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Biomedical subjects

S Goldberger

Publications and source records attributed to S Goldberger.

14 recordsLinked to original sources
PubMed1992

Placental insufficiency as a possible cause of low maternal serum human chorionic gonadotropin and low maternal serum unconjugated estriol levels in triploidy.

We report three cases in which triploidy (69,XXX) was detected by amniocentesis performed for very low maternal serum human chorionic gonadotropin levels. All three cases also had low maternal serum unconjugated estriol levels. We suggest placental insufficiency as the cause of the very low human chorionic gonadotropin because of histologic observations and because a known marker for placental insufficiency, estriol, was also very low.

Abortion, Therapeutic↗
PubMed1992

Role of diabetes mellitus on the natural history of central retinal vein occlusion.

In order to elucidate the role of diabetes mellitus on the natural history of central retinal vein occlusion, we compared two groups of central retinal vein occlusion, one with diabetes mellitus (32 patients) and one without diabetes mellitus (113 patients). The two groups were quite similar with respect to age, sex, systemic hypertension and glaucoma. No fellow eye had proliferative diabetic retinopathy. The diabetic group had angiographically a more ischemic type of central retinal vein occlusion (72%) than the nondiabetic group (39%; p less than 0.002). Diabetics with central retinal vein occlusion should be closely monitored.

Adolescent↗
PubMed1992

Uterine remodelling following conservative myomectomy. Ultrasonographic evaluation.

Uterine leiomyomata develop during the reproductive years and may interfere with fertility through mechanisms as yet not fully understood. A developing intramural or large submucosal leiomyoma causes hypertrophy of the myometrium. Conservative myomectomy, as opposed to hysterectomy, is the preferred surgical procedure for patients who wish to preserve their fertility. Ten patients were ultrasonographically evaluated at monthly intervals following myomectomy and the changes in uterine (myometrial) volume were assessed. There was a gradual decrease in uterine volume in all patients during the six months following removal of intramural and submucosal leiomyomata. The most remarkable decrease in size occurred during the initial two to three months for the majority of the patients. The impact of this process on fertility should be further evaluated. One of the intriguing questions is whether the period of uterine shrinkage represents the time of the healing process during which conception should be prevented.

Adolescent↗
PubMed1991

Double rhomboid silicone rod frontalis suspension.

The frontalis suspension operation has proven effective for patients with significant ptosis and poor levator function. In patients with poor eye protective mechanisms, silicone rods may be used since the material has enough tensile strength to raise the eyelids yet it is sufficiently elastic to allow closure via action of the orbicularis muscle. This article reports the technique and results of a modified operation that uses two silicone rods per upper eyelid and eliminates fixation sutures to tarsus inferiorly and frontalis muscle superiorly. The results obtained are discussed. This technique provides a better upper eyelid contour and is easily adjustable postoperatively.

Adult↗
PubMed1990

Complete ovarian unresponsiveness to hMG stimulation after prolonged GnRH analogue administration.

GnRH agonists (GnRH-a) have recently been shown to exert an inhibitory effect on human reproductive functions, the mechanism for this effect being attributed solely to the desensitization of the pituitary gonadotropin receptors to GnRH-a. We present two cases where chronic treatment with a GnRH-a caused complete suppression of ovarian activity in vivo. The effect could not be counteracted by large hMG doses and resulted in high FSH plasma concentrations. Normal ovarian activity was restored only after withdrawal of GnRH-a.

Adult↗
PubMedDate not supplied

Major peripheral veins injuries.

The injury was severe in wounded limb patients of this series who suffered from an associated major peripheral vein trauma. The presence of such an injury weighed heavily on the prognosis. Thirty eight patients with major peripheral veins injuries are reviewed. The injury had resulted from war wounds, work or road accidents. The superficial femoral vein was the most frequently injured vein. Associated injuries were frequently noted: soft tissues injuries in 35 patients, fractures in 33, arterial injuries in 32 and peripheral nerve injuries in 22 patients. Shock was more often present and more severe in patients who suffered also from a vein injury than in patients with an arterial injury only. The lacerated femoral vein was ligated in the majority of patients. Attempts were made to repair the lacerated popliteal veins. Repair of the vein was usually done by anastomosis of debrided ends. When an arterial injury was also present, it was repaired first. The postoperative complications were frequent and included infections, thrombophlebitis and pulmonary embolisations. Twenty four patients were discharged with a viable limb. Complete function was recovered in seven patients only. Partial neurological deficit remained in twelve patients and complete paralysis in five. Twelve patients underwent subsequent amputation of the injured limb. Indications for amputation were ischemia in eight, infection or extensive destruction of tissues in four. Two patients died.

Adolescent↗
PubMedDate not supplied

Combined severe vascular and skeletal trauma. Management and results.

The viability and final functional ability of a limb following a vascular trauma will depend upon many factors, among these are the associated injuries. Thirty three patients suffering from combined vascular and skeletal injuries are presented. The presence of associated fractures weighed heavily upon the prognosis in these patients. Thus, twelve patients, or 36.3%, underwent limb amputation. Two patients died. In war wounds, the high velocity missile had caused severe and extensive destruction of tissues and the presence of the skeletal injury reflected well the degree of severity of the injury sustained by many of these wounded. The site of the fracture had a definite influence on the prognosis. For instance, all patients with a popliteal vessel injury lost their limb. The post operative complications noted in this series were essentially infectious complications. Internal fixation of the fracture, when used, was followed by a 45% rate of infection against a 27% rate when external fixation had been used. A higher rate of amputation was however observed in patients who had external fixation of the fracture (45.3%) rather than in those with internal fixation of the fracture (45.3%) rather than in those with internal fixation (30%). This is explained by the severity of the injury sustained in the former group. Nineteen patients were discharged with a viable limb, a success rate of 57.5%. The functional result was excellent in thirteen patients only (39.3%). Six patients remained with residual functional disability due to the associated injuries.

Adolescent↗
PubMedDate not supplied

Prognostic factors in peripheral vascular injuries.

A series of 73 patients suffering from peripheral vascular injuries is presented. The injury had been severe in most patients and associated injuries were present in a high percentage of cases. 46% of patients had long bone fractures, 52% had a major peripheral vein injured and 41% had peripheral nerve injuries. End to end anastomosis of the artery had been used in 51% of the cases and vein graft interposition in 46%. 71 patients survived the injury and 56 patients had a viable limb on discharge, or a success rate of 76.7%. Factors which weighed heavily on the prognosis are analyzed. The deleterious effect of the tourniquet is emphasized. Bleeding and shock were more severe in patients with an associated major peripheral vein injury. The latter had a definite influence on limb survival and was responsible for frequent thromboembolic complications. The associated fracture too weighed heavily on the prognosis, as well as infection, and loss of tissue. The associated injuries had a major influence on the final functional result. Function was poor in 10% of patients because of severe neurological deficits or extensive destruction and loss of tissue.

Adolescent↗