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Biomedical subjects

S A Heifetz

Publications and source records attributed to S A Heifetz.

At least 37 records · Page 2Linked to original sources
PubMed1988

Thrombosis of the umbilical cord: analysis of 52 cases and literature review.

Fifty-two cases of umbilical cord thrombosis from 3 patients populations are analyzed and compared with 68 cases from the literature. The incidence of cord thrombosis is approximately 1/1300 deliveries, 1/1000 perinatal autopsies, and 1/250 high-risk gestations. There is a slight male predominance. Umbilical vein thrombosis occurs more frequently than thrombosis of one or both umbilical arteries, but poor fetal outcome is more likely with arterial thrombosis. The mechanism of fetal death when only one umbilical artery is thrombosed is illustrated and discussed. The strong association between cord thrombosis and perinatal morbidity and mortality is not noted among prospective cases but, when present, is related to additional umbilical cord abnormalities, obstetrical complications, or systemic fetal conditions that are the likely cause of both the thrombosis and the poor fetal outcome. The pathogenetic relationship between cord thrombosis and these associated conditions is discussed, and it is concluded that cord thrombosis is a marker of both the severity of these conditions and the likelihood of poor fetal outcome.

Female↗
PubMed1988

Neonatal ovarian torsion: report of three cases and review of the literature.

Ovarian cysts are common incidental findings in term infants and, if unusually large, may result in dystocia, torsion, or rupture. Torsion and infarction of a normal ovary tend to occur in older childhood. During a 4-month period, 3 cases of neonatal ovarian torsion were observed after antenatal ultrasonography had detected fetal pelvico-abdominal cystic lesions. The three infants were explored between 4 and 16 days of age. Ovarian torsion was right-sided in all 3, and 1 ovary had been autoamputated. The resected specimens were nontense, thin-walled cysts, filled with hemorrhagic fluid, that measured between 4.5 and 8 cm in diameter. Microscopically, focal calcification and widespread necrosis precluded recognition of underlying histologic landmarks. Neonatal ovarian cysts or cystic ovaries greater than 4 cm in diameter should be excised, even if asymptomatic, because they are prone to, or have undergone, torsion.

Female↗
PubMed1988

Fetus in fetu: a fetiform teratoma.

Examination of a retroperitoneal fetus in fetu, diagnosed preoperatively, revealed previously unreported histologic findings in the vascular pedicle and membranous capsule that indicated that these structures are not "umbilical cord" or "amnion." These findings include nervous innervation of both structures and a well-defined lamina elastica interna and vaso vasorum in the artery of the vascular pedicle. Thus, strong support is provided for the theory that many examples of fetus in fetu are remarkably complex, well differentiated, highly organized teratomas. Additional arguments that favor the identity of fetus in fetu and teratoma are presented.

Abdominal Neoplasms↗
PubMed1988

Experimental respiratory infection with Bordetella pertussis in mice: comparison of two methods.

The mouse respiratory model is being used increasingly to study the pathogenesis and immunology of Bordetella pertussis infection. Two methods of inoculation, aerosol and intranasal, are routinely used to establish the infection. We compared the two methods of inoculation for reproducibility of infection using quantitative lung cultures and distribution of infection with [35S] methionine labeled bacteria and pulmonary histopathology. Ability to produce a respiratory infection intranasally was related to the inoculum volume; a minimum of 20 microliters was required although considerable variability remained. Lung bacterial counts in identically inoculated mice varied 1,000 fold following intranasal inoculation compared to only 5 fold following aerosol inoculation. Distribution of pulmonary 35S-labeled bacteria varied widely (right lung, 43-84%; left lung 16-57%) following intranasal in comparison to aerosol inoculation (right, 60-68%; left 32-40%). Finally, intranasal inoculation produced a scant, patchy, bronchopneumonia whereas diffuse pathology involving all pulmonary segments was seen following aerosol infection. Due to the superior reproducibility and predictable distribution of infection and pathology, aerosol inoculation is the method of choice for establishing the mouse model of pertussis respiratory infection.

Administration, Intranasal↗
PubMed1988

Tissue distribution of ethosuximide and clobazam in a seizure related fatality.

The case of a six-year-old male who died in a hospital while receiving several anticonvulsant drugs is described. Phenytoin, desmethyldiazepam, clobazam (an experimental 1,5 benzodiazepine), and desmethylclobazam were quantitated in serum, liver, and brain tissue by high performance liquid chromatography. Ethosuximide was quantitated by gas chromatography. To our knowledge, this is one of few reports describing tissue concentrations of ethosuximide collected at autopsy and the first report of clobazam/desmethylclobazam tissue distribution in man.

Anti-Anxiety Agents↗
PubMed1987

Deceased co-twin as a cause of false positive amniotic fluid AFP and AChE.

A pregnancy was terminated because of persistently elevated amniotic fluid AFP (+10 S.D.) and an AChE band of low intensity on gel electrophoresis. No fetal anomalies were detected by ultrasonographic examination. Autopsy revealed an apparently normal fetus of about 20 weeks gestation. Attached to the placenta was a small sac containing a fetus papyraceus co-twin of about 8-9 weeks gestation. The small deceased co-twin and its gestational sac were not detected prenatally despite multiple ultrasonographic examinations. The difficulty in the interpretation of apparently conflicting results is emphasized.

Abortion, Therapeutic↗
PubMed1986

Total anomalous origin of the coronary arteries from the pulmonary artery.

The clinicopathologic features of four patients with total anomalous origin of the coronary arteries from the pulmonary artery (TCAPA) are presented and compared with 21 previously reported cases. Patients with TCAPA usually present with left ventricular heart failure, angina, or associated cardiovascular anomalies. Of the 19 patients in whom a clinical history was available, 16 were symptomatic before three days of age. All patients died with 60% dying before two weeks of age. Longer survival was associated with additional cardiovascular anomalies that increased pulmonary arterial perfusion pressure, oxygen saturation, or both. Seventeen (68%) patients had additional cardiovascular anomalies, most commonly atrial (nine cases) or ventricular (eight cases) septal defects and tetralogy of Fallot or other variants of pulmonary atresia (four cases). Only five (22%) of 23 had noncardiovascular anomalies. The coronary arteries arose equally from either one ostium or from two, and the number of ostia was not related to either anomalous coronary artery distribution or to the presence of additional cardiovascular anomalies. Cardiomegaly was present in 56% of cases and the majority of patients had myocardial fibrosis or infarction. Embryology is reviewed and evidence is presented to support the theory of involution-persistence of coronary artery anlagen as the pathogenetic mechanism of TCAPA.

Coronary Vessel Anomalies↗
PubMed1984

Strangulation of the umbilical cord by amniotic bands: report of 6 cases and literature review.

The amniotic band syndrome is the triad of amnion-denuded placenta; fetal attachment to or entanglement by amniotic remnants; and fetal deformation, malformation, or disruption. Theories of pathogenesis and etiology of the syndrome are discussed. Amniotic bands occur in 1 of every 5000-15,000 births and are demonstrable in 1-2% of malformed infants. Nearly 10% of cases include umbilical cord strangulation. Six cases of umbilical cord strangulation by amniotic bands are presented, and 57 previously reported cases are reviewed. Two of the 63 were liveborn and 61 were stillborn, 3 of whom died intrapartum. Thirty had associated fetal abnormalities. Five were from multiple gestations. Outcome of the co-twin was determined by its presence within the same amniotic sac. Four fetuses beyond 28 weeks had short cords and were the only malformed fetuses in this age group. The earlier in gestation that amniotic bands form, the greater the likelihood of associated fetal abnormalities. All but 2 of 28 less than 32 weeks and only 4 of 35 greater than 32 weeks were malformed. A marked male predominance was noted in the former group, perhaps because the larger size and/or more vigorous movements of male fetuses promote early amnion rupture.

Amniotic Band Syndrome↗
PubMed1984

Single umbilical artery. A statistical analysis of 237 autopsy cases and review of the literature.

Two hundred thirty-seven autopsy cases of SUA and 1,242 unselected perinatal autopsies from military hospitals were reviewed and statistically analyzed. Results were correlated with those found in a comprehensive literature review. Incidence: The incidence of SUA in prospective deliveries is about 1%. Incidence is related to the portion of the umbilical cord examined, the method of cord examination (gross or microscopic), and to the race of the population base. The incidence of SUA in autopsy series is about twice the incidence in prospective series. SUA has a much higher incidence amont malformed, stillborn, or spontaneous abortuses than among apparently normal, liveborn, or induced abortuses. The incidence of SUA is less among very early embryos than among newborns because of the likelihood that SUA results from secondary atrophy of a preexisting normally formed second artery. As gestation proceeds, more cases will have become manifest to increase the incidence of SUA. There is no evidence of a familial tendency for SUA. SUA occurs slightly more frequently in females than in males, although there is a greater tendency for males with SUA to be malformed. The prognosis for SUA males is worse than for SUA females but no worse than that for male infants, in general. There is no relationship between the incidence of SUA and the month of the mother's last menstrual period. SUA and multiple births: The incidence of twins among SUA infants is at least three times greater than the overall incidence of twins. SUA occurs three to four times more frequently among twins than among Singletons. Although twin infants are subject to twice the expected incidence of malformations, twin SUA infants have no greater incidence of associated malformations than SUA singletons. Most SUA twins are discordant for the anomaly with SUA occurring in the smaller twin. The increased incidence of SUA among twin infants is not due to a greater incidence among monozygotic twins, since there is little difference from the usual proportion of monozygotic and dizygotic twins among twins with SUA. Mortality: In prospective series the mean perinatal mortality is about 20.0%. Approximately two-thirds of the perinatal deaths are stillborn and one-third are liveborn; and of the stillborn SUA infants, approximately three-quarters die antepartum and one-quarter die intrapartum. Mortality of SUA infants is related to associated fetal and placental malformations, prematurity and low birth weight, and intrauterine growth retardation. Although associated malformations are the primary cause of the high perinatal mortality, even nonmalformed SUA infants have an increased mortality rate.(ABSTRACT TRUNCATED AT 400 WORDS)

Abnormalities, Multiple↗