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Biomedical subjects

P Moerman

Publications and source records attributed to P Moerman.

At least 127 records · Page 7Linked to original sources
PubMed1991

Intra-uterine Candida infection: a report of four infected fetusses from two mothers.

Although Candida albicans is a frequent inhabitant of the female genital tract, chorioamnionitis is rarely caused by this fungal organism. In this report we present two cases with manifest Candida chorioamnionitis. The first case is a twin pregnancy with premature delivery and survival of both twins. The second case is a pregnancy with intra-uterine contraceptive device in situ ending in a midtrimester abortion, followed by the next pregnancy also ending in an abortion in the second trimester. Possible triggers responsible for the increased invasiveness of otherwise benign Candida vaginitis are discussed. Foreign intra-uterine bodies such as contraceptive devices and cerclage sutures necessitate repetitive search for Candida species infection, and prompt adequate antifungal treatment in cases of documented infection. Both cases of the present report add further substantial evidence to the hypothesis of amniotic infection by ascending transcervical infection. The frequent concomitant cervical infections with other infectious agents as well as antibiotherapy influencing the normal Lactobacillary defence mechanisms are both likely to increase the risk. Systemic debilitating diseases that promote invasiveness are briefly discussed.

Adult↗
PubMed1991

The association between Chlamydia cervicitis, chorioamnionitis and neonatal complications.

In a prospective study on genital infections, the influence of Chlamydial cervicitis on pregnancy outcome was evaluated. In eleven women with Chlamydial cervicitis perinatal outcome was recorded, the placenta was examined and the newborns were screened for Chlamydial conjunctivitis. They were compared with 13 women who were negative for Chlamydia and were delivered immediately after a Chlamydia positive woman. Compared to negative women, women with Chlamydia cervicitis were younger and presented for antenatal care at a later gestational age (difference not significant) and started having sexual intercourse at an earlier age (P less than 0.02). There was a significant association between Chlamydial infection and chorioamnionitis, lower birth weight and severe neonatal infection (P less than 0.05); but a contribution from concomitant genital pathogens could not be completely ruled out. Therefore a screening program for Chlamydia should include screening for other genital infections. While almost all cases of Chlamydia could have been suspected by this technique, a screening based on lactobacillary grades in Pap smears might be helpful for this purpose, even more so because it also facilitates tracing other genital pathogens. Detection of Chlamydial antigen from conjunctival swabs taken immediately after birth did not adequately reflect the risks of neonatal infection in this small group.

Adult↗
PubMed1991

Different patterns of pulmonary sequelae after hyaline membrane disease: heterogeneity of bronchopulmonary dysplasia? A clinicopathologic study.

In an autopsy study of 37 infants who suffered from hyaline membrane disease (HMD), two distinct patterns of pulmonary lesions could be defined. One pattern, characterized by marked interstitial fibrosis in the absence of airway abnormalities, was labelled 'interstitial-type' histology. A second type, labelled 'bronchiolar-type' histology, showed marked airway lesions and alveolar emphysema. Nine patients of each type were analysed. Nineteen other patients had a 'mixed-type' histology and were not further studied. Retrospectively, the clinical and radiological characteristics of both series were analysed. No differences in birth weight, gestational age and initial radiological HMD grade could be demonstrated. The pulmonary function of the bronchiolar-type patients however was significantly worse at the onset, and these infants needed more oxygen and ventilatory support during the first 10 days of life. They all died from respiratory failure whereas 4 patients from the interstitial group had non-pulmonary fatalities. In the bronchiolar group chest X-rays showed atelectasis and pulmonary interstitial emphysema in the early stages, and hyperinflation with bullae and irregular streaky densities in the later. Patients in the interstitial group had no or minor emphysema with more homogeneously spread densities over both lungs. We conclude that both types of evolution represent two extremes of the bronchopulmonary dysplasia spectrum.

Bronchopulmonary Dysplasia↗
PubMed1991

Lobar holoprosencephaly and Xq22 deletion.

A 20 weeks gestation female fetus with a lobar holoprosencephaly and Xq22 deletion is described. The phenotype correlation of the cerebral defect with the facial features is positive. On the contrary phenotypic-karyotypic correlation is non obvious.

Abortion, Induced↗
PubMed1991

The fetal phenotype of partial trisomy of the long arm of chromosome 4 (4q22----4qter).

A slightly malformed female fetus with partial trisomy 4q due to a maternal balanced translocation t(1;4)(q44;q22) is reported. This fetus presented some of the typical facial features and internal malformations associated with pure partial trisomy 4q indicating that chromosomal diagnosis is needed to confirm the reality of the malformative syndrome.

Adult↗
PubMed1991

The diaphragm of the newborn infant: anatomical and ultrasonographic studies.

In the newborn infant, the diaphragm seems badly adapted to perform the burden of respiratory work. Indeed, due to the large angle of insertion on the rib cage and the small area of apposition, the flat diaphragm of the newborn infant seems better designed to suck in the rib cage rather than air. To better understand this paradox, and get insight in the structure-function relationship, the anatomical connections between the diaphragm and the rib cage were studied in 16 infants of various postmenstrual and postnatal ages. It was concluded (1) that the diaphragm inserts on the rib cage border only in the anterior costo-diaphragmatic triangle. From antero-laterally to posteriorly it inserts at increasingly greater distance from the rib cage border; (2) that the dorsal diaphragm ends its free course at the 11th rib and continues caudally as a spur ending between the 12th rib and the crista iliaca. From echographic studies of the right diaphragm with simultaneous measurement of the caudad displacement of the diaphragm and abdominal circumference change, the dynamics of the diaphragmatic movements could be better understood. It was concluded that, in contrast with the adult diaphragm, acting as a piston within the rib cage, the diaphragm of the newborn infant acts as a below moving mainly in the posterior part.(ABSTRACT TRUNCATED AT 250 WORDS)

Apnea↗
PubMed1990

Pathogenesis of the lethal multiple pterygium syndrome.

We present autopsy studies in 4 unrelated fetuses with the lethal multiple pterygium syndrome (LMPS) with special emphasis on the neuromuscular system. The data suggest that LMPS combines the manifestations of a jugular lymphatic obstruction sequence with those of an early severe fetal akinesia sequence. The jugular lymphatic obstruction sequence with resultant edema and cystic hygroma colli causes fetal lethality usually in the second trimester of pregnancy. Generalized amyoplasia appears to be an important mechanism in the pathogenesis of fetal akinesia as part of LMPS and is not associated with dysgenesis or degeneration of the central nervous system (CNS) but is apparently the result of an early fetal muscular "dystrophy." We propose a genetically determined insult affecting the early embryonic development of both lymph vessels and muscles as the basic defect in LMPS. Placental structure, studied in all 4 cases, demonstrated that triploidy-like placental lesions are specific to LMPS. The present findings suggest that LMPS may be a less heterogeneous entity than previously proposed.

Abnormalities, Multiple↗
PubMed1990

Neonatal haemochromatosis.

Four cases of neonatal haemochromatosis presenting as fulminant hepatic failure in the newborn were diagnosed by autopsy. In all four cases the diagnosis was made by histochemical demonstration of excessive iron deposition in hepatocytes and extrahepatic parenchymal cells, particularly pancreatic acinar epithelium, thyroid follicular epithelium and distal renal tubules. No haemosiderin was detectable in the extrahepatic mononuclear-phagocytic cells of the spleen, lymph nodes and bone marrow. The liver was the most severely affected organ. The hepatic haemosiderosis was associated with massive hepatocellular necrosis of prenatal onset in three patients, one of whom showed formation of regenerative nodules, establishing true congenital cirrhosis. Other inconstant findings included giant cell transformation, diffuse sinusoidal fibrosis with segregation of small groups of hepatocytes and cholestasis with pseudoacinar change of liver cell plates. The fetal liver disease had its onset in the late second trimester of pregnancy and was reflected clinically by severe panhypoproteinaemia with non-immune hydrops; hyperbilirubinaemia and haemorrhagic diatheses were apparent in the newborn. Neonatal haemochromatosis is a metabolic disorder, probably of autosomal recessive inheritance. The site and nature of the basic defect remain uncertain. Pathologists should be aware of this condition and its potential recurrence in subsequent pregnancies.

Female↗
PubMed1990

The fetal akinesia deformation sequence. A fetopathological approach.

In this paper we review the present knowledge on the etiological factors and pathogenetic mechanisms of the fetal akinesia deformation sequence, based on a fetopathological approach. Special attention is given to two sever, lethal subgroups i.e. the Pena-Shokeir I syndrome and the lethal multiple pterygium syndrome.

Abnormalities, Multiple↗
PubMed1989

Isochromosome 12p in mediastinal germ cell tumor.

The occurrence of an i(12p) in an extragonadal mediastinal germ cell tumor indicates that this chromosome change, which is characteristic for testicular germ cell tumors, can also occur in germ cell tumors present elsewhere in the body. In addition, the karyotype in this patient was near-diploid, in contrast with testicular germ cell tumors, which as a rule are near-triploid or near-tetraploid.

Adolescent↗
PubMed1989

Fatal aortic rupture: an unusual complication of percutaneous balloon valvuloplasty for acquired valvular aortic stenosis.

A case report complicated by a perforation of the ascending aorta during percutaneous balloon valvuloplasty for acquired aortic stenosis in a bicuspid aortic valve is presented. The clinical and pathological findings are discussed. It is suggested that in patients with hard calcified valve cusps and calcifications of the aortic annulus balloon sizes exceeding the aortic diameter should be avoided.

Aged↗
PubMed1989

In situ localization of melanotransferrin (melanoma-associated antigen P97) in human liver. A light- and electronmicroscopic immunohistochemical study.

Using an indirect immunoperoxidase technique on frozen sections with the monoclonal antibody 96.5, we investigated the in situ distribution of melanotransferrin, a transferrin (Tf) and transferrin receptor (TfR) related glycoprotein, in human liver. Specimens included normal liver, liver in iron overload, hepatocellular carcinoma, angioma and foetal liver. On light microscopy, immunoreactivity was almost exclusively present on sinusoidal lining cells, apparently endothelial cells; the pattern was similar in normal and in iron-loaded liver. A gradient of more enhanced staining in acinar zone II and III was observed. The endothelial localization of the staining was supported by the positivity of the central vein endothelium and of the angiomas. Immunoelectron microscopy on three liver specimens showed positivity on sinusoidal endothelial cells but not on Ito and Kupffer cells. In addition, positivity on rough endoplasmic reticulum vesicles of some hepatocytes was also present. Four hepatocellular carcinomas showed an intense staining in tumour cells, 3 were weakly positive and 3 were negative. In the foetal livers, the central vein endothelium was positive from 21 weeks of gestation onward and additional positivity of zone III sinusoidal endothelial cells was present from 27 weeks on. The present results show that in the liver melanotransferrin has a localization different from Tf and the TfR. These latter molecules are predominantly localized in parenchymal cells. In addition, there does not appear to be a coordinate regulation secondary to iron storage, between melanotransferrin, Tf and the TfR. The observed gradient in the staining pattern in foetal and adult liver specimens further supports the heterogeneity of the endothelial cell population in the liver and suggests a developmental relationship between endothelial cells of sinusoids and central vein.

Adult↗
PubMed1989

[A new sublethal syndrome with multiple malformations associating diaphragmatic hernia, distal digital hypoplasia, and craniofacial anomalies. The "Fryns syndrome"].

Prevalence, Clinical variability, Etiology, Survival and Prenatal Diagnosis--In this report, we summarize the actual data on the Fryns syndrome, a true MCA/MR syndrome with autosomal recessive inheritance and sublethal outcome. In addition to the diagnostic triad of diaphragmatic hernia--digital limb hypoplasia--coarse facies, multiple internal malformations are a constant feature.

Abnormalities, Multiple↗
PubMed1988

Holzgreve-Wagner-Rehder syndrome: Potter sequence associated with persistent buccopharyngeal membrane. A second observation.

Here we present a second example of the syndrome first reported by Holzgreve et al. [1984] in this journal, i.e., Potter sequence with persistent buccopharyngeal membrane type II, postaxial polydactyly, cleft palate, cardiac anomalies, intestinal nonfixation, and intrauterine growth retardation. This specific complex MCA syndrome is not associated with a detectable chromosome abnormality.

Abnormalities, Multiple↗