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Biomedical subjects

K J Moise

Publications and source records attributed to K J Moise.

146 records · Page 9Linked to original sources

Transuterine puncture of the fetal stomach provides access to the small bowel in the rabbit.

The prevention of perinatal complications of congenital gastrointestinal (GI) diseases such as cystic fibrosis may require prenatal treatment. New Zealand White rabbits were evaluated as a potential animal model to study gastrointestinal anatomy and transit in the fetus. The lengths of the GI tract of fetuses at 21/31 and 28/31 days gestation were established, and gastric volume was measured. Gastric volume at 28 days gestation averaged 2.6 mL, adequate to permit instillation of a solution into the fetal stomach. A study was then carried out to establish gastric emptying and delivery of the solution into the small bowel. Using ultrasound guidance, the stomachs of 26 fetuses from 7 litters were punctured and 0.5 mL of dilute barium was injected. A cesarean section was performed 4 h later and the progression of barium though the GI tract was measured. In 18/26 (69.2%) of the fetuses barium was successfully delivered to the lumen of the stomach. In these 18 fetuses, barium progressed to the duodenum in 15 (58%), the jejunum in 13 (50%), and the ileum in 8 (31%). The stomach of the 3.5- to 4-week-old fetus is large enough to allow transuterine delivery of a solution of dilute barium. Gastric and intestinal motility in the 25-day-old rabbit fetus is coordinated and results in delivery of barium to the small bowel in 50% of animals successfully injected. The results suggest that the rabbit is an acceptable model for the study of gastrointestinal delivery of therapeutic drugs or genes to the fetus.

Animals↗

Neonatal outcome after active perinatal management of the very premature infant between 23 and 27 weeks' gestation.

OBJECTIVE: To record the effect of aggressive perinatal management on neonatal outcome in the very premature infant. METHODS: A retrospective chart review of 114 infants born between 23 and 27 weeks' gestation, managed by one perinatal transport service at one hospital between July 1989 and December 1993. Fetuses > 23 weeks' gestation were considered viable and were managed with tocolytics, antibiotics, and surfactant at the discretion of the treating physician. Morbidity and mortality rates in the first 6 months, including stillbirths were analyzed. A major neurologic condition was defined as ultrasonographic evidence of grade 3 or 4 intraventricular hemorrhage or periventricular leukomalacia. RESULTS: Both neonatal mortality rate and the incidence of stillbirths decreased with advancing gestational age. Of 24 infants born at 23 weeks' gestation, 33% were stillborn and 13% were alive at 6 months. This survival rate improved to 48% for infants delivered at 24 weeks' gestation, and to 68%, 75%, and 71% for those delivered at 25, 26, and 27 weeks' gestation, respectively. The percentage of infants who survived without a major neurologic condition increased with advancing gestational age at delivery from 13% at 23 weeks' gestation to 40% at 24 weeks, 48% at 25 weeks, 70% at 26 weeks, and 71% at 27 weeks. The incidence of retinitis of prematurity, respiratory complications, and days spent in the hospital decreased with greater gestational age. CONCLUSIONS: An active plan of management for all gestations of > 23.9 weeks seems appropriate.

Adolescent↗