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Biomedical subjects

R Israel

Publications and source records attributed to R Israel.

At least 37 records · Page 2Linked to original sources
PubMed1976

Male pseudohermaphroditism consistent with 17,20-desmolase deficiency.

A 16-year-old phenotypic female with XY genotype presented an unusual form of nonfamilial male pseudohermaphroditism. Seemingly a normal girl during childhood, the patient failed to undergo pubertal changes presenting with scant pubic hair, absent axillary hair, lack of breast development, retarded bone age and primary amenorrhea. Neither uterus nor adnexa were palpable above the blind-ending vagina. Serum testosterone and estradiol were barely detectable by radioimmunoassay, while LH and FSH reached castrate levels. Two small testes were removed from the pelvic sidewalls which, on biopsy, showed atrophy and hyalinization of seminiferous tubules, but clusters of Leydig cells without signs of hypertrophy or hyperplasia. Administration of testosterone resulted in urinary nitrogen retention and a decrease in serum LH and FSH. Radioimmunoassay of various serum or plasma steroids and gas chromatographic determination of urinary steroids prior to and following ACTH stimulation yielded results which permitted to rule out 20,22-desmolase, 3beta-hydroxysteroid dehydrogenase, 17-hydroxylase and 17beta-hydroxysteroid dehydrogenase deficiency. Low plasma dehydroepiandrosterone sulfate (DHEA-S) and androstenedione (delta4 A) concentrations, low urinary 17-ketosteroid and particularly low dehydroepiandrosterone (DHEA) excretion and the minimal rise of plasma DHEA-S and delta4 A and of urinary DHEA in response to ACTH in conjunction with a normal response of other serum and urinary C-21 steroids are consistent with 17,20-desmolase deficiency. Direct confirmation of this defect, however, seems impossible in the absence of in vitro studies of testicular steroidogenesis.

17-Ketosteroids↗
PubMed1976

Intrauterine adhesions secondary to elective abortion. Hysteroscopic diagnosis and management.

Ten patients who developed Asherman's syndrome following elective first trimester abortion underwent outpatient hysteroscopy under local anesthesia. Six of the 10 patients had hysterosalpingograms prior to surgery. Correlation between the radiographic findings and those at hysteroscopy was poor. Treatment consisted of hysteroscopic lysis of adhesions, placement of an IUD or Foley catheter, and sequential estrogen-progestin administration. Normal menses were resumed in all women. Hysteroscopy was also used for followup in 4 patients. Outpatient hysteroscopy under local anesthesia is safe and is the method of choice for diagnosing, treating, and following patients with Asherman's syndrome.

Abortion, Induced↗
PubMed1975

Randomized comparative study of the copper T 300, Dalkon shield, and Shell Loop in parous women.

A randomized comparative study of the Copper T 300, the standard Dalkon Shield and the Silicone Shell Loop D was conducted on 776 parous women. Net cumulative first event rates at 1 year and at 18 months, calculated by life-table analysis, were as follows: Copper T 300--pregnancy 1.2/1.9, expulsion 6.4/7.0, removal for pain or bleeding 7.4/10.8; Dalkon Shield--pregnancy 2.7/4.5, expulsion 5.8/5.8, removal for pain or bleeding 7.7/14.7; Shell Loop--pregnancy 3.8/4.9, expulsion 0.5/0.5, removal for pain or bleeding 9.1/13.1. None of the differences in event rates, except the lower expulsion rate of the Shell Loop, were significant. The continuation rates for the three devices at both 12 and 18 months were similar, indicating that there was little difference in their performance. As the results of this study showed a similarity of the incidence of events among very differently disigned IUD's, previously reported differences in performance of these and possibly other types of IUD's may very likely be more related to differences among clinics than to differences among the devices themselves.

Adolescent↗