摘要:

Using the Mishell and Dutton culture system an assay was developed for eliciting and quantifying sperm surface antigen (SSA)-specific immune responses in vitro. Peripheral blood mononuclear cells (PBMC) from sexually inexperienced and experienced women that were antisperm antibody (ASA) negative gave rise to a plaque-forming cell (PFC) response of similar magnitude (1,362 and 1,254 PFC/culture, respectively). PBMC from women that were ASA positive had lower PFC responses if cervical mucous antibodies were detected along with circulating antibodies (876 PFC/culture) than if they were not detected (1,512 PFC/culture). Limit dilution analysis was used to demonstrate that the level of the anticipated antibody response is regulated by T helper cell activity. The results of this investigation suggest that the antibody response to SSA is governed at least in part by both the secretory immune system and circulating T helper cells.

ISSN:0378-7346    

DOI:10.1159/000292628

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The risk of congenital malformations was assessed in infants born to women who underwent immunotherapy for habitual abortion. One hundred and eighty women were immunized with paternal mononuclear cells and 85 were not. Of 135 pregnancies in immunized patients, 27 (20%) were miscarriages, and 4 of the remaining 108 had congenital malformations. Two (encephalocele and common AV canal) were diagnosed in the 20th and 21st week of gestation. A case of esophageal atresia and Fallot’s tetralogy were diagnosed at birth. Of 65 pregnancies in the non-immunized group 38 (58.5%) were miscarriages, and of the remaining 27, 1 case of Down’s syndrome occurred. In a subgroup of 7 habitually aborting couples with parental balanced chromosomal anomalies, the balanced translocation was transferred to the infant in 1 case. No other congenital anomalies were found in either group. Consequently, these anomalies are probably not the result of abnormal pregnancies retained as a result of immunization.

ISSN:0378-7346    

DOI:10.1159/000292629

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

In order to investigate the possible role of suppressor cells in paternal leukocyte immunization to prevent recurrent miscarriages, peripheral blood lymphocytes from habitually aborting women before and after immunization were assessed. Immunization-induced suppressor activity as shown by (1) rise in CD8-positive cells and a decline in the CD4/CD8 ratio, (2) failure of cyclosporine A to inhibit the proliferation of phytohemagglutinin- and alloantigen-stimulated cells and (3) unresponsiveness to the immunizing spouses’ antigen. These findings resembled those in normal pregnant women. Hence, paternal leukocyte immunization may induce specific and nonspecific T cell suppression which may induce the immune tolerance necessary to maintain pregnancy.

ISSN:0378-7346    

DOI:10.1159/000292630

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Plasma levels of thrombomodulin (TM), a glycoprotein found on the surface of the endothelial cell, are elevated in certain diseases that are characterized by damage to the vascular endothelium. Such damage is thought to be involved in preeclampsia. We therefore studied the plasma levels of this substance in 13 preeclamptic women as compared with 14 normal pregnant and 16 nonpregnant women. We found that the plasma levels of TM were significantly elevated in preeclamptic women vs. controls. A significant positive correlation was observed between the plasma TM level and that of serum creatinine. It is thus suggested that elevated TM levels in preeclampsia may reflect a decrease in renal clearance rather than vascular endothelial damage.

ISSN:0378-7346    

DOI:10.1159/000292631

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

A new method to diagnose localized placental lesions is introduced. The method involves Fourier analysis of intraplacental and umbilical Doppler velocity waveforms. It is shown, using a theoretical model based on an electrical transmission line approach, that intraplacental waveforms that are of higher pulsatilities than those in the umbilical artery indicate placental abnormalities. The method was applied in a series of cases with normal umbilical waveforms in which placental abnormalities were diagnosed. The method promises to be more sensitive and specific than analyzing umbilical waveforms alone as it does not depend on uncertain threshold values.

ISSN:0378-7346    

DOI:10.1159/000292632

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

An enzyme-linked immunosorbent assay was developed for the detection of anticardiolipin antibody (ACA) in habitual aborters. Results above the 98th percentile of a distribution of 100 blood donors were considered to be positive. Specific binding index for ACA was higher in 20 patients with at least 3 consecutive spontaneous abortions (group A) than in 20 women with at least one live birth without pregnancy wastage (group B). ACA was detected in 4 patients of group A and in none of the women of group B. Most of the pregnancy wastages occurred after the first trimester in ACA-positive patients and during the first trimester in ACA-negative patients.

ISSN:0378-7346    

DOI:10.1159/000292633

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

A total of 132 pregnant women with average gestational age of 14.2 weeks (range 11–22 weeks) undergoing legal abortion volunteered for a trial utilizing vaginal administration of misoprostol. In 106 women a dose of 800 μg was utilized, whilst in 26 women 1,200-1,600 μg were given. Nonsurgical expulsion of the fetus was successful in 117 cases (88.6%). Four cases had to be excluded for various social reasons. A total of 11 did not achieve fetal expulsion within 56 h after application of misoprostol. These cases (11/132; 8.3%) were considered failures. Previous reports in the literature of toxicity trials on animals reporting no fetotoxic nor teratogenic effects of misoprostol at doses up to 10,000 μg/kg body weight seem to be of no validity in the human since we could demonstrate that almost 80% of pregnancies were interrupted at a dose of 10–15 μg/kg body weight. The conclusion is that vaginal administration of this prostaglandin analogue, not requiring cool temperature for storage, is remarkably effective in achieving safe interruption of pregnancy without any significant complications.

ISSN:0378-7346    

DOI:10.1159/000292634

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The effects of long-term use of oral contraceptives containing less than 50 μg of estrogen (sub-50 OCs) on the kinetics of folic acid monoglutamate, vitamin B12 levels, and iron status have been studied in 29 OC users (Marvelon®) and in 13 women without OC use serving as controls. At 210 min after oral folate loading the median serum folate concentration was significantly lower in OC users when compared to the control group. OC users showed significantly higher total iron binding capacity and significantly lower serum vitamin B12 concentrations. This data demonstrates that sub-50 OCs significantly affect folate kinetics and vitamin B12 levels. However, the folate and vitamin B12 status does not seem to be at risk.

ISSN:0378-7346    

DOI:10.1159/000292635

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

There is scant information on the effects of progesterone on circulation. Changes in catecholamine levels, blood pressure and transcapillary fluid balance were measured in 12 men before and during administration of natural progesterone (Utrogestan). Before administration, systolic blood pressure was significantly correlated with venous adrenaline (r = 0.67, p = 0.01). There was a significant decrease (p = 0.004) in venous noradrenaline during progesterone administration, and systolic blood pressure was significantly correlated with the arteriovenous difference for noradrenaline (r = 0.66, p = 0.02). Serum progesterone, which attained levels similar to those found in women during the luteal phase, did not significantly alter blood pressure, body weight or intra- to extravascular fluid shift. It is concluded that progesterone may have a direct action by increasing the uptake of noradrenaline from the synaptic cleft or by decreasing the nerve firing rate. Interestingly, the pretreatment finding of a significant correlation between blood pressure and adrenaline was less evident during progesterone administration.

ISSN:0378-7346    

DOI:10.1159/000292636

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

A decade of perinatal audit in the Maputo Central Hospital is reviewed with the objective of addressing the potential value of the audit process in monitoring the different constituents of morbidity and mortality in the perinatal period. The perinatal mortality showed a significant but transient change during the observation period 1982–1991, while intrapartum fetal mortality was significantly reduced from 10.9 to 3.9 per thousand (p < 0.0005). Staff members were sensitized towards immediate and long-term effects of implemented surveillance routines by regular feedback of perinatal data on visible wall charts and by weekly conferences. The advantages of a comprehensive audit approach in perinatal medicine comprising both maternal and fetal/infant aspect are underscored. An ethical commitment to nonconfidential straightforwardness and openmindedness in critical discussions regarding mismanagement is emphasized for a successful audit strategy.

ISSN:0378-7346    

DOI:10.1159/000292637

出版商:S. Karger AG    

年代:1993

数据来源: Karger