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Biomedical subjects

B Kjessler

Publications and source records attributed to B Kjessler.

At least 19 recordsLinked to original sources
PubMed1992

Towards an essential data set: applicability in the domain of maternal health services.

There is a need for consensus on the quantity of data that must be available in a computer-based information system of a health care organization. In this paper we take up the issue of defining the data content of an information system and introduce the concept of Essential Data Sets with an explicit methodology which was applied to define a data set for the Maternal Health Services program. A key step in the method was a recognized technique used in systems development process called data modelling, in this case infological modelling, by an interdisciplinary group. A preliminary set of 86 data elements was identified and it provided the foundation for development of an application software for discussion and a real-world testing framework. The acceptability of the data set was tested in a laboratory perspective by retrospective data entry from records of 94 pregnant women registered at a maternal health care center in Sweden. Data from a total of 1,318 prenatal visits, an outcome visit, and a postnatal visit for each woman was entered into a computer using the software, with no loss of information. Thus, in a short-term perspective the acceptability of the data set was demonstrated. The software has since been implemented for pilot prospective studies at sites in India and Sweden. The use of a common data protocol is an essential foundation for patient outcome research, especially as the trend of health care management has changed from a "process of care" orientation to an "outcome of care" orientation.

Electronic Data Processing↗
PubMed1989

hCG-treatment alone is insufficient for restitution of spermatogenesis in a state with arrest at the spermatogonial level.

In an infertile man with azoospermia and arrest at the spermatogonial stage, hCG treatment alone improved the spermatogenesis but not beyond the primary spermatocyte stage. During hCG treatment steroid conversion in vitro in testicular biopsy material, as well as serum testosterone concentrations increased dramatically. When hMG treatment was added, spermatogenesis was complete. Combined hCG/hMG treatment seems to be an efficient therapy in well-selected infertile men, whereas increased testosterone production induced by hCG-treatment may be insufficient for restitution of spermatogenesis.

Adult↗
PubMed1985

Incomplete androgen insensitivity: asymmetry in morphology and steroid profile and metabolism of the gonads. An analysis of a case.

A patient with clinical manifestations of the incomplete androgen insensitivity syndrome was studied with respect to peripheral blood levels of steroids and steroid sulphates before, during and after gonadectomy. Steroid and steroid sulphate concentrations were also analyzed in spermatic venous blood and gonadal tissue collected during surgery. The metabolic capacity of gonadal tissue was also studied in vitro using progesterone, dehydroepiandrosterone sulphate and oestrone sulphate as substrates. Profound differences between the two gonads were noted with respect to both steroid content and release into pampiniform veins and to in vitro conversion of progesterone and oestrone sulphate. Histological examination revealed the presence of seminiferous tubules with carcinoma in situ in both gonads. It is suggested that the differences between the gonads may be due to an autonomous steroid production in the right gonad in spite of adequate or even elevated gonadotrophic stimulation resulting in a steroidogenic situation resembling the complete androgen insensitivity syndrome, while the conditions found in the left gonad more resembles the incomplete form of the disease.

Adenoma↗
PubMed1985

Conceptual dating by ultrasonic measurement of the fetal biparietal diameter in early pregnancy.

The accuracy and precision of gestational dating, based on single measurements of the fetal biparietal diameter (BPD), was estimated in a consecutive series of 970 apparently normal, singleton pregnancies. The BPD sizes used varied between 11 and 60 mm, corresponding to 9-22 postconceptional weeks. The 'conceptual ages', used for reference, were estimated by means of ultrasonic measurements of the fetal crown--rump lengths (CRL). The association between the estimated conceptual age (dependent variable) and BPD size (independent variable) was found to be well represented (R2 = 0.972) by a second order polynomial: conceptual age = 44.7 + 1.069 X BPD + 0.01382 X BPD X BPD. To check the validity of the proposed equation, we used 23 fetuses conceived by artificial insemination with donor semen as controls. There was good agreement between the virtual conceptual ages of the control cases and their corresponding BPD-estimated conceptual ages (0.5 days mean difference, 3.6 days SD) when the suggested regression equation was used. The estimated precision of BPD-dating was minumum +/- 4.4 days (= +/- 2SD) at 9-10 completed postconceptional weeks. At 14 completed weeks the corresponding precision was found to be +/- 11 days (+/- 2SD). At the end of the studied BPD size interval, i.e. 56-60 mm BPD corresponding to 22 conceptual weeks, the precision was +/- 15 days. From an obstetrical point of view it seems obvious that the imprecision of gestational dating associated with BPD measurements greater than 35 mm should call for ultrasonic dating procedures to be performed earlier in pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Cephalometry↗
PubMed1985

In vitro metabolism of 3H-pregnenolone and 3H-progesterone by adult and prepubertal human testicular tissue before and during gonadotrophic treatment.

The in vitro conversion of tritiated pregnenolone and progesterone was studied in testicular tissue from three infertile adult males before and during 25-30 weeks of therapy with hCG alone or combined with hMG. Furthermore, the in vitro conversion of pregnenolone was studied in testicular tissue from five prepubertal boys with undescended testes, two of whom had been subjected to hCG treatment for 5 weeks. The gonadotrophic treatment appeared to augment the steroid conversion mediated by the enzymes 3 beta-hydroxysteroid dehydrogenase and 17 alpha-hydroxylase in adult as well as prepubertal testicular tissue. The conversion mediated by C17-20-lyase along the delta 4 metabolic pathway was not increased, causing a "trap" along the delta 4 metabolic pathway. The increased production of testosterone in vitro from tritiated pregnenolone, which was observed during gonadotrophic treatment, probably took place along the delta 5 metabolic pathway through the C17-20-lyase step, whereas C21 steroids converted to the delta 4 metabolic pathway were found to be "trapped" as 17 alpha-hydroxyprogesterone.

Adult↗
PubMed1984

Who declines from antenatal serum alpha-fetoprotein screening--and why?

One hundred women who declined a voluntary alpha-fetoprotein screening test during early pregnancy and one hundred women who accepted the test were investigated by means of semistructured interviews with particular reference to background factors which could have influenced upon the decision making. Those who declined were, as expected, overrepresented among those opposed to legal abortion and they often showed an ambivalent or negative attitude towards prenatal diagnosis as such. These women were also more frequently legally married and active members of various religious denominations. Otherwise there were no socioeconomic, psychologic or other background factors specially associated with women who declined. The paramount individual reason given for abstaining from the test was the feeling that the test was 'unreliable'. The personal ethical attitude, together with the current reputation of the test in society, seem to be major factors affecting the rate of participation in an AFP-screening program.

Adult↗
PubMed1978

Prenatal diagnosis of an XXY foetal karyotype in a woman with a previous 21-trisomic child.

Prenatal chromosome analysis revealed that a 34-year-old, gravida 2 mother was pregnant with a XXY foetus. She had previously given birth to a 21-trisomic boy with another spouse. Both parental karyotypes were normal, but a high frequency of associations between satellited chromosomes was observed in maternal lymphocytes. The possibility that increased satellite associations may predispose to aneuploidy in the offspring is discussed. The finding of normal testicular histology in the aborted XXY foetus provides evidence that the characteristic XXY testicular dysgenetic lesions are likely to occur not earlier than in the late prenatal period.

Chromosomes, Human, 21-22 and Y↗
PubMed1978

Apparently non-deleted ring-1 chromosome and extreme growth failure in a mentally retarded girl.

A girl, who was the product of the first recognized conception by healthy and chromosomally normal parents, and who was born 5 weeks before term with a birth weight of only 1,690 g, was found to have a ring-1 chromosome, r(1), in almost all cells analysed. A minor proportion of cells had a normal diploid chromosome complement including two regular No. 1 homologues. A few cells contained a large dicentric ring, and two monocentric ring-1 chromosomes were simultaneously observed in a few other cells. Q- and G- banding revealed the r(1) chromosome to be apparently non-deleted. The patient phenotypically resembled the three previously described human subjects with r(1) chromosomes, especially with respect to her remarkable growth failure and metal retardation. From consideration of data available on general development in subjects with an autosomal ring chromosome, it appears likely that the presence of such a ring chromosome per se in an early foetal chromosome complement may predispose to significantly retarded intrauterine and postnatal growth. Various genetical implications, including mitotic irregularities with subsequent loss of cells at division, are thought to account for the significant reduction of body mass in these patients.

Abnormalities, Multiple↗
PubMed1978

A variant chromosome 17 in a mother with repeated abortions and a 46, XY/47, XXY Klinefelter son.

A female with a satellited chromosome 17 is presented. She had suffered repeated abortions and later gave birth to a 46,XY/47,XXY Klinefelter boy. The significance of the variant chromosome 17 in the etiology of the mother's reproductive failure is discussed. The mental and physical development of her now 8-year-old 46,XY/47,XXY son has been checked regularly since birth. The boy showed a significant deviation in behaviour pattern and development of body habitus already from early infancy.

Abortion, Habitual↗
PubMed1978

Delayed diagnosis in a case of secondary amenorrhea caused by a long arm isochromosome--X; i(xq).

Secondary amenorrhea was observed in a 27-year-old woman with a structurally abnormal isochromosome--X, i(Xq), in all cells analyzed. The apparent phenotypical variability that may be observed in subjects with functional monosomy for the short arm of X, must be taken into consideration when patients with amenorrhea are clinically investigated. A correct, and early diagnosis of the etiology of the dysgenetic state of the gonads may only be obtained by accurate cytogenetic investigations, i.e., by utilizing various modern banding techniques.

Adult↗