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Biomedical subjects

E Stern

Publications and source records attributed to E Stern.

At least 91 records · Page 5Linked to original sources

Sib risk of neural tube defect: is prenatal diagnosis indicated in pregnancies following the birth of a hydrocephalic child?

Recurrence frequencies of central nervous system malformations in sibs of probands with anencephalus or spina bifida range between 1% and 7%. The frequency of hydrocephalus among sibs of such probands is low (0.21%) but, nevertheless, is increased 2 to 5-fold when compared to general population frequencies. Anencephalus and spina bifida cystica were observed in 1.65% of sibs of children with hydrocephalus, a 2- to 8-fold increased over the population frequencies. These data indicate that some aetiological factors may be common to all three malformations. The risk figure of 1.65% for anencephalus and spina bifida in sibs born after the birth of a hydrocephalic proband constitutes sufficient indication for prenatal diagnosis by alphafetoprotein determination of the amniotic fluid.

Anencephaly↗

Enhancement of fetal lung maturity by intra-amniotic administration of thyroid hormone.

Following preliminary results in animal studies demonstrating that thyroxine (T4) injected directly into the fetus or the amniotic sac is capable of enhancing fetal lung maturity, a trial of thyroxine treatment in mean was carried out. Two hundred micrograms of T4 were injected intra-amniotically in eight women with high-risk pregnancies in which premature delivery was inevitable or indicated. Fetal lung maturity was evaluated by a recently developed, accurate, and rapid method using the microviscosity value epsilon (this being the linear expression of the polarization value P) of the lipid assembly of the amniotic fluid as a parameter of the surfactant content. epsilon Values, which were very high before T4 injection, dropped steeply to below the value of 4.344, indicating fetal lung maturity. Eight newborn infants delivered, five by caesarean section, soon after the T4 injection did not develop respiratory distress syndrome, although they were born prematurely. Intra-amniotic injection of T4 appears to be of therapeutic value in enhancing fetal lung maturity.

Amnion↗

[Arteriovenous aneurysm of the left internal thoracic artery with hypertrophy of the left upper limb (author's transl)].

Case report on a 5 years old boy suffering from a congenital arteriovenous fistula of the left internal thoracic artery. At the age of 9 months hypertrophy of the left arm combined with dilated veins in this area developed. Diagnosis was made by clinical examination together with a density in the left upper chest on x-ray and was confirmed by phlebography and thoracic aortography. A dilatation of the left heart, which was marked at the age of 9 months vanished in childhood without any therapy. The child was operated successfully.

Arm↗

Steroid contraceptive use and cervical dysplasia: increased risk of progression.

In a prospective study of women with dysplasia of the cervix, there was an increase in severity of dysplasia and of conversion to cancer in situ in users of the contraceptive pill compared with users of other contraceptive methods. There was a delay in this adverse response. Nonreversal of dysplasia within the first 6 months of pill use is predictive of progression after prolonged exposure.

Adult↗

"Pap" testing and hysterectomy prevalence: a survey of communities with high and low cervical cancer rates.

There is an inverse relation between cervical cancer rates and income in Los Angeles County communities, and there is a positive association between level of Papanicolaou (Pap) testing and income. Ethnic differences in cervical cancer rates and Pap testing are dependent on income. The relatively high rate of cervical cancer and low level of systematic screening in low income communities suggest that a community trial to assess the value of cytologic screening in reducing cervical cancer rates is feasible. Information on hysterectomy prevalence by type of procedure supports the idea that the long-observed decline in cervical cancer rates is in part attributable to a concomitant decrease in the ratio of subtotal to total hysterectomy.

Adult↗

[The oculo-oto-vertebral syndrome (author's transl)].

A new case of a combined malformation of the ear (anotia), eye (anophthalmia) and vertebral colum is presented. The distinction from the Goldenhar Syndrome and possible embryologic causes are discussed.

Abnormalities, Multiple↗

Papanicolaou testing and hysterectomy prevalence in low-income communities: a survey in Los Angeles County.

A survey of the prevalence of Papanicolaou (Pap) testing and of hysterectomy and a feasibility study were conducted in low-income communities with high rates of cervical cancer, identified by an analysis of mortality and case rates. Although about 90% of the women reported having had a Pap regular testing. For example, in the 5 years preceding the study (1971--75), about a quarter of the women had been tested only once and about a third not at all. No evidence of a secular change in hysterectomy prevalence in these communities was found.

Adult↗

A new method for assessment of fetal lung maturity.

A new method for evaluation of fetal lung maturity in utero is described. The method is based on the fluorescence polarization (P) of the lipids in the amniotic fluid after labelling with a special dye. Tests performed with 49 amniotic fluid samples drawn from 33 pregnancies clearly demonstrated a decrease in P during gestation which correlated with the increase in the lecithin/sphingomyelin ratio (L/S) in the fluid. During gestation the P value at 24 degrees C decreased steadily from about 0-4 to 0-2 and the value of P (24 degrees C) = 0-310 has been tentatively chosen as the threshold above which respiratory distress syndrome may develop. The described method, which requires a specially designed instrument, offers a series of important advantages over the presently available methods. It is simple, rapid, highly accurate and reproducible, and independent of amniotic fluid volume. The P value reflects the microviscosity in the whole lipid assembly of amniotic fluid and is not confined specifically to lecithin.

Amniotic Fluid↗

Evaluation of Papanicolaou smear and effect of sample biopsy in follow-up of cervical dysplasia.

In a prospective study of women with dysplasia, a superficial sampling biopsy of the cervix was carried out as a periodic check of the cytological findings. The relationship of smear and biopsy results was evaluated, as well as the effect of the biopsy procedure on the subsequent course of dysplasia. We found sufficiently close agreement between smear and biopsy results to conclude that smears and biopsies measure similar aspects of dysplasia. It would appear unwise, however, to rely on Papanicolaou smears exclusively in following women with a history of dysplasia, since negative smears in such women may occasionally show dysplasia in the corresponding biopsy. Periodic corroborative biopsy procedures are therefore indicated in the follow-up care of women with a history of dysplasia. There was no evidence that a superficial sampling biopsy significantly altered the short-term course of dysplasia. There was also no evidence of a cumulative effect of repeated sampling biopsies. These results do not rule out possible effects of other forms of biopsy procedures and schedules on the subsequent course of dysplasia.

Adolescent↗