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Biomedical subjects

J C Morrison

Publications and source records attributed to J C Morrison.

At least 289 records · Page 16Linked to original sources
PubMed1985

Plasma prolactin concentrations and pregnancy-induced hypertension.

Human prolactin (PRL) has been related to various pathologic disorders known to be associated with osmoregulation and hypertension. In this study, we compared changes in plasma PRL concentrations in normal pregnant patients to those in patients with severe pregnancy-induced hypertension (PIH). Comparison of plasma PRL concentrations collected antepartum, at delivery, and 48 hours postpartum failed to distinguish women with PIH from those without. Only women with PIH, however, showed a significant rise in systemic PRL concentrations between admission to the study and delivery. Antepartum abnormalities in plasma PRL concentrations associated with PIH may not have been detected because of diurnal variations in PRL secretion.

Adult↗
PubMed1985

Clinical management of sickle cell hemoglobinopathies during pregnancy.

Although the maternal and perinatal morbidity as well as mortality in pregnant patients with sickle cell disease is significantly higher than those parturients with hemoglobin A, marked amelioration has been obtained by comprehensive health care utilizing expert perinatal teams and by providing careful attention to preventive measures for infection and crisis. Through these consistent efforts, the life span for the mother/fetus/newborn has improved considerably over that observed in the past. Although there is no present cure for sickle cell disease and no effective and safe physiologic treatment in a preventive sense, our experience suggests that adherence to careful management principles, offered in this article, will increase the likelihood that significant vaso-occlusive crisis and infection can be reduced, thus resulting in a healthier pregnancy outcome. In addition, the future is bright for the development of pharmacologic agents to prevent sickle cell crisis and for advances in techniques designed to induce endogenous production of normal hemoglobin.

Blood Transfusion↗
PubMed1985

Effect of intrauterine antibiotic lavage after cesarean birth on postoperative morbidity.

Intrauterine lavage using broad-spectrum antibiotics after cesarean section has been reported to reduce maternal morbidity, but many such patients are not at high risk for postoperative infection. This study tested intrauterine antibiotic lavage in patients at risk for infectious morbidity. The patients were randomly assigned to one of three groups based on the last digit of the hospital admission number. Group I received no lavage, group II received lavage with 800 ml of saline plus 2 gm of cefamandole nafate in the intrauterine incision, bladder flap and peritoneal cavity, and group III received a similar lavage using 800 ml of saline alone. There was a significant decrease in maternal hyperpyrexia (simple morbidity) as well as serious infection in both lavage groups as compared to the control group (p less than 0.01 and 0.05, respectively). Also, there was significantly reduced morbidity when the antibiotic lavage was compared to the saline technique (p less than 0.001). The use of intrauterine lavage with saline, with or without antibiotics, appears helpful in reducing postoperative morbidity in patients at high risk for infectious morbidity after cesarean section.

Anti-Bacterial Agents↗
PubMed1984

Autoimmune thrombocytopenic purpura: current concepts and recommended practices.

Autoimmune thrombocytopenic purpura is the most common autoimmune disorder encountered in the pregnant patient. It is potentially fatal for the mother and fetus yet treatable and potentially curable. Analysis of current perinatal literature reveals not only a great deal of interest and activity in the study of this syndrome and its special problems during pregnancy but also significant controversy. The disease can be acute or chronic and vary in time of onset and severity of manifestations. If not forewarned with an awareness of this disorder's pathogenesis and potential fetal effects particularly in the pregnant woman who has undergone splenectomy, the obstetrician cannot respond appropriately. The usefulness of platelet antibody determinations to facilitate obstetric management decisions is discussed. The importance of cooperative care among the obstetrician, hematologist, and neonatologist is emphasized. Recommendations for management of autoimmune thrombocytopenic purpura in pregnancy are derived from a review of current concepts of the disorder's pathogenesis, pathophysiology, criteria for diagnosis, and modes of therapy as well as special maternal/fetal considerations of antepartum, intrapartum, and postpartum care.

Acute Disease↗
PubMed1984

Maternal administration of dexamethasone in severe pregnancy-induced hypertension.

Fourteen patients with severe pregnancy-induced hypertension and low lecithin/sphingomyelin (L/S) ratios were treated with 5 mg of dexamethasone phosphate intramuscularly every 12 hours for four doses to induce fetal pulmonary maturity. A comparison was made of the average gestational age, mean L/S ratio, method of delivery, Apgar scores, mean birth weight, and incidence of respiratory distress syndrome in these patients and in 16 patients with similar demographic backgrounds and clinical presentations who did not receive corticosteroid therapy. There was no significant difference between the two groups except that the time of treatment (or nontreatment) to delivery was longer in the steroid group. There were two cases of neonatal respiratory distress syndrome in the treatment group, and one of these infants died. In the control group, there were two neonatal deaths among four cases of respiratory distress syndrome. There was no clinical evidence of intraventricular hemorrhage in any neonate nor was there aggravation of hypertension in the parturient patients. The administration of corticosteroids to induce fetal pulmonary maturity in patients with severe pregnancy-induced hypertension who are carefully selected and monitored does not appear to be contraindicated.

Amniotic Fluid↗
PubMed1984

Association between ruptured membranes, tocolytic therapy, and respiratory distress syndrome.

Two hundred ninety-seven patients from the placebo group of the National Institutes of Health Collaborative Study on Antenatal Steroid Therapy for prevention of respiratory distress syndrome were selected for analysis to investigate a possible association between premature rupture of the membranes, tocolytic therapy, and respiratory distress syndrome. Both premature rupture of the membranes and tocolytic therapy with isoxsuprine were individually associated with a lowered incidence of respiratory distress syndrome. However, when present together, their protective effect was not additive and resulted in a higher incidence of respiratory distress syndrome. It is suggested that the use of tocolytic therapy with beta-adrenergic agents be restricted to patients with intact membranes.

Amniotic Fluid↗
PubMed1984

Intrapartum fetal heart rate monitoring as a predictor of fetal distress and immediate neonatal condition in low-birth weight (less than or equal to 1,800 grams) infants.

Among 1,318 live born infants delivered in our institution during a 120-day period, 1,025 (77.8%) were monitored electronically. Of the 1,025 monitored infants, 89 were of low birth weight (less than or equal to 1,800 gm) and were admitted to the neonatal intensive care unit. Twenty-seven (30%) of these had abnormal fetal heart rate tracings. The remaining 62 (70%) had normal fetal heart rate tracings. Of the 27 low-birth weight neonates with an abnormal fetal heart rate tracing, 24 (89%) were asphyxiated, whereas of those 62 low-birth weight infants with a normal fetal heart rate tracing, only nine (14%) had asphyxia (p less than 0.001). Of the 27 low-birth weight neonates with abnormal fetal heart rate tracings, 20 (74%) developed hyaline membrane disease, whereas of the 62 low-birth weight neonates with normal fetal heart rate tracings, 10 (16%) developed hyaline membrane disease (p less than 0.001). The results of this study suggest that electronic fetal monitoring provides a specific and sensitive method for identifying those low-birth weight infants who are at high risk for asphyxia and hyaline membrane disease.

Asphyxia Neonatorum↗
PubMed1984

Ciliary process microvasculature of the primate eye.

Using methylmethacrylate microvascular luminal castings, we studied the three-dimensional angioarchitecture of the primate ciliary process with the scanning electron microscope. We found that the ciliary processes are served by vessels that radiate anteriorly and posteriorly from the "major arterial circle" of the iris. The anterior arterioles possess focal constrictions and supply the anterior and marginal aspects of the major ciliary processes as well as interprocess networks that connect contiguous processes. The posterior arterioles lack focal constrictions and supply the minor ciliary processes via posterior interprocess networks. Major and minor ciliary process capillaries are irregularly dilated and pass posteriorly to drain into the choroidal veins. Finally, venous arcades exist which directly connect anterior and posterior interprocess networks with the choroidal veins and thus bypass the ciliary processes entirely. The presence of focal constrictions in the anterior arterioles suggests a site for possible autonomic or neurohumoral control of blood flow into the major ciliary processes.

Animals↗
PubMed1984

Meperidine and normeperidine metabolism in the rhesus monkey.

Meperidine and its principle metabolite, normeperidine, were given intravenously to four non-human primates prior to cesarean delivery in an equivalent dose for human parturients. The status of the infants regarding neonatal depression was assessed at delivery. Repeated blood samples from both the mother and the neonate were obtained over a period of 4 days. The levels of meperidine and normeperidine were analyzed. The results showed that the metabolism of meperidine and normeperidine in the non-human primate was essentially the same as that observed in the human parturient. In addition, normeperidine appeared to be more toxic than meperidine to the neonate. Finally, there does not appear to be an evidence for neonatal metabolism of meperidine to normeperidine.

Animals↗
PubMed1984

Managing the parturient with sickle cell crisis.

Sickle cell crisis is a serious obstetric emergency. Maternal and perinatal morbidity and mortality secondary to sickle cell disease and crisis can be reduced significantly with expert perinatal teams, the benefits of comprehensive tertiary health care, and careful, consistent attention to medical detail. The combined life span for mother and fetus today has improved considerably over what it was just a few years ago, primarily because of better medical, obstetric, and neonatal care. Although the disease has not been cured, and at present we have no effective and safe pharmacologic treatment for sickle crisis, our experience suggests that adherence to the outlined management principles offers increasing hope to the sickling patient that her vasoocclusive episodes can be managed effectively for a healthier pregnancy outcome. The future is bright for the development of pharmacologic agents to prevent sickle cell vasoocclusive crisis altogether.

Analgesia↗
PubMed1984

Comparison of two prostaglandins used to terminate midtrimester pregnancy.

One of the most widely used methods of pregnancy termination has involved the use of prostaglandin drugs. Vaginal suppositories containing prostaglandin E2 (PGE2) have been used successfully by many investigators. Because of problems with a long delay between induction and abortion, as well as minor side effects, other prostaglandin agents have been tested. In our study, 17 matched patients given PGE2 vaginal suppositories to induce abortion were compared with a similar group in whom the methyl ester of prostaglandin F2 alpha ( MPGF2 alpha) was used. There was no statistically significant difference between the two groups in side effects, number of patients requiring curettage, or placental expulsion time. Patients treated with PGE2 had a shorter fetal expulsion time (P less than .001), and there were no major complications in either group. It appears from these data that multiple PGE2 vaginal suppositories are equal to or better than the newer single MPGF2a suppository followed by intramuscular injections when used for second trimester terminations.

Abortion, Induced↗
PubMed1984

Pheochromocytoma in pregnancy: diagnosis and collaborative management.

Antenatal diagnosis and appropriate management of pheochromocytoma complicating pregnancy offers a reduction in mortality for both mother and fetus. We have presented the successful management of such a case, emphasizing the close collaboration between obstetricians, pediatricians, anesthesiologists, surgeons, and internists that is mandatory for a successful outcome.

Adrenal Gland Neoplasms↗
PubMed1984

A decreased incidence of necrotizing enterocolitis after prenatal glucocorticoid therapy.

In a large multicentered, collaborative randomized and blinded trial utilizing antenatal corticosteroids, the goals included determining the effectiveness of these agents in accelerating lung maturation, as well as monitoring any short-term or long-term adverse effects of this treatment on the parturient, fetus, and/or infant. More than 100 specific items, pertaining to diagnoses, complications, and outcomes were recorded for the 696 mothers enrolled in the study and their 745 infants. A significantly decreased incidence of necrotizing enterocolitis (P = .002) was found in the infants treated with steroids. The possibility of accelerated intestinal maturation induced by antenatal maternal steroid therapy exists. This treatment regimen is particularly attractive as adverse aspects of steroid therapy at the dosage utilized have not been demonstrated.

Clinical Trials as Topic↗
PubMed1984

Sequential microdissection and scanning electron microscopy of ciliary microvascular castings.

Intracarotid injection of methylmethacrylate followed by tissue corrosion produces detailed replicas of the ocular microvasculature that can then be studied with the scanning electron microscope. The resultant photographs allow careful scrutiny of even the finest capillaries. However, when applied to the ciliary body, a complicated three dimensional system, we found stereo scanning electron micrography essential to fully appreciate its arteriolar and capillary interconnections. These stereoscopic analyses indicated that specific superficial vessels required excision to visualize deeper, previously hidden microvascular relationships. Using a pneumatically powered ultra microscissors guided by a micromanipulator we successfully removed these vessels. Deeper views were then obtained through repeat stereo scanning electron microscopy. This sequential microdissection and stereo scanning electron microscopy revealed that the major ciliary processes are supplied by two types of arterioles arising from the major arterial circle. Constricted anterior arterioles supply anterior and marginal aspects of the processes as well as interprocess capillary beds. Less constricted posterior arterioles feed capillaries confined to the base of the major processes as well as minor ciliary processes via posterior interprocess connections. Choroidal veins were seen to directly drain both anterior and posterior interprocess capillary beds.

Animals↗