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Biomedical subjects

T D Kerenyi

Publications and source records attributed to T D Kerenyi.

At least 19 recordsLinked to original sources
PubMed2001

[The role of uterine and umbilical artery Doppler velocimetry for the early detection of pathologic pregnancy].

Pregnancy induced hypertension remains the most frequent reason of maternal and fetal complications. Recent studies of the entire pathophysiology of the abnormal implantation proved association between the impaired placental performance and the reduced uteroplacental circulation. Therefore the Doppler examination of uterine and umbilical blood flow may provide the early recognition of high-risk pregnancies complicated by maternal hypertension and fetal intrauterine growth retardation. The authors endeavor to describe the details and characteristics of uteroplacental haemodynamic changes during the course of physiologic and defective implantation. On the basis of the currently available scientific publications they summarize the role of the uterine and umbilical artery Doppler velocimetry as a screening tool in the detection of the consequences of the impaired uteroplacental perfusion. They conclude that abnormal velocity waveforms obtained from the uterine and umbilical arteries may help to improve the efficacy of the prenatal care and the perinatal outcome as well. The clinical benefits of this screening method will be precisely defined on the basis of further multicenter studies in Hungary.

Arteries↗
PubMed1981

Significance of the midline echo in the ultrasound diagnosis of hydrocephalus.

Fetal intracranial anatomy can now be visualized as early as the 13th to 15th menstrual week using commercially available ultrasound equipment. It has consequently become possible to diagnose hydrocephalus early in pregnancy, often in the second trimester. We present a case of unsuspected hydrocephalus diagnosed in utero which demonstrated marked undulation of the midline echo. The significance of the midline echo and the diagnostic criteria in evaluating hydrocephalus are discussed.

Abnormalities, Multiple↗
PubMed1980

Transplancental cardioversion of intrauterine supraventricular tachycardia with digitalis.

Intrauterine congestive heart-failure caused by a supraventricular tachyarrhythmia was diagnosed in a fetus at 29-30 weeks' gestation. Major congenital malformations were excluded by sonography, amniocentesis, and fetal abdominal paracentesis, and those of the heart by intrauterine fetal echocardiography. The mother was given digoxin and the fetal tachycardia converted to sinus rhythm.

Adult↗
PubMed1980

A comparison between vaginal prostaglandin E2 suppositories and intrauterine extra-amniotic prostaglandins in the management of fetal death in utero.

This retrospective study was undertaken to compare the efficacy, side effects, and complications of prostaglandin E2 (PGE2) given as a vaginal suppository with those of PGE2 administered via the intrauterine extra-amniotic route to induce labor after fetal death. The induction-to-delivery intervals were comparable, with 9.2 +/- 3.94 hours and 8.6 +/-4.49 hours, respectively. However, the mean total amount of PGE2 administered was much less via the intrauterine extra-amniotic route (1.8 milligrams) than by the vaginal suppository (45.2 mg). There was a 100% success rate in the patients treated by the intrauterine extra-amniotic route, but only a 91.3% success rate in those patients treated via the vaginal route. The side effects (vomiting, diarrhea, fever) and the complications (incomplete abortion, uterine rupture, oxytocin augmentation) occurred more frequently with the use of PGE2 as a vaginal suppository. The vaginal route of administration of PGE2 is somewhat more convenient, but the intrauterine extra-amniotic route may offer a higher degree of efficacy and safety with fewer side effects in the management of fetal death in utero.

Abortion, Therapeutic↗
PubMed1980

Leukocyte migration enhancement as an indicator of immunologic enhancement. I. Pregnancy.

Leukocyte migration studies with amniotic fluid (AF) were performed in 47 pregnant women and 24 control patients. Previous reports about the enhancing effect of AF on leukocyte migration during pregnancy were confirmed (p less than 0.003). No enhancing effect was observed with first-trimester leukocytes. Maximal enhancement occurred during the second trimester (p less than 0.0001). It decreased during the third trimester (p less than 0.01) and lost significance in the postpartum period (p less than 0.072). Fifteen pregnant and control patients were investigated with autologous plasma. Leukocyte migration enhancement (LME) was significant with pregnancy plasma (PL) (p less than 0.03). Again LME was the largest during the second trimester (p less than 0.006). It is concluded that an immunologically active factor is present in AF and PL which in term induces the enhancing activity of a predetermined effector cell subgroup. This process is absent in conjunction with male leukocytes and is lacking in the majority of patients with toxemia of pregnancy.

Amniotic Fluid↗
PubMed1980

Leukocyte migration enhancement as an indicator of immunologic enhancement. III. Common denominators of pregnancy and malignancy.

Leukocyte migration enhancement (LME), a common denominator of pregnancy and malignancy, was investigated in order to determine the immunologic factors and processes involved in this in vitro assay. Reproducibility of results was confirmed by parallel investigations of single patients in an independent laboratory. Preliminary evidence also suggests that the phenomenon of LME is observable not only with the leukocyte migration assay, as performed in the present study, but also with the "indirect" migration inhibitory factor (MIF) assay. Highly significant correlation between results obtained with plasma (PL) and amniotic fluid (AF) was observed (p less than 0.00089). No significant correlation between LME and IgG concentrations as well as complement (C3) concentrations in AF and PL could be detected. C3 concentrations correlated significantly to gravity (p less than 0.007) and parity (p less than 0.003). No immune complexes were detected in either AF or PL samples. An unspecific protein effect as the cause of LME was ruled out in showing no significant correlation between LME and protein concentrations of AF and PL. A highly significant correlation between antigen concentration in PL and migration area was demonstrated (p less than 0.00001). It is suggested that leukocyte migration inhibition (LMI) represents a state of antigen excess, while LME represents antibody excess. Through selective removal of the IgG immunoglobulins LME could be converted into LMI, indicating an IgG subfraction as the responsible immunoglobulin in the phenomenon of LME.

Amniotic Fluid↗
PubMed1980

Leukocyte migration enhancement as an indicator of immunologic enhancement. II. Malignancy.

Leukocyte migration studies were performed on 19 cancer patients and 24 control subjects. Amniotic fluid (AF) as well as autologous plasma (PL) were investigated. No difference in the migration pattern between patients and control subjects was observed with AF, but cancer patients showed significant leukocyte migration enhancement (LME) with PL when compared to control subjects (p less than 0.04). Among 18 cancer patients with persistent disease only three did not show significant LME. All three represented specifically immunodepressed states. None of the untreated group of cancer patients failed to show LME with autologous PL. It is concluded that, as in pregnancy, an immunologic active factor is present in PL of cancer patients which induces a specific subpopulation of leukocytes and thereby LME. The possible mechanism of activation is briefly discussed. Through the detection of LME leukocyte migration may become of importance for the early detection of malignancy and monitoring of treatment success.

Adenocarcinoma↗
PubMed1980

Post-conceptional induction of menses with a single vaginal suppository of (15S)-15-methyl prostaglandin F2 alpha methyl ester.

The induction of post-conceptional menses needs a technically simple method which would avoid instrumentation of the uterus. One possible method investigated in this study is the abortifacient effect of a single dose long-acting vaginal suppository containing 3.0 mg of (15S)-15-methyl prostaglandin F2 alpha methyl ester. Pregnancy was terminated successfully in 13 of the 14 subjects. Two successful patients required curettage for prolonged bleeding and retained products of conception. Prolonged vaginal bleeding and the uncertainty of endpoints with particular reference to human chorionic gonadotropin (HCG) constitute the major problem with this non-invasive method, and are discussed in the light of the data obtained.

Abortion, Induced↗
PubMed1980

Intrauterine meconium aspiration syndrome.

A case of presumptive intrauterine meconium aspiration is reported in which the diagnosis was made on the basis of an unexplained intrauterine fetal tachycardia and the presence of severely meconium-stained amniotic fluid. The possible pathophysiology of intrauterine meconium aspiration is discussed with special attention to animal experimentation. The importance of an early diagnosis of this condition is stressed. The clinical management of such cases may change once the antenatal diagnosis of intrauterine meconium aspiration can be made with more certainty. In addition, the legal implications of a confirmed diagnosis of intrauterine meconium aspiration are discussed as meconium aspiration is considered presently to represent a largely preventable neonatal event.

Adolescent↗
PubMed1979

A blocking factor in amniotic fluid causing leukocyte migration enhancement.

Amniotic fluid was found to cause significant leukocyte migration enhancement during the second and third trimester of pregnancy and in the early postpartum period when compared to the migration area obtained with an ovarian tumor homogenate antigen (p less than 0.01), choriocarcinoma spent medium (p less than 0.01), and placental pool homogenate (p less than 0.01). Only borderline significance (p less than 0.1) was obtained when migration enhancement with AF was compared between pregnant and nonpregnant female control patients, indicating minimal unspecific activity of AF. Migration enhancement with autologous amniotic fluid was slightly larger than with homologous amniotic fluid, but the difference did not reach significance (p less than 0.4). None of the control antigens caused migration enhancement; placental pool homogenate in concentrations above 4 mg. per cent caused migration inhibition but did not in lower concentrations. The enhancing effect of AF could be abolished by dilution but not by addition of excessive antibody to estrogen of HCG. It is suggested that a blocking factor is present in AF preventing recognition of fetoplacental antigen by the maternal immune system. Thus in vitro leukocyte migration enhancement may correlate to in vivo graft enhancement.

Amniotic Fluid↗
PubMed1977

The preventability of "bloody taps" in second trimester amniocentesis by ultrasound scanning.

In 856 patients over a 6-year period, amniocentesis was performed in the midtrimester for prenatal genetic counseling. The use of ultrasound scanning of the gravid uterus prior to the procedure reduced the incidence of bloody taps threefold and the withdrawal of grossly bloody amniotic fluid by fourfold. The best results (7.6% overall and 2.0% grossly bloody taps) were obtained when the procedure was performed by an operator not only experienced and adept at intrauterine manipulation but who had training and experience in ultrasonography as well. These results contrast favorably with that of operators utilizing but not trained in ultrasound scanning (36% overall, 8% grossly bloody taps) and of those who had the uterus "mapped out" by a sonographist but performed the amniocentesis later in their offices (18% overall, 12.1% grossly bloody taps). Other advantages of prior sonography are also discussed.

Amniocentesis↗
PubMed1975

Fetal crown-rump length and biparietal diameter in the second trimester of pregnancy.

This study examines the relationships between fetal size (biparietal diameter and crown-rump length) and gestational age among subjects aborted by hypertonic saline in the second trimester of pregnancy. With a confidence of 90 per cent, biparietal diameter can be used to predict gestational age within plus or minus 2 weeks, and crown-rump length can be used to predict gestational age within plus or minus 3 weeks.

Abortion, Induced↗
PubMed1975

Oxytocin administration, instillation-to-abortion time, and morbidity associated with saline instillation.

Among 4,069 healthy gravidas undergoing saline abortion, patients administered intravenous oxytocin had a significantly shorter instillation-to-abortion time (median, 25.5 hours) than did patients not administered oxytocin (median 33.3 hours). The instillation-to-abortion time was independent of the rate of oxytocin administration, which ranged from 1 to 4 U. per hour (17 to 67 mU. per minute), but was associated with the time at which oxytocin infusion was begun. When oxytocin infusion was started within eight hours after instillation, a shortened time from instillation to abortion was observed. Although oxytocin augmentation may result in a lower proportion of patients being exposed to the risk of infection associated with prolonged intervals from instillation to abortion, this potential advantage appears counterbalanced by an increased incidence of clinical consumptive coagulopathy associated with instillation-to-abortion intervals of less than 24 hours.

Abortion, Induced↗