Biomedical subjects
Publications and source records attributed to M Mazor.
We report an unusual case of a poorly differentiated signet ring cell type of adenocarcinoma of the cecum, rare in its own right, that had metastasized to the endometrium. The diagnosis was made on the basis of fractional uterine curettage. It is believed that this is the first case of such an unusual cecal carcinoma metastatic to the endometrium.
Repeated samplings of scalp blood pH were obtained from 62 fetuses in whom continuous fetal heart rate monitoring was indicative of fetal distress. In all, 182 scalp blood samples were evaluated. Umbilical cord blood pH was determined immediately after delivery in 48 cases. In addition to heart rate abnormalities, fetal metabolic changes were considered in determining the mode of delivery. Vaginal delivery was allowed in 74.2% of the patient in our series and only 25.8% had cesarean sections. Repeated scalp blood pH sampling proved to be an important adjunct to continuous fetal heart rate monitoring in increasing the accuracy of diagnosis of fetal distress.
There is an ethical and legal problem for obstetricians when a pregnant patient, before or during labor, is notified by her physician that the fetus is in danger of dying and in need of surgical intervention, and she does not accept this advice. Such a case may occur for various reasons. This report attempts to address the issue of the fetus' right to life and the legal aspects thereof according to the laws of different countries. We accept the fact that the fetus has a legal right to live and the parents are the natural guardians. If the child is capable of being born alive and the patient does not consent to being subjected to a given treatment directed to save the fetus, the doctor must be legally entitled to warn the patient that she is committing a felony.
The intelligibility of frequency-compressed speech was measured for four normal and eight hearing-impaired subjects with sensory-neural high-frequency loss. Hearing levels were roughly 40 dB. Four conditions of frequency compression, 0%, 20%, 33%, and 55% were obtained using a Varispeech compressor. The test materials were PB-50 word lists recorded by one male and one female speaker. The effect of frequency compression was to reduce intelligibility in all cases except one, that of the female speaker at 20% frequency compression. For this case, the hearing-impaired listeners showed a small average improvement. Although the effect was small, it represents one of the few instances when an experimental evaluation of a frequency-compression system has yielded positive results with the hearing impaired.
OBJECTIVE: Spontaneous rupture of the fetal membranes occurs after the commencement of labor in 90% of cases. Recent evidence indicates that the process of parturition requires not only an increase in myometrial contractility and cervical ripening, but also degradation of extracellular matrix in fetal membranes (i.e., leakage of fibronectin into cervico-vaginal secretions). This study was undertaken to determine if parturition is associated with in vivo evidence of increased bioavailability of matrix metalloproteinases-9 (MMP-9) and its inhibitor, tissue inhibitor of metalloproteinases-1(TIMP-1). METHODS: A cross-sectional study was conducted with women in the following categories: 1) midtrimester (n = 25); 2) preterm labor and intact membranes in the absence of intraamniotic infection (n = 78); 3) term not in labor (n = 25); and 4) term with intact membranes in labor (n = 25). MMP-9, and TIMP-1 were measured using sensitive and specific immunoassays. RESULTS: 1) Spontaneous labor at term was associated with a significant increase in MMP-9 but not in TIMP-1.2) Women with preterm labor who delivered prematurely had significantly higher concentrations of MMP-9 but not TIMP-1 in amniotic fluid than those with preterm labor who delivered at term. 3) The concentrations of TIMP-1 decreased with advancing gestational age. In contrast, MMP-9 concentrations did not change with advancing gestational age. CONCLUSIONS: Spontaneous human parturition is associated with specific changes in the enzymatic machinery responsible for extracellular matrix degradation.
Interleukin-1 (IL-1) has been implicated in the mechanism of human parturition in the setting of infection. The purpose of this study was to determine the effect of labor (term and preterm) and microbial invasion of the amniotic cavity on amniotic fluid (AF) concentrations IL-1 alpha and IL-1 beta. AF was retrieved by transabdominal amniocentesis from the following groups of women: midtrimester genetic amniocentesis (16 to 18 wk) (N = 15), preterm labor with intact membranes (21 to 36 wk) with or without infection (N = 72), preterm premature rupture of membranes (PROM) (N = 88), and term not in labor or in active labor with or without infection (N = 58). AF was cultured for aerobic and anaerobic bacteria as well as Mycoplasmas. IL-1 was measured with a commercially available immunoassay validated for AF (sensitivity: IL-1 alpha, 157 pg/ml; IL-1 beta, 50 pg/ml). All women at midtrimester had undetectable AF IL-1 alpha and IL-1 beta. Among women in preterm labor with positive AF cultures, IL-1 alpha and IL-1 beta were detectable in the AF in 86.6% (13/15) and 100% (15/15), respectively. In contrast, all women with negative AF cultures without labor (N = 36) had undetectable AF IL-1 alpha concentrations and 52.7% (19/36) had undetectable AF IL-1 beta concentrations. Histopathological chorioamnionitis was present in 92.8% (13/14) of patients who had positive AF cultures and detectable IL-1 in the AF. IL-1 was significantly higher in patients with preterm PROM, labor, and positive AF cultures than in the other subgroups of patients with preterm PROM.(ABSTRACT TRUNCATED AT 250 WORDS)
OBJECTIVE: To evaluate the role of overdistended uterus on the uterine artery (UA) blood flow velocimetry by comparing UA Doppler in patients with idiopathic hydramnios to patients with normal amniotic fluid (AF) volume. METHODS: Pulsatility index (PI) of both UAs was determined prospectively between 26 and 41 weeks of gestation in 72 consecutive pregnant women with singleton pregnancies and idiopathic hydramnios and in 72 pregnant women with normal AF volume. Hydramnios was defined as an AF index (AFI) above 24 cm. A normal amount of AF was defined as an AFI of 6-24 cm. Patients with known fetal structural or chromosomal anomalies and those with diabetes mellitus were excluded. RESULTS: No significant differences were observed between the groups with regard to maternal age, gravidity, and gestational age at examination. Gestational age at delivery and accordingly birth weight were significantly lower in patients with hydramnios compared to those with a normal AFI (34.9 +/- 2.1 vs. 39.1 +/- 1.2, p < 0.001; 2,508 +/- 399 vs. 2,995 +/- 420, p < 0.001, respectively). No significant differences were noted between right UA PI (0.73 +/- 0.3 in the hydramnios group vs. 0.71 +/- 0.2 in the control group; p = 0.091) and left UA PI (0.91 +/- 0.3 in the hydramnios group vs. 0.84 +/- 0.3 in the control group; p = 0.131) of both groups. CONCLUSION: UA velocimetry in patients with idiopathic hydramnios was not significantly different from those with a normal AF volume.
The localization ability of 10 normally hearing adults was determined under varying microphone separations and varying sound source azimuths. The stimuli (white noise busts) were prerecorded, after being transduced through 'body' hearing aids and then played to the subjects over headphones. Results indicated that there was an improvement in localization ability for all azimuth conditions when the microphones were spaced wider than 12.7 cm apart (15.2-30.5 cm). The smaller the separations (5.5-12.7 cm), the poorer the localization. Localization was always poorer at 30 degrees azimuth (the smallest used) than at any of the other azimuths (0 degree, 30 degrees, 60 degrees, 90 degrees right and left), regardless of microphone spacing. Implications are made about the relation of these findings to the use of binaural body aids on infants and young children.
Neurofibromatosis (Recklinghausen's disease) is an autosomal dominant disorder that affects multiple organ systems. The disease usually manifests itself during puberty although it occasionally occurs during infancy and childhood. Pregnancy seems to exacerbate the condition. Four cases of neurofibromatosis during pregnancy are presented. Three of the patients had uneventful pregnancies and deliveries, and the fourth had severe thrombocytopenia. This complication has not previously been reported in association with neurofibromatosis in pregnancy. By close supervision of pregnant patients with neurofibromatosis, most complications can be avoided.
The first case of pyogenic liver abscess during pregnancy is described. Despite its rarity, this severe complication has to be considered when a febrile illness accompanied by upper abdominal pain and hepatomegaly occurs during pregnancy and puerperium. Diagnostic methods and treatment are suggested.
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