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Biomedical subjects

S Weiner

Publications and source records attributed to S Weiner.

At least 163 records · Page 9Linked to original sources

Duplex Doppler ultrasound in the evaluation of growth in twin pregnancies.

Fifty-six multiple pregnancies were evaluated for evidence of discordant growth using traditional ultrasonic methods and duplex Doppler ultrasound. The pregnancies consisted of 52 sets of twins and four sets of triplets. Duplex Doppler ultrasound predicted normal growth in 44 of 45 normal sets of fetuses, and correctly predicted discordant growth in nine of 11 discordant sets of twins. Among those nine abnormal sets, Doppler ultrasound predicted that six would become discordant before this was recognized by traditional ultrasonic measurements. Duplex Doppler ultrasound is useful in predicting and confirming concordant and discordant growth, and defining the cause of fetal discordancy.

Adult↗

Fetal heart rate measurement during maternal exercise--avoidance of artifact.

The purpose of this study was to investigate the possibility that motion artifact may override the recording of fetal heart rate (FHR) with Doppler ultrasound fetal monitors during maternal exercise on cycle ergometers and treadmills, and to test the efficacy of two-dimensional ultrasound directed M-mode echocardiographs for determining FHR during maternal treadmill exercise. Four pregnant women (26 to 30 yr, means = 28, gestational age = 28 to 34 wk) pedaled a cycle ergometer at 25 to 50 W, while a second group (N = 4) (24 to 36 yr, means = 29, gestational age = 30 to 37 wk) walked on a treadmill at either 1.5 or 2.0 mph. Fetal monitor recordings (Hewlett-Packard 8040A) were consistent with pedal rate in the range of 50 to 70 rpm and with stepping rate in the range of 70 to 76 steps per min at 1.5 mph and 100 to 106 steps per min at 2.0 mph on the treadmill. Actual mean FHRs (audible signal from fetal monitor) were in the normal range [150.5 +/- 10.25 bpm (cycle ergometer) and 148.8 +/- 2.3 bpm (treadmill)]. In a separate session, the cycle ergometer group walked on a treadmill at a maternal heart rate of 140 bpm while FHR was determined by two-dimensional ultrasound directed M-mode echocardiographs. Off-line analysis of fetal cardiac cycle time (clinical graphics analyzer) allowed accurate FHR measurements which were not confounded by motion artifact. Mean FHR during maternal treadmill exercise (158.0 +/- 12.0 bpm) was not different (P greater than 0.05) when compared to pre-exercise standing (140 +/- 3.6) and also during the post-exercise period (sitting) (151 +/- 6.5) compared to the sitting pre-exercise measurements (147 +/- 8.2).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Percutaneous umbilical blood sampling. A new technique for prenatal diagnosis.

Direct access to fetal blood during the second and third trimesters of pregnancy opens new fields of prenatal diagnosis and in utero fetal treatment. Percutaneous umbilical blood sampling, a method that involves ultrasonographically guided needle insertion into the umbilical vein, appears to have an acceptable complication rate. This technique has tremendous potential for use in evaluating fetal status.

Adult↗

Organization of hydroxyapatite crystals within collagen fibrils.

Transmission electron micrographs of individual mineralized collagen fibrils show that hydroxyapatite crystals are located mainly within the fibrils at the level of the gap regions. The plate-shaped crystals are observed to be more or less uniformly stacked across the fibril diameter. We therefore suggest that the crystals are primarily located in 'grooves' created by contiguous adjacent gaps. The proposal is consistent with the observed crystal distribution in the fibril and with their average widths, which are almost 10-times greater than an individual gap diameter.

Animals↗

Hibernoma. A case report and discussion of a rare tumor.

A case report is presented of a large retroperitoneal hibernoma along with the clinical, radiographic, and pathologic findings. Despite the unusual size and location of this hibernoma, the case illustrates the salient features of these rare tumors of brown fat origin. Pitfalls in preoperative diagnosis are discussed. To date, there has been no convincing evidence of malignant potential of this tumor, and total excision remains the treatment of choice.

Adult↗

Cervical tissue uptake of all-trans-retinoic acid delivered via a collagen sponge-cervical cap delivery device in patients with cervical dysplasia.

The present study was undertaken to evaluate the systemic absorption and cervical tissue uptake of all-trans-retinoic acid (TRA), delivered via a collagen spongecervical cap delivery device in patients with intraepithelial cervical dysplasia. Ten patients with histologically proven mild or moderate cervical dysplasia were included in this pharmacologic study. The two TRA concentrations (0.05% and 0.372%) selected for study represent the starting and maximally tolerated doses used in phase I clinical trial. All-trans-retinoic-11-3H acid (3H-TRA, 500 mu Ci) was used to facilitate cervical tissue uptake studies. Cervical biopsies and post-treatment blood samples were obtained from each patient after TRA exposure. The uptake of TRA into cervical tissues four hours after drug administration was significantly increased at the maximally tolerated TRA dose. There was a rapid decrease in cervical tissue concentration of TRA at the 0.372% dose between 4 and 24 h after drug exposure, suggesting a relatively short elimination half-life of TRA in cervical tissues. HPLC analysis of post-treatment blood samples indicate that there was no systemic absorption of TRA after local cervical administration.

Administration, Topical↗

Disaggregation of bone into crystals.

The sizes, shapes, and organizational states of the crystals in bone are studied by systematic disaggregation of the mineral phase. This is achieved by oxidizing the organic phase with sodium hypochlorite, dispersing the resultant particles by sonication, and separating the crystal aggregates from the crystal monomers by gravity setting in ethanol. Six different bones are compared. Bones in which crystals are intimately associated with the collagen fibrils mostly disaggregate into crystal monomers. In dense bones, where the crystals are mostly located between fibrils, they tend to persist as "fused" aggregates. All the crystals are tabular or plate-shaped. In bones in which the majority of crystals are associated with the collagen fibrils, just less than 90% of the crystals are shorter than about 450 A in length. Their widths are on the average about 250 A, almost an order of magnitude larger than the diameters of individual gap regions within the collagen fibril. The notion that one crystal is located in one gap region is therefore untenable and a reevaluation of the relations between collagen and mineral in bone is necessary.

Animals↗

The "vanishing twin": ultrasonographic assessment of fetal disappearance in the first trimester.

Review of the sonographic findings of 1000 pregnancies with viable gestations in the first trimester revealed a minimum incidence of twinning of 3.29%. Of these, 21.2% demonstrated the "vanishing twin" phenomenon, often with associated bleeding, but with a good prognosis for the remaining fetus. Ovulation induction did not appear to alter these data. The sonographic criteria for "vanishing twin" are discussed. The incidence of multiple gestation is 3.29% to 5.39%, higher than previously believed.

Diagnostic Errors↗

Protein conformation in rat tooth enamel.

Orientated 0.47 nm reflections in X-ray diffraction patterns of developing rat tooth enamel were confirmed using a wide range of specimen preparations and experimental conditions. This indicates that some of the organic matrix proteins adopt a beta-sheet conformation.

Animals↗

Neonatal pulmonary manifestations due to prolonged amniotic leak.

Neonatal pulmonary manifestations of prolonged (2-8 weeks) amniotic fluid leak (PAL) were evaluated in 22 neonates. The severity of respiratory insufficiency was evaluated by a profile scoring system based on arterial blood gases, ventilatory support, and evidence of "fetal compression". The spectrum included acute respiratory failure with pulmonary hypoplasia (3), pulmonary hemorrhage (2), severe bronchopulmonary dysplasia (3), subacute lung disease (5), and transient respiratory disease (2). Seven neonates were completely asymptomatic. Clinical manifestations were correlated to age of onset and duration of PAL. The onset of PAL in the asymptomatic babies had occurred after 32 weeks gestation (mean +/- SEM, 33.5 +/- 1.1 wk; duration was 4.4 +/- 1.1 wk). In symptomatic neonates the onset of PAL was 24.0 +/- 1.0 weeks; duration being 6.0 +/- 0.6 weeks. When PAL occurred before 22 weeks and the duration of leak was longer than 6 weeks, the pulmonary profile score was less than 3 and associated with severe respiratory sequelae. These manifestations culminated in neonatal demise despite aggressive conventional ventilatory techniques. Onset of PAL between 23 and 28 weeks gestation and continuing longer than 8 weeks also was associated with a similar outcome. Duration of PAL between 2 and 7 weeks in this group was associated with less severe pulmonary manifestations and higher scores. Pulmonary morbidity was significantly correlated to the initial profile score (P less than .05) and was influenced by the prenatal reduction in thoracic volume.

Amniotic Fluid↗

Modeling complex molecular interactions involving proteins and DNA.

We have presented a perspective of progress in three areas of simulations of complex molecules: the development of force fields for molecular simulation; the application of computer graphics, molecular mechanics and molecular dynamics in simulations of DNA and DNA-drug complexes and the application of computer graphics, molecular mechanics and quantum mechanics in studies of enzyme substrate interactions. It is our perspective that improvements are being made in force fields, and these will allow a more accurate simulation of structures and energies of complex molecules. In the area of DNA molecular mechanics and dynamics, it is clear that the use of computer graphics model building combined with NMR NOE data is a potentially very powerful tool in accurately determining structures of drug-DNA complexes using molecular mechanics and dynamics. Finally, we are in a position to reasonably simulate structures and (qualitatively) energies for complete reaction pathways of enzymes using a combination of computer graphics, molecular mechanics and quantum mechanics. More accurate energies and pathways are sure to follow, using the combined molecular mechanics/quantum mechanics optimization developed by Singh and the free energy perturbation methods pioneered in Groningen and Houston.

Base Sequence↗

Organization of extracellularly mineralized tissues: a comparative study of biological crystal growth.

Biological mineralization processes are extremely diverse and, to date, it is an act of faith rather than an established principle that organisms utilize common mechanisms for forming crystals. A systematic analysis of the structural organization, as far as possible at the molecular level, of five different extracellularly mineralized tissues is presented to demonstrate that at least these mineralization processes are all part of the same continuum. The degrees of control exercised over crystal nucleation and crystal growth modulation are the basic variables. The five tissues, extracellularly mineralizing algae, radial and granular foraminifera, mammalian bone, mammalian enamel, and mollusk shell nacre, probably span the entire spectrum. Their crystal shapes, sizes, and the relations between the mineral phase and the organic phase, are primarily used to assess probable degrees of control exercised over crystal nucleation and modulation. Three different types of nucleation processes can be recognized: nonspecific, stereochemical, and epitaxial. Modulation of crystal growth after nucleation is either absent, achieved by adsorption of macromolecules onto specific crystal faces, or occurs by the prepositioning of matrix surfaces which interrupt crystal growth. The tissues in which active control is exercised over crystal growth all contain similar types of acidic matrix macromolecules. Significantly, the framework matrix macromolecules are all quite different and hence probably perform some tissue-specific functions. The study shows that there is a common basis for understanding these mineralization processes which is reflected in the nature of the protein-crystal interactions which occur in each tissue.

Animals↗

Antibiotic prophylaxis in cesarean section. Comparison of intrauterine lavage and intravenous administration.

Intrauterine irrigation with a cefazolin solution at cesarean section was compared with intravenous cefazolin administration for prophylaxis against post-cesarean-section endomyometritis in a randomized, controlled, prospective fashion. There were no statistically significant differences in the incidence of infection between the lavage and intravenous groups. The incidence of endomyometritis was 37% in the lavage group and 29% in the intravenous (P = NS). Intrauterine cefazolin lavage is safe, effective, time saving and more cost effective than intravenous cefazolin in preventing post-cesarean-section endomyometritis.

Adult↗

Assessment of fetal growth.

Normal fetal growth is a logarithmic process, marked by rapid mitosis at its early stages and by cellular hypertrophy and the accumulation of fat, glycogen, and connective tissue later in gestation. Growth-retarding influences can alter cell number, with a symmetric pattern of IUGR resulting if they occur early. Later insults, the result of uteroplacental compromise, affect cell size and may cause an asymmetric growth retardation. Fetuses with asymmetric growth retardation are at particular risk for intrauterine fetal demise and fetal distress in labor. The assessment of fetal growth is complicated by a lack of clear definition for what constitutes normality. Fetal growth curves should be derived from uncomplicated pregnancies. Separate curves should be available on the basis of multiple gestation and sex, maternal parity, and ethnic-racial grouping. Correction factors for maternal height and prepregnancy weight as well as sibling size at birth would be useful. Birth weight-derived data are suspect for preterm gestations; sonographic fetal weight curves may improve accuracy. Without sensitive epidemiologic growth assessment, other modalities (clinical, biochemical, and sonographic) will have limited usefulness. The assessment of fetal growth may include clinical means but care must be taken to garner a meticulous history and to record precisely serial fundal height. Many biochemical methods have been proposed for the detection of IUGR but they have a limited role as screening tests. Ultrasound remains the best method for the diagnosis, characterization, and follow-up of IUGR. Ultrasonography allows for the precise estimation of fetal weight. The calculation of HC:AC ratios allows for characterization of the pattern of IUGR. Evaluation of amniotic fluid volume and placental grading as well as the search for congenital anomalies are helpful exercises. Doppler flow studies of uterine and fetal blood flow may provide an understanding of the cause and severity of the growth-retarding process. Finally, careful antenatal surveillance and judicious timing of delivery are required following the identification of IUGR. Delivery should be planned in concert with the neonatologist.

Biometry↗

Malacoplakia of Bartholin's gland.

Two cases of malacoplakia involving Bartholin's glands occurred in postmenopausal women. Grossly the lesions were ovoid cysts with rubbery, soft walls. Microscopically there were sheets of von Hansemann's histiocytes and rare Michaelis-Gutmann bodies. After surgical excision, both patients remained asymptomatic. These cases involving Bartholin's glands are, to our knowledge, the first reported in the female genital tract.

Bartholin's Glands↗

Phase II trial of beta-all-trans-retinoic acid for cervical intraepithelial neoplasia delivered via a collagen sponge and cervical cap.

Retinoids are effective suppressors of the phenotypic development of cancer in many animal systems, whether the process is initiated by chemical, physical or viral carcinogens. Cases of cervical intraepithelial neoplasia are excellent for studying the effectiveness of retinoids as chemopreventive agents because the process can be closely followed by serial colposcopic and pathologic (cytology or biopsy) means and changes in the condition safely monitored. We have previously conducted a phase I study of trans-retinoic acid (Tretinoin) given topically by a collagen sponge and cervical cap. A dose of 0.372% was selected for phase II trial. We have treated 20 patients with topical retinoic acid, and a complete response with total regression of disease was obtained in 50%. Systemic and cervical side effects were mild and vaginal side effects moderate but tolerable. These results provide a clinical basis for a randomized, double-blind phase III study to definitely answer the question of whether retinoic acid is an effective chemopreventive agent for cervical cancer.

Animals↗