy we observed a bone loss at vertebral, femoral neck, and trochanter of 4.4% (P < 0.05 versus baseline; P = not significant versus 6 months), 7.5% (P < 0.01 versus baseline, P < 0.01 versus 6 months), and 7.6% (P < 0.001 versus baseline, P < 0.05 versus 6 months), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Basic fibroblast growth factor and ovarian cancer.

The factor(s) which regulate the rapid growth of ovarian epithelial carcinoma, as well as other types of malignant tumors, are still largely unknown. Recently, experimental evidence indicated that neoplastic cells are able to synthesize peptide growth factor and their receptors. This autocrine secretion could be one of the mechanisms to sustain their abnormal proliferation. In this study, we evaluated the possible role of basic fibroblast growth factor (bFGF) that is a likely candidate because it has both angiogenic and mitogenic activity and has been found in a variety of other neoplasms. As assessed by both bioassay and radioimmunoassay, a bFGF-like protein was present in seven ovarian epithelial neoplasms and in primary culture of dispersed ovarian cancer cells. Levels of this protein as well as its bioactivity varied in the different tumors examined. Reverse transcription-polymerase chain reaction indicated that the genes for bFGF and its receptor are expressed in all the samples studied. These data suggest that bFGF might be one of the growth factor regulating ovarian cancer cell proliferation through an autocrine mechanism. We are currently investigating whether the expression of this growth factor varies as a function of the histologic grade of the tumors.

Biological Assay↗
PubMed1994

Options for primary chemotherapy in advanced ovarian cancer: the European perspective.

Primary chemotherapy for ovarian cancer has evolved over the past 30 years from the use of single alkylating agent to several combination regimens. Treatment strategies, however, vary greatly both nationally and internationally, since no firm results can be derived from available data. Five questions can be identified: (1) Should primary chemotherapy consist of single agent or combination? (2) Should it include doxorubicin? (3) Is cisplatin or carboplatin preferred? (4) Which is the role of cisplatin dose intensity? (5) Should it include taxol? Available data from the European experience are discussed. Final considerations include: (1) Platinum combinations are more effective than single agent platinum when this drug is used at the same dose (now considered lower than current standard). (2) CAP offers a survival benefit of 7% at 6 years compared to CP. However, in most trials dose intensity was higher in CAP than in CP. (3) Cisplatin and carboplatin are equally effective. (4) There is no survival benefit when doubling the dose intensity of cisplatin over 25 mg/m2/week. (5) A confirmatory study will help define the contribution of Taxol in the first-line treatment of ovarian cancer, when administered at 175 mg/m2 over a 3-hr infusion in association with cisplatin.

Antineoplastic Agents↗
PubMed1994

Laparoscopic creation of a neovagina in Mayer-Rokitansky-Küster-Hauser syndrome by modification of Vecchietti's operation.

A neovagina was created by a laparoscopic modification of Vecchietti's operation in two women with Mayer-Rokitansky-Küster-Hauser syndrome. A plastic olive was applied to the vaginal dimple and pulled upward by two threads passed through the potential neovaginal space at laparoscopy, without the need for laparotomy or dissection of the vesicorectal space. In both cases we obtained very good results in anatomic and sexual functional terms.

Adult↗
PubMed1994

Gestrinone inhibits macrophage function and mitogen-stimulated lymphocyte proliferation in vitro.

Clinical and experimental evidence supports the hypothesis that some steroidal drugs with androgenic effects might influence the immune system. The present study investigated whether gestrinone is able to affect macrophage and lymphocyte activity in vitro. Macrophage function was determined by phagocytosis of fluorescent microspheres, whilst lymphocyte proliferation was assessed by cell counting. Macrophage phagocytosis was evaluated after an overnight incubation in the presence or absence of gestrinone at serial dilutions; lymphocyte proliferation was detected in basal conditions and after stimulation with Concanavalin A (Con A) in the presence or absence of gestrinone. The results of this study showed that gestrinone significantly inhibited macrophage phagocytosis at the concentrations of 10(-8), 3 x 10(-8) and 10(-7) M. Furthermore, a significant suppression of lymphocyte blastogenesis was observed when lymphocytes were incubated with gestrinone at the concentration of 10(-7) M for 6 days. The biological significance of gestrinone as an inhibitor of immune functions under experimentally defined conditions is discussed in relation to its potential mechanism for fertility enhancement.

Adult↗
PubMed1994

Pre-operative cervical preparation before first trimester missed abortion: a randomized controlled comparison between single or double intracervical administration of PGE2 gel.

The aim of this study was to evaluate whether a single intracervical application of prostaglandin E2 (PGE2) gel is as effective as a repeated administration with respect to the % of curettage for a missed abortion and to incidence of side effects. 32 consecutive patients with ultrasonographic diagnosis of missed abortion from 6th-13th week of gestation were randomly allocated to either single (group A) or repeated, 2 h apart (group B), intracervical application of PGE2 gel. No differences were observed in cervical dilatation before the administration of the gel between the two groups. In group B, evaluation of cervical dilatation 2 h after the first administration of PGE2 gel and before the second one did not show significant changes as compared to baseline values. The degree of cervical dilatation before surgery was significantly improved as compared to the initial dilatation in both groups; no significant difference was observed between the two study groups. A single administration of PGE2 gel followed by surgery 5 h later has the same effectiveness on cervical dilatation but fewer side effects than repeated administration of the drug 2 h apart.

Abortion, Missed↗
PubMed1994

Effects of the coculture with human endometrial cells on the function of spermatozoa from subfertile men.

OBJECTIVE: To evaluate the effects of a coculture with human endometrial cells on the function of spermatozoa from samples obtained from infertile couples. DESIGN: In a prospective study, human spermatozoa selected by swim-up from fresh samples were cultured on human endometrial feeder layers. Thereafter, their viability, motility, acrosome integrity, and ability to penetrate zona-free hamster oocytes were evaluated. Spermatozoa from the same samples incubated under the same conditions but in the absence of endometrial cells, as well as in the medium previously spent for cell culture, were used as controls. SETTING: Andrology Laboratory of the Infertility Center of San Raffaele Hospital. PATIENTS: Spermatozoa were obtained from 17 infertile men attending the Infertility Center at our hospital. RESULTS: Spermatozoa incubated in the presence of endometrial cell feeder layers did not differ from controls with regard to their viability or motility. Conversely, the percent spontaneous acrosome reactions after 18 hours of incubation was significantly higher for spermatozoa cocultured (19.7 +/- 2.2 versus 11.2 +/- 1.9; mean +/- SE). The mean number of spermatozoa penetrating hamster oocytes was also significantly improved (1.24 +/- 0.3 versus 0.68 +/- 0.24). This effect did not seem to be solely due to the secretion of soluble factors by endometrial cells in the medium, in that spermatozoa incubated in the medium spent for endometrial cell culture had a similar acrosome reaction percentage but a lower rate of hamster egg penetration. CONCLUSIONS: The coculture with human endometrial cells appeared to be beneficial for improving the sperm function. This effect partially may be due to the secretion of steroids in the medium, which increases the quota of spontaneous acrosome reaction and in part due to the direct contact of cells with spermatozoa, maybe for the detoxification of the medium or the release of trophic factors. Coculture might be a promising approach to preparing spermatozoa for assisted fertilization in cases of subfertile males.

Acrosome↗
PubMed1994

Evolution of codon usage and base contents in kinetoplastid protozoans.

In this study we analyze and compare the trends in codon usage in five representative species of kinetoplastid protozoans (Crithidia fasciculata, Leishmania donovani, L. major, Trypanosoma cruzi and T. brucei), with the purpose of investigating the processes underlying these trends. A principal component analysis shows that the G+C content at the third codon position represents the main source of codon-usage variation, both within species (among genes) and among species. The non-Trypanosoma species exhibit narrow distributions in codon usage, while both Trypanosoma species present large within-species heterogeneity. The three non-Trypanosoma species have very similar codon-usage preferences. These codon preferences are also shared by the highly expressed genes of T. cruzi and to a lesser degree by those of T. brucei. This leads to the conclusion that the codon preferences shared by these species are the ancestral ones in the kinetoplastids. On the other hand, the study of noncoding sequences shows that Trypanosoma species exhibit mutational biases toward A + T richness, while the non-Trypanosoma species present mutational pressure in the opposite direction. These data taken together allow us to infer the origin of the different codon-usage distributions observed in the five species studied. In C. fasciculata and Leishmania, both mutational biases and (translational) selection pull toward G + C richness, resulting in a narrow distribution. In Trypanosoma species the mutational pressure toward A + T richness produced a shift in their genomes that differentially affected coding and noncoding sequences. The effect of these pressures on the third codon position of genes seems to have been inversely proportional to the level of gene expression.

Animals↗
PubMed1994

Expression of intercellular adhesion molecule-1 (ICAM-1) on cultured human endometrial stromal cells and its role in the interaction with natural killers.

PROBLEM: Recent evidence emphasizes the role of natural killer cells (NKs) as potential effectors of peritoneal immune surveillance directed against the outgrowth of endometrial cells, refluxed with menstrual debris, in ectopic sites. This NK-mediated cytotoxicity toward autologous endometrial antigens seems to be significantly decreased in endometriosis patients. METHOD: We set up experiments to clarify which molecules are involved in NK-endometrial cell interaction. In particular, we evaluated the surface expression and functional activity of intercellular adhesion molecule-1 (ICAM-1), a cell surface glycoprotein that has been identified as one of the ligands for lymphocyte function-associated antigen-1 (LFA-1), present on almost all leucocyte cell types. Immunofluorescence flow cytometry was used to assess ICAM-1 expression on resting and IL 1 beta-activated endometrial stromal cells in culture. Dermal fibroblasts were used as control cells. Cytotoxicity and binding assays by 51Cr release in presence and absence of a specific monoclonal antibody (mAb) against ICAM-1 were then performed in order to determine the effect of this molecule on NK-mediated cytotoxic and binding activity toward endometrial stromal cells. RESULTS: The results of this study indicated that ICAM-1 expression on endometrial stromal cells seems to be constitutively higher than on dermal fibroblasts and can be up-regulated upon exposure to IL 1 beta. Furthermore, a mAb against ICAM-1 strongly inhibits the binding but not the cytotoxicity of NKs toward endometrial cells. No difference in the expression of this molecule was observed throughout the cycle. CONCLUSIONS: The presence of ICAM-1 on human endometrium might relate to the action of the immunocompetent cells in human specific reproductive events.

Adult↗