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Biomedical subjects

A B Gerbie

Publications and source records attributed to A B Gerbie.

At least 19 recordsLinked to original sources
PubMed1988

Pathology of endometriosis.

In summary, endometriosis is a protean pathologic entity of uncertain nature and etiology, occurring commonly in the pelvis and rarely in remote sites. The lesions are characterized by gross and microscopic evidence of endometrium, past and present hemorrhage, inflammatory response, scarring, and dense adhesions. Electron microscopic evaluation suggests that early lesions are more common than appreciated, often retroperitoneal, and not clinically recognized. The diagnosis is established by the identification of microscopic foci of endometrium, although often the end stage reveals only hemosiderin-laden macrophages, foreign body giant cells, and proliferation of fibrous connective tissue. The presence of endometriosis alters the biology of the pelvic peritoneum in ways not universally agreed upon, but which undoubtedly influence the clinical manifestation of the disease.

Endometriosis↗
PubMed1987

The value of curettage in the diagnosis of ectopic pregnancy.

The charts of all patients hospitalized between 1978 and 1983 with proved ectopic pregnancies at Northwestern Memorial Hospital, Chicago, and Meir Hospital, Kfar-Sava, Israel, were reviewed. Eighty-four patients with ectopic pregnancies had endometrial tissue available for histologic analyses. Review of the endometrial curettings revealed that the most common endometrium associated with ectopic pregnancy was secretory (39.4%). Proliferative endometrium present 19% of the time was as common a finding as Arias-Stella phenomenon. This study shows that any type of endometrium lacking trophoblasts may be associated with an ectopic pregnancy. The lack of decidual reaction or Arias-Stella phenomenon should not alone lower the clinician's index of suspicion.

Dilatation and Curettage↗
PubMed1986

Vulvovaginitis in the preadolescent girl.

Vaginal discharges in prepubertal girls can be categorized under two broad headings--those with specific microbiological causes and, in the absence of such, those that are nonspecific in origin. For specific vulvovaginitis, treatment should be tailored to the findings on cultures, wet mounts, KOH, or other slide preparations. For the sexually transmissible organisms resulting in a vaginal discharge, thorough social service investigation should be undertaken in addition to appropriate antibiotic therapy. When a microbiological cause cannot be found and a foreign body has been ruled out, one is left with a diagnosis of nonspecific vulvovaginitis; treatment goals should be aimed at reassuring and re-educating the patient and parents in good hygienic practices as well as the elimination of potential irritants.

Adolescent↗
PubMed1985

Predictive value, sensitivity, and specificity of ultrasonic targeted imaging for fetal anomalies in gravid women at high risk for birth defects.

In this report the predictive value of ultrasonic targeted imaging for fetal anomalies (TIFFA) is defined. Six hundred fifteen pregnant women at high risk for birth defects were scanned from January, 1980, to December, 1983. Follow-up evaluation was available on 569 fetuses. The pregnancies were classified into five groups according to the indications used for ultrasonic targeted imaging studies. The largest number of women were placed in group 1 and were referred because of a variety of abnormalities in previous or ongoing pregnancies. The women classified in the other four groups were examined because of maternal or fetal reasons related to specific craniospinal (29%), urinary (7.9%), gastrointestinal (6.7%), and skeletal (3.7%) defects. In our series the predictive values of abnormal and normal ultrasonic targeted imaging studies were 95% and 99%, respectively. A detailed breakdown of the accuracy of ultrasonic targeted imaging in relation to each anatomic category is presented; these data are useful in counseling gravid women with anomalous fetuses.

Congenital Abnormalities↗
PubMed1985

Chorionic villus sampling for first-trimester prenatal diagnosis: Northwestern University program.

We present our initial experience in developing a chorionic villus sampling program at Northwestern University. In phase 1, we performed chorionic villus sampling in 58 patients prior to elective first-trimester abortion, assessing the reliability and reproducibility of obtaining adequate villus samples and performing cytogenetic analysis by means of both the direct and culture methods. Specimens were categorized according to quality: class I, multiple identifiable villi (n = 20); class II, few villi or villi mixed with decidua (n = 15); class III, no villi (n = 23). There was a positive trend between operator experience, amount of villi obtained, and quality of cytogenetic preparations. In March, 1984, we received Institutional Review Board approval to perform chorionic villus sampling in continuing pregnancies (phase 2). Among the first 20 cases we found two abnormalities (47,XY, + 13; 45,X). The remaining 18 pregnancies were continuing. Recommendations are made for developing a chorionic villus sampling program.

Adolescent↗
PubMed1983

Heritable aspects of uterine anomalies. II. Genetic analysis of Müllerian aplasia.

The genetics of Müllerian aplasia (absent fallopian tubes, absent or rudimentary uterine corpus and cervix, absent upper vagina) has never been investigated systematically. Some investigators believe the disorder is inherited in female-limited autosomal dominant fashion, males transmitting the mutant gene but, of course, not manifesting the trait. To investigate this possibility, we obtained pedigrees in 23 probands with Müllerian aplasia. None had an affected relative. The absence of affected individuals among 30 postpubertal sisters, 31 paternal aunts, and 40 maternal aunts makes it unlikely that a sex-limited autosomal dominant gene is a common cause of Müllerian aplasia in our population. Dominant genes might exist in other populations, and fresh dominant mutations cannot be excluded. However, polygenic/multifactorial inheritance is perhaps more plausible.

Cervix Uteri↗
PubMed1981

Prenatal detection of cystic fibrosis.

Previous studies in our laboratory have suggested that measurement of methylumbelliferylguanidinobenzoate (MUGB) reactive proteases in midtrimester amniotic fluid is potentially of value for the intrauterine detection of cystic fibrosis. Thirty-nine pregnancies of obligate heterozygotes of cystic fibrosis and 12 cases where one parent has a sib with cystic fibrosis have been previously monitored by means of quantitative and qualitative measurements of MUGB in amniotic fluid. In all but one case the diagnosis was accurately ascertained in the midtrimester and confirmed after delivery. The measurement of MUGB reactivity in midtrimester amniotic fluid by three different procedures--quantitative analysis, polyacrylamide isoelectric focusing, and column filtration--appears to provide a practical and reliable approach for the intrauterine detection of cystic fibrosis.

Amniotic Fluid↗
PubMed1981

Amniocentesis for prenatal diagnosis.

Amniocentesis is a relatively safe and reliable procedure. However, there probably is a slightly increased risk of fetal loss following amniocentesis (approximately 0.5%). Other risks are minimal. Amniocentesis should be performed by obstetrician-gynecologists familiar with both the indications for the technique of second-trimester genetic amniocentesis. Recent social trends, including the increased availability of medical information to the lay public and the interest of many women in delaying childbearing, will increase public demand for antenatal diagnosis. It is important that obstetrician-gynecologists prepare to meet these demands.

Adult↗
PubMed1980

Fetal cranial and craniocervical masses: ultrasound characteristics and differential diagnosis.

Ultrasound is assuming an essential role in the detection of fetal cranial and spinal anomalies. Illustrated in this article is the sonographic appearance of cranial abnormalities wherein the diagnosis of encephalocele is clear cut because the anatomic defect of the neural tube is visualized. Additionally presented is a variety of cranial and craniocervical cystic masses, including meningocele, wherein the anatomic defect of the neural tube is not apparent and the diagnosis is reached by careful attention to the specific ultrasonic characteristics of each mass.

Adult↗
PubMed1980

Genetic amniocentesis in twin gestations.

Among 1,613 women studied with routine ultrasonography prior to genetic amniocentesis at Northwestern University Medical School, 25 of 26 multiple gestations were detected. Sampling of fluid from both amniotic sacs was requested by 20 women with twin gestations in which both fetuses were ultrasonographically determined to be viable and of normal size. Fluid was obtained successfully from both amniotic sacs in 19 of 20 cases. The conclusions are that (1) twin gestations can be reliably detected by the use of routine ultrasonography, (2) both amniotic sacs can usually be sampled, and (3) the complication rate appears to be minimal to the patient and the fetuses, although the sample size is still small.

Amniocentesis↗
PubMed1980

Amniocentesis for antenatal diagnosis of genetic defects.

Amniocentesis for intrauterine diagnosis of genetic disease is a safe and highly accurate procedure. This is most fortunate since the timing of the procedure (14 to 16 weeks) and the length of time necessary to cultivate the cells and perform the analysis (3 to 5 weeks) makes it almost mandatory, and almost unique in medicine, that patient management be based on a single non-repeated laboratory procedure. It should be recommended to all patients for whom there is a specific indication for antenatal genetic studies.

Adult↗