Biomedical subjects
Publications and source records attributed to M Mogilner.
A case of microcephaly that developed intrauterine is described. Since it began three weeks after a car accident during second trimester of pregnancy, we attribute it to "brain disruption sequence" resulting in an arrest of brain development after the injury.
Forty consecutive patients with uterine hyperactivity, defined as either tachysystole and/or hypertonus during the active phase of vertex delivery, were treated with intravenous ritodrine (50 up to 300 micrograms/min, in 50 micrograms increments/5 min). Thirty-four patients (85%) responded within 20 min with termination of the uterine dysfunction and all (21, 52%) concomitant fetal heart rate distress signs disappeared. The treatment did not prolong labor, as this was significantly correlated to parity and cervical dilation when treatment was initiated (P less than 0.0006 and P less than 0.008, respectively). Fifteen patients were delivered by cesarean section (37.5%) mainly for cephalopelvic disproportion. Multiparas were older and had shorter ritodrine initiation-delivery intervals, but these were the only significant differences when compared to primiparas. Ritodrine is therefore suggested as an effective treatment of uterine hypercontractility dysfunction.
The effects of nimodipine, on total and regional cerebral blood flow and cardiovascular function of the newborn chloralose-anesthetized lamb were investigated following intravenous bolus infusions (0.2, 0.6 and 2.0 micrograms/kg). At 2.0 micrograms/kg, the mean arterial blood pressure increased from 72.3 to 85.8 mm Hg. Total cerebral blood flow 45 min after infusion increased by 93%, as did regional flows to the gray (101%) and white (77%) matter and subcortex (108%). In a separate series of experiments we decreased arterial blood pressure from 71 to 40 mm Hg by phlebotomy. Nimodipine (30 micrograms/kg) bolus infusion significantly increased blood flow above control values to the total brain (41%), gray matter (53%), subcortex (76%) and brainstem (69%) 10 and 40 min later. However, no further increase in flow or decrease in cerebrovascular resistance was observed when compared to hypotension alone. Nimodipine appears to be well tolerated in the newborn lamb, and appears to increase cerebral flow during normotension. At the levels of hypotension used in the current experiments, nimodipine produced no further increases in cerebral blood flow.
An analysis of the course and complications in the ligation of patent ductus arteriosus (PDA) in 30 very low birth-weight preterm neonates was carried out. The mean gestational stage at birth was 26.97 weeks, and median weight was 811 gm. Attempted closures of the ductus with indomethacin in 19 infants failed, although there was temporary closure in nine. Congestive heart failure was present in 29 and respiratory distress syndrome in 22 patients. Endotracheal intubation with ventilation assistance was necessary in the entire series. The mean age at operation was 13.5 days, and ductal ligation was performed in the intensive care unit under local anesthesia, supplemented with pancuronium and pethidine. There were no intraoperative deaths, but five infants died during their hospitalization from unremittent respiratory distress syndrome. There were seven additional late deaths. Eighteen survivors were followed for a mean of 26.5 months. Early ligation of PDA in very low birth-weight prematures improved the cardiorespiratory status, and long-term follow-up revealed good clinical progress in two-thirds of the surviving group.
A family is presented in which ano-rectal malformation and features common to Alport Syndrome appear to be present in three generations. The possibility of a new syndrome based on a single gene defect is discussed.
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Acute appendicitis with perforation in a premature baby, weighing 1 050 g, is described. Initially the infant did well after surgery, but succumbed to sepsis, as a result of hyperalimentation, eleven days later. This is the smallest infant suffering from appendicitis reported in the English literature.