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Biomedical subjects

I Kessler

Publications and source records attributed to I Kessler.

At least 19 recordsLinked to original sources
PubMed1992

A muscarinic receptor different from the M1, M2, M3 and M4 subtypes mediates the contraction of the rabbit iris sphincter.

In order to analyse the subtype of muscarinic receptors involved in the methacholine-induced contraction of the rabbit iris sphincter we have determined equilibrium dissociation constants (KB) of various antagonists in the sphincter muscle. The values were compared with those observed at M1 (rabbit vas deferens), M2 (heteroreceptors in rat iris) and M3 receptors (guinea-pig ileum), or at the muscarinic receptors in the guinea-pig uterus. The methacholine-induced contraction of the uterus from immature guinea-pigs was competitively antagonized by pirenzepine (6.64, -log KB), 4-DAMP (8.39), hexahydrodifenidol (HHD; 7.00 for the (R)- and 5.40 for the (S)-enantiomer), p-fluoro-hexahydrosiladifenidol (p-F-HHSiD; 6.25) and valethamate bromide (8.04). The affinity of the antagonists is consistent with the presence of an M2 receptor. The -log KB values of the antagonists in the rabbit iris sphincter (6.43, p-F-HHSiD; 6.22, AQ-RA 741; 7.23 and 5.34, (R)- and (S)-trihexyphenidyl) were lower than, or within the lowest range of, estimates in the other experimental models, irrespective of the subtype selectivity of the antagonist. This excludes the presence of an M1, M2, M3 or M4 receptor in this smooth muscle. The affinity of UH-AH 37 in the iris was intermediate between that for M1 or M3, and M2 receptors. The low affinity of AQ-RA 741 and the low enantiomeric ratio of trihexyphenidyl (THP) in the iris (77.6) would be compatible with a presumed M5 receptor.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Disseminated intravascular coagulopathy and adult respiratory distress syndrome: life-threatening complications of hysteroscopy.

A 23-year-old, healthy woman underwent hysteroscopy during which Hyskon solution was injected into the uterine cavity. Soon afterward she developed a bleeding coagulopathy followed by acute respiratory insufficiency and pulmonary edema, necessitating endotracheal intubation and artificial ventilation with positive end-expiratory pressure. This rare complication of hysteroscopy was most probably due to the injection of Hyskon solution.

Adult↗
PubMed1989

[Metroplasty in congenital uterine malformations].

44 women with congenital uterine malformations, aged 22-39, underwent metroplasty during a 19-year period. They constituted 7.3% of all patients with such malformations diagnosed during that period. Indications were a high rate of spontaneous abortions (78.3%), and low rates for term deliveries (9.3%) and live children (11.8%) among 163 pregnancies. The operations were tailored to the uterine malformations; some were by the abdominal route and others involved hysteroscopic resection of a uterine septum (13 cases). After metroplasty, in 52 pregnancies the abortion rate was reduced to 26.9%, and term deliveries increased to 59.6% and neonatal survival to 69.2% (for all 3, p less than 10(-8)). It is concluded that a poor obstetric history is an indication to search for uterine malformations, and that if found, there is a clear indication for metroplasty. The surgeon must know the types of malformations and should be well acquainted with the different operative techniques.

Abortion, Spontaneous↗
PubMed1989

Centralisation of the radial club hand by gradual distraction.

Centralisation of the carpus on top of the distal end of the ulna in radial club hand of types III and IV has been performed by gradual distraction. For this purpose, I have used the apparatus originally developed for lengthening of digital structures and the forearm. This technique avoids extensive dissection and acute stretching of the radial neuro-vascular structures. Experience has shown that gradual distraction is a safe and relatively simple method for correction of the deformity, particularly in long-standing and neglected cases.

Bone Lengthening↗
PubMed1988

Ovarian tumors in pregnancy.

Thirty-eight women were operated for an ovarian tumor diagnosed during pregnancy, with an incidence of 1/2328 deliveries. The diameter of all tumors was above 5 cm. Of the 31 women operated before delivery, seven were untreated and 24 received supportive progestational therapy. The rate of abortions was 85.7% in the untreated group and 10% in the hydroxy-progesterone-caproate group (HPC) (P less than 0.02). When the women received a total dose of HPC of more than 300 mg, 9 of 10 pregnancies reached term with a live child. Two ovarian malignancies were found, 5.3% of all cases. In 42.9% of the women there were fertility problems later in life. Ovarian tumors during pregnancy should be removed as soon as possible, irrespective of the age of the pregnancy. If fully progesterone therapy is given, the danger of abortions is reduced to a minimum. Prophylactic antibiotic treatment should also be administered.

17 alpha-Hydroxyprogesterone Caproate↗
PubMed1988

Complications associated with genital colonization in pregnancies with and without cerclage.

Cultures from the cervical milieu were taken from 24 antibiotic-treated patients (group A) and from 25 patients with no antibiotic treatment (group B). Both groups had undergone cerclage and were compared to 30 randomly chosen pregnant patients without cerclage (group C). Positive cultures were obtained in 70.8% and 48% before cerclage and in 66.7% and 68% after cerclage in groups A and B, respectively. These were not significantly different from group C (56.7%). Escherichia coli was found in over 75% of positive cultures. The rate of premature deliveries and premature rupture of the membranes were significantly higher in the cerclage groups. Maternal morbidity was significantly higher in group A compared to B and C. Our data suggest that bacterial colonization of the cervix and the vagina is not influenced by cerclage and antibiotics. It is concluded that cervical cerclage is associated with increased morbidity, therefore it is indicated only for definite anatomic and/or functional defects.

Administration, Oral↗
PubMed1987

Re-evaluation of the obstetrical risk for the older primipara.

The obstetric data relating to 92 older primiparas (OP) treated as regular obstetric patients and data relating to 92 older multiparas (OM) are compared to a previous study of 98 OP, which led to the conclusion that OP should not be managed as high-risk patients during gestation. No difference was found between the two periods regarding complications of pregnancy, gestational age and birth weight, onset of labor, perinatal morbidity and mortality. Nevertheless, cesarean deliveries were significantly higher in the study group. It seems that the conservative attitude towards OP during pregnancy is justified, but at labor, more rigid indications for cesarean section should be applied to establish objective patient care.

Adult↗
PubMed1986

Indications and results of metroplasty in uterine malformations.

During 14 years, 430 women with some type of congenital uterine malformation were discovered by different methods, with a rate of 1 in 137 deliveries. In only 17 was metroplasty indicated, because of very poor reproductive performance; out of 42 desired pregnancies, only 14.3% live births resulted. The abortion rate was 65.2%, and there were 13% premature deliveries. The operations performed included the Strassmann type in 13, the Tompkins technique in three and the Jones operation in one. After the metroplasty, out of 27 completed pregnancies the rate of abortions fell in 14.8% (P less than 0.00003) and the rate of live births rose to 85.2% (P less than 0.00003). There is no doubt that when the indication for metroplasty is strictly imposed, the staff is well versed in the different types of operations and the treatment is done in a center which has acquired competence, the improvement in reproductive performance can be quite impressive.

Abortion, Spontaneous↗
PubMed1986

Face presentation.

The diagnosis, aetiology, management and outcome of face presentation were analyzed in 51 cases. Primigravidas accounted for 17.6%, multiparas for 54.9% and grand multiparas (5 deliveries or more) for 27.5%. Prematurity did not appear to be an important aetiologic factor. The position was mentum anterior in 26 patients (51%), all but one of whom were delivered vaginally. Of 12 fetuses in the mentum transverse position, 11 were delivered vaginally after spontaneous rotation to mentum anterior. Ten patients presented with mentum posterior; only 2 were delivered vaginally after spontaneous rotation. Three fetuses were diagnosed as face presentation during Caesarean section. The mean birth-weight of the infants who rotated from mentum posterior to mentum anterior was 3,425 +/- 35g, while that of those with persistent mentum posterior was 3,792 +/- 347 (p less than 0.01). Records of monitored fetal heart rate were available in 21 cases. Late decelerations and variable decelerations were recorded in 6 (28.5%). The incidence of Caesarean section was 25.5% compared to an overall incidence of 4.4% during the period of the study. Oxytocin was administered to 10 patients, and 7 of them were delivered vaginally. Early diagnosis of presentation and position, with close fetal surveillance may improve fetal outcome. In case of mento-posterior position, primary Caesarean section at term should be considered.

Adult↗
PubMed1985

Uterine sarcoma in Israel: a study of 104 cases.

Data gathered during the first epidemiologic study of sarcoma of the uterus in Israel are presented. In the 7-year period of this survey, 104 new cases of sarcoma of the uterus were diagnosed, representing an incidence of 1.55/100,000 females over the age of 20. Half of the patients were in their fifth and sixth decades of life at the diagnosis of the tumor. Uterine sarcomas were more prevalent in women of European-American origin than in those of Asian-African descent. In 54.9% of the patients the diagnosis was made while the disease was in stage I. A definite correlation between sarcoma of the uterus, diabetes, hypertension, and obesity was not found. The 5-year survival rate in the present survey was 38%. Factors affecting prognosis were the clinical stage of the disease at diagnosis, histologic type, and the method of treatment.

Adult↗
PubMed1979

Distraction-lengthening of digital rays in the management of the injured hand.

The distraction-lengthening principle and apparatus, formerly used in the hand for reconstruction in congenital anomalies and traumatic amputations, is described for reconstruction of metacarpals and phalanges shortened by injuries, especially gunshot wound, where those bones have lost significant length. Hands in which single metacarpals have been shortened or in which multiple digits are involved may benefit from the technique.

Adult↗
PubMed1979

A simplified technique to correct hyperextension deformity of the metacarpophalangeal joint of the thumb.

A flexible hyperextension deformity of the metacarpophalangeal joint of the thumb in eleven patients was repaired by tendon reinforcement of the volar capsule of the joint using the tendon of the extensor pollicis brevis. This tendon, which was regarded as a deforming factor, was left attached at its insertion on the proximal phalanx and was divided at the musculotendinous junction proximally. The mobilized tendon was pulled out distally and then passed proximally and volarly, first superficial to the sheath of the long flexor tendon and then back through a hole in the neck of the metacarpal, and finally in a distal direction to form a criss-cross pattern and be sutured to the tendon of the adductor pollicis. The procedure gave reliable results after an average follow-up of 6.5 years in these eleven patients who had rheumatoid, paralytic, and traumatic lesions.

Adolescent↗
PubMed1978

Snapping elbow due to dislocation of the medial head of the triceps. A report of two cases.

Two cases of unusual snapping at the elbow are described. In both, the medial head of the triceps was found to be separated from the main muscle belly. During flexion of the elbow, the medial head dislocated over the medial epicondyle, producing a characteristic snapping phenomenon. Both cases were of long standing and had been asymptomatic for years. The first clinical symptoms were those of an ulnar neuropathy. In order to restore the normal position of the medial head of the triceps, its tendon was detached from the olecranon, passed under the central tendon and interlaced to it. The ulnar nerve was left in the epicondylar groove in one case and transposed anteriorly in the other. At the end of the procedure flexion of the elbow was unobstructed and the snapping phenomenon had disappeared.

Adult↗