[Clinical, virological and immunological studies of human T-lymphotropic virus type-I-associated myelopathy (HAM)].
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Biomedical subjects
Publications and source records attributed to C Endo.
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In order to investigate changes in FHR when a fetus suffers acidemia, we produced progressively advanced acidemia in lamb fetus by intermittently repeated cord compression. FHR was monitored throughout the study. FHR patterns were classified into five characteristic types as fetal arterial pH fell from around 7.35 to below 6.90. It was confirmed by studies involving catecholamine release and the administration of drugs such as atropine sulfate, alpha or beta adrenergic antagonists that sympathetic and parasympathetic regulation was deeply involved in the changes. Among the patterns, type 4, in which decreased amplitude of the initial drop and hypoxia-induced deceleration was followed by overshoot acceleration, took place during acidemia at arterial pH below 7.15. In conclusion, the appearance of type 4 FHR indicates a deteriorating state in human fetus as well, induced by repeated cord compression, and obliges us to deliver the fetus as soon as possible.
During the period between 1980 and 1983, a versatile experimental model for fetal physiology (chronic fetal preparation) was made using 26 pregnant Corriedale and Suffolk sheep. The sheep fetuses were removed from the uterus at the gestational ages of from 96 to 133 days. After performing cannulation of the carotid arteries, the jugular veins , and the trachea of the fetuses, applying tripolar cardioelectrodes, and attaching an occluder of the umbilical cord, the fetuses were returned to the uterus to complete the gestational period. The time left until the termination of the postoperative pregnancy and available for various intrauterine monitoring procedures varied from 3 to 800 hr. Eleven sheep (42.3%) continued their postoperative intrauterine term for 5 days or more. The continuation of the postoperative gestation for longer than 5 days indicated a return to the physiological state on the evidence of the measured PO2, PCO2 and pH values and rapid irregular breathing movements.
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On 811 pregnant subjects, a sampling that included high-risk pregnancies, NST was performed 3,015 times from 24 to 42 weeks' gestation. Reactive NST and nonreactive NST accounted for 67.9% and 26.1%, respectively. Both amplitude and duration of acceleration showed an increase with the advance of pregnancy. The number of accelerations which occurred in the examination period increased as well. V-shaped decelerations were sometimes found in the NST recordings of normal fetuses accompanied by fetal movements, but the incidence of this type of deceleration tended to decrease as the subjects reached full term. No correlation was found between the occurrence of V-shaped deceleration during antepartum NST and that of variable deceleration during intrapartum monitoring. Taking 10 bpm and 10 seconds as the standard values of the acceleration amplitude and the duration of acceleration, respectively, there was found a significantly higher incidence of late deceleration during labor in the fetuses who showed nonreactive NST antepartally than those showed reactive NST. The incidence of persistent late deceleration was significantly higher in the nonreactive fetuses under the 10 bpm/10 second criteria than in those under the conventional 15 bpm/15 second criteria.
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