Deep vein thrombosis and pulmonary embolism in head injured patients.
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Biomedical subjects
Publications and source records attributed to D Bernstein.
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The effect of hormonal stimulation on the intracellular mucus production of the endocervical cells was histochemically and morphometrically investigated. Twenty-seven cervixes from patients who had received estrogen or gestagen prior to hysterectomy were examined. "Upper" versus "lower" cervix and "small" versus "large" crypts were compared in both groups of patients. The histochemical analysis of mucins within the cells was based mainly on the combined alcian blue/periodic acid Schiff (AB/PAS) techniques at various pH levels. A semiquantitative estimation using cell counts and statistical evaluations was done for each staining method. The results indicate that sex hormones influence the chemical composition of endocervical mucus production. In addition, the nature of the intracellular mucus varies with the cryptal size and location within the cervical canal.
Polyzoospermia has been repeatedly associated with reduced fertility and increased rates of spontaneous abortion. We examined semen samples of 1374 infertile men and found an incidence of 4.2% of semen with a sperm density exceeding 250 X 10(6) sperm cells/ml. The spontaneous pregnancy rate in 30 evaluated couples in whom the male partner presented with polyzoospermia was 38.7% and the spontaneous abortion rate was 25%. Sperm penetration tests revealed normal mucus-penetrating ability in 29 of 30 men examined. The reason for reduced reproductive performance in polyzoospermic men does not seem to be disturbed sperm mucus interaction.
Out of 714 hysterographies performed because of infertility, Four cases of unilateral "patent" mesonephric duct remnants were found and are described. In these patients a dysfunction of the uterus may be postulated, as all four had some pathology in their pregnancies, whether abortions, bleeding, premature deliveries, or a combination of these processes. It is suggested that there is a possible connection between mesonephric duct remnants and congenital uterine pathology.
Gentamicin levels were determined in 100 serum specimens by a new latex agglutination inhibition card test, a radioimmunoassay (RIA), and a bioassay. Correlation coefficients determined by linear regression analysis demonstrated that the levels obtained by the latex agglutination inhibition card test had a high degree of correlation with the RIA and could be performed much faster and more economically when processing small numbers of specimens. The bioassay had a slightly lower degree of correlation with both the RIA and the latex test and was adversely influenced by concurrently administered antibiotics which could not be eliminated by beta-lactamase. When measuring gentamicin concentrations above 2 micrograms/ml, the coefficient of variation was less than 14% for the latex agglutination assay compared with 15% for the bioassay and 12% for RIA. The latex agglutination inhibition card test is a rapid, accurate, specific, and reproducible method for monitoring gentamicin levels in patients and is particularly applicable for laboratories processing small numbers of specimens.
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Twenty-five women scheduled for hysterectomy for nonmalignant disease participated in the study. Sperm storage in endocervical crypts was examined in three groups of patients: nine women pretreated with estrogen and inseminated with normal semen, nine women pretreated with gestagen and inseminated with normal semen, and seven women pretreated with estrogen and inseminated with abnormal semen. The number of crypts containing spermatozoa (colonized crypts) and the sperm density per crypt were examined in serially sectioned cervices. In estrogen-pretreated cervices both the percentage of colonized crypts and the sperm density were significantly higher than in gestagen-pretreated cervices. Large and giant crypts proved to be the main storage facility for spermatozoa. The localization of crypts along the endocervical canal did not influence sperm storage. The quality of semen appeared to be of critical importance to sperm storage. The percentage of colonized crypts and sperm density were severly reduced in patients inseminated with abnormal semen.
A newer approach to the early diagnosis of acute biliary tract disease is review. Ninety-two patients were evaluated with a new hepatobiliary agent (H.I.D.A/P.I.P.D.A.) for the presence of cystic duct obstruction. Seven patients with suspected acute gall bladder disease were dropped from the study for the lack of pathologic confirmation of the diagnosis. Forty-four of the remaining 85 patients were subsequently operated on and found to have acute cholecystitis. Forty-three of the 44 had cystic duct obstruction demonstrated on H.I.D.A. Scan (one false negative). An additional 23 patients underwent cholecystectomy for chronic disease. In this group, the gallbladder scan was only 43% (10/23) accurate in correctly identifying disease. Eighteen patients with nonbiliary disease had normal scans. The accuracy of ultrasonography and the scan are also compared in a smaller subgroup of 53 patients who had both studies.
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Human antibodies to streptococcal groups A and C carbohydrates were measured quantitatively with a radioimmunoassay using tyrosylated 125I carbohydrate. Analysis of acute and convalescent sera from people with groups A or C streptococcal pharyngeal infection or persistent carriage revealed a significant rise in antibodies. Inhibition reactions with the cold carbohydrate indicated the specificity of the elicited antibodies. In some instances, group C as well as group A antibodies occurred after group A pharyngeal infections. Further clinical and epidemiological studies are required to determine the significance of group-specific antibodies. Antistreptolysin-O (ASO) rises were observed in individuals with group C antibody responses after persistent group C pharyngeal carriage. For this reason, epidemiological surveys that rely primarily on ASO surveys to determine the incidence of group A streptococcal infections must be interpreted with caution, at least in the developing countries, where group C pharyngeal carriage is common.
309 couples with infertility of 1 to 11 years duration in whom pregnancies occurred during examination or treatment were evaluated. The couples were classified into diagnostic groups according to the main cause of their infertility; anovulatory, mechanical, male, cervical, unexplained, combined. Pregnancies were divided into treatment-related and nontreatment-related. Analysis of results revealed that whereas in infertile patients with a defined cause of infertility, the treatment-related pregnancy rate was 73.1%, in the unexplained infertility group the incidence of treatment-related pregnancies was only 6.6%. We concluded that a meticulous fertility survey should be carried out in each infertile couple in order to detect a specific cause impeding fertility, but if such a cause cannot be found, reassuring of patients and decreasing their anxiety is more effective in inducing pregnancy than nonspecific therapy.
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Intrauterine adhesions (Asherman's syndrome) may follow curettage in a recently pregnant uterus. Treatment consisting of dilatation and curettage and possibly the insertion of an intrauterine device usually is started early. The success rate is high. Very few cases of spontaneous recurring menstruation have been reported, and none of them have been based on hysterosalpingographic evidence of adhesions. The pregnancy outcome is generally poor in those cases of assumed spontaneous resolution. We present a case of spontaneous restitution of a functional uterine cavity and normal menstruation following Asherman's syndrome. Subsequent pregnancy was uneventful. A short review of the literature is presented, and the possible self-limiting character of the disease is discussed.
Urine samples from 76 pregnant women were tested for pregnanediol content during the first 6 weeks of pregnancy. Pregnanediol was measured by gas chromatography in 24-hour urine samples obtained once weekly from 76 randomly selected pregnant women 21, 28, 35, and 42 days after the last menstrual period. Pregnancy was ascertained by a positive hemagglutination inhibition test for human chorionic gonadotropin. In patients in whom the urinary pregnanediol content was less than 3 mg/24 hours the abortion rate was 81.5%, and 18.5% had normal pregnancies and births In patients whose pregnanediol content was greater than 3 mg/24 hours the abortion rate was 8.3%, and 91.7% had normal pregnancies and births. The 24-hour urinary pregnanediol excretion rate reflects corpus luteum function and can be considered as a means of monitoring pregnancy in its initial stage.