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Biomedical subjects

W N Spellacy

Publications and source records attributed to W N Spellacy.

At least 145 records · Page 8Linked to original sources
PubMed1980

A comparison of medical student performance on the obstetrics and gynecology National Board Part II examination and a comparable examination given during the clerkship.

An obstetrics and gynecology clerkship examination obtained from the National Board of Medical Examiners was administered to 96 medical students at the end of their clerkship rotation. They also took part II of the National Board examination 18 to 30 months later. There was a significant correlation between their ob-gyn scores on the two tests (r=0.56; p less than 0.01). In addition, all of the "high" performers (greater than 700) on the part II exam were predicted by their excellent scores on the clerkship exam. Only 25% of the "low" performers (less than 400) on the part II exam were also "low" performers on the clerkship exam; however, none had been superior performers. A clerkship exam score of 600 cleraly separated the two groups without overlap. This clerkship exam is useful in medical student education.

Certification↗
PubMed1980

Evaluation of a continuous tissue pH monitor in the human fetus during labor.

Continuous tissue pH monitoring of the fetus was successfully conducted in 13 of 21 patients (61.9%) during labor. There was a significant correlation between the tissue pH and both the scalp capillary blood pH (r = 0.94, P less than 0.001) and the umbilical artery blood pH (r = 0.92, P less than 0.01). These findings confirm the accuracy of the tissue pH instrumentation in reflecting fetal acid-base status and support the potential usefulness of the instrumentation in perinatal medicine for continuous fetal acid-base monitoring.

Acid-Base Equilibrium↗
PubMed1980

Endometrial estrogen and progesterone receptors in a uterus didelphys.

A 23-year-old woman with a uterus didelphys and a totally occluded left tube had a hysterectomy one year after having a child. Endometrial estrogen and progesterone receptors, both cytoplasmic and nuclear, were determined in five longitudinal sections of each horn. The amount and distribution of these receptors were normal, but the receptor content of the right horn was higher than that of the left.

Adult↗
PubMed1980

Anencephaly, twins and HLA-B27.

A patient with a twin pregnancy where both infants were affected with anencephaly is reported, and the world's literature on anencephaly in twins is summarized. The anomalies were diagnosed by ultrasound during the prenatal period. Studies of the genetic histocompatible lymphocyte antigens (HLA) types of both parents were performed, and they failed to demonstrate the HLA-B27 locus in either. Anencephaly in twins is an unusual phenomenon, with concordance even more rare. The possibility that anencephaly is a heterogeneous entity, both morphologically and genetically, and its relationship to the HLA locus are discussed.

Adult↗
PubMed1979

Oxytocin challenge test results compared with simultaneously studied serum human placental lactogen and free estriol levels in high-risk pregnant women.

Three perinatal health indicators (serum human placental lactogen [hPL] levels, serum free estriol [E3] levels, and OCT) were simultaneously completed in 149 high-risk women who were more than 34 weeks pregnant. There was a significant correlation between the hPL and E3 results (r = 0.28, p less than 0.01). There was a 15.4% positive OCT result rate and the blood hormone values for the negative and positive OCT groups were compared. There was a significantly lower hPL value in the positive OCT group (4.7 +/- S.E.M. 0.4 vs. 6.2 +/- S.E.M. 0.2 micrograms/ml for positive and negative groups, respectively), whereas the free E3 levels were not different in these two OCT groups (14.8 +/- S.E.M. 1.5 vs. 16.3 +/- S.E.M. 0.7 ng/ml for positive and negative groups, respectively). The free E3 value did not help in predicting the OCT result as the low free E3 subgroup had the same frequency of positive OCT result as did the over-all group. There was a highly significant increase in the positive OCT results (42.9%) in women with a low hPL value (p less than 0.01). In those women with an hPL value of 6.0 microgram/ml or more there were only 8% positive OCT's. It is concluded that on hPL test at about 34 weeks of gestation could be used to screen pregnant women, and if the value were low (less than 4.0 microgram/ml) an OCT evaluation test would be indicated, for there is a very high frequency of positive results in that subgroup of women.

Estriol↗
PubMed1979

An evaluation of a continuous tissue pH monitor in the fetal and neonatal goat.

The validity of continuous tissue pH measurements was established in the fetal and neonatal goat model. Simultaneous determinations of tissue, arterial, and venous pH were done during alterations in acid-base status. A highly significant correlation was found between tissue and blood pH levels (r = 0.89, p less than 0.001). These data confirm the accuracy of the tissue pH instrumentation in predicting core blood pH status and support the potential usefulness of the instrumentation in perinatal medicine for continuous fetal acid-base monitoring.

Animals↗
PubMed1979

1977 National survey of support in space and dollars for departments of obstetrics and gynecology from their medical schools.

A questionnaire was sent to all chairpersons in obstetrics and gynecology departments in United States Medical Schools in the fall of 1977 seeking information on the school's support of that department for the year 1977 in terms of space and dollar commitments. A total of 113 schools were contacted; 106 responded (93.8%) and the data were tabulated. There were no significant differences between the private and state school resources. The average space commitment was 9,277 +/- SEM 709 square feet and the average school budget was 441,023 +/- SEM 24,265 dollars/year. These data were adjusted for class size and provide the first data base for assessing the adequacy of a medical school's commitment to a department of obstetrics and gynecology.

Costs and Cost Analysis↗
PubMed1979

Assessment of fetal lung maturity: a comparison of the lecithin/sphingomyelin ratio and the tests of optical density at 400 and 650 nm.

Seventy-eight amniotic fluid samples were obtained by transabdominal amniocentesis and were analyzed for their L/S ratio and optical density at 400 and 650 nm. The L/S ratio was considered to be mature if the values were greater than 2.0. The optical density of the fluids decreased with prolonged refrigeration. With freshly centrifuged samples, the OD650 reading of greater than 0.15 gave the best correlation with the mature L/S ratio. There were 3.8% false positive results and 14.1% false negative results. The study confirms that the OD650 test on fresh amniotic fluid is a rapid and inexpensive way to determine fetal maturity. All samples with values of less than 0.15 must, however, also be tested for their L/S ratio since some of the infants with these values may also be mature.

Amniotic Fluid↗
PubMed1979

Carbohydrate metabolism prospectively studied in women using a low-estrogen oral contraceptive for six months.

Twenty-four women were prospectively evaluated for their carbohydrate metabolic status before and after six months of using an oral contraceptive containing 0.035 mg ethinyl estradiol and 0.4 mg of norethindrone. At each testing, a 100-gm oral glucose load was administered and blood glucose and plasma insulin values were measured over a three-hour period. Nineteen women with "normal" control tests demonstrated a significant decrease in their fasting glucose values and two of these women (10.5%) had a slight deterioration of their glucose curves. There were no other significant glucose or insulin changes. They had no change in weight and there was a significant reduction in their blood pressure during the treatment time. Five women had "borderline abnormal" control glucose tests, and four of these (80%) improved during the six months of treatment, and two of them (40%) became "normal." Thus, there is no evidence of an adverse effect of this low-estrogen oral contraceptive on carbohydrate metabolism during six months of therapy.

Adult↗
PubMed1979

Carbohydrate and lipid studies in women using the progesterone intrauterine device for one year.

Carbohydrate and lipid metabolism was evaluated in 31 women before and after 1 year's use of a progesterone-releasing intrauterine device. The studies involved measuring blood glucose and plasma insulin levels during a 3-hour oral glucose tolerance test and also measuring fasting cholesterol and triglyceride levels. There was no change in the cholesterol levels, whereas the triglyceride concentration was lower at the 1-year test. The blood glucose values were unchanged at four of the time periods, whereas the 3-hour value was elevated at the 1-year test. The plasma insulin values were increased in the fasting, 0.5-, and 3-hour samples at the 1-year test. The increased insulin secretion needed to maintain the blood glucose concentration suggests that the released progesterone may have a systemic effect.

Adult↗
PubMed1979

Carbohydrate metabolism and the semen profile: glucose, insulin, and sperm studies.

Twenty-seven men attending an infertility clinic received detailed studies of their ejaculate and carbohydrate metabolism. The latter was done using a 3-hour oral glucose tolerance test with a 100-gm glucose load and measuring both blood glucose and plasma insulin levels. There was no significant difference in either the blood glucose or the plasma insulin values between the men with normal sperm counts and those with abnormal sperm counts. These data suggest that mild subclinical states of carbohydrate abnormalities do not routinely alter male fertility.

Adult↗
PubMed1979

Prospective studies of the gonadotropin responses to graded injections of gonadotopin-releasing factor in women using a low-estrogen type oral contraceptive for three months.

A prospective study of pituitary gonadotropin response to gonadotropin-releasing factor (GnRF) was made in women before and after 3 months of use of a low-estrogen type oral contraceptive containing 0.035 mg of ethinylestradiol and 0.4 mg of norethindrone. A series of three intravenous GnRF injections (0.5, 5.0, and 50.0 micrograms) was given in each test and 10 blood samples were obtained and analyzed for their luteinizing hormone (LH) and follicle-stimulating hormone (FSH) content by radioimmunoassay. The results show that there was no significant effect of the contraceptive steroids on either basal or stimulatable FSH or LH levels. These data are different from those for higher-estrogen types of oral contraceptives, and the possible clinical importance of these findings is discussed.

Contraceptives, Oral↗
PubMed1979

Intrauterine transfusion with continuous ultransonic assistance.

This paper describes a technic of intrauterine transfusion using continuous real time ultransonic assistance and discusses complications of intrauterine transfusion. The advantage of ultrasound-assisted intrauterine transfusion in reducing fetal injury and radiation exposure is emphasized.

Blood Transfusion, Intrauterine↗
PubMed1979

Factors influencing adherence of group B streptococci to human vaginal epithelial cells.

Factors affecting the adherence of group B streptococci to human vaginal epithelial cells in vitro were examined. Maximal adherence was achieved within 15 min of incubation of bacteria with epithelial cells. Adherence was temperature and pH dependent; maximal adherence occurred at 37 degrees C and pH 5.5. Killing of streptococci with ultraviolet light or penicillin did not affect adherence. Similarly, adherence was not altered by preincubating epithelial cells at 65 degrees C for 30 min. Thus neither bacterial nor epithelial cell viability appears to be a prerequisite for adherence. Preincubation of streptococci at 65 degrees C for 30 min resulted in a marked decrease in adherence, whereas preincubation of group B streptococci with neuraminidase was associated with a significant increase in adherence. The adherence of strains belonging to five different group B streptococcal serotypes was not altered by group-specific or type-specific rabbit antisera. These findings suggest that the site for adherence on the bacterial cell wall is heat sensitive and is marked by sialic acid, but is not related to either group-specific or type-specific antigens.

Adhesiveness↗
PubMed1979

Treatment of premature labor with ritodrine: a randomized controlled study.

Twenty-nine women with premature labor were randomly assigned to a ritodrine (N = 14) or placebo (N = 15) drug group. The 2 groups were of similar age, parity, weight, gestational age, and cervical change at the onset of treatment. They were treated sequentially with intravenous, intramuscular, and oral drugs and monitored carefully during therapy. There was a significant increase in both the maternal and fetal heart rates during ritodrine treatment, and also a significant decrease in maternal blood pressure. Ritodrine-treated women often complained of palpatations. There was no significant difference in the extension of pregnancy, birth weight, or infant survival for the ritodrine group. Although the 1-minute Apgar scores in the ritodrine group were higher, the 5-minute scores were similar in both groups.

Adult↗
PubMed1979

Epilepsy and pregnancy. Serum thyroxine levels during phenytoin therapy.

Blood levels of phenytoin, total thyroxine, and free thyroxine were determined in 10 epileptic women during and following pregnancy. Although total thyroxine concentrations of phenytoin-treated subjects were significantly lower than control values, pregnancy did not appear to diminish the relative increase in total thyroxine seen in normal pregnancy. Free thyroxine concentrations, which were equally depressed at all test times, remained at low euthyroid levels during pregnancy. Following delivery, 3 patients developed free thyroxine levels below 1.0 ng/100 ml. Phenytoin dosage was increased to improve seizure control but produced relatively low blood levels during pregnancy. Following delivery, phenytoin dosage was slightly decreased but produced a significant increase in phenytoin blood levels. The potential effects of phenytoin-related changes in maternal and fetal thyroxine levels are discussed.

Abnormalities, Drug-Induced↗