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Biomedical subjects

N Rojansky

Publications and source records attributed to N Rojansky.

At least 55 records · Page 3Linked to original sources
PubMed1994

Myasthenia gravis and preeclampsia.

Serious diagnostic and therapeutic dilemmas may arise when preeclampsia complicates pregnancy in a myasthenic patient. Four cases of such an association were previously reported in the English-language medical literature and the fifth one is reported here. Based on the literature review and our own case, the problems that may arise when myasthenia gravis is complicated by severe preeclampsia during pregnancy are discussed and guidelines for diagnosis and management are suggested.

Adult↗
PubMed1993

Increased imidazoline and alpha 2 adrenergic binding in platelets of women with dysphoric premenstrual syndromes.

An association between dysphoric premenstrual syndromes (PMS) and a lifetime history of major depressive disorders has previously been documented. Other studies have demonstrated an increase in the binding of radiolabeled imidazoline compounds to platelets of depressed patients. Clonidine and related imidazoline compounds interact with alpha 2 adrenoceptors to inhibit neuronal noradrenergic activity and in higher concentrations, they stimulate noradrenergic activity through their interaction with imidazoline receptors. Here we report increased 3H para-aminoclonidine binding to high affinity alpha 2 adrenoceptor sites as well as to nonadrenergic imidazoline binding sites in platelets of women with dysphoric PMS. This higher binding was most pronounced during the late-luteal-symptomatic phase of the menstrual cycle and, to a lesser degree, during the non-symptomatic mid-follicular phase. Binding to the imidazoline site distinguished women with dysphoric PMS from women with no such symptoms, was highly positively correlated with the severity of symptoms, and was negatively correlated with plasma levels of progesterone. These findings suggest that platelet imidazoline binding sites might be a biological marker for dysphoric states in PMS or for the vulnerability to develop them. These findings also point to a possible biological link between dysphoric PMS and major depressive disorders.

Adrenergic alpha-Agonists↗
PubMed1993

The use of fetal tissue for therapeutic applications.

In recent years, dramatic progress has been made through research using dead human fetal tissue. Cellular transplantation is an attractive alternative to organ grafting when only a discrete function of the organ is impaired. Early fetal donor cells have an advantage because they engraft readily and do not cause graft-versus-host disease. Similarly, the fetus is an ideal recipient of allogenic fetal cells as it is incapable of rejecting them early in gestation. Recent research advances have led to its use in endocrine, neurologic and immune system disorders as well as in hematologic and hepatic deficiencies. Concurrently, this research has led to controversy over the ethics of using human fetal tissue, particularly tissue from induced abortions. Although legalized abortion remains a hotly debated controversial issue in the USA and some other countries, a consensus has been forming, in the scientific community, on the ethical use of fetal tissue in research and clinical transplantation. This review presents the theoretical background and recent research and clinical advances in fetal tissue transplantation, in the light of the current debate on its ethical and moral implications.

Aborted Fetus↗
PubMed1992

Seasonality in human reproduction: an update.

A seasonal distribution in human natural conception and birth rates has been consistently demonstrated by epidemiological studies in several geographical areas. Possible hypotheses abound to explain this seasonality. Though a seasonal effect on reproduction is well-documented and has been extensively investigated in mammals, information concerning the influence of seasonal variation and its mechanism on human and primate reproduction is scarce. Recent evidence suggests that deterioration in sperm quality during the host summer in sub-equatorial areas, may result in lower conception rates leading to a reduction in the birth rate in spring. In northern countries, however, in regions where a strong seasonal contrast in luminosity exists, activity of the anterior pituitary-ovarian axis and the conception rate are decreased during the dark winter months. In these areas, inversely, a peak in conception rate during summer leading to a maximum in birth rate in spring has been observed. It is believed that seasonality in the ovulation rate may cause this variability. However, changes in the quality of the ovum or in endometrial receptivity which may lead to a greater waste of ovulated eggs and peri-implantation conceptuses at specific times of the year, have also been suggested. These phenomena might have important implications for in-vitro fertilization and gamete intra-Fallopian transfer as well as infertility in general. The seasonal effects, which may influence primate and human fertility and reproduction and its possible mediators, are critically reviewed.

Animals↗
PubMed1991

Influence of age, sex and diurnal variability on imipramine receptor binding and serotonin uptake in platelets of normal subjects.

Imipramine (IMI) binding and serotonin (5-HT) uptake were determined in platelets of 98 healthy volunteers; and their association with age, sex and circadian rhythm were evaluated. A large interindividual variability was found for both IMI and 5-HT parameters. There was a negative correlation of IMI affinity constant (Kd) and binding (Bmax) with age, but no such correlation of 5-HT affinity constant (Km) or uptake (Vmax). Significant age-related diurnal variability was found for 5-HT Km in the whole group as well as for IMI Kd in males, but not in females. There was no significant correlation between 5-HT Vmax and IMI Bmax. Our results underscore a cautious approach to the interpretation of platelet serotonergic studies. In light of the multiple variables influencing the results, the usefulness of IMI or 5-HT as clinical markers should be re-evaluated.

Adult↗
PubMed1991

Imipramine receptor binding and serotonin uptake in platelets of women with premenstrual changes.

Gonadal hormones are believed to be involved in the pathophysiology of premenstrual changes (PMC) possibly through their interaction with neurotransmitter systems in the brain. The serotonergic system, an important central modulator of mood and behavior which is involved in the pathophysiology of affective disorders has been suggested to play a role in the genesis of dysphoric PMC. Blood platelet serotonin (5-HT) uptake and imipramine (IMI) binding have been shown to share similarities with serotonergic mechanisms in the brain thus enabling the study of serotonergic mechanisms. In this study, we report on platelet 5-HT uptake and IMI receptor binding which were simultaneously studied in women with PMC. Subjects with PMC showed a large interindividual variability with no consistent typical pattern or change during the late symptomatic as compared to the early nonsymptomatic luteal phase. Their IMI receptor binding, however, was lower compared to controls already during the early luteal phase before they developed symptoms and was similar during the symptomatic phase. This might suggest a preexistent vulnerability to the development of dysphoric PMC that might be related to impaired gonadal hormone modulation of the serotonergic system.

Adult↗
PubMed1991

Elimination of ovulation and menstrual cyclicity (with danazol) improves dysphoric premenstrual syndromes.

OBJECTIVE: To assess whether the therapeutic effect of danazol on premenstrual syndromes (PMS) is associated with suppression of ovulation. DESIGN: After 1 month on placebo, we administered 200 mg/d of danazol for 90 days to 24 women with dysphoric PMS. Symptoms during ovulatory cycles were compared with anovulatory periods. SETTING: Outpatient PMS program in a general hospital. PATIENTS: Twenty-four women who had dysphoric PMS and otherwise were physically and mentally healthy. INTERVENTIONS: None (except the oral medication). MAIN OUTCOME MEASURE: Prospective daily monitoring of symptoms with the Daily Rating Form, before, during, and after treatment. RESULTS: Twenty of 23 anovulatory periods were symptom-free versus 6 of 32 ovulatory periods (chi 2 = 15.63, P = 0.0002). CONCLUSION: The beneficial effect of danazol as treatment depends mostly on achieving an an-ovulatory state and elimination of hormonal cyclicity and not on the drug per se.

Adult↗
PubMed1991

Menstrual irregularities associated with bupropion treatment.

The authors report two cases of menstrual irregularities associated with bupropion treatment. This is the first report of such an association, and it is supported by data collected by the Burroughs Wellcome Co. Since the mode of action of this effective new antidepressant is basically unknown and does not operate through any of the putative mechanisms of the classical antidepressants, its side effect profile is of heuristic as well as practical importance.

Adult↗
PubMed1991

Prevalence and severity of premenstrual changes after tubal sterilization.

Many women report an association between tubal sterilization and the premenstrual syndrome. While early reports suggested such a linkage, more recent studies failed to confirm this association. In an attempt to elucidate the alleged association of tubal sterilization with premenstrual changes, we compared the severity of symptoms and their possible correlates with hormonal levels in 78 sterilized and nonsterilized women with prospectively confirmed premenstrual syndrome. No significant difference could be demonstrated between the groups in both the retrospective and prospective evaluation of the severity of premenstrual syndrome symptoms as well as in luteal hormonal levels. Our data confirm that premenstrual symptoms probably are not associated with tubal sterilization.

Adult↗
PubMed1989

Breech presentation after cesarean section: always a section?

A retrospective review of 71 breech deliveries after previous cesarean was done to determine the need for repeat cesarean section. Twenty-four (33.8%) women were allocated to the elective repeat cesarean section group and forty-seven (66.2%) patients were allocated to a trial of labor group. Thirty-seven (78.7%) were delivered of their infants vaginally. A total of 37 of the 71 women (52.1%) had successful vaginal deliveries. Neonatal morbidity did not differ for women who were delivered vaginally or by cesarean section. Maternal febrile morbidity was significantly higher in the cesarean section group than in the vaginal delivery group (p less than 0.001). On the basis of these data, a trial of labor seems reasonable in carefully selected cases of breech presentation after a previous cesarean section.

Adult↗
PubMed1987

Fetal heart rate and uterine activity following paracervical block.

Bupivacaine without adrenaline was used for paracervical block (PCB) anesthesia in 60 low-risk parturients in whom there were no signs of fetal asphyxia. In order to evaluate its effects on fetus and uterine activity, 30 patients were given a "high dose" of 50 mg Bupivacaine, an amide-type local anesthetic agent, while 30 patients were given a "low dose" of 25 mg. Continuous fetal heart rate (FHR) monitoring in both study groups revealed nine patients with typically post PCB bradycardia and five patients with moderate PHR depression. All of them were born with excellent Apgar score. Although a decrease in fetal heart rate following PCB was noted in both groups more significant reduction was associated with the high dose block (P less than 0.05). In 11 cases, FHR depression was clearly associated with increased uterine activity, while in another three cases it was not (P less than 0.005). Oxytocin administration during the block did not affect fetal heart rate or uterine activity. The results indicate that FHR depression following PCB using Bupivacaine is dose dependent, transient and not dangerous to a normal fetus. No adverse maternal effects were noted. It is suggested that fetal heart rate depression following PCB using Bupivacaine is related to increased uterine activity.

Anesthesia, Caudal↗