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Biomedical subjects

W C Hop

Publications and source records attributed to W C Hop.

At least 271 records · Page 15Linked to original sources
PubMed1990

Spontaneous abortion rate and advanced maternal age: consequences for prenatal diagnosis.

Maternal age related and procedure-related fetal abortion rates were studied in 384 women aged 36 and over scheduled for transabdominal chorionic villus sampling (TA-CVS) at 12-14 weeks of gestation. The pre-TA-CVS abortion rate within 30 days of intake (at 6-10 weeks of gestation) rose from 1.9% at age 35-36 years to 10.9% at 40 years and older. Women entering in the 6th week of gestation had a greater probability of aborting before TA-CVS than women entering after day 48. 26 women aborted spontaneously before TA-CVS, the majority of abortions occurring at 10-12 weeks. TA-CVS was done in 346 women. 11 pregnancies were terminated because of genetic anomalies, and 8 women had spontaneous fetal loss. These findings justify delaying prenatal diagnosis in older pregnant women until 12 weeks of gestation.

Abortion, Spontaneous↗
PubMed1990

[The treatment of recurrent inguinal hernia].

Between 1980 and 1987 a total of 163 patients were operated for unilateral recurrent inguinal hernia in the University Hospital Dijkzigt. Various factors were analysed statistically with the log rank test for their prognostic value to predict repeat recurrence. Lower repeat recurrence rates were found with increase of age (p = 0.05) and time passed since the previous hernia operation (p = 0.001). Using the actuarial method of analysis the total cumulative repeat recurrence rate after five years was 23%.

Actuarial Analysis↗
PubMed1990

Lithium augmentation in geriatric depression.

In the geriatric department of a Dutch psychiatric hospital the charts of 51 patients treated with lithium in addition to cyclic antidepressants were reviewed. A response was seen in 33 patients (65%). For patients with recurrent depressive episodes, a statistical trend was found towards more responders with more complete responses, compared to patients with first depressive episodes. During lithium augmentation, 10 patients suffered from severe adverse effects 12 times. In spite of adverse effects, with expert monitoring lithium augmentation can, in our opinion, be of value in the treatment of older depressed patients.

Aged↗
PubMed1990

Treatment of molluscum contagiosum using a lidocaine/prilocaine cream (EMLA) for analgesia.

Eighty-three 4- to 12-year-old children, scheduled for curettage of at least five molluscum contagiosum lesions, participated in a double-blind study. The children were randomly allocated to receive lidocaine/prilocaine (EMLA) cream (n = 58) or placebo cream (n = 25), applied 15, 30, or 60 minutes before treatment. The pain was assessed by the children and the physician as none, slight, moderate, or severe. In addition, the children rated the pain on a visual analog scale. EMLA cream effectively prevented the pain after all three application times (p less than 0.01). No significant difference in pain was observed among the 15-, 30-, and 60-minute EMLA-treated groups, but the proportion of children reporting no pain on the verbal scale increased from 36% in the 15-minute group to 61% in the 60-minute group. In the placebo group, only one of 24 children (4%) reported no pain. Transient local redness was the only skin reaction noted. In conclusion, an application time of EMLA cream of less than 60 minutes is satisfactory for the curettage of molluscum contagiosum in children.

Anesthetics, Local↗
PubMed1990

Growth patterns of nondominant ovarian follicles during the normal menstrual cycle.

Transvaginal ultrasound examinations were performed in seven normally cycling women to characterize growth of nondominant follicles in both ovaries. Mean follicle number showed little variation throughout the menstrual cycle with no differences between dominant and nondominant ovaries. Up to 11 follicles (greater than or equal to 2 mm) were observed in any one ovary. From observations of the first appearance of the dominant follicle (mean size 9.9 +/- 3.0 [SD] mm), selection was assumed to take place on cycle day 6.3 +/- 2.3. The diameter of nondominant follicles always remained less than 11 mm. Growth of small follicles was established in both dominant and nondominant ovaries up to the time of selection. The late follicular and luteal phases were characterized by a decrease in mean growth slopes of nondominant follicles in the dominant ovary only. These observations may provide in vivo evidence for the concept of intraovarian paracrine mechanisms and may have implications for the sonographic diagnosis of anovulation and monitoring of ovulation induction.

Adult↗
PubMed1990

Comparison of clinical Acinetobacter strains using a carbon source growth assay.

A quantitative carbon source growth assay, comprising ten carbon sources, was used to compare acinetobacter strains from three hospitals. The strains had been obtained during episodes of increased prevalence of isolations and were, for each hospital, assumed to be epidemiologically related. This assumption was supported by the electrophoretic protein profiles of the strains. Univariate analysis of growth data showed significant differences between strains from the three hospitals. Moreover, cluster analysis revealed that the major pattern in the data was related to the epidemiological origin of the strains. Exceptions to the epidemic-related pattern were observed. Thus, apart from epidemiological factors, other factors might contribute to carbon source growth profiles of the strains. It is concluded that the carbon growth assay may be useful to distinguish roughly between acinetobacter strains from different sites of origin. Further studies are required to analyse additional factors which influence carbon source growth of strains.

Acinetobacter↗
PubMed1990

Bioactive and immunoreactive FSH in serum of normal and oligospermic men.

In men suffering from idiopathic oligospermia and azoospermia the hypothesis was tested that decreased spermatozoa production could be due in part to inadequate hormonal stimulation of spermatogenesis. In 53 healthy male subjects with normal spermatozoa production (n = 10), varying degrees of oligospermia (n = 40), and azoospermia (n = 3), serum immunoreactive LH, testosterone (T), and oestradiol (E2), and immunoreactive and bioactive FSH concentrations were determined. FSH bioactivity was estimated using the rat granulosa cell aromatase bioassay. Mean LH, T, and E2 levels were similar in the control group (spermatozoa concentration greater than 40 x 10(6)/ml) compared with men exhibiting mild (10-20 x 10(6)/ml), moderate (5-10 x 10(6)/ml), or severe oligospermia (1-5 x 10(6)/ml), and in the azoospermia group. An inverse correlation was found between immunoreactive FSH levels and spermatozoa concentration (P less than 0.05), with elevated levels (twofold increase) of FSH in the combined severe oligospermia and azoospermia (P less than 0.01) groups. Moreover, augmented (P less than 0.01) bioactive FSH levels were also observed in this group of patients. The mean bioactive to immunoreactive FSH ratio was also negatively correlated with sperm counts (P less than 0.005). In addition, T/LH ratios were inversely correlated with immunoreactive (P less than 0.05) and bioactive (P less than 0.05) FSH, which may indicate that altered Leydig cell function is involved in the augmented secretion of FSH. The data presented in this study indicate that immunoreactive FSH, as measured in oligospermia and azoospermia, does not exhibit decreased bioactivity.

Estradiol↗
PubMed1990

Hepatitis B vaccination of haemodialysis patients: randomized controlled trial comparing plasma-derived vaccine with and without pre-S2 antigen.

The pre-S2 protein of the hepatitis B virus envelope evokes anti-pre-S2 antibodies and enhances the anti-HBs response after vaccination in mice. In order to evaluate the immunogenicity of the pre-S2 Ag in man, 102 HBsAg, anti-HBs, anti-HBc-negative haemodialysis patients were vaccinated at random according to one of four vaccination schedules: 5 micrograms plasma vaccine Pasteur (containing 1% pre-S2) or 20 micrograms plasma vaccine MSD (no pre-S2) at 0, 1, 2, 4, 6 and 12 months; or 10 micrograms Pasteur or 40 micrograms MSD at 0, 1, 2 and 6 months. Anti-HBs levels were measured by RIA and expressed in IU l-1; anti-pre-S2 response was evaluated by both EIA and Western blot analysis. Eighty-four per cent (95% confidence interval: 75-93) of the patients exhibited an anti-HBs response of 2 IU l-1 or more and 71% (95% confidence interval: 61-81) reached an anti-HBs level of at least 10 IU l-1 within 13 months of the start of vaccination. Anti-HBs response correlated with age (the response rate decreased with increasing age) but not with either the type of vaccine or dosage. An anti-pre-S2 response was observed in 16% (EIA) and 46% (Western blot) of the patients immunized with the Pasteur vaccine and none (EIA, Western blot) of the MSD group. The level of anti-pre-S2 antibodies correlated with high anti-HBs titres; an anti-pre-S2 response occurred in only one anti-HBs-negative patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Cerebral lesions in preterm infants after tocolytic indomethacin.

The incidence and type of cerebral lesions in 159 infants born before 30 weeks gestation were studied, using ultrasound. Indomethacin was given as part of tocolytic management to mothers with a high incidence of early rupture of membranes and preterm labour; and 76 fetuses were exposed to the drug as a result. For the remaining 83 pregnancies, in which there was a high incidence of chronic fetal distress and in utero hypoxia, tocolysis was either not started or limited to fenoterol. The neonatal course was similar for both groups of infants, except that patent ductus arteriosus was less commonly diagnosed in the 76 infants exposed to indomethacin. However, the incidence of periventricular leukomalacia was increased among infants exposed to any tocolytic agent; and cystic lesions occurred more commonly in those exposed to indomethacin.

Administration, Rectal↗
PubMed1990

Does the outcome of the tidal breathing and dosimeter methods of assessing bronchial responsiveness in children with asthma depend on age?

As minute volume increases with age, a study was carried out to determine whether the measurement of bronchial responsiveness to pharmacological agents with the tidal breathing technique in children might be influenced by age. Bronchial responsiveness to histamine administered by tidal breathing was therefore compared with that produced with a dosimeter in 25 children with asthma aged 5-18 years. Bronchial responsiveness was defined as the concentration of histamine that caused a 40% rise in pulmonary resistance (PC40) measured by random noise forced oscillation at 6 Hz. Values of PC40 measured by the tidal breathing method were lower than those obtained with the dosimeter method, presumably owing to differences in the dose administered and variations in the pattern of breathing. The difference between the two methods was not related to age, however. It is concluded that the tidal breathing and the dosimeter methods are both suitable for the measurement of bronchial responsiveness in children of various ages and that both can be used in longitudinal studies.

Adolescent↗
PubMed1990

Umbilical cord separation: histological findings and perinatal factors.

The aim of this study was to investigate if perinatal factors influenced the histology of the umbilical area of neonates who died when umbilical cord separation was occurring or had just been completed. It was found that the older the infant was at death the greater the degree of infiltration of polymorphonuclear leucocytes into the area of separation of the umbilical cord. The infiltration was less when the infant was delivered by caesarean section than when the infant was delivered vaginally. The other factors studied (sex, birth-weight, gestational age, positive blood culture, time of rupture of the membranes) did not influence the histological findings.

Birth Weight↗
PubMed1990

High plasma prorenin in diabetes mellitus and its correlation with some complications.

Plasma prorenin is abnormally high, whereas renin is normal or even low, in many patients with long-standing diabetes mellitus complicated by microvascular disease. Nephropathy or autonomic neuropathy has been put forward as a cause. We found that in 223 consecutive diabetics prorenin correlated positively with serum creatinine, the presence of macroalbuminuria (greater than 250 mg/L), and the presence of diabetic retinopathy, particularly the proliferative type. This correlation did not depend on the presence of neuropathy or whether the patient was receiving insulin. It was also independent of sex, age, duration of diabetes, blood pressure, and blood levels of glucose and hemoglobin-A1c. The association between elevated prorenin and retinopathy remained significant after adjustment for creatinine and the presence of macroalbuminuria. Of the whole group of diabetics 94 consecutive patients were assessed for the presence of microalbuminuria (30-300 mg/24 h). Independently of the presence of micro- or macroalbuminuria, the mean level of prorenin was not above normal in the patients without retinopathy and was 2-3 times normal in those with proliferative retinopathy. Thus, retinopathy appears to be a more important determinant of abnormally high prorenin than nephropathy. In addition, the renal vein to artery ratio of prorenin in 7 diabetics with both advanced nephropathy and proliferative retinopathy was not elevated, despite the high peripheral venous prorenin level and the impaired renal perfusion. Thus, the abnormally high prorenin level in these patients could not be explained by abnormal secretion by the kidneys. Finally, prorenin was not high in 16 nondiabetics with loss of sympathetic activity due to chronic autonomic neuropathy, which indicates that in the absence of diabetes, this type of autonomic failure is not sufficient to cause the high prorenin levels seen in diabetics. Our findings are evidence that abnormally high plasma prorenin levels in diabetics are not an immediate consequence of altered glucose metabolism. This abnormality is related to the development of microvascular disease in the eye and kidney and is at least in part due to decreased clearance of prorenin from the circulation, increased production from extrarenal sources, or both.

Albuminuria↗
PubMed1990

Adverse hemodynamic effects and echocardiographic consequences of pericardial closure soon after sternotomy and pericardiotomy.

The acute hemodynamic and echocardiographic effects of pericardial closure on cardiac function were studied in 11 pigs during steady-state anesthesia and ventilation. Observations were made after sternotomy, both while the pericardium was open and after it had been closed, and then after closure of the chest, after the pericardium had been reopened by removing the pericardial suture through the chest wall. In five pigs, further observations were made when a suture was tightened to close the pericardium while the chest remained closed. Closure of the pericardium when the chest was open reduced cardiac output by 14% and mean stroke volume by 19% (both p less than 0.05). Systemic vascular resistance increased by 15% when the pericardium was closed while the chest was open (NS), and increased by 19% when it was closed while the chest was closed (p less than 0.05). Heart rate did not change significantly, and the systemic blood pressure was maintained (-8%, NS). All these effects were reversed by opening the pericardium. Intrathoracic epicardial echocardiographic monitoring of the left ventricle showed that its end-diastolic dimension increased (by 11%, p less than 0.05) when the pericardium was opened. After chest closure, paradoxical motion of the interventricular septum was consistently demonstrated only during ventilation, and it was not related to whether or not the pericardium was open. This study suggests that cardiac function may be impaired by pericardial closure after cardiac surgery because of some degree of constriction of the heart chambers, although acute circulatory responses compensate for the mild decrease in stroke volume. Monitoring of blood pressure alone cannot document the subtle circulatory changes induced by pericardial closure, and therefore it is not a reliable guide to decisions of whether to close the pericardium or leave it open in individual patients.

Animals↗
PubMed1989

A method to evaluate changes in prognostic status during follow-up, illustrated by an assessment of the effect of a rebleed in patients with oesophageal variceal bleeding.

A BASIC computer program to assess the time-dependent prognostic status of patients in follow-up studies is described. At each point in time, patients should be in one of two mutually exclusive conditions of interest, e.g. some biochemical measurement is within normal limits or not. The method is applied to data from a clinical study to investigate the prognostic effect of a rebleed in cases with oesophageal variceal bleeding.

Adolescent↗
PubMed1989

Effects of dietary protein content on weaning from the ventilator.

The effect of enteral nutrition with different protein contents on metabolic and ventilatory variables during weaning from the ventilator was studied in 10 mechanically ventilated patients as indication of the effect of protein on the ventilatory drive. Resting energy expenditure (R.E.E.) was assessed in the post-absorptive state and 2 enteral regimens both with a fat and carbohydrate content 1.25 times R.E.E. but with a moderate (190 mg N/kg/24 h) and high (260 mgN/kg/24 h) protein content were given to the patients in random order. Minute ventilation (V(E)), CO2-production (VCO2), O2-consumption (VO2) and arterial blood-gases were obtained during mechanical ventilation and weaning. Compared with post-absorptive state, both intakes gave significant increases in VCO2 during mechanical ventilation; the VCO2 values were equal for both regimens before the start of the weaning procedures. High protein intake was associated with significantly higher VCO2 during weaning and smaller increases in paCO2 from mechanical ventilation to the end of the weaning-period, compared with the moderate protein intake. This result is in agreement with studies in which an infusion of amino-acids in spontaneous breathing healthy volunteers increased ventilatory sensitivity to CO2. For mechanically ventilated patients high protein nutrition may be beneficial in enhancing weaning from the ventilator.

Journal Article↗
PubMed1989

Uterine and ovarian flow velocity waveforms in the normal menstrual cycle: a transvaginal Doppler study.

A combined transvaginal 2D real-time and pulsed Doppler method was used for recording flow velocity waveforms in the uterine and ovarian arteries from 16 healthy women during the follicular and luteal phase of the normal menstrual cycle. Continuous forward end-diastolic flow velocities were documented in 74% of the ovarian artery and 96.5% of the uterine artery flow velocity waveforms. Comparison of the pulsatility index from the left and right ovarian artery revealed a significantly lower pulsatility index on the side of the ovary bearing the developing corpus luteum, suggesting reduced down-stream impedance or increased blood flow. The pulsatility index from the uterine artery only seems to be marginally involved in the observed impedance changes during the luteal phase of the menstrual cycle.

Adult↗
PubMed1989

The efficacy of the combination of teicoplanin or flucloxacillin with netilmicin in the treatment of Staphylococcus aureus bacteraemia.

Twenty one patients with serious Staphylococcus aureus infection and bacteraemia were randomized prospectively to receive either teicoplanin and netilmicin or flucloxacillin and netilmicin. After at least 48 h of treatment serum samples were collected for the determination of trough and peak antibiotic concentrations, the serum killing level and the serum bactericidal rate. With the help of a severity-of-disease scoring system (APACHE II) the clinical efficacy of antimicrobial therapy was assessed. Eighteen patients were evaluable. The clinical results and the results of the serum assays suggest that treatment with teicoplanin or flucloxacillin, combined with netilmicin, is a safe approach in patients with bacteraemia caused by S. aureus.

Adult↗