摘要:

Ventricular arrhythmia may follow the infiltration of dilute, epinephrine-containing solutions to achieve hemostasis during surgery. The objective of this study was to determine the cardiovascular and metabolic changes associated with the infiltration of 1.5μg/kg epinephrine 1 : 200,000 in 0.5% lidocaine into the cervix of patients having a cervical cone biopsy under epidural anesthesia. These observations were compared with a control group who were infiltrated with 0.5% plain lidocaine under similar epidural anesthesia during cone biopsy. In the epinephrine-treated group, marked heart rate, rhythm, and systolic/diastolic blood pressure changes from baseline values were observed as well as significant glycogenolysis, lactic acidosis, and hypokalemia. Based on these observations, the total dose of injected epinephrine should be less than 1 μg/kg; the solution should be diluted to 1 : 400,000 concentration, and the injection, after careful aspiration, should be performed over at least five minutes into the less vascular anterior and posterior cervix sites.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The completeness of maternal death reporting in Washington state was determined by comparing death certificates to the birth and fetal death records for women, age 15 to 45, dying from selected causes. From 1977 to 1981 there was 112% underreporting of maternal deaths. Only 17 of 36 maternal deaths were able to be identified on death certificates as being pregnancy related. Of the 36 deaths, two major causes of death were identified: Hypertensive disorders of pregnancy (13 deaths) and pulmonary embolism (six deaths).

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

To study the effect of nicotine on fetal prostacyclin and thromboxane A2, specimens from the umbilical arteries of infants born to healthy nonsmoking mothers were superfused in the absence or presence of nicotine (50 to 10,000 μg/ mL), and the releases of 6-keto-prostaglandin FIα(a breakdown product of prostacyclin) and thromboxane B2(a metabolite of thromboxane A2) were measured. The baseline production of 6-keto-prostaglandin FIα(63.9 ± 8.8 ng/minute per gram of dry weight tissue, mean ± SE, N=10) or that of thromboxane B2(1.3 ± 0.2 ng/minute per gram, N=10) were unaffected by nicotine. To study the effect of nicotine on thromboxane A2synthesis by the fetal platelets, thrombin-induced platelet aggregation and consequent thromboxane A2synthesis were allowed to occur in the whole cord blood in the absence or presence of nicotine (10 to 500 μg/mL). Nicotine inhibited concentration dependently platelet thromboxane A2synthesis from the baseline level (107.3 ± 7.1 ng/mL) by 15 to 93%. This inhibition was also seen in thromboxane A2synthesis starting from exogenous arachidonic acid, suggesting that nicotine inhibits either cyclooxygenase and/or thromboxane A2synthetase in the fetal platelets. Thus, nicotine is hardly responsible for maternal smoking-induced changes in fetal prostacyclin formation.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Progestational agents induced an objective response in 11.2% of 155 patients with advanced primary or recurrent endometrial carcinoma. Response rates decreased with decreasing tumor differentiation from 40% with Broders grade 1 lesions to 17.5, 2.4, and 0%, respectively, with grades 2, 3, and 4. 17α-Hydroxyprogesterone caproate (Delalutin), 6,17α-dimethyl-6-dehydroprogesterone (Colprone), and 6- methyl-6-dehydroprogesterone acetate (Megace) were the progestogens used; there was no significant advantage for any one agent. Overall, survival after initiation of hormone therapy was 40% at one year, 19% at two years, and 8% at five years. Survival was highly dependent on the degree of tissue differentiation (P<.001) and was influenced significantly by the estimated tumor volume at the start of therapy (P<.01) and by the time interval from primary treatment to the beginning of hormone therapy (P<.01).

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Six cases of primary ovarian choriocarcinoma were reviewed. Five-year follow-up was available for all patients except the most recently diagnosed case. Overall survival was 80%. The problems of distinguishing between gestational and nongestational neoplasia and differentiating primary from metastatic disease are discussed. Surgical staging of disease may be more informative in initiating aggressive chemotherapy than in determining the gestational or nongestational origin of the tumor.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Thirty specimens from 28 patients (15 previously treated, 13 previously untreated) with ovarian carcinoma were studied in a soft agar colony-forming assay to determine whether or not the assay could be useful for treatment planning. There were sufficient colonies for drug testing in 23 cases. An in vitro drug response was found in 12 of 106 drug tests. In vivo–in vitro correlations could be made for 28 drug trials in 16 patients. Eight patients were not evaluated for response because they were clinically disease free after debulking surgery. Single agents were evaluated in vitro, although most patients received combination chemotherapy. In 23 cases the tumor was resistant in vitro and in vivo. There were two false-negative and three false-positive results. Cell aggregates that may artificially increase growth rates and apparent in vitro drug resistance were a major problem technically. In view of the problems identified, the assay in its current form should not be used routinely to direct therapy.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The Centers for Disease Control has maintained a register of women who received rubella vaccine within three months before or three months after conception to follow prospectively the outcome of pregnancy and to quantitate the risks to the fetus from the vaccine virus. The data indicate that rubella vaccine can cross the placenta and rarely can infect the fetus. However, no abnormalities consistent with congenital rubella syndrome have been noted in 144 infants whose susceptible mothers received the RA 27/3 rubella vaccine, the only vaccine available in the United States since 1979. Although the observed risk of defects consistent with congenital rubella syndrome is zero, there is a statistical theoretic risk of a congential rubella syndrome-like defect; the maximum theoretic risk is 2.6%. These findings indicate that vaccination of nonpregnant postpubertal women who lack either serologic proof of immunity or a written record of vaccination on or after the first birthday can be done safely and effectively. Whereas congenital rubella infection will disappear from the United States as vaccinated children enter the childbearing years, if these practices are followed elimination of congenital rubella infection will be hastened.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A cytologic method is described for the identification of trophoblastic epithelium in products of first-trimester abortion. In material from 50 consecutive induced first-trimester abortions, trophoblast was identified cytologically in 46 cellular samples (93.9%). In addition, nucleated fetal erythrocytes were found in 26 cellular samples (53%). There were no false positives, and three false negatives occurred. One negative examination, confirmed by histologic study, led to procedures that diagnosed ectopic tubal pregnancy. The cytologic method is easily performed and is rapid, sensitive, certain, inexpensive, and permanent. Cytologic study should not supplant meticulous macroscopic examination of abortion products by the clinician.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Ovarian cancer is the most frequent cause of death from gynecologic malignancies in the western world. Much effort has been put into attempts to correlate differences in incidence rates with environmental, endocrinologic, and genetic factors. A review of the literature reveals that there is currently no evidence to incriminate any single etiologic factor for this group of tumors. There is growing evidence of familial predisposition in a small group of patients and of a relationship with reproductive history. If current knowledge of the epidemiology of ovarian cancer is to be translated into disease prevention, more attention should be paid to women at risk because of their family history, and more awareness should be made of the protective effect of oral contraceptives.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Hemoglobin E occurs in 30 million people, primarily Southeast Asians. Their resettlement within the US has dramatically increased the incidence of E hemoglobinopathies. A gravid Vietnamese woman with thalassemia major is reported herein. Her pregnancy was complicated by severe anemia, intrauterine growth retardation, and a paraspinal mass representing extramedullary hematopoiesis. The diagnosis of hemoglobin E/β°-thalassemia was established when analysis of her hemoglobin showed 60% F, 40% E, and 0% A. The patient was transfused with packed red blood cells to maintain the maternal hematocrit at 30%. A term growthretarded infant was delivered who had severe thrombocytopenia and an imperforate anus. The infant's thrombocytopenia responded only to infusion of maternal platelets. The differential diagnosis and expected hematologic manifestations of the various E hemoglobinopathies are detailed. Hematologic and obstetric guidelines for management during pregnancy are offered.

ISSN:0029-7844    

出版商:OVID    

年代:1985

数据来源: OVID