Biomedical subjects
Publications and source records attributed to M Sharf.
The combination of fetal ascites and polyhydramnios is an uncommon problem that can be detected in utero by sonography. A case is reported where the etiology was found to be generalized cytomegalovirus infection. The differential diagnosis, etiology and diagnostic procedures are discussed. A thorough sonographic study is essential in the diagnosis and evaluation of fetal ascites in utero.
Oestrogen is recognized as having profound effects on lipid and lipoprotein levels. It is also considered as the agent protecting the pre-menopausal woman from arteriosclerotic cardiovascular disease. High density lipoprotein (HDL) has also been ascribed a protective role against the development of arteriosclerosis. The effect of natural oestrogen (17 beta-oestradiol) administered in the form of a subcutaneous pellet on concentrations of lipids and lipoproteins, particularly high density lipoproteins and its subfractions were determined in three young women with premature menopause. Plasma cholesterol, low density lipoprotein and very low density lipoprotein and very low density lipoprotein levels decreased following oestrogen implantation. High density lipoproteins and in particular subfraction 2 (density cut 1.063-1.125 gm/ml) and subfraction 3 (density cut 1.125-1.21 gm/ml) increased profoundly but there was a slight fall in the HDL 2/HDL 3 cholesterol ratio. The HDL/LDL cholesterol ratio increased from 0.21 to 0.46. A decrease in the urinary FSH levels paralleled these changes in the lipoprotein concentrations. Oestrogen administered in this form, unlike other oestrogen or mixed oestrogen--progestogen compounds is a definite modifier of arteriosclerotic risk, and as such could be given therapeutically in menopausal hypercholesterolemic females.
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The presence of an enkephalin-like substance ('humoral endorphin') in human maternal and cord blood, as well as in amniotic fluid, has been demonstrated in this study. Utilizing antibodies to leucine-enkephalin, it was found that the level of this substance in maternal and in cord blood remained stable during pregnancy whereas the concentration in amniotic fluid was significantly higher at mid-trimester than during labor at term.
Recordings of fetal motor activity in utero were carried out on 17 women with normal pregnancies at 23 to 37 weeks' gestation. Fetal motility was monitored by a method based on integrative EMG recordings derived through electrodes attached to maternal abdominal surface. Orthogonal spectral analysis revealed 40 minute and 80 minute cycles in fetal motility in 59% of the fetuses. The correlation between objective and subjective (maternal self-assessment) scores of fetal activity was generally confirmed. Methods of monitoring fetal activity, based on short-term recordings, are criticized in the light of the present results.
This study was designed to examine various risk factors in regard to their correlation with carbohydrate intolerance and in relation to birthweight and well-being of the newborn. Of the various alleged prediabetic stigmata among a selected group of 390 women, only marked maternal overweight, diabetes in previous pregnancy, family history of diabetes at the sibling level, and accompanying maternal morbidity were associated with increased risk for both gestational carbohydrate intolerance and for morbidity in the newborn. In women over 30 years of age a definite increase in the incidence of carbohydrate intolerance was noted among this high-risk population. Multiplicity of screening criteria presented a significantly (P less than 0.001) greater risk for the development of carbohydrate intolerance and was seen to be positively (P less than 0.001) with increased perinatal morbidity.
The present study was designed to compare the relative validity of the 2-hour postprandial glucose test (2hpp) and the rapid intravenous glucose tolerance test (IVGTT) as predictors of the outcome of pregnancy. Both tests were performed at the onset of the third trimester of pregnancy in each of 77 women who constituted a selected group of patients considered to be at high risk of developing gestational diabetes. Data concerning newborns were recorded in each case. The IVGTT was found to give a significantly larger yield of positive results (44.15%) as compared to the 2hpp test (35.06%). Furthermore, significantly heavier babies and higher rates of perinatal morbidity were noted in those cases with abnormal IVGTT results as compared to those with normal values. No such association was seen in those cases with abnormal values of 2hpp. These results suggest that the rapid IVGTT is a more dependable test than a single postprandial blood glucose estimation in screening pregnant women for gestational diabetes.
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Clinical otosclerosis is a familial disease which is more frequent among women in their reproductive years. The condition usuallly is aggravated by pregnancy. Endocrinologic variables may influence the time of onset and the course of the disease. It is suspected that oral contraceptives (OCs) might stimulate the onset of the disease. Six hundred nulliparous women between the ages of 16 and 30, who used a variety of OCs for 12-36 months, were examined. The hearing of these women was thoroughly investigated. The first audiometric examination of the 600 women revealed three cases (0.5%) of clinical otosclerosis. This incidence is equal to that of the population as a whole, but lower than the incidence found in previously parous women. Audiometric examinations were normal in the remaining 597 women, and repeated examinations revealed no new cases of clinical otosclerosis, despite continuous OC use.
A new method of rapid antenatal assessment of fetal lung maturity was evaluated in relation to the newborn outcome and two other accepted test. This method is based on fluorescence depolarization (FD) technique. The special instrumentation required for this method (the Microviscosimeter) was found to be simple and easy to handle even to nonprofessional personnel. Analysis of 47 samples of amniotic fluid received within 48 hours of delivery demonstrated that lung maturity threshold may be related to a numeric value (P value) measured by this technique. With a P value of less than 0.320 respiratory distress syndrome (RDS) is unlikely to develop. With a P value greater than 0.340, chances for RDS, usually severe, are high. With a P value of less than 0.340 but greater than 0.320, RDS may or may not develop. This method did not prove to be more reliable then the determination of L/S ratio by thin layer chromatography, but its advantage is that it supplies the results in less then an hour. The FD technique proved to be more reliable then the commonly used foam stability test.
The controversy regarding the possible role of genital mycoplasma infection in human reproductive failure gave rise to a study in which pregnant rats, previously shown to be of normal fertility, were inoculated 7-11 days after conception with either Mycoplasma arthritidis or an equal volume of sterile broth medium. Repeated observations during the course of pregnancy revealed several pathogenic effects. A statistically significant decrease was observed in the mean litter size of infected mothers. Furthermore, the offspring showed low viability at birth and, still more, at 10 days after birth. Our data are compatible with the hypothesis that genital mycoplasma infection plays a role in reproductive failure.