Biomedical subjects

B S Shapiro

Publications and source records attributed to B S Shapiro.

30 records · Page 2Linked to original sources

PubMed1989

Ectopic pregnancy: duplex Doppler evaluation.

Of 398 patients in whom there was a clinical suspicion of ectopic pregnancy, 96 (24%) were found to have the condition. Of the 96, 70 underwent duplex Doppler imaging. A viable ectopic fetus was seen in 10 of 70 (14%), and an extrauterine sac without an identifiable fetus was seen in an additional 27, giving a sensitivity for imaging alone of 53%. Fetal heart activity was detected with Doppler in 13 (19%). High-velocity flow, which suggested the presence of an ectopic pregnancy, was detected in 38 of 70 (54%) patients (total preoperative sensitivity, 73%). In the 91 patients who did not have an ectopic pregnancy, duplex Doppler imaging of the intrauterine contents alone allowed an ectopic pregnancy to be excluded in 29 (32%) on the first examination and in a further 21 on the second scan (specificity, 55%). Nine vascular adnexal masses were falsely considered to be ectopic pregnancies (specificity, 90%). The positive predictive values were 47% for imaging alone and 85% for Doppler. The negative predictive values were 60% for imaging alone and 81% for Doppler.

Adult↗

PubMed1989

Ultrasound and infertility.

The development of ultrasound has provided the clinician with the opportunity to visualize the pelvic reproductive organs noninvasively. The use of ultrasound for the diagnosis and treatment of infertility has progressed rapidly to become an integral part of the management of the infertile woman. Examinations for each component of the reproductive tract have been refined. Thus, the diagnosis of uterine, tubal and ovarian pathology has been facilitated by the use of sonography. Ovarian follicular development is monitored effectively with ultrasound and has resulted in the widespread use of the technique in both spontaneous and induced cycles of ovulation. The development of the transvaginal ultrasound probe, with its better resolution, has enabled the clinician to routinely recover oocytes for in vitro fertilization without the risk of general anesthesia in a surgical procedure and has also enhanced the clinician's ability to diagnose early ectopic pregnancy.

Fallopian Tubes↗

PubMed1988

Salpingoscopy: an adjunctive technique for evaluation of the fallopian tube.

The success of tubal surgery is dependent upon both the nature and extent of tubal damage as well as the expertise of the surgeon. The present study describes the new technique of salpingoscopy to further appraise the status of tubal health by examination of the endosalpinx, utilizing readily available equipment. There were no complications during salpingoscopy attributable to the endoscopic procedure itself, except for a minimal amount of bleeding occasionally noted on the tubal serosa at the site of forceps stabilization. A discordance of 23.5% was noted overall between the fimbrial appearance at surgery and salpingoscopic examination. This new technique of tubal evaluation may eventually help the reproductive surgeon to more accurately counsel the patient in the choice between tubal reconstructive surgery or IVF-ET, one of the most difficult decisions in reproductive surgery today.

Endoscopes↗

PubMed1988

Transvaginal ultrasonography for the diagnosis of ectopic pregnancy.

The transvaginal (TVU) and transabdominal (TAU) ultrasound approaches were compared in their ability to identify by direct visualization the adnexal mass of ectopic pregnancy. There were 22 patients who had a surgically proven ectopic pregnancy. The TAU approach identified the adnexal mass in 50% and the TVU approach in 91% of the patients (P less than 0.01). Below both previously reported threshold titers for the expected TAU intrauterine sac visualization, at 6500 mIU and 3600 mIU, respectively, the TVU approach allowed the identification of significantly more ectopic adnexal masses than the TAU approach. The results of the present study demonstrate the increased efficacy of TVU over TAU in the direct identification of the adnexal mass associated with ectopic gestation.

Abdomen↗

PubMed1988

Instrumentation in hysteroscopy.

The use of diagnostic and operative hysteroscopy has evolved rapidly over the past decade to become an integral part of gynecologic care. The hysteroscopies and ancillary equipment are readily available commercially, and the techniques can be mastered, as is true of any surgical technique, with an appropriate amount of supervised practice. With a good basic understanding of the types of equipment available and their appropriate uses, the maximum utility of the hysteroscopic technique can be fully realized in an environment of safety.

Endoscopes↗

PubMed1987

The nonsurgical management of ectopic pregnancy.

The nonoperative management of unruptured tubal ectopic pregnancy by either chemotherapy or expectant observation may be appropriate in a select group of patients, as outlined above. The routine use of these management modalities as a replacement for conservative surgery is not yet justified.

Abortifacient Agents, Steroidal↗

PubMed1981

The relationship between loss of dopamine nerve terminals, striatal [3H]spiroperidol binding and rotational behavior in unilaterally 6-hydroxydopamine-lesioned rats.

The relationship between the destruction of dopamine-containing nerve terminals, specific binding of [3H]spiroperidol and contralateral rotation in response to L-DOPA, was studied in rats with unilateral lesions of the nigrostriatal dopamine (DA) system, induced by intracerebral injections of the neurotoxin 6-hydroxydopamine (6-OHDA). Animals with significant rotational behavior in response to L-DOPA had both a greater amount of specific binding of [3H]spiroperidol in the lesioned striatum compared to the non-lesioned striatum, and at least 90% destruction of DA terminals in the lesioned striatum (less than 10% of control uptake). The nonrotators to L-DOPA had considerably less destruction of DA terminals and no significant increase in specific binding on the lesioned side. The data from this study suggest that before L-DOPA is effective as an inducer of contralateral rotational behavior, there must be both unilateral damage to the DA terminals greater than 90%, and increased specific binding.

Animals↗

PubMed1979