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Biomedical subjects

D Rosenak

Publications and source records attributed to D Rosenak.

11 recordsLinked to original sources
PubMed2004

Adverse outcome of isolated fetal intra-abdominal umbilical vein varix despite close monitoring.

BACKGROUND AND OBJECTIVES: Fetal intra-abdominal umbilical vein (FIUV) varix-a focal dilatation of the umbilical vein-is an uncommon entity. Outcome varies from spontaneous resolution to fetal death. We describe here the experience of our center with this perplexing entity. METHODS: Case series review of seven cases of isolated FIUV treated in a tertiary care center from 2000 to 2003. RESULTS: We describe seven cases of isolated FIUV varix with varying natural history, follow-up strategies, and fetal outcome. In one of the cases, intrauterine fetal demise occurred despite close follow-up. CONCLUSIONS: We suggest that the course of FIUV is unpredictable, with a high fetal mortality rate. Close fetal monitoring with early delivery at 34 weeks' gestation should be advocated.

Abdomen↗
PubMed1995

The vanishing fetal intrathoracic mass: consider an obstructing mucous plug.

An intrathoracic homogeneous hyperechogenic mass diagnosed in the second trimester of pregnancy represents a challenge to the sonographer. A disappearance of such a finding is an enigma. We have recently encountered such a case in which a mucous plug obstructing a main bronchus was the causative factor. To the best of our knowledge, this is the first report of such an etiology in cases of vanishing fetal intrathoracic masses diagnosed by ultrasonography.

Adolescent↗
PubMed1994

Ureteric jet examination by color Doppler ultrasound versus IVP for the assessment of ureteric patency following pelvic surgery--a pilot study.

During the study period 228 women underwent major gynecological surgery in our department. Of these, 25 were selected for the study because of suspected post-operative ureteric obstruction. Post-operatively, both intravenous pyelography (IVP) and ureteric jet examination by the means of color Doppler ultrasound were performed in the study group. The aims were to exclude iatrogenic ureteric occlusion and to test the reliability of ureteric jet examination with ultrasound, as compared with IVP, as a diagnostic test for ureteric obstruction. In 19 patients both IVP and jet examination were normal. In the remaining six patients, jet was negative either uni- or bi-laterally. Of these six, only two obstructions were diagnosed using IVP. This test was associated with a positive predictive value of 33.3%, negative predictive value of 100%, sensitivity of 100%, specificity of 88.6%, false negative of 0% and a false positive of 17.4%. It is concluded that the results suggest that color Doppler ultrasound may be a good screening test for ureteric occlusion following pelvic surgery. Whenever a jet test is negative, further evaluation by IVP is required.

Adult↗
PubMed1993

Simultaneous swim-up/swim-down of sperm in assisted reproduction procedures.

PURPOSE: High-quality motile human spermatozoa were obtained following treatment of semen by simultaneous swim-up into medium and swim-down into an isotonic 40% Percoll solution. RESULTS: This procedure was significantly better than the swim-up method and comparable to discontinuous Percoll gradient centrifugation. Recovery rates of motile sperm were 35% for swim-up, 65% for Percoll gradient centrifugation, and 73% for swim-up/swim-down. CONCLUSION: The swim-down sperm was inferior to the swim-up sperm in its upward migration capacity but superior in morphology. Spermatozoa obtained by the swim-up/swim-down procedure demonstrated fertilizing ability in IVF, and clinical pregnancies were established. The simultaneous swim-up/swim-down procedure offers an alternative efficient method of simple separation of high-quality motile sperm for various assisted reproduction techniques.

Cell Separation↗
PubMed1991

Recurrent tetraamelia and pulmonary hypoplasia with multiple malformations in sibs.

A term amelic female infant was born to an apparently nonconsanguineous Arab Moslem couple. This was followed by the birth of 4 normal children. Afterwards, in 2 subsequent pregnancies, 2 amelic fetuses were diagnosed by transabdominal ultrasonography in the 18th and 12th week of gestation. Pregnancies were terminated and on autopsy both amelic fetuses had severe lung hypoplasia and aplasia of the peripheral pulmonary vessels. The first fetus also had apparently low-set ears and micrognathia, whereas the last had hydrocephaly and left cleft lip beside the lung hypoplasia and aberrant pulmonary artery. This appears to be a new autosomal recessive malformation syndrome.

Abnormalities, Multiple↗
PubMed1990

The effect of disopyramide on uterine contractions during pregnancy.

To evaluate the effect of disopyramide on uterine contractions during pregnancy, the drug was given for 48 hours to 10 women with indications for labor induction. Placebo was given to 10 other women with the same indications for induction. During the study period, regular uterine contractions occurred in 10 women in the study group, as compared with none in the control group (p less than 0.0001). Eight women in the study group were delivered of infants within 48 hours, as compared with none in the control group (p less than 0.0001). The mean time until the appearance of regular uterine contractions in the study group (4.15 +/- 1.76 hours) was significantly shorter (p less than 0.001) than that in the control group (56.13 +/- 5.28 hours). Patients who were not delivered of infants within 48 hours received other medications (prostaglandin E2, oxytocin). The mean maternal blood level of disopyramide at the time of appearance of uterine contractions was 1.52 +/- 0.9 mg/ml. The mean maternal level at delivery was 0.93 +/- 0.43 mg/ml and the cord blood level at the time of delivery was 0.33 mg/ml (cord blood/maternal level ratio = 0.36, r = 0.73, p less than 0.05). These results indicate that disopyramide should not be used in pregnancy for antiarrhythmic purposes because it may induce uterine contractions and delivery.

Adult↗
PubMed1990

Cocaine: maternal use during pregnancy and its effect on the mother, the fetus, and the infant.

Cocaine was previously regarded as a soft drug causing only mild damage. Its use during pregnancy, however, creates a variety of grave medical problems which necessitate immediate attention not only on the part of internists and psychiatrists but also, and more particularly, by obstetricians and pediatricians. The pregnancy of a cocaine-using woman must be carefully managed and regarded as a high-risk one. This in view of the numerous obstetric risks caused by the drug, notably premature separation of the placenta, increased incidence of stillbirths, congenital malformations, premature births, and intrauterine growth retardation. The neonatal monitoring must be focused on prevention of complications resulting from the withdrawal syndrome and associated conditions such as pneumonia, severe weight loss, and contagion from the mother. Moreover, efforts must be made to ensure a strict observation of the infant outside the hospital in view of the far greater incidence of idiopathic infant death in such cases. Owing to the sharp rise of the regular and occasional use of the drug and since pregnant women tend on anamnesis to deny any drug taking, we recommend a test of maternal urine for cocaine and other drugs whenever a suspicion to this effect arises. It is also advisable to test for the presence of such drugs in the urine of the neonate in cases of reasonable suspicion of maternal use during pregnancy, though a negative outcome of the urine test naturally does not rule out a possible use. Strict monitoring of positive cases, accompanied by preventive treatment, may contribute a great deal toward a reduction of perinatal morbidity and mortality associated with cocaine use use.

Cocaine↗