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Biomedical subjects

S S Shapiro

Publications and source records attributed to S S Shapiro.

At least 109 records · Page 6Linked to original sources
PubMed1980

Progesterone-induced glycogen accumulation in human endometrium during organ culture.

An organ culture system was used to evaluate the response of human proliferative endometrium to progesterone stimulation. The glycogen content of proliferative tissue was increased as much as thirteenfold during organ culture in media containing progesterone. The steroid-induced increase in tissue glycogen was detectable after 16 hours and reached a maximum at 48 and 72 hours of culture. Progesterone induced a significant increase in glycogen at a media concentration of 1.6 x 10(-8)M and a maximal increase at 3.2 x 10(-7) to 3.2 x 10(-6)M. At higher media concentrations of progesterone (1.6 x 10(-5)M), glycogen levels failed to reach the maximum obtainable. The extent of the response correlated poorly with the initial glycogen content of the tissue and not at all with the initial content of high-affinity progesterone-binding sites in cytosol. Addition of estradiol-17 beta to medium (10(-10)M to 10(-7)) has no effect on the progesterone-induced increase in tissue glycogen. Delaying the addition of progesterone to the cultures for 24 hours resulted in a diminished glycogen response; the reduced response may be related to a rapid decrease in high-affinity progesterone-binding sites as measured in cytosol prepared from tissues cultured in the absence of progesterone. High-affinity progesterone-binding sites in endometrial cytosol were found to decrease rapidly during the first 24 hours of culture. The addition of cycloheximide or actinomycin D to the culture media inhibited the increase in tissue glycogen caused by progesterone. These results demonstrate that progesterone can induce an in vitro response in human proliferative endometrium similar to that seen in vivo. The response of the endometrium is reproducible and allows for comparisons between grouped data obtained by using tissues from several different donors.

Adult↗
PubMed1980

The Pennsylvania hemophilia program 1973-1978.

In Pennsylvania, the prevalence of hemophilia is one per 10,000 males. Factor VIII deficiency is five times more frequent than Factor IX deficiency, and 34% of the patients have no relatives affected with the disease. The mean age is 23 years old, and 50% of the patients are less than 20 years old. Approximately one-third of the patients with Factor VIII deficiency and one fourth of the patients with Factor IX deficiency have levels of less than 0.01 mu/ml. By clinical criteria, 55% of those with Factor VIII deficiency are severe compared to 45% of those with Factor IX deficiency. Factor VIII-deficient patients are treated an average of 18 times per year compared to ten times per year for patients with Factor IX deficiency. Hemarthroses account for 70% of the hemorrhages treated and for 40% of the concentrate usage. Home therapy patients use an average of 45,950 Factor VIII units per year at a cost of ø170 per patient and their use accounts for 60% of the total Factor VIII usage of 1.7 million units. Less than five days per patient per year are lost from school or work because of bleeding, and patients are hospitalized for bleeding an average of only two to three days per patient year. Adverse immediate reactions to therapy are infrequent. Five percent of patients have persistence of the hepatitis B virus, and 7.5% have inhibitors. The mortality rate is 0.04% per year, with half of the deaths being hemophilia-related.

Adult↗
PubMed1980

Virilism as a late manifestation in the Bardet-Biedl syndrome.

The second case of virilism as a late manifestation of Bardet-Biedl syndrome (BBS) is described, with endocrine and histological evaluation. Both cases manifested ovulatory cycles and developed virilism in adulthood. Elevated plasma testosterone and 17-OH-progesterone were not suppressed by dexamethasone but were suppressed by medroxyprogesterone acetate. Peripheral and ovarian venous blood obtained at the time of surgery demonstrated a marked gradient for testosterone in both ovaries and for progesterone in the ovary bearing the corpus luteum. Histological evaluation of the ovaries demonstrated bilateral ovarian stromal hyperplasia with focal hyperthecosis. Bilateral ovariectomy resulted in complete correction of the endocrine abnormality, although the established hirsutism remains a mark of previous androgen excess.

Adult↗
PubMed1980

Liver dysfunction in Pennsylvania's multitransfused hemophiliacs.

Transaminase values [alanine amino transferase (ALT) and aspartate amino transferase (AST)] and markers for hepatitis B were serially determined in 558 hemophiliacs exposed to blood products. Hepatitis B surface antigen (HBsAg) persistent for over 12 months was present in 6% of the patients. Antibody to hepatitis B surface antigen (anti-HBs) was noted in 90% of the 259 patients treated with factor VIII or IX concentrates but in only 49% of the 43 patients treated with fresh frozen plasma (FFP) or cryoprecipitate. Persistently abnormal transaminase values were noted in 31% of the patients treated with commercial concentrates but in only one (2%) of the patients exposed to cryoprecipitate or FFP. This difference continued even when the two groups of patients were matched for the amount of blood products, up to 50,000 units, which they had received in the study period. In the concentrate-treated patients, no correlation could be found between transaminase values and the number of units of factor VIII or IX they had received during the six years of the study (1973-1978).

Adolescent↗
PubMed1980

Laparoscopic findings in twenty-five failures of artificial insemination.

The laparoscopic findings, treatment, and follow-up of 25 patients who failed artificial insemination donor (AID) were retrospectively evaluated. A high incidence (72%) of abnormal pelvic findings was encountered. Endometriosis was found in 60% and pelvic adhesions in 12% of the patients. The incidence of these two entities was not significantly different from their incidence in patients with unexplained infertility in the same institution (44% for endometriosis and 36% for adhesions). After surgical or medical treatment, a pregnancy rate of 22.2% (16.6% for endometriosis and 66.6% for pelvic adhesions) was achieved in patients with positive pelvic findings; in the group with negative pelvic findings, a pregnancy rate of 20% was achieved. The value of diagnostic laparoscopy in AID failures is discussed in the light of the findings presented and the relatively low rate of post-treatment pregnancy.

Adult↗
PubMed1980

Monoclonal immunoglobulin M lambda coagulation inhibitor with phospholipid specificity. Mechanism of a lupus anticoagulant.

Prolongation of all phospholipid-dependent coagulation tests was found in a patient with macroglobulinemia, despite absence of bleeding manifestations. The purified monoclonal IgM lambda protein and its Fabmu tryptic fragment induced similar changes in normal plasma. Patient IgM and Fabmu completely inhibited Ca++-dependent binding of radiolabeled prothrombin and Factor X to mixed phospholipid micelles. The patient's IgM lambda paraprotein reacted with phosphatidylserine and, to a lesser extent, with phosphatidylinositol and phosphatidic acid, but not with phosphatidylcholine or phosphatidylethanolamine. Prior incubation of phospholipid with patient Fabmu blocked the positive reactions. Substitution of washed platelets for phospholipid led to normalization of patient coagulation tests and corrected all abnormalities produced in normal plasma by patient IgM. Furthermore, binding of 125I-Factor Xa to thrombin-treated platelets was entirely normal in the presence of patient IgM. These studies support the concept that platelets, rather than phospholipid micelles, are the primary locus of prothrombin and Factor X activation in normal hemostasis.

Antibody Specificity↗
PubMed1980

Renal failure wit XY gonadal dysgenesis: report of the second case.

The second case is reported of renal failure in association with XY gonadal dysgenesis. The random association of these conditions appears unlikely. Recognition of a possible association is important because of potential fatality due to renal failure or gonadoblastoma in unrecognized cases. In groups at risk, follicle-stimulating hormone (FSH) studies are appropriate in cases of renal disease occurring in phenotypic prepubertal females; in women with XY gonadal dysgenesis, BUN and urinalysis should be studied.

Adult↗
PubMed1979

The value of hysterosalpingography prior to donor artificial insemination.

The value of hysterosalpingography as a tool in the pretreatment evaluation of candidates for donor artificial insemination has been retrospectively evaluated. In 89 consecutive artificial inseminations by donor candidates, hysterosalpingograms were evaluated for genital tract abnormalities. In only four of these studies was there a failure of dye to spill into the peritoneal cavity. The low incidence of significantly abnormal hysterosalpingographic studies, and the failure of these studies to correlate with pregnancy outcome, strongly argues against the use of hysterosalpingography in the preliminary evaluation of the patient considered for donor artificial insemination.

Adult↗
PubMed1979

Genetic causes and workup of male and female infertility. 1. Prenatal reproductive loss.

Studies show that the greatest check on human reproduction occurs prenatally in apparently fertile couples. Most chromosomally abnormal embryos are aborted spontaneously. This paper, to be published in three parts, reviews the major known anatomic, functional, genetic, and environmental causes of infertility and reproductive wastage. The second and third parts, to appear in succeeding issues, are concerned with chromosome abnormalities and congenital malformations in the period from birth to adult life and with the diagnostic workup of infertile men and women.

Abortion, Habitual↗
PubMed1979

Genetic causes and workup of male and female infertility. 2. Abnormalities presenting between birth and adult life.

At birth some 6/1,000 persons have chromosome abnormalities; in about 60% of cases these abnormalities cause death or infertility, and in one third fertility is reduced. Some 1.7% of persons (3.4% of couples) with recurrent spontaneous abortion, infertility, or both have a chromosome abnormality. Chromosome abnormalities are far more common in men than in women with infertility; 15% to 20% of men with azoospermia have the Klinefelter syndrome. Meiotic defects explain 20% of male infertility in patients with apparently normal somatic chromosomes. Congenital malformations of the genitalia are more common in males than in females; about 0.82% of liveborn males have hypospadias. Almost one sixth of women with primary amenorrhea have some form of müllerian atresia, usually with associated renal anomalies.

Chromosome Aberrations↗
PubMed1979

Genetic causes and workup of male and female infertility. 3. Details of the clinical evaluation.

In the evaluation of male and female infertility the history, family history, physical examination, and endocrine and gonadal functional evaluations are the most informative measures. The cause of the infertility is never found in some 17.5% of couples and in almost one fourth of males. In over one third of cases male infertility is attributed to varicocele. In 40% of women infertility can be attributed to ovulatory or cervical factors, uterotubal disease, endometriosis and other pelvic disease, or a combination of these factors. For couples with primary infertility the fertility rate after seven years is only 36%; in such cases the neonatal death rate, frequency of low birth weight, and incidence of major malformations are several time greater than in the normal population.

Adult↗