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Biomedical subjects

J G Quirk

Publications and source records attributed to J G Quirk.

At least 37 records · Page 2Linked to original sources
PubMed1991

Landry Guillain-Barré Strohl syndrome in pregnancy: report of three cases treated with plasmapheresis.

Landry Guillain-Barré Strohl syndrome complicating pregnancy is a rare occurrence, with only 31 cases previously reported in the obstetric literature. Cytomegalovirus as a potential etiologic agent has been documented in only two of these cases. In the past, symptomatic treatment of pregnant patients with severe and progressive symptoms has been associated with an unacceptably high rate of maternal morbidity and mortality. Recent studies have shown convincingly that plasmapheresis is the treatment of choice for nonpregnant patients acutely ill with Guillain-Barré syndrome, but data regarding its use in pregnancy are limited. We report three patients, two of whom had positive cytomegalovirus titers, in whom aggressive plasmapheresis prevented the need for ventilatory support and its inherent increase in maternal morbidity and mortality.

Adult↗
PubMed1990

Second-trimester ultrasonography: determinants of visualization of fetal anatomic structures.

Little information has been published regarding rates of visualization of fetal anatomic structures or factors affecting visualization in unselected patients. We prospectively studied these points by scoring visualization of intracranial, spinal, cardiac, ventral wall, umbilical cord, stomach, bladder, and genital anatomy in 573 consecutive midtrimester scans in which no fetal anomalies were seen. Each feature was scored 0, 1, or 2, corresponding to poor, adequate, or optimal visualization, and these eight numbers were summed for an overall visualization score. Overall visualization fell abruptly beyond maternal weight 165 pounds (p less than 0.001) and rose with advancing gestational age (p less than 0.001). Placental location did not significantly influence visualization. Overall, an adequate screening scan, defined as adequate visualization of central nervous system, heart, stomach, ventral wall, bladder, and cord was obtained in 51% of scans, and optimal visualization of each of these in only 9% of cases. Factors that might improve anatomic visualization and the implications of these results for the use of ultrasonography in screening for congenital anomalies are discussed.

Amniocentesis↗
PubMed1990

Distribution of CA 125 in embryonic tissues and adult derivatives of the fetal periderm.

New murine monoclonal antibodies to a partially purified CA 125 antigen were developed and identified as M 2 and M 11. With immunohistochemical techniques, these new antibodies and OC 125 antibody were used to search for CA 125 in embryonic tissues and adult apocrine sweat glands and mammary glands. The embryonic skin, the periderm, expressed CA 125 antigen and its adult derivatives, the mammary glands and apocrine sweat glands, expressed CA 125 while in the active state of secretion. In a 6-week-old formalin-fixed and paraffin-embedded ectopic embryo specimen, antibodies M 2 and M 11 recognized CA 125 in the periderm, the notochord, the myocardium, the pericardium, the gastroenteric tract, enteric duct remnants in the umbilical cord (vitelline and allantoic ducts), the mesonephric duct, and the amnion. OC 125 staining of these formalin-fixed specimens was either very faint or absent. In a formalin-fixed and paraffin-embedded specimen of apocrine sweat glands from the axilla, antibodies M 2 and M 11 detected CA 125 antigen intracellularly in the secretory cells. Again no staining was observed with OC 125 antibody. In a frozen and acetone-fixed specimen of lactating mammary glands, antibodies M 2 and OC 125 detected CA 125 antigen intraductally. Colostrum and milk collected from 25 mothers at various stages post partum had mean CA 125 levels of 34,213 U/ml in colostrum, 1469 U/ml at 3 to 7 days, and 105 U/ml at 5 to 26 weeks.

Amnion↗
PubMed1990

Increase in the plasma levels of the N-terminal and C-terminal portions of the prohormone of atrial natriuretic factor during normal pregnancy.

The influence of pregnancy on the circulating concentrations of atrial natriuretic factor, the 28 amino acid carboxy (C)-terminal end of the 126 amino acid atrial natriuretic factor prohormone, and the amino (N)-terminus of the prohormone was studied with three specific radioimmunoassays recognizing: (1) atrial natriuretic factor (i.e., amino acids 99 through 126), (2) the 98 amino acid N-terminus, and (3) amino acids 31 through 67 from the midportion of the N-terminus of the prohormone. Plasma atrial natriuretic factor in normal pregnant women gradually increased as pregnancy progressed, with the mean +/- SEM being 58 +/- 4 pg/ml in the first trimester, 74 +/- 5 pg/ml in the second trimester, and 89 +/- 7 pg/ml in the third trimester. Likewise, proatrial natriuretic factor 31 through 67 increased from 1421 +/- 76 pg/ml (first trimester) to 1509 +/- 84 pg/ml (second trimester) to 1758 +/- 83 pg/ml in the third trimester, whereas the whole N-terminus of the prohormone increased from 1804 +/- 98 pg/ml (first trimester) to 1909 +/- 111 pg/ml (second trimester) to 2160 +/- 79 pg/ml in the third trimester. These results suggest that release of the N-terminus of the prohormone, as well as atrial natriuretic factor, increases with the rise in blood volume associated with a normal pregnancy. The circulating concentrations of both the C-terminus and N-terminus of the atrial natriuretic factor prohormone increased further in the 48 hours after delivery. Because both the C-terminus and N-terminus of the atrial natriuretic factor prohormone contain diuresis-producing peptides, these results suggest that postpartum diuresis may be mediated by these peptides.

Analysis of Variance↗
PubMed1990

Amniotic and thromboembolism.

Embolic phenomena in pregnancy demand rapid investigation and treatment. Regardless, some patients will not survive due to the enormity of the insult. Optimally, such patients should be treated in tertiary care centers, but this is not always possible.

Embolism, Amniotic Fluid↗
PubMed1989

Expression of the ras oncogene in gynecologic tumors.

Control of oncogene expression has been shown to be a coordinated regulatory mechanism in normal growth and development. Overt expression of these genes also has been noted in transformed or neoplastic cell types. The ras family of oncogenes has been shown to be particularly evident among genes expressed in malignant tissues. We provide evidence, using ribonucleic acid dot analysis and Western blot analysis of gynecologic tumor extracts, that ras expression may be a common occurrence in these malignancies. Furthermore, the ras-related peptides can be detected in sera of some patients with tumors.

Electrophoresis, Polyacrylamide Gel↗
PubMed1988

Fetal teratomas: antenatal diagnosis and clinical management.

Four cases of fetal teratomas arising from the sacrococcygeal and oropharyngeal areas are reported. The diagnosis, method of management, and grade of tumor are compared with previous experience in the literature. Pharyngeal lesions carry a worse prognosis for survival compared to the more common sacrococcygeal type (SCT). Atraumatic delivery and early repair of the lesion contribute to prolonged survival and lack of complications in cases of sacrococcygeal teratomas.

Adult↗
PubMed1988

Prenatal diagnosis of abdominal cystic hygroma.

We present a case of fetal abdominal cystic hygroma that presented at 19 weeks of gestation. Ultrasonographic evaluation of the fetus revealed soft tissue enlargement of the left leg and a retroperitoneal mass in the left pelvis and abdomen. This represents the first reported case of prenatal diagnosis of abdominal cystic hygroma.

Abdominal Neoplasms↗
PubMed1988

ras oncogene is expressed in adenocarcinoma of the endometrium.

Activation of c-ras oncogenes has been implicated in human carcinomas of the colorectum, prostate, bladder and breast. The major peptide product of c-ras is a 21 kilodalton peptide (p21), but other larger "ras-related" peptides have been described in urine obtained from patients with several types of cancers. In the present investigation immunohistochemical methods were used to assess c-ras expression in tissues obtained from patients with endometrial adenocarcinoma. Formalin-fixed, paraffin-embedded tissues were processed in routine fashion, then incubated with a monoclonal antibody raised against a v-H-ras synthetic peptide. ras Peptides were not detected in proliferative or secretory endometrium or in benign adenomatous hyperplasia. One of four specimens of atypical adenomatous hyperplasia and two of 11 specimens of grade 1 (international Federation of Gynecology and Obstetrics) adenocarcinoma stained positive for ras peptides. A total of 95% of the grade 2 and 3 adenocarcinoma studied contained detectable ras peptides within neoplastic cells. In contrast to previous immunohistochemical studies that identified ras peptides only in neoplastic cells of bladder, prostate, colon, and breast cancers, we routinely found ras peptides within stromal cells of high-grade endometrial carcinomas. When stained with hematoxylin and eosin, these cells have the appearance of foamy macrophages.

Adenocarcinoma↗
PubMed1988

CA 125 in tissues and amniotic fluid during pregnancy.

CA 125 was assayed in amniotic fluid and tissue extracts by immunoradiometric assay, and immunohistochemical studies were performed on paraffin-embedded sections of endometrium, decidua, and fetal membranes with the monoclonal antibody OC 125 used as primary antibody. The concentration of CA 125 in amniotic fluid changes during pregnancy so that levels of 800 to 1000 U/ml are found before 12 weeks. Thereafter, levels of 4000 to 10,000 U/ml are detected routinely. As term approaches, amniotic fluid CA 125 concentrations fall to a range of 1000 to 2000 U/ml. Levels of CA 125 in tissue extracts of secretory endometrium and decidua were 65,000 and 29,500 U/gm of tissue, respectively. CA 125 was readily detected on the apical surfaces of glandular epithelium and in the secretions of endometrial glands obtained throughout the menstrual cycle. It was also detected in the lumina of decidualized glands throughout pregnancy. No antigen was detectable within glandular epithelial cells. We have previously reported high concentrations of CA 125 in chorionic tissue extracts (42,000 U/gm) and low concentrations in amniotic tissue extracts (275 U/gm). In contrast to those findings, immunohistochemical techniques detected CA 125 within the intercellular canaliculi that surround amniotic epithelial cells but not in chorion. We conclude that the likely source of amniotic fluid CA 125 is the decidua and that it gains access to the amniotic fluid via the intercellular canalicular system that traverses the amniotic epithelium.

Amniotic Fluid↗
PubMed1987

Abruptio placenta.

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Abruptio Placentae↗