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Salamalekis E, Batalias L, Kassanos D, Loghis C, Pyrgiotis E, Zourlas PA. The acoustic stimulation test and antenatal cardiotocography as diagnostic tools in high risk pregnancies. J OBSTET GYNAECOL 2009. [DOI: 10.3109/01443619509030920] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Vitoratos N, Botsis D, Grigoriou O, Bettas P, Papoulias I, Zourlas PA. Smoking and preterm labor. CLIN EXP OBSTET GYN 1998; 24:220-2. [PMID: 9478324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The aim of the present study was to investigate the role of maternal smoking during pregnancy in the occurrence of the premature rupture of the membranes (PROM) and premature labor . Our study consisted of 1,133 women of which 283 (group A) had premature labor (gestation < or = 37 weeks), while 850 (group B) had term labor (gestation > 37 weeks). The two groups did not differ in their socioeconomic status and did not include women with serious complications during pregnancy. There were no apparent effects of smoking on the length of gestation. However, our results showed that smoking had a marked effect on preterm labor of less than 32 weeks; we also found a statistically significant correlation between PROM in premature deliveries and smoking during pregnancy, but no gradient was observed between the number of cigarettes smoked per day and the risk for PROM, in cases of premature labor. We conclude that smoking during pregnancy raises the risk of delivery before the 32nd week, as well as the PROM in premature deliveries, independently of the number of cigarettes smoked per day.
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Affiliation(s)
- N Vitoratos
- 2nd Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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Abstract
UNLABELLED The aim of this study was to evaluate the effect of increasing postnatal age on soluble intercellular adhesion molecule-1 (sICAM-1), a very early and sensitive marker of immune activation and response in the serum of newborn infants. Serum sICAM-1 was measured by EIA (T Cell Diagnostics) in 20 healthy adults (controls) and in 43 (24 females/19 males) healthy neonates, of whom 28 were full term, and 15 were born at a gestational age between 35 and 38 weeks of pregnancy, on the 1st, 5th and 30th day of life. Neonatal serum sICAM-1 values showed a very significant increase (P < 0.01) from the 1st day (137.3+/-62.0 ng/ml) to the 5th day (259.3+/-124.0 ng/ml) and then to the 30th day of life (415.0+/-114.0 ng/ml), being significantly lower on the 1st day (P < 0.01), whereas significantly higher on the 30th day of life (P < 0.05), than those in healthy adults (305+/-195 ng/ml). Serum sICAM-1 values on the 1st day of life depended on both the mode of delivery (significantly higher in neonates born vaginally) and the gestational age at birth (significantly lower in those born at a gestational age over 38 weeks). A significant strong correlation was found in sICAM-1 values between the 1st and the 5th day following delivery (rp = 0.77, P < 0.009). CONCLUSION The results of this study demonstrate a significant rise of serum sICAM-1 during the 1st month of life in healthy neonates suggesting a progressively increased activation of the neonatal immune system.
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Affiliation(s)
- I Phocas
- Second Department of Obstetrics and Gynaecology, Areteion University Hospital, Athens, Greece
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Botsis D, Kassanos D, Kalogirou D, Antoniou G, Karakitsos P, Zourlas PA. A comparative study of an estradiol-releasing vaginal ring versus tibolone in postmenopausal women: a transvaginal color Doppler study. Maturitas 1997; 27:77-83. [PMID: 9158081 DOI: 10.1016/s0378-5122(97)01105-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To evaluate endometrial blood flow characteristics in response to estrogen replacement therapy (ERT) and tibolone in postmenopausal women and to correlate the resistance index (RI) with plasma estradiol levels. MATERIALS AND METHODS Transvaginal color Doppler ultrasound examinations were performed in 72 asymptomatic, postmenopausal women who demonstrated endometrial thickness < or = 5 mm. Thirty-six women receiving tibolone and 36 patients receiving ERT by a vaginal ring comprised the study groups. RESULTS All postmenopausal women treated with tibolone or ERT showed continuous forward end-diastolic flow. The lowest RI was obtained in women with the vaginal ring inserted. The plasma concentrations of estradiol were found to be significantly higher in the vaginal ring group than those of tibolone. CONCLUSIONS The data observed suggest that ERT and tibolone modify normal postmenopausal endometrial perfusion. Tibolone had a weaker estrogenic effect on endometrial blood flow resistance, and vaginal ring treatment enhanced endometrial blood perfusion through vasodilatation.
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Affiliation(s)
- D Botsis
- Second Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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Loghis C, Salamalekis E, Panayotopoulos N, Vitoratos N, Zourlas PA. The effect of early second stage bradycardia on newborn status. Eur J Obstet Gynecol Reprod Biol 1997; 72:149-52. [PMID: 9134393 DOI: 10.1016/s0301-2115(96)02683-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In the present study 45 patients with intrapartum cardiotocograms showing prolonged fetal bradycardia during the early second stage of labor were included. Bradycardia persisted for 180 s or more with either rapid or prolonged return to baseline, without loss of variability and rise of baseline fetal heart rate (FHR). The mean duration of bradycardia was 5.0 +/- 1.3 min. In the group with normal FHR tracings the rate of normal delivery (73.3%) was significantly higher than that of the group with fetal bradycardia (26.7%, P < 0.0001). We also noted a significantly higher rate of cesarean section (44.4%) in patients with abnormal FHR tracings, compared to that (11.1%) of parturients with normal FHR tracings (P < 0.001). In all cases blood samples were obtained from the umbilical cord artery, immediately after delivery. Only in two cases with abnormal FHR tracing umbilical cord artery was the pH less than 7.20. We conclude that in most cases, prolonged fetal bradycardia in the early second stage with the characteristics described above is well tolerated by a mature fetus.
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Affiliation(s)
- C Loghis
- Second Department of Obstetrics and Gynaecology, University of Athens, Areteion Hospital, Greece
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Vitoratos N, Louridas C, Salamalekis E, Loghis C, Botsis D, Zourlas PA. Hematological parameters of the mother and neonatal status during normal labor. Biol Neonate 1997; 71:156-61. [PMID: 9096894 DOI: 10.1159/000244411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study reviews the relationship between hematological parameters of the mother and the newborns status. Our material consisted of 180 pregnant women with singleton pregnancies who had an uncomplicated vaginal delivery. A negative relationship was noted between the pH and the maternal hemoglobin values both in the umbilical artery and vein (r = -0.27, p < 0.001, for the umbilical vein and r = -0.32, p < 0.0001, for the umbilical artery). A negative relationship was also noted between the umbilical vein pH and the maternal hematocrit, which was statistically significant (r = -0.28, p = 0.001). A similar negative correlation was observed between the umbilical artery pH and the maternal hematocrit (r = -0.32, p < 0.0001). In conclusion, maternal hematological parameters (hemoglobin, hematocrit) can affect the fetal acid-base balance.
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Affiliation(s)
- N Vitoratos
- 2nd Department of Obstetrics and Gynecology, Areteion Hospital, University of Athens, Greece
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Liapis A, Paphiti A, Karvouni E, Arnoyannaki N, Salambasis K, Zourlas PA. Clinicopathological study of serous papillary carcinoma of the endometrium in three cases. EUR J GYNAECOL ONCOL 1997; 18:78-9. [PMID: 9061332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- A Liapis
- 2nd Department of Gynecology and Obstetrics, University of Athens Areteion Hospital, Greece
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Gregoriou O, Kalabokis D, Mantzavinos T, Kanakas N, Zourlas PA. Rupture of an heterotopic pregnancy in the 15th week and normal continuation of the intrauterine gestation. Case report. CLIN EXP OBSTET GYN 1997; 24:15-6. [PMID: 9107448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A rare case report of heterotopic pregnancy, ruptured in the 15th week of gestation is presented. The intrauterine pregnancy continued after the laparotomy and removal of the extrauterine fetus and ended with a normal delivery in the 39th week.
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Affiliation(s)
- O Gregoriou
- 2nd Department of Obstetrics and Gynecology, University of Athens, Greece
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Chryssicopoulos A, Koutsikos D, Kapetanaki A, Agroyannis B, Tzanatos H, Rammos G, Fourtounas C, Kopelias I, Bossiolis B, Darema M, Zourlas PA. Evaluation of the hypothalamic-pituitary axis in uremic males using dynamic tests. The possible role of testicular inhibin: a preliminary report. Ren Fail 1996; 18:911-21. [PMID: 8948525 DOI: 10.3109/08860229609047717] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Two dynamic tests (Gn-RH i.v. and clomiphene citrate-CC p.o.) were used to evaluate the hypothalamic-pituitary axis in hemodialysis patients and renal transplant recipients (recipients). In the Gn-RH test the gonadotropin secretion was maximally decelerated in hemodialysis patients while it was normal in recipients. During the CC test a decrease of gonadotropin secretion, chronically and quantitatively identical for both group, was found; while on the following test days an increase was noted, which was more accelerated in male recipients. In cases with uremia a strong negative feedback dominates at the pituitary level probably owing to testicular inhibin. The estrogenic feedback in uremia was intact, while the antiestrogenic feedback at the level of hypothalamus is partly impaired, owing to altered opioid metabolism.
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Affiliation(s)
- A Chryssicopoulos
- Second Department of Gynecology and Obstetrics, Aretaieon University Hospital, Athens, Greece
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Mantzavinos T, Phocas I, Sarandakou A, Kanakas N, Arvaniti K, Zourlas PA. Serum markers of immune activation in women undergoing in-vitro fertilization and embryo transfer. Hum Reprod 1996; 11:2412-7. [PMID: 8981122 DOI: 10.1093/oxfordjournals.humrep.a019126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
We evaluated serum concentrations of two early and sensitive markers of immune activation, interleukin-2 receptor (sIL-2R) and intercellular adhesion molecule-1 (ICAM-1) in two age-matched groups of in-vitro fertilization (IVF)-embryo transfer women, group I (n = 26) without and group II (n = 40) with methylprednisolone (MPD) supplementation of the luteal phase, on the days of oocyte retrieval (sample A) and embryo transfer (B), and second (C) and 13th (D) days post-transfer and in 20 normally cycling women (controls) on the day of luteinizing hormone (LH) peak. No difference in the outcome of the IVF-embryo transfer was observed between groups I and II. In sample A, both immunomarker concentrations showed no significant difference between the two groups of IVF women, while they were significantly higher (P < 0.01) than values in controls. In cycles in which conception occurred, significantly higher immunomarker concentrations were observed in sample A of both groups I and II compared with those in unsuccessful cycles of the same group. A significant decrease of both sIL-2R and ICAM-1 was noticed in sample B only in group II (P < 0.0001 and P < 0.001 respectively; paired t-test) that continued further in the late luteal phase only in the case of conception, independently of MPD supplementation. These data suggest that (i) due to multiple ovulations, IVF-embryo transfer women show elevated concentrations of sIL-2R and ICAM-1 at oocyte retrieval; (ii) since, even at oocyte retrieval stage, high concentrations of immunomarkers are associated with IVF-embryo transfer success, sIL-2R and ICAM-1 could be used as early indicators for conception cycles; (iii) transient suppression of T cell activity by MPD supplementation following IVF-embryo transfer does not improve pregnancy rate.
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Affiliation(s)
- T Mantzavinos
- 2nd Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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Phocas I, Sarandakou A, Sikiotis K, Rizos D, Kalambokis D, Zourlas PA. A comparative study of serum alpha-beta A immunoreactive inhibin and tumor-associated antigens CA125 and CEA in ovarian cancer. Anticancer Res 1996; 16:3827-31. [PMID: 9042265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
alpha-i.r Inhibin, has been recently proposed as a useful tumor marker for mucinous ovarian carcinomas (Ca), as the widely used tumor marker for ovarian malignancies, CA125 is efficient only in nonmucinous ovarian Ca, and, together with CEA, fails to detect minimal disease and show long half-life in serum after successful surgery. Moreover, conflicting evidence has been reported as to whether inhibin in ovarian malignancies is the biologically active dimer alpha-beta A inhibin or the inactive free alpha-subunits and inhibin precursors. Serum alpha-beta A i.r inhibin. CA125 and CEA were measured preoperatively and 8 days postoperatively in 39 postmenopausal patients with ovarian cancer (13 mucinous, 15 serous and 11 different other ovarian Ca) in comparison with 20 age-matched healthy women (Controls), 18 patients with benign ovarian tumors and 10 patients with nonovarian gynecological malignancies. Serum alpha-beta A i.r inhibin values were very low in controls (0.121 U/ml; 0.060-0.250) while they were greatly elevated in both benign (67% sensitivity) and malignant ovarian tumors (100% sensitivity in mucinous Ca, 80% in serous and 90.9% in other ovarian Ca, taken as cut-off level the maximum value in Controls, 0.250 U/ml). In contrast, in non-ovarian malignancies no increased values of alpha-beta A inhibin were found (0% sensitivity). Our results on the sensitivity of CA125 and CEA are in agreement with previous studies. After successful surgery the very high concentrations of alpha-beta A i.r. inhibin were reduced very rapidly (8 days) to normal postmenopausal values in contrast to those of CA125 and CEA, that remained elevated. Serum alpha-beta A i.r inhibin seems to be very useful in monitoring after treatment the patients with any type of ovarian malignancy and specifically those with mucinous ovarian cancer.
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Affiliation(s)
- I Phocas
- 2nd Department of Obstetrics and Gynecology of Athens University, Areteion University Hospital, Greece
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Chryssikopoulos A, Mantzavinos T, Kanakas N, Karagouni E, Dotsika E, Zourlas PA. Correlation of serum and follicular fluid concentrations of placental protein 14 and CA-125 in in vitro fertilization-embryo transfer patients. Fertil Steril 1996; 66:599-603. [PMID: 8816623 DOI: 10.1016/s0015-0282(16)58574-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To study serum and follicular fluid (FF) concentrations of placental protein 14 (PP14) and CA-125 in patients participating in an IVF-ET program. DESIGN Determination in serum and FF on the day of hCG administration, day of oocyte retrieval, and on ET day of PP14 and CA-125. SETTING Second Department of Obstetrics and Gynecology of the University of Athens; Euromedica IVF Unit; and Hellenic Pasteur Institute. PATIENTS Thirty-three patients undergoing IVF-ET divided in three groups: 8 with conception, 18 with fertilized oocytes but no conception, and 7 without fertilized oocytes. INTERVENTIONS All patients underwent an ovarian stimulation with a short protocol of GnRH analogue-pure-FSH-hMG. Three blood probes were collected from each patient, on the day of hCG administration, on retrieval day, and on ET day, respectively, whereas FF was collected on retrieval day. MAIN OUTCOME MEASURES Determination in serum and FF of CA-125 and PP14. RESULTS On the day of oocyte retrieval, both mean values of serum PP14 and CA-125 were significantly higher in conceptional than nonconceptional cycles. On the day of ET, the mean values of serum PP14 increased significantly in conceptional cycles whereas CA-125 showed no difference. The mean concentration of PP14 in FF was significantly higher in conceptional cycles whereas there was no significant change in the mean concentration of FF CA-125. CONCLUSIONS In conceptional cycles after IVF, PP14 increases in serum significantly from hCG day to ET day compared with nonconceptional cycles, whereas CA-125 increases from hCG day to oocyte retrieval day and decreases on ET day. In FF, PP14 was increased in conceptional cycles, whereas CA-125 in FF showed no change.
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Affiliation(s)
- A Chryssikopoulos
- Second Department of Obstetrics and Gynecology, Areteion Hospital, University of Athens, Greece
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Abstract
OBJECTIVE To evaluate prophylactic oophorectomy in the prevention of ovarian cancer. METHOD Between 1970 and 1990, 5262 hysterectomies were performed at Areteion Hospital, Athens. RESULTS Ovarian cancer was subsequently diagnosed in 520 women (9.9%). The mean interval from hysterectomy to diagnosis of ovarian cancer was 7.2 years. If prophylactic bilateral oophorectomy had been practiced routinely in women undergoing hysterectomy at age 40 or above, 9.4% of cases would have been prevented. CONCLUSION We recommend bilateral oophorectomy for all women with a positive family history of ovarian carcinoma and for all women undergoing hysterectomy after the age of 40. The decision for prophylactic oophorectomy as a complementary procedure to other indicated gynecologic surgeries should depend on the individual patient and her ability to comply with lifelong estrogen replacement therapy.
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Affiliation(s)
- A Kontoravdis
- 2nd Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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Kontoravdis A, Chryssikopoulos A, Hassiakos D, Liapis A, Zourlas PA. The diagnostic value of laparoscopy in 2365 patients with acute and chronic pelvic pain. Int J Gynaecol Obstet 1996; 52:243-8. [PMID: 8775676 DOI: 10.1016/0020-7292(95)02611-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To discriminate the etiology in 2365 patients with acute and chronic pelvic pain (APP, CPP). METHODS Diagnostic laparoscopy was carried out in 736 patients (31.1%) with APP and in 1629 (68.9%) with CPP. In 315 patients (13.3%) the diagnostic procedure was extended to operative laparoscopy. RESULTS The most frequent laparoscopic findings in patients with APP were acute salpingitis and pelvic adhesions (22.8%) and ectopic pregnancy (19%), while in patients with CPP the most frequent findings were pelvic adhesions (35.4%) and endometriosis (24.6%). In 7.5% of patients with APP and 24% with CPP, laparoscopy did not reveal any pathological finding in the pelvis. Among the 315 patients in whom operative laparoscopy was carried out, 40% suffered from APP and 60% from CPP. In the 446 patients (18.9%) without laparoscopic findings no treatment was given, while of the remaining 905 patients 40% were subjected to laparotomy and 60% received conservative treatment. The total incidence of side effects reached 4.7% and serious side effects resulting from emergency laparotomy occurred in 0.15% of patients with pelvic pain. CONCLUSION Our results in a large group of patients with pelvic pain show that there are discrepancies in the incidence of laparoscopic findings between patients with APP and CPP. Discrepancies between the two groups of patients were also found during operative laparoscopy, the treatment administered after laparoscopic diagnosis and the complications encountered.
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Affiliation(s)
- A Kontoravdis
- Second Department of Obstetrics and Gynaecology, University of Athens, Greece
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Christodoulou CN, Liapis AE, Agapitos EB, Zonas CA, Zourlas PA. Intrafetal prostaglandin F2alpha administration for uterine evacuation in a case of intrauterine death. Eur J Obstet Gynecol Reprod Biol 1996; 64:227-9. [PMID: 8820009 DOI: 10.1016/0301-2115(95)02289-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
An original route of prostaglandin F2alpha administration for uterine evacuation in a case of a midtrimester intrauterine death is presented. The ultrasonographic study revealed a hydropic fetus with a massive nuchal cystic hygroma and oligohydramnios. Given our previous experience with intrafetal prostaglandin administration in a similar case but with a living fetus, we injected prostaglandin F2alpha into the nuchal cysts under continuous ultrasonographic guidance in order to induce uterine evacuation. The pregnancy was successfully terminated 16 h later.
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Affiliation(s)
- C N Christodoulou
- 2nd Dept. of Obstetrics and Gynaecology, University of Athens, Greece
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Botsis D, Kassanos D, Antoniou G, Vitoratos N, Zourlas PA. Transvaginal sonography in postmenopausal women treated with low-dose estrogens locally administered. Maturitas 1996; 23:41-5. [PMID: 8861085 DOI: 10.1016/0378-5122(95)00951-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of this study was to determine the efficacy of low-dose estrogens, administered locally, in postmenopausal women with symptoms and signs of atrophic vaginitis. Transvaginal ultrasonography was performed for the evaluation of endometrial or ovarian abnormalities. MATERIALS AND METHODS Fifty-six healthy postmenopausal women with symptoms of atrophic vaginitis due to estrogen deficiency were examined with transvaginal ultrasound. The endometrial thickness, the uterus and the ovaries were measured before and after 6 months of treatment with low-dose estrogens. RESULTS The mean endometrial thickness, before and after treatment was 3.1 +/- 0.8 mm and 3.1 +/- 1.2 mm respectively. The mean ovarian volume before treatment was 4.5 ml and there was no difference after treatment. There were no changes in uterine thickness during the treatment period. CONCLUSIONS Our study, using transvaginal ultrasonography, has shown that low-dose estrogens, administered locally, give no sign of endometrial proliferation, measured as endometrial thickness, and do not alter the ovarian volume in postmenopausal volume.
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Affiliation(s)
- D Botsis
- 2nd Department of Obstetrics and Gynecology, Athens University, Areteion Hospital, Athens, Greece
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Liapis A, Pyrgiotis E, Kontoravdis A, Louridas C, Zourlas PA. Genuine stress incontinence: prospective randomized comparison of two operative methods. Eur J Obstet Gynecol Reprod Biol 1996; 64:69-72. [PMID: 8801153 DOI: 10.1016/0301-2115(95)02247-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Eighty-one women with clinical and urodynamic findings of genuine stress incontinence and genital prolapse were randomly selected to be surgically treated with either anterior colporrhaphy or Burch colposuspension. Each patient had a complete clinical and urodynamic evaluation before surgery and at 2 months and 3 years after surgery. Differences in cure rates between the two procedures at the 2-month post-operative evaluation were insignificant; however, at the 3-year post-surgical evaluation, the cure rate of women who had undergone Burch colposuspension was significantly higher than that of women who had undergone anterior colporrhaphy (cure rates were 88% and 57%, respectively; P < 0.001). The Burch colposuspension was more effective than the anterior colporrhaphy in the stabilization of the bladder base, neck and proximal urethra as confirmed by transvaginal sonography. Post-operative spontaneous voiding was uneventful in both procedures. Results of this study demonstrate that the Burch colposuspension in our hands was more effective in treating genuine stress incontinence and pelvic relaxation than was anterior colporrhaphy.
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Affiliation(s)
- A Liapis
- Second Department of Obstetrics & Gynecology, University of Athens, Greece
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Dalamaga AL, Agroyannis B, Vitoratos N, Frangos-Plemenos M, Patsouras K, Kostoglou-Papalamprou M, Zourlas PA. Effect of smoking on ceruloplasmin and its ferroxidase activity in pregnant women. Gynecol Obstet Invest 1996; 42:13-5. [PMID: 8840170 DOI: 10.1159/000291880] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
This study deals with the effects of smoking on serum ceruloplasmin and its ferroxidase activity in pregnant women. The mean value (+/- SD) of serum ceruloplasmin in women smokers during pregnancy is significantly higher (p < 0.01) in comparison to that of nonsmokers, whereas the ferroxidase activity of ceruloplasmin in smokers is not significantly different from that of nonsmokers. These findings suggest that ceruloplasmin in women smokers loses part of its ferroxidase activity.
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Affiliation(s)
- A L Dalamaga
- Second Department of Obstetrics, Gynecology, Areteion Hospital, Medical School, University of Athens, Greece
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Abstract
The prevalence of polycystic ovaries in a large population of 1078 women of reproductive age was determined by pelvic ultrasonography. The ovarian ultrasonic appearance of 183 (17%) women met the morphological criteria of polycystic ovaries. Of these women, 147 (80.3%) had irregular cycles (group A) and 36 (19.7%) had normal cycles (group B). The remaining women constituted the control group. Ovarian volume was calculated in all women in whom at least one ovary was visualized. Serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH) and testosterone were measured in 124 women from group A, 25 from group B and 50 controls. Mean ovarian volume was statistically higher in both group A (13.4 ml) and group B (11.8 ml) than in the control group (6.2 ml). Mean LH/FSH ratio and mean testosterone values were statistically higher in group A only (2.1 and 1.1 ng/ml, respectively) compared with the mean values in the control group (0.7 and 0.7 ng/ml, respectively). Obesity and hirsutism were more common in group A than in group B and the controls. Screening the ovaries in women of reproductive age and subsequent assessment of morphology in polycystic ovaries can aid in the diagnosis of this condition in patients who may have a varied clinical presentation.
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Affiliation(s)
- D Botsis
- Second Department of Obstetrics and Gynecology, Athens University, Areteion Hospital, Greece
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Phocas I, Mantzavinos T, Sarandakou A, Dimitriadou F, Zourlas PA. Serum and follicular fluid sex hormone-binding globulin in stimulated and unstimulated cycles. J Assist Reprod Genet 1995; 12:348-53. [PMID: 8589554 DOI: 10.1007/bf02215725] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND It is well-known that sex hormone-binding globulin (SHBG) concentrations in the follicle are relatively low in comparison with the corresponding estradiol (E2) levels, which are extremely high. A direct comparison of these data in stimulated and unstimulated cycles, as well as the relationship of SHBG with testosterone (T) and E2 in serum and follicular fluid (FF), is assessed. METHODS SHBG was measured in serum and FF in 42 cycles stimulated by GnRH agonists and gonadotropins and in 15 unstimulated cycles. The levels of SHBG were compared to the corresponding total estradiol and total testosterone concentrations. The analyzed FFs of 42 women, 12 of whom conceived, were randomly selected from 90 patients participating in an in vitro fertilization program. Mature oocytes were retrieved from all follicles from which FFs were analyzed. RESULTS Markedly elevated SHBG was found in both the serum and the FF of stimulated cycles compared to unstimulated cycles. In contrast, serum T and E2 were significantly higher in induced than in unstimulated cycles, while there was no significant difference in FF T or E2 between the two groups of cycles. No correlation was found between serum and FF SHBG in either stimulated or unstimulated cycles. In stimulated cycles, only in FF, SHBG was significantly correlated with both E2 and T. In unstimulated cycles, no correlation was found between SHBG and either one of the corresponding steroids either in serum or in FF. CONCLUSIONS The fraction of non-SHBG bound, biologically active sex steroids may be lower in the FF of stimulated than that of unstimulated cycles.
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Affiliation(s)
- I Phocas
- Second Department of Obstetrics and Gynecology, Athens University, Areteion University Hospital, Greece
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22
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Gregoriou O, Pyrgiotis E, Konidaris S, Papadias C, Zourlas PA. Fallopian tube sperm perfusion has no advantage over intra-uterine insemination when used in combination with ovarian stimulation for the treatment of unexplained infertility. Gynecol Obstet Invest 1995; 39:226-8. [PMID: 7635364 DOI: 10.1159/000292415] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In this prospective randomized study we treated 60 couples with unexplained infertility with a combination of ovarian stimulation and either intrauterine insemination (IUI) or fallopian sperm perfusion (FSP). In the IUI we used a volume of 0.5 ml of inseminate and in the FSP a volume of 4 ml. The demographic characteristics of the patients, the stimulation parameters and the sperm data were not statistically different between the two groups. The pregnancy rate per cycle was 16.2% in the IUI group and 14.5% in the FSP group and the pregnancy rate per woman was 40 and 36.7%, respectively (not statistically different). We conclude that IUI and FSP are equally effective in the treatment of couples with unexplained infertility.
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Affiliation(s)
- O Gregoriou
- Second Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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23
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Mantzavinos T, Kanakas N, Genatas C, Papadias K, Zourlas PA. Five years' follow-up in two patients with borderline tumours of the ovary hyperstimulated by gonadotrophin therapy for in-vitro fertilization. Hum Reprod 1994; 9:2032-3. [PMID: 7868669 DOI: 10.1093/oxfordjournals.humrep.a138388] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
In two women (36 and 30 years old) during infertility evaluation by ultrasound, an ovarian cyst was found on the left side (5 x 7 and 6 x 9 cm respectively). In both cases, it was decided to perform a unilateral salpingo-oophorectomy, keeping the other ovary (after a negative biopsy) for a future in-vitro fertilization (IVF) procedure with their own oocytes. The histology report for each patient showed the cyst was an epithelial borderline tumour. The first woman achieved a pregnancy and delivered a healthy baby after the first IVF attempt, while the second is currently undergoing her third attempt. This paper reports on a follow-up 5 years after the first IVF attempt.
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Affiliation(s)
- T Mantzavinos
- 2nd Department of Obstetrics/Gynaecology, University of Athens, Areteion Hospital, Greece
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Salamalekis E, Vitoratos N, Loghis C, Mortakis A, Zourlas PA. The predictive value of a nonstress test taken 24 h before delivery in high-risk pregnancies. Int J Gynaecol Obstet 1994; 45:105-7. [PMID: 7915677 DOI: 10.1016/0020-7292(94)90116-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES A series of 180 cases of high risk pregnancies were studied in order to assess if a nonstress test taken 24 h before delivery is of any prognostic significance. METHODS To assess the predictability of the NST (reactive or nonreactive) in terms of fetal outcome, the following variables were taken into consideration: fetal distress during labor, low Apgar score (< 7) and perinatal mortality rate. RESULTS A reactive test was found to be a good predictor of the healthy fetus (negative predictive value = 91.2%). Also, specificity of the test was found to be 85.4%. CONCLUSIONS The nonreactive test could identify a population at risk but it was not helpful as a 'stand alone' modality in decision making, because of the low sensitivity and positive predictive value rates (40.9% and 28.1%, respectively).
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Affiliation(s)
- E Salamalekis
- 2nd Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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25
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Phocas I, Sarandakou A, Rizos D, Dimitriadou F, Mantzavinos T, Zourlas PA. Tumour-associated antigens, CEA, CA 125 and SCC in serum and follicular fluid of stimulated and unstimulated cycles. Eur J Obstet Gynecol Reprod Biol 1994; 54:131-6. [PMID: 8070597 DOI: 10.1016/0028-2243(94)90252-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Serum and follicular fluid levels of CEA, CA 125 and SCC of women participating in an IVF program, in 42 cycles stimulated with GnRH-a and gonadotropins and in 26 unstimulated cycles triggered with HCG, were evaluated and compared with (a) steroid and gonadotropin levels, (b) the results of IVF, and (c) serum values in a control group of women with spontaneous normal ovulatory cycles. In the control group, serum antigens did not vary significantly during the 3 phases of the cycle. In stimulated cycles the median values in serum were 0.7 ng/ml (range, 0.0-2.1) for CEA, 14.0 U/ml (3.3-32.4) for CA 125 and 2.05 ng/ml (1.1-17.8) for SCC, whereas the median values in follicular fluid were 0.6 (0.0-27.9), 21.5 (0-670) and 21.4 (1-360), respectively. In unstimulated cycles the median values and ranges in serum were 0.9 (0.4-3.9), 12.1 (4.8-63.4) and 1.85 (0.7-4.4), respectively, whereas in follicular fluid they were 2.9 (0.4-180.7), 32 (1.7-600) and 231 (10.8-904). Different follicles of the same patients in stimulated cycles showed a wide divergence for all three antigens. In unstimulated cycles all three antigens in follicular fluid were strongly-correlated and a significant inverse correlation was observed between LH and both CA 125 and SCC in serum. In either group of cycles, no significant relationship was found between any serum or follicular fluid antigen and estradiol or testosterone, pregnancy rate, or oocyte quality and fertilization.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- I Phocas
- Second Department of Obstetrics and Gynecology, University of Athens, Areteion University Hospital, Greece
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26
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Abstract
Thirty-two patients with cystocele and rectocele with complaints of genuine urinary stress incontinence were subjected to complete urodynamic study, including intravaginal endosonography, before the operation and 6 weeks and 1 year after the operation. Intravaginal endosonography demonstrated the anatomic correlation of the bladder base, neck, and proximal urethra in relation to the inferior border of the symphysis pubis. In 28 patients, satisfactory correction of the bladder anatomy was achieved with operative treatment of genuine stress incontinence (GSI). Four patients presented persistent and recurrent GSI (2 in each group) after several weeks postoperatively. In addition, 2 patients had frequency-urgency syndrome, and 3 had voiding difficulties after the operation, but with no symptomatology of GSI. The patients with the symptoms described had various anatomic configurations after colposuspension. Vaginal endosonography is a simple technique with many advantages and satisfactory results in preoperative postoperative study, without radiation exposure and with minimal inconvenience to the patient.
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Affiliation(s)
- A H Liapis
- 2nd Department of Obstetrics and Gynecology, University of Athens, Greece
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27
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Phocas I, Mantzavinos T, Rizos D, Sarandakou A, Dimitriadou F, Zourlas PA. A comparative study of serum and follicular fluid alpha-immunoreactive inhibin, steroids, and gonadotropins in stimulated and unstimulated patients. Ann N Y Acad Sci 1993; 687:288-95. [PMID: 8323184 DOI: 10.1111/j.1749-6632.1993.tb43878.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- I Phocas
- Second Department of Obstetrics and Gynecology, Aretaieion University Hospital, Athens, Greece
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29
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Kassanos D, Botsis D, Gregoriou O, Bezantakos C, Kontogeorgi Z, Zourlas PA. The tap test: a simple and inexpensive method for the diagnosis of fetal pulmonary maturity. Int J Gynaecol Obstet 1993; 41:135-8. [PMID: 8099028 DOI: 10.1016/0020-7292(93)90695-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To report our experience in the prediction of fetal lung maturity with the tap test. METHOD Amniotic fluid was obtained from 207 pregnant women from 17-40 weeks' gestation and the tap test compared with the phospholipid profile. RESULTS The predictive values for a mature tap test were 100%, 99.9% and 98.2% and for immature tap test were 45.8%, 50% and 56.4% at 2.5 and 10 min, respectively. CONCLUSION The tap test is a reliable, rapid, easy, inexpensive and accurate method for detection of fetal lung maturity.
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Affiliation(s)
- D Kassanos
- Second Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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30
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Loghis C, Pyrgiotis E, Panayotopoulos N, Batalias L, Salamalekis E, Zourlas PA. Comparison between metal cup and silicone rubber cup vacuum extractor. Eur J Obstet Gynecol Reprod Biol 1992; 45:173-6. [PMID: 1511762 DOI: 10.1016/0028-2243(92)90079-e] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A total of 400 primiparous patients who were delivered by vacuum extractor were studied. The patients were divided in two groups: Group A included 200 patients who were delivered by metal cup vacuum extractor and Group B consisted of 200 patients who were delivered by rubber cup vacuum extractor. There were no statistically significant differences in the mean maternal age, mean gestational age, mean neonatal birth weight, indications for operative delivery, occipital positions and head stations between the two groups. No differences were found in the rates of birth canal trauma (11% vs. 12.5%), major neonatal scalp trauma (6.5% vs. 5.5%), neonatal jaundice (15.5% vs. 13.5%) and Apgar score. From this study we can conclude that both metal and silicone cups are equally satisfactory for vacuum extraction.
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Affiliation(s)
- C Loghis
- 2nd Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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31
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Phocas I, Mantzavinos T, Rizos D, Dimitriadou F, Arvaniti K, Zourlas PA. Hormone levels of follicular fluids with and without oocytes in patients who received gonadotropin-releasing hormone analogues and gonadotropins in an in vitro fertilization program. J Assist Reprod Genet 1992; 9:233-7. [PMID: 1525452 DOI: 10.1007/bf01203819] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Are follicles where no oocytes are retrieved "empty follicles"? METHODS The levels of estradiol (E2), progesterone (P), testosterone (T), cortisol (F), and prolactin (PRL) of follicular fluids (FF) aspirated individually from 34 randomly selected IVF patients in whom no oocytes were recovered were compared with the respective hormone levels of FF obtained from the same patients when oocytes were retrieved. Two FF without oocytes of a 35th patient in whom no oocytes were retrieved were analyzed. RESULTS Hormones did not differ significantly in the paired samples, while in the two FF of the 35th woman they were in agreement with cystic follicles. CONCLUSIONS It is necessary to differentiate aspirated follicles where no oocytes are retrieved from the "empty follicle syndrome," which was not observed in the IVF series studied and should be rare in IVF patients.
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Affiliation(s)
- I Phocas
- Second Department of Obstetrics and Gynecology, University of Athens, Greece
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32
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Abstract
alpha-Immunoreactive inhibin was measured using an enzyme immunoassay kit in the culture medium (Ham's F-10 medium supplemented with 14% heat-inactivated human serum) from day 3 or 4 to day 14 post-fertilization of 31 surplus pre-embryos from eight women participating in an in-vitro fertilization programme. Inhibition secretion was demonstrated in all of them from the fourth day after fertilization (mean +/- SEM: 3.0 +/- 0.7 U) and was independent of the morphological development of pre-embryos (2-4 cells, n = 4; 6-8 cells, n = 4; 8-10 cells, n = 9; 10-12 cells, n = 4; morulae, n = 5 and blastocysts, n = 4). On days 7, 10, 13 and 14 post-fertilization, mean inhibin values +/- SEM for non-disintegrated pre-embryos were respectively: 6.5 +/- 0.9 U, 12.3 +/- 2.0 U, 16.8 +/- 3.2 U and 20.2 +/- 3.7 U; however, when disintegration was noted on days 10 and 13 after fertilization, inhibin mean values were 9.0 +/- 1.4 U and 8.4 +/- 1.7 U respectively. Inhibin levels were significantly correlated with human chorionic gonadotrophin levels in the same culture media only on day 13, while correlation with pregnancy specific beta 1-glycoprotein occurred on day 7 post-fertilization. In conclusion, early human pre-embryos secrete alpha-immunoreactive inhibin before the cytotrophoblast is formed. This secretion increases significantly with time when development is continued, while disintegration is followed by a net decline in the rate of inhibin release.
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Affiliation(s)
- I Phocas
- Second Department of Obstetrics and Gynaecology, University of Athens, Areteion University Hospital, Greece
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33
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Dimitriadou F, Phocas I, Mantzavinos T, Sarandakou A, Rizos D, Zourlas PA. Discordant secretion of pregnancy specific beta 1-glycoprotein and human chorionic gonadotropin by human pre-embryos cultured in vitro. Fertil Steril 1992; 57:631-6. [PMID: 1740210 DOI: 10.1016/s0015-0282(16)54912-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To study and compare the secretion of pregnancy specific beta 1-glycoprotein (SP1) and human chorionic gonadotropin (hCG) by human pre-embryos, cultured in vitro, with their respective morphological development. DESIGN Spare human pre-embryos from randomly selected women participating in a program of in vitro fertilization (IVF) were studied prospectively. SETTING Pre-embryos were cultured, and hormone release was determined in academic research laboratories. PATIENTS, PARTICIPANTS Pre-embryos (n = 108) cultured for 14 days after fertilization in Ham's F-10 medium (GIBCO Ltd., Paisley, Scotland) were observed, and hCG and SP1 were measured in the culture media at regular intervals. MAIN OUTCOME MEASURES Discordant secretion of SP1 and hCG. RESULTS Of the 98 bipronucleate pre-embryos, 53.6% formed blastocysts, 17.3% of which hatched. Human chorionic gonadotropin was detected from day 7 after fertilization concomitantly with blastocyst formation, thereafter showing a logarithmic increase (maximum 10,650 mIU) until the first signs of embryonic disintegration. Pregnancy-specific beta 1-glycoprotein release started 3 to 4 days after fertilization independently of the morphological development and the future production of hCG, thereafter displaying a nonlogarithmic increase (maximum 41 ng). CONCLUSIONS Hormone secretion and morphological development are unique for each pre-embryo. Human chorionic gonadotropin and SP1 seem to have different biochemical and physiological regulation.
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Affiliation(s)
- F Dimitriadou
- University of Athens, Areteion University Hospital, Greece
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34
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Salamalekis E, Loghis C, Kassanos D, Traka A, Zourlas PA. Comparison of extra-amniotic prostaglandin F 2αend dinoprostone use for labour induction after second trimester intra-uterine fetal death. J OBSTET GYNAECOL 1992. [DOI: 10.3109/01443619209013610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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35
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Gregoriou O, Vitoratos N, Papadias C, Konidaris S, Maragudakis A, Zourlas PA. Intrauterine insemination as a treatment of infertility in women with antisperm antibodies. Int J Gynaecol Obstet 1991; 35:151-6. [PMID: 1680089 DOI: 10.1016/0020-7292(91)90819-q] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Twenty-four women with infertility caused by antisperm antibodies were treated by homologous intrauterine insemination. Initially, all the women had timed intrauterine insemination by washed spermatozoa for three cycles. The pregnancy rate per couple was 4.20%. The remaining 23 patients received a combined treatment of chlomiphene citrate and intrauterine insemination for three cycles, which did not increase the pregnancy rate per couple and per cycle (4.3% and 1.4% respectively). Thereafter, the remaining 22 patients received a combined treatment of hMG and intrauterine insemination for another three cycles which resulted in a pregnancy rate per cycle (6.1%) and per couple (18.20%) that was significantly greater (P less than 0.01). We conclude that infertile women with antisperm antibodies can benefit after a trial of induction of multiple follicular development with hMG in combination with intrauterine insemination.
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Affiliation(s)
- O Gregoriou
- Second Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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36
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Mantzavinos T, Phocas I, Chrelias H, Sarandakou A, Zourlas PA. Serum levels of steroid and placental protein hormones in ectopic pregnancy. Eur J Obstet Gynecol Reprod Biol 1991; 39:117-22. [PMID: 2050251 DOI: 10.1016/0028-2243(91)90074-u] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
UNLABELLED The hormonal profiles of extra-uterine pregnancies (EP) were compared with the normal intra-uterine pregnancies (IUP), and threatened abortions (TA) of good outcome. In 45 cases of EP confirmed histologically, maternal serum human chorionic gonadotropin (hCG), pregnancy specific beta 1-glycoprotein (SP1), 17 beta-estradiol (E2) and progesterone (P) were measured serially before treatment by enzyme immunoassays (EIA). The same hormones were also determined in the control groups, 26 with normal IUP and 24 with TA. All four hormone levels in EP were significantly lower (P less than 0.01-P less than 0.0001) than in normal pregnancies and threatened abortions of matched gestational age except the hCG and E2 in the fifth week of pregnancy. The mean values of E2 and P were found in the normal levels of luteal phase or slightly over them (8th-9th and 9th-10th weeks, respectively). No increase in the hormonal profiles of the above two steroids was noticed between 5 and 10 weeks' gestation in EP. IN CONCLUSION (a) The significantly lower values of hCG and SP1 in EP were confirmed; (b) the serial and concurrent hormonal measurements assure the verification of EP and the differentiation from normal IUP and TA of good outcome; (c) the ectopic implantation of trophoblast critically reduces its vitability to hCG and SP1 synthesis and it can only partially compensate for the reduction of corpus luteum function.
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Affiliation(s)
- T Mantzavinos
- Second Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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37
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Vitoratos N, Gregoriou O, Hassiakos D, Zourlas PA. The role of androgens in the late-premenopausal woman with adenomatous hyperplasia of the endometrium. Int J Gynaecol Obstet 1991; 34:157-61. [PMID: 1671371 DOI: 10.1016/0020-7292(91)90231-s] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
To examine the possible role of androgens in hyperplasia of the endometrium, the concentrations of testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate (DHEA-S), sex hormone-binding globulin (SHBG), estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH), were measured in peripheral venous serum obtained from 42 premenopausal women with adenomatous hyperplasia of the endometrium (group A) and from 18 women without hyperplasia (group B). In patients with hyperplasia of the endometrium, significantly higher peripheral venous concentrations were found for all androgens (P less than 0.05) and estradiol (P less than 0.001) than in control patients. In contrast, there was no statistically significant difference in the mean serum values of SHBG as well as in gonadotropins among the population of compared groups. We conclude that apart from the increased estrogenic activity in patients with adenomatous hyperplasia of the endometrium, androgens may play a significant role.
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Affiliation(s)
- N Vitoratos
- Second Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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38
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Hassiakos D, Mantzavinos T, Kalomiris K, Zourlas PA. Comparison of maternal serum estradiol and progesterone levels in pregnancies after induced and spontaneous ovulation. Arch Gynecol Obstet 1991; 248:145-50. [PMID: 2018410 DOI: 10.1007/bf02390092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Maternal serum estradiol and progesterone levels during the early 6th to 15th weeks of gestation, were measured by radioimmunoassay in 140 pregnancies following induction of ovulation with gonadotropins or clomiphene citrate. The levels were compared with those observed in 79 spontaneous pregnancies. Significantly higher levels were observed in gonadotropin and clomiphene citrate induced pregnancies (both P values less than 0.001) between the 6th to 9th week of gestation as compared to spontaneous pregnancies. Steroid levels were similar in the two groups from the 9th week onwards. No statistically significant differences in steroid hormone values were observed in aborted and successful pregnancies within each group studied. We conclude that ovulation induction is associated with higher estradiol and progesterone levels until placental steroidogenesis starts.
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Affiliation(s)
- D Hassiakos
- 2nd Department of Obstetrics and Gynecology, Areteion Hospital, University of Athens, Greece
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39
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Hassiakos D, Zourlas PA, Mantzavinos T. Artificial insemination with fresh donor semen. Int J Fertil 1990; 35:292-6. [PMID: 1980665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
One hundred and thirty-four patients received artificial insemination with fresh donor semen (AID). Using the life-table method of analysis, 72 pregnancies occurred, yielding a crude conception rate of 53.7%. The 134 women received an average of three inseminations per cycle for a total of 1,282 inseminations near the day of ovulation. The majority of pregnancies occurred by the seventh cycle. Forty-two pregnancies were achieved using a single donor; 30 pregnancies required changing the donor once, twice, or more. Among 42 patients who subsequently were treated with clomiphene citrate, 16 conceived. Two of these patients became pregnant after receiving hMG and hCG additionally. The life-table analysis of cumulative pregnancy rates following infertility therapy provides a relatively simple, powerful, and reliable tool for evaluating the effectiveness of therapy and its benefits. Patients should be advised that their chances of conception with AID approach that of normal fertile couples, provided that these patients persist in their treatment.
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Affiliation(s)
- D Hassiakos
- Second Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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40
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Abstract
In this study we evaluate the efficacy of a new home ovulation test to identify LH surge (LH-Color, Organon). Fifty-five spontaneously ovulating women were followed during their cycles with twice daily urinary LH testing as well as daily ultrasound and BBT charts. In 39 (70.91%) of the 55 patients, ovulation occurred within 24 h after the decoloration of the LH-Color. Follicular collapse as visualized by ultrasonography, took place in all patients within 36 h after the decoloration of the LH-Color. Thus a good correlation was found between urinary LH surge and ultrasound. We conclude that the rapid LH test was able to predict impending ovulation.
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Affiliation(s)
- O Gregoriou
- 2nd Department of Obstetrics and Gynecology, University of Athens Areteion Hospital, Greece
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41
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Affiliation(s)
- D K Hassiakos
- Second Department of Obstetrics and Gynecology, University Hospital, Athens, Greece
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42
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Abstract
A case of combined subsequent development of intrauterine and extrauterine pregnancy is reported. Signs of normal pregnancy associated with abdominal pains and an adnexal mass were the most significant symptoms and the final diagnosis was verified by laparoscopy in both cases. We consider that drugs for induction of ovulation (chlomiphene citrate and menopausal gonadotropins) were the causative factors of this rare obstetric complication.
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Affiliation(s)
- N Vitoratos
- 2nd Department of Obstetrics and Gynecology, University of Athens, Areteio Hospital, Greece
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43
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Abstract
Four patients who developed endometriosis at the episiotomy scar are reported. The latent period varied from 6 months to 10 years before the onset of symptoms. Three of them experienced cyclic pain at the site of the lesion during their menses and one patient had bloody discharge from the scar during menstruation. All patients were managed surgically and no one had recurrence during the follow-up period which ranged from 2 to 5 years. The pathogenesis of endometriosis is discussed as a clinical entity; the literature is also reviewed.
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Affiliation(s)
- E Salamalekis
- University of Athens, 2nd Department of Obstetrics and Gynecology, Areteion Hospital, Greece
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44
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Gregoriou O, Vitoratos N, Legakis N, Gregoriou G, Zourlas PA. Detection of sperm-bound antibodies in the male partners of infertile couples using the immunobead test. Eur J Obstet Gynecol Reprod Biol 1989; 33:235-9. [PMID: 2599253 DOI: 10.1016/0028-2243(89)90135-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of this investigation was to determine the incidence of sperm-bound antibodies in the male partners of an unselected infertile population using an immunologically specific test (IBT). With this method 34 out of 450 infertile men (7.55%) were positive for one or more of the immunoglobulins IgA, IgG and IgM. For IgG and IgA, the majority of antibody binding was located on the entire sperm with a minor amount bound to the head or tail. For the IgM, the majority of the binding was detected to the tail tip, and tail binding was observed only in a minority of cases.
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Affiliation(s)
- O Gregoriou
- Second Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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45
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Salamalekis EE, Mortakis AE, Phocas I, Dalamanga N, Zourlas PA. Successful pregnancy in a renal transplant recipient taking cyclosporin A: hormonal and immunological studies. Int J Gynaecol Obstet 1989; 30:267-70. [PMID: 2575055 DOI: 10.1016/0020-7292(89)90414-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A successful pregnancy following renal allotransplantation is reported. Until now azathioprine has been used as the standard immunosuppressive agent in such cases. Because of the potential teratogenicity of azathioprine, low doses of cyclosporin A, a new immunosuppressive drug, was used in our pregnant recipient. We present the management and the outcome of the pregnancy, as well as the hormonal and immunological follow up.
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Affiliation(s)
- E E Salamalekis
- 2nd Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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46
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Kalogirou D, Kouskouni E, Davri G, Zourlas PA. Die Chlamydia trachomatis bei Schwangeren und Neugeborenen. Arch Gynecol Obstet 1989. [DOI: 10.1007/bf02417244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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47
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Phocas I, Sarandakou A, Kontoravdis A, Chryssicopoulos A, Zourlas PA. Vaginal fluid prolactin: a reliable marker for the diagnosis of prematurely ruptured membranes. Comparison with vaginal fluid alpha-fetoprotein and placental lactogen. Eur J Obstet Gynecol Reprod Biol 1989; 31:133-41. [PMID: 2474464 DOI: 10.1016/0028-2243(89)90174-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of this study is the evaluation of the reliability of vaginal fluid (VF) prolactin (PRL) for detecting prematurely ruptured membranes (PROM) and the comparison of this marker with vaginal fluid alpha-fetoprotein (AFP) and placental lactogen (HPL). In 21 pregnant women with recent or prolonged PROM from 20 to 41 weeks' gestation, in whom intact membranes were never found subsequently VF- and MS-PRL, -AFP and -HPL were measured by enzyme immunoassays, which are sensitive and very rapid. The same markers were also measured in MS, VF and urine samples (U) in 12 pregnant women of the same gestational age, without PROM, in whom the membranes were ruptured later during labor. In PROM, independently of prematurity and duration of PROM VF-PRL levels were significantly higher (2-10-fold) than the paired MS-PRL (p less than 0.0001) and ranged from 130 to 2315 ng/ml. In contrast, VF-PRL and urine PRL concentrations in pregnancies without PROM were very low or undetectable (range: 0-5 ng/ml and 0.15-1 ng/ml, respectively). Vaginal fluid AFP values in PROM from 20th to the 33rd week of pregnancy were significantly higher (5-50-fold) than the paired MS-AFP (p less than 0.01) and ranged from 103 to 5500 ng/ml. In PROM after the 33rd week of pregnancy, VF-AFP values were either lower (1/3), or equal to, or even higher (up to 2-fold) than MS-PRL. On the contrary in pregnancies with intact membranes, VF-AFP were always less than 9 ng/ml and urine AFP was undetectable (range: 0.2-1.1 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- I Phocas
- 2nd Department of Obstetrics and Gynecology Medical School, University of Athens, Areteion Hospital, Greece
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48
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Gregoriou O, Botsis D, Papadias K, Kassanos D, Liapis A, Zourlas PA. Culture of seminal fluid in infertile men and relationship to semen evaluation. Int J Gynaecol Obstet 1989; 28:149-53. [PMID: 2563702 DOI: 10.1016/0020-7292(89)90475-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Bacterial flora of the seminal fluid and its influence on semen quality, was examined in 225 asymptomatic unselected men. Each semen sample was cultured aerobically, anaerobically, for genital mycoplasmas, and for Chlamydia trachomatis. Semen analysis was made according to standard methods recommended by the W.H.O. All 225 semen samples had microbial isolates. All isolates had colony counts of 10(2) colony forming units (cfu/ml). Thirty-three cases had greater than 10(2) cfu/ml, 85 cases had greater than 10(3) cfu/ml and 78 cases greater than 10(5) cfu/ml. The most common organisms isolated were Ureaplasma urealyticum in 86 samples and C. trachomatis in 26 samples. The most frequent abnormal parameters were viability (117 of 212, 52%), motility (85 of 212, 40%) and number of sperm cells (74 of 225, 32.8%). No significant correlation was found between abnormal semen parameters and presence of U. urealyticum, and C. trachomatis. We concluded that asymptomatic bacteriospermia (infection) in the semen did not significantly affect the count, motility or morphologic features of the specimen.
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Affiliation(s)
- O Gregoriou
- 2nd Department of Obstetrics and Gynecology, University Areteion Hospital, Athens, Greece
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49
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Abstract
The incidence of serum antibodies to Chlamydia trachomatis and the possible association of a positive serology on semen parameters in 120 subfertile men were studied. The findings were compared with those of 120 fertile volunteers fathering two or more children. The two groups were divided into those without and those with a history of genito-urinary infection. There was no significant difference (p greater than 0.1) in the prevalence of antibody testing between the subgroups of fertile population. A statistically significant difference in the incidence of antibodies was found between the two subgroups of subfertile population. No significant difference was noted in the semen parameters between Chlamydia-positive and Chlamydia-negative fertile and subfertile patients.
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Affiliation(s)
- O Gregoriou
- Second Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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50
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Abstract
Frequency of micturition and dysuria were prominent symptoms in 135 (57%) of 237 women with urethral syndrome. Ureaplasma urealyticum, Mycoplasma hominis and Chlamydia trachomatis were the principal organisms associated with the urethral syndrome (38.41%, 28.14% and 11.11%, respectively). Escherichia coli was cultured from four patients and Herepes genitalis and Neisseria gonorrhoea were isolated from five patients. Infections with more than one organism were frequent. Thirty-one of 135 patients were infected by two organisms, 27 by three and 4 patients by four microorganisms. Vaginitis due to Garnerella vaginalis, Candida spp. and Trichomonas vaginalis was discovered in 52 (39%) of 135 patients.
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Affiliation(s)
- N Vitoratos
- Second Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece
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