Antenatal, perinatal, or postnatal brain damage?
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Asphyxia↗
Biomedical subjects
E M Symonds
Publications and source records attributed to E M Symonds.
Diagnostic imaging of gynecologic tumors with the monoclonal antibody 791T/36.
One hundred twenty-three patients with suspected primary or recurrent gynecologic cancer were imaged after infusion with radiolabeled antitumor monoclonal antibody (791T/36). Overall sensitivity of tumor detection was 87% and specificity was 75%. Indium 111- and iodine 131-labeled antibody were compared, the former yielding a higher specificity for tumor detection. This antibody shows potential for routine tumor detection, particularly in cases of suspected recurrent cancer, but the development of antimouse antibodies is a drawback to this technique still to be overcome. The specific targeting of cytotoxic agents with this antibody is in progress.
Antibodies, Monoclonal↗
On-line processing of the fetal electrocardiogram. A new direction for fetal monitoring.
Digital filtering techniques can be applied to the recovery of the fetal electrocardiogram (ECG) from noise, using optimized digital filters matched to the frequency characteristics of the waveform. By forming a linear model of the fetal ECG, it is possible to measure time constants and characteristics on a real-time basis. The technique provides a powerful tool for the detection of subtle changes in the ECG, but the interpretation of these changes is critical to the application of the technique in fetal monitoring. Shifts in the ST segment and changes in T wave configuration are late indicators of fetal asphyxia, whereas the earliest indicators of stress are shortening of the PR interval and inversion of the normal positive relationship between the PR and RR intervals. The method appears to substantially enhance our ability to predict fetal stress at an early stage.
Electrocardiography↗
Prevalence of lumbar disc degeneration observed by magnetic resonance in symptomless women.
302 women aged 16-80 without symptoms of spinal disease had their lumbar intervertebral discs examined by magnetic resonance. The prevalence of one or more degenerate discs increased linearly with age but disc degeneration was already present in over one-third of women aged 21-40; these young women may prove to be at special risk of disc prolapse later in life. The high prevalence of symptomless disc degeneration must be taken into account when magnetic resonance is used for assessment of spinal symptoms.
Adolescent↗
Magnetic resonance imaging and placenta previa.
Twenty-five women with diagnoses of placenta previa on ultrasound examination underwent magnetic resonance imaging examination. An assessment of placental position and the relationship of the lower placental edge to the internal os was made with both techniques and the results were compared. There was complete correlation of placental localization but significant differences were found in the determination of the degree of placenta previa. This occurred more often with posteriorly situated placentas. Magnetic resonance imaging directly affected management with regard to delivery in seven cases. Magnetic resonance imaging provides a technique capable of accurately assessing placental position and its relationship to the cervix, thereby leading to a reduction in hospitalization and inappropriate operations.
Cervix Uteri↗
Obstetrical policy during labor and perinatal results: a comparison between two university clinics.
The obstetrical policy during labor at two University clinics in Nottingham (United Kingdom) and Nijmegen (The Netherlands) was investigated prospectively and simultaneously during a period of three months (1984). At the University of Nijmegen the obstetrical population tended to be more 'pathologic', and less intervention during labor was observed for early amniotomy, pain relief, induction and augmentation of labor. The pH in umbilical arterial blood was as a mean 0.01 unit lower in Nijmegen than in Nottingham. The validity of electronic fetal monitoring appeared to be higher in Nijmegen. It is concluded that data on the neonate probably cannot give an answer in favor of one of these policies. Parenthood information could give more conclusive evidence.
Adolescent↗
Can fetal electrocardiography improve the prediction of intrapartum fetal acidosis?
An outline is given of a computer-based system which continuously enhances and measures the waveform of the intrapartum fetal electrocardiogram. This system has been used to examine the behaviour of the ST segment and T wave in a group of 14 fetuses where the outcome was biochemically and clinically normal, and in a group of 10 fetuses which were acidotic at birth. When the mean values in each group were compared, highly significant differences were found for both of these components of the waveform. These differences have also been demonstrated by the analysis of long-term trends in the behaviour of these variables. The highly significant correlation between both a long-term increase in ST segment and T wave height and fetal acidosis, found in this study, reflects earlier work by others in the experimental animal fetus. The findings suggest that continuous monitoring of the waveform of the fetal electrocardiogram in labour may give a much better prediction of fetal acidosis than is currently achieved with the monitoring of heart rate alone.
Acidosis↗
Magnetic resonance imaging--its application to cervical carcinoma.
Twenty-five women with primary carcinoma of the cervix were examined with magnetic resonance imaging (MRI). A number of different pulse sequences with T1 and T2 weighting were employed to determine optimum tissue contrast, and the potential for staging cervical cancer was assessed and compared with the clinical findings. MRI is seen to give a unique view of cervical cancer in particular in stage I and II disease where other imaging techniques have known limitations. In addition, stages III and IV were well seen with demonstration of tumour comparable with that of computerized axial tomography (CT).
Adenocarcinoma↗
Genetics of hypertension in pregnancy.
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Eclampsia↗
Magnetic resonance imaging and hydatidiform mole.
Five women with complete and partial hydatidiform mole were examined by magnetic resonance imaging (MRI). Spin-echo pulse sequences (T2 weighted) were found to provide excellent resolution, while inversion-recovery pulse sequences (T1 weighted) gave better pathological detail. The myometrium was clearly seen on each patient and no invasion by the tumour detected. This corresponded to the histological findings. The potential uses of magnetic resonance in the diagnosis of primary and recurrent trophoblastic disease and its role in management are discussed.
Female↗
Fetal electrocardiographic monitoring: past, present and future--a historical perspective.
The first recording of the fetal electrocardiogram was described 80 years ago. Since that time only the peak of the QRS complex has been used in fetal monitoring for the measurement of fetal heart rate. Attempts to quantify changes in the configuration and time constants have been attempted over the last 30 years but despite the data obtained from animal experiments suggesting configurational changes in relation to hypoxia, the problems of electrical noise and signal distortion have restricted the application of these observations in the detection of fetal hypoxia in the human. Recent technical developments have now enabled continuous real time monitoring of the PR interval, heart rate and ST segment, and their findings and the interrelationships between different variables suggest a new approach to precise monitoring of the fetal state.
Electrocardiography↗
The application of magnetic resonance imaging to gynaecology.
Magnetic resonance imaging is a significant new imaging modality currently undergoing assessment. Already it has an established role in evaluation of the central nervous and musculoskeletal systems. Its potential application in gynaecology is reviewed with a discussion of its advantages over other imaging techniques.
Female↗
Pre-operative magnetic resonance imaging of stage 1 endometrial adenocarcinoma.
Twelve women with stage I endometrial adenocarcinoma were examined by magnetic resonance imaging before definitive surgery. Using this technique the depth of myometrical invasion, tumour site and cervical involvement were assessed and the results compared with the operative and pathological findings. Magnetic resonance imaging is a unique non-invasive method of assessing the early stages of endometrial adenocarcinoma before radiotherapy and surgery.
Adenocarcinoma↗
Osmolarity changes can enhance the release of renin from human chorion.
Sections of human chorion were perfused with an aerated buffer for 5 hours. Samples were collected every 20 minutes and the concentration of active and total renin in the perfusate was measured. Substitution of the initial bicarbonate buffer (281 mosm/L) with a buffer of 251 mosm/L doubled the rate at which active and inactive renin were released into the perfusate. When the osmolarity of the solution was reduced by 60 mosm/L, a threefold rise in the concentration of active renin and a sixfold rise in that of total renin was seen. However, these effects were transient, and renin secretion decreased before osmolarity was raised to the previous value.
Angiotensin I↗
Clinical implications for immunoscintigraphy in patients with ovarian malignancy: a preliminary study using monoclonal antibody 791T/36.
Twelve patients with suspected primary and recurrent carcinoma of the ovary have undergone immunoscintigraphy with an antitumour monoclonal antibody in order to assess the impact of the technique on patient management. Consistent tumour uptake of radiolabelled antibody was visualized in malignant tumours after subtraction of the blood background activity. Eight patients were imaged before surgery and in all of these the sites of uptake visualized on the images agreed with the surgical findings. In one patient with recurrent disease the imaging information was used as an aid for establishing the extent of external beam radiotherapy. A repeat study in this patient 6 months later revealed a reduction in the size of the tumour, which still concentrated labelled antibody and confirmed the viability of repeat investigations. Immunoscintigraphy was capable of providing diagnostic information which may offer an alternative to second-look surgery in these patients.
Adult↗
Litigation in obstetrics and gynaecology.
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Female↗
Fetal plasma renin and renin substrate in mid-trimester pregnancy.
Blood samples were obtained by fetoscopy from 30 fetuses in the middle trimester of pregnancy. The results indicate that high concentrations of renin and relatively low levels of renin substrate are present in the fetus early in pregnancy. These values are similar to those previously demonstrated in the full-term fetus.
Angiotensinogen↗
Sex steroid hormone concentrations in preterm labour and the outcome of treatment with ritodrine.
Peripheral plasma concentrations of unconjugated oestradiol-17 beta, progesterone and total oestriol were measured in patients presenting with uncomplicated preterm labour. Control samples were obtained from normal healthy women matched for maternal age, parity and duration of pregnancy. Oestrogen concentrations were often higher and progesterone concentrations often lower in patients presenting in preterm labour, and in particular, in those presenting in advanced labour and those failing to respond to treatment with ritodrine, but the differences were not statistically significant.
Adult↗