Biomedical subjects

W R Meyer

Publications and source records attributed to W R Meyer.

42 records · Page 3Linked to original sources

PubMed1990

Nifedipine versus ritodrine for suppressing preterm labor.

Fifty-eight women in preterm labor were selected randomly to receive either oral nifedipine or intravenous ritodrine hydrochloride. In comparison to ritodrine, nifedipine had similar tocolytic efficacy with fewer adverse maternal and fetal side effects. On Doppler studies nifedipine had an insignificant effect on umbilical blood flow. Preliminary data suggest that nifedipine is a safe, effective and well-tolerated tocolytic agent. It may prove to be a suitable alternative to ritodrine hydrochloride, especially for women in whom beta-sympathomimetics are contraindicated.

Female↗

PubMed1989

Laparoscopic treatment of ectopic pregnancy.

Over the last decade and a half the success and safety of endoscopic surgery for ectopic pregnancy has been established. Shapiro and Adler (1973) reported laparoscopic salpingectomy using electrocoagulation followed by excision. Soderstrom (1981) followed with the snare technique of salpingectomy. Valle and Lifchez (1983) reported tubal patency rates approaching and attaining 100% following salpingostomy in the sole oviduct during laparotomy encouraged continued laparoscopic approach. DeCherney (1981) described linear salpingostomy via a cutting current in 18 women with an intrauterine pregnancy rate of 50% 1 year afterwards. No spontaneous abortions or repeat ectopics were reported. Pouly et al (1986) described laparoscopic salpingostomy in 321 women with a resultant 64% intrauterine pregnancy and 22% repeat ectopic rate. These studies support the realization that previous surgical approaches per laparotomy for ectopic pregnancy may be achieved endoscopically, but intraoperative and postoperative complications have occurred. As noted by Kelly et al (1979) and Richards (1984) these consist mainly of persistent or delayed haemorrhage along with continued trophoblastic growth. Haemorrhage is most often a result of failed salpingostomy in larger ectopics. Continued trophoblastic development requiring repeat surgical exploration due to incomplete removal of tissue has been reported by Pouly (1986) in as many as 5% of cases. This rare but reported consequence signals the importance of following quantitative HCG concentrations into the negative range. Occasionally HCG levels remain elevated more than 30 days postoperatively with eventual resolution; Cartwright et al (1986) claim that tubal patency rates appear to be unaffected by this prolonged clearance of tissue. Despite infrequent morbidity, laparoscopic treatment of ectopic pregnancy, in comparison to laparotomy, significantly shortens hospital stays, operating time, convalescence and postoperative analgesic requirements (Brumsted et al, 1988). Endoscopic surgery also reduces postoperative formation of pelvic adhesions (Fayez and Schneider, 1987). As familiarity and technical expertise with endoscopy continues to increase, exploratory laparotomy may be considered too radical an approach to ectopic pregnancy treatment regardless of the procedure performed.

Female↗

PubMed1989

Ectopic pregnancy: duplex Doppler evaluation.

Of 398 patients in whom there was a clinical suspicion of ectopic pregnancy, 96 (24%) were found to have the condition. Of the 96, 70 underwent duplex Doppler imaging. A viable ectopic fetus was seen in 10 of 70 (14%), and an extrauterine sac without an identifiable fetus was seen in an additional 27, giving a sensitivity for imaging alone of 53%. Fetal heart activity was detected with Doppler in 13 (19%). High-velocity flow, which suggested the presence of an ectopic pregnancy, was detected in 38 of 70 (54%) patients (total preoperative sensitivity, 73%). In the 91 patients who did not have an ectopic pregnancy, duplex Doppler imaging of the intrauterine contents alone allowed an ectopic pregnancy to be excluded in 29 (32%) on the first examination and in a further 21 on the second scan (specificity, 55%). Nine vascular adnexal masses were falsely considered to be ectopic pregnancies (specificity, 90%). The positive predictive values were 47% for imaging alone and 85% for Doppler. The negative predictive values were 60% for imaging alone and 81% for Doppler.

Adult↗

PubMed1989

Hysteroscopic removal of an interstitial ectopic gestation. A case report.

A 31-year-old woman with plauteauing quantitative serial beta-human chorionic gonadotropin levels, suspect pelvic sonography and the absence of products of conception on uterine curettage was suspected of having an interstitial ectopic pregnancy. Confirmation was by endoscopy. Cornual uterine wedge resection was avoided with laparoscopically guided hysteroscopic removal of the products of conception.

Adult↗

PubMed1984

Malignant melanoma of the gallbladder. Report of a case.

A case of malignant melanoma in a 31-year-old man is described to add to the eight cases previously reported in the literature. The tumor in this case shares many common gross and microscopic features with those previously reported. These similarities, in addition to the clinical absence of any primary melanoma in the more common site of occurrence, indicate that the tumor in this case is primary in the gallbladder.

Adult↗

PubMed1981

Report on a very young dizygotic human twin pregnancy.

Two ova implanted in one uterus were found at the autopsy of a 28-year-old woman. The ovulation age of both implantations has been estimated to be 10-12 days. The presence of two equally large corpora lutea, one in each ovary, indicates that the implanted ova originated from different ovaries. Thus, an "ovulatio biovarialis" seems to be the basis for the dizygotic twinning in this case. The case is believed to be the only documented example of a very early dizygotic, fraternal pregnancy in humans.

Adult↗