Biomedical subjects

Ram Kerner

Publications and source records attributed to Ram Kerner.

4 recordsLinked to original sources

PubMed2005

Expression of cell cycle regulatory proteins in ovaries prophylactically removed from Jewish Ashkenazi BRCA1 and BRCA2 mutation carriers: correlation with histopathology.

OBJECTIVES: Prophylactic oophorectomy in Ashkenazi Jewish women with BRCA mutations represents a unique opportunity to search for premalignant changes in ovaries. Reports on the presence of dysplastic lesions in these ovaries are contradictory. Our aim was to study the expression of cell cycle regulatory proteins--p53, Skp2, p27, Ki67, Bcl2 and p16--in correlation with histopathological changes. p16(INK4A) was not studied before in prophylactically removed ovaries. METHODS: Ninety-four ovaries from 50 Ashkenazi Jewish BRCA carriers were compared with 42 ovaries removed for reasons unrelated to cancer and with 16 ovarian carcinomas. RESULTS: Three (6%) patients from the high-risk group had an occult carcinoma. A significant association was found between BRCA-positive expression and the presence of atypical changes in the superficial ovarian epithelium (P = 0.014) as well as the presence of epithelial cortical clefts (P = 0.042). Expression of p53 in cortical inclusions was significantly higher in the BRCA-positive cases than in the benign control group (P = 0.03). The high-risk and the benign control group did not differ significantly by the expression of p16, BCL2, Ki67, p27 and SKP2 (P > 0.05). However, both groups significantly differed from the carcinoma group (P < 0.0001). A significant positive correlation was found between the expression of Ki67, and the grade of atypia in the high-risk group (R = 0.3, P = 0.01) and in the benign control group (R = 0.5, P = 0.02). CONCLUSIONS: BRCA mutation carriers had more atypical changes in the superficial epithelium (P = 0.014) and more epithelial cortical clefts (P = 0.042) compared to the benign control group. The histopathology changes were not supported by significantly altered expressions of the proteins used in our study. Additional molecular studies could contribute to the disclosure of precancerous ovarian lesions.

Cell Cycle Proteins↗

PubMed2005

Immediate ambulation after embryo transfer: a prospective study.

OBJECTIVE: To assess whether bed rest following the embryo transfer (ET) procedure contributes to the implantation process and pregnancy rate. DESIGN: A prospective (patient-influenced) study. SETTING: An in vitro fertilization (IVF) unit of an academic medical center. PATIENT(S): Four hundred six patients undergoing controlled ovarian hyperstimulation and IVF. INTERVENTION(S): All women undergoing in vitro fertilization-embryo transfer (IVF-ET) cycles in our unit were given a special individual counseling session before the ET procedure in which they were informed that our previous experience showed no advantage for bed rest over immediate ambulation after ET. The women were allowed to select the practice of their choice, and they were assured that their decision would have no influence on their further treatment. MAIN OUTCOME MEASURE(S): The stimulation pattern and cycle outcome were compared between the two groups (bed rest and immediate ambulation). RESULT(S): Of the 406 patients counseled during the study period, 167 preferred immediate ambulation and 239 opted to stay in the unit for 1 hour's bed rest. There were no significant differences between the groups in mean patient age, number of embryos transferred, and other variables of the assisted reproductive technique cycles. Pregnancy rates did not differ between the groups: 41 out of 167 (24.55%) in the immediate-ambulation group and 51 out of 239 (21.34%) in the bed-rest group. CONCLUSION(S): Immediate ambulation following the ET procedure has no adverse influence on the ability to conceive.

Adult↗

PubMed2003

Telemedicine for antenatal surveillance of high-risk pregnancies with ambulatory and home fetal heart rate monitoring--an update.

Antepartum fetal surveillance is routinely used to assess the risk of fetal death in high-risk pregnancies. Traditionally, testing is performed in the hospital or outpatient clinic by trained medical staff. New equipment is now available that is easy to operate and can be used for self-monitoring of the fetal heart rate (FHR) in the home setting. The tracings are transmitted by modem to a referral center for immediate interpretation by a health provider. The aim of this review was to assess the current data on the application of this new technology with regard to feasibility, access to care, maternal and neonatal outcome, patient and physician satisfaction, and cost-effectiveness.

Ambulatory Care↗

PubMed2002

Comparison of leuprolide acetate and triptorelin in assisted reproductive technology cycles: a prospective, randomized study.

OBJECTIVE: To compare the use of two depot GnRH-a, leuprolide and triptorelin, in long-suppression GnRH-a protocols. DESIGN: Prospective, randomized study. SETTING: An IVF unit of an academic medical center.Fifty-two women who underwent controlled ovarian hyperstimulation and IVF. INTERVENTION(S): Patients were prospectively randomized to receive 3.75 mg depot formulations of either leuprolide or triptorelin on days 21-23 of the menstrual cycle. Stimulation with gonadotropins was initiated after pituitary desensitization was achieved. MAIN OUTCOME MEASURE(S): The stimulation pattern and cycle outcomes were compared between the two groups. RESULT(S): Twenty-six patients were included in each group. No significant differences were observed in the patient age, estrogen, and P levels on day of hCG administration, gonadotropin dosage, number of oocytes retrieved, fertilization rate, percentage of high-quality embryos, and number of embryos transferred. However, significantly higher clinical implantation and pregnancy rates were found in the leuprolide group compared with the triptorelin group. CONCLUSION(S): A depot preparation of leuprolide is associated with higher implantation and pregnancy rates than a depot preparation of triptorelin when it is used in the midluteal phase as part of the long-suppression GnRH-a protocol in IVF.

Adult↗