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Biomedical subjects

C Jörgensen

Publications and source records attributed to C Jörgensen.

At least 19 recordsLinked to original sources

Normal ultrasonic fetal growth ratios evaluated in cases of fetal disproportion.

During a 2-year period, 5476 normal routine obstetrical ultrasound investigations were performed in the 2nd trimester (16th to 20th week). Data on biparietal diameter (BPD), abdominal diameter (AD) and femur length (FL) have been obtained from this material. Ratios between BPD/AD and BPD/FL have been calculated, and from these ratios, graphs were constructed. Only nine normal fetuses (0.2%) were found to be outside mean +/- 3 SD, and none of the normal cases were +/- 4 SD, so this is perhaps a better guideline for those warranting further investigation. To evaluate if these ratios could better reflect disproportional fetal growth, three cases of triploidy and four cases of dwarfism were tested against these ratios. Triploidy was obvious on the BPD/AD graph and dwarfism on the BPD/FL graph. The ratios were not found to be conclusive in the intrauterine diagnosis of trisomy 21 or of trisomy 18, as only 4 of 17 cases were obvious on the graphs.

Embryonic and Fetal Development

Pneumothorax in pregnancy.

Since 1957, only 15 cases of isolated spontaneous pneumothorax in pregnancy have to our knowledge been reported in the English literature. The treatment of pneumothorax in pregnancy is more difficult than in non-pregnant patients. A case is reported and therapy discussed.

Adult

Intrauterine growth of the fetus at term. A prospective and longitudinal study with real-time ultrasound.

Intrauterine fetal growth was followed in a prospective study of 654 consecutive singleton pregnancies. Ultrasound fetometry was performed in gestational weeks 17, 32, and 39, and then weekly until delivery took place. A total of 408 fetuses were examined in the 39th week and 55 investigations were performed in the postterm period. This enabled us to follow the intrauterine growth of the normal fetus both at term and postterm. We found that the intrauterine rate of growth continued constantly, even postterm, for the biparietal diameter, abdominal diameter, and femur length.

Abdomen

A prospective comparison of transabdominal and transvaginal ultrasound with surgical findings in gynecologic disease.

Eighty-five patients underwent transabdominal (TAU) and transvaginal ultrasound (TVU) 24 hours before elective surgery for gynecologic disease. No obstetric cases were included. The diagnostic outcome of TVU was not significantly better than that of TAU in spite of a better image quality. The evaluation of large ovarian cysts and sizeable fibroids was difficult with TVU due to the limited field of view. Endometrial pathology was clearly diagnosed by TVU. We recommend using TVU in combination with TAU, especially in cases of unclear pelvic pathology or when larger masses are present.

Abdomen

Cystic lesions in elderly women, diagnosed by ultrasound.

A retrospective review of an entire clinical series of 152 women over 50 years of age, in whom cystic lesions without solid parts had been diagnosed by ultrasound, found there were no malignancies in 58 completely anechoic lesions less than 5 cm in diameter. Of 10 small lesions (less than 5 cm in diameter) with some echogenicity or septa, one was a borderline tumour. In contrast, in patients with lesions greater than 5 cm in diameter there were three malignancies in the group of 33 totally anechoic cysts, five in the group of 32 cysts with some echogenicity, and as many as eight malignancies in the 18 lesions where several septa were present. Two borderline and one malignant tumour had been missed at previous clinical examination. We conclude that small anechoic lesions are seldom, if ever, malignant in elderly women. Sonography is helpful in patients with a negative clinical examination when pelvic pain or signs of malignancy are present.

Aged

Simple adnexal cysts diagnosed by ultrasound in postmenopausal women.

Thirty simple adnexal cysts in postmenopausal women detected by sonography were followed prospectively. The cysts were totally anechoic or with at most two septations. Size varied from 2 cm to 8 cm, but one was as large as 17 cm. Only seven were discovered at the pelvic examination prior to the scan. Fifteen underwent surgery and no malignant tumor was found. The remaining 15 were followed by sonography only. Six lesions had disappeared after one month, altogether 12 had disappeared after seven months. After two years, only two 2-cm cysts remained. The results indicate that surgery on simple adnexal cysts may not be necessary but they should be followed by sonography.

Adult

A prospective comparison of clinical ultrasound and operative examination of the female pelvis.

The value and accuracy of ultrasound examination in patients with gynecological disease is still controversial. Patients scheduled for elective surgery participated in a "blind" ultrasound examination the day before. Findings at surgery were compared with those of ultrasound and of manual examination. Ultrasound was superior to clinical examination in terms of sensitivity (83% and 67%, respectively), whereas specificity was similar for both methods (96% and 94%, respectively). Neither ultrasound nor clinical exam was reliable in detecting tubal anomalies, whereas small solid lesions were missed by sonography and larger cystic lesions by manual exam. Ultrasound would seem to be superior in overall performance, and a useful complement to palpatory exam.

Adolescent

Ultrasound measurement of the ovarian volume.

The ovaries of 377 women between the age of 40 and 70 years were measured by ultrasound. About one third of the patients were postmenopausal. Mean value, standard deviation and S.E.M. of the ovarian volume were calculated and related to age, parity and menstrual cycle. Ovarian size decreased with age in all women but bore no relation to parity and day of menstrual cycle in the menstruating group of women over 40 years of age. A diagram of the ovarian volume related to age is presented. In postmenopausal women the volume was related to estrogen treatment, age, parity and years since menopause. In the group of women receiving orally administered estrogens for at least a year the p-values for all parameters were greater than 0.005. Furthermore, the ovarian volume of women under hormonal treatment did not decrease with age. On the other hand the most important factor for ovarian size in subjects not receiving estrogen treatment was age (p = 0.0056). The results presented here will serve as a prerequisite for sonar examination of the ovaries in women at high risk for development of ovarian carcinoma.

Adult

The diagnosis and course of antenatal urinary tract dilatation.

During 1980-1984 the ultrasound examination (US) performed in the third trimester revealed urinary tract dilatation in 18 foetuses. After delivery all the infants were reexamined within the first weeks with US, intravenous pyelography and micturition urethrocystography to confirm the malformation. Pelvic dilatation was seen in 12 foetuses, 5 bilaterally. The dilatation was caused by pelviureteric obstruction in 6 infants, 4 of which were operated on with dismembered pyeloplasty. In 6 infants the dilatation was caused by distal ureteric stenoses, and 5 of them were operated on. Two foetuses with dilated pelvis and ureter had distal ureteric stenosis and both were operated. Four infants with the diagnosis of unilateral multicystic kidney, confirmed postnatally, were nephrectomised. At the follow-up the kidney function was normal in 15 infants and slightly decreased in 3 infants with bilateral malformations. The antenatal US revealed pelvic dilatation, but the diagnosis of a dilated ureter was inaccurate. Prenatal urinary tract dilatation should be controlled via US shortly after delivery and, if persistent, evaluated further by means of x-ray examinations.

Creatinine

Nephrosis and disturbances of neuronal migration in male siblings--a new hereditary disorder?

Two male siblings (a boy aged 2 years 10 months at death and a male fetus aborted in gestational week 22) showed similar brain and kidney malformations, comprising paraventricular heterotopias, central canal abnormalities (including hydrocephalus in the boy), and glomerular kidney disease with proteinuria. There were no known hereditary diseases in the families of the parents, and there was one healthy sibling of either sex. The malformations thus seem to be hereditary in an autosomal or possibly X linked recessive fashion.

Cerebral Ventricle Neoplasms

Placental grading with ultrasound in hypertensive and normotensive pregnancies. A prospective, consecutive study.

Placental grading was studied prospectively with real-time ultrasound in 654 consecutive pregnancies. The placental maturation was clearly demonstrated in both unselected and hypertensive pregnancies. No differences in placental grading were found between normotensive and hypertensive pregnancies. Fetal outcome was not associated with different placental grades and a grade III placenta was not predictive of an adverse outcome. The value of antenatal placental grading in unselective and hypertensive pregnancies could not be demonstrated.

Female

Hemostasis following inoculation and during spreading of colon carcinoma in the rat.

Platelet function following inoculation of chemically induced carcinoma was evaluated in the rat. The original line of tumor (NGW1) was obtained using N-methyl-N-nitrosoguanidine. After trypsin homogenation a cell suspension of 0.3 X 10(6) viable tumor cells was injected subserosally in the cecum of each animal. Controls received injections of equal volumes of 0.9% NaCl solution or trypsin. The animals were subjected to laparotomy 2, 4, and 6 weeks after inoculation. Platelet function was assessed in vivo by measuring bleeding time and blood loss during mesenteric vessel transection or liver resection upon laparotomy. Hemoglobin, hematocrit, platelet count, activated partial thromboplastin time, platelet aggregation, thromboxane B2, platelet factor 4, and fibrinogen levels were evaluated after sacrifice by exsanguination. Significant decrease in bleeding time and blood loss was observed in animals with local primary tumors as well as in rats with lymph node metastases. Hemoglobin and hematocrit were decreased in the presence of metastases. Platelet count was not changed. Activated partial thromboplastin time was not affected by the presence of tumor. Platelet aggregation in vitro was accelerated in the presence of primary tumor or lymph node metastases, as well as following addition of tumor cells to platelet suspensions. No changes in thromboxane B2 or platelet factor 4 could be registered. Fibrinogen levels were decreased in the presence of liver metastases. Enhancement of primary hemostasis and platelet function in the presence of colon carcinoma in the rat was demonstrated both in vivo and in vitro. Direct or indirect interaction of the tumor cell with thrombocytes may play a role in determining the metastatic potential of the neoplasm.

Adenosine Diphosphate

Amniocentesis in treatment of acute polyhydramniosis in twin pregnancies.

A rare complication in twin pregnancy is acute polyhydramniosis. If left untreated, the perinatal mortality is 100%. The clinical courses of two cases treated with ultrasound-guided amniocentesis are presented. In the first case altogether 4875 ml amniotic fluid was drained. Both twins died within the first 24 hours of life after delivery in gestational week 26. In the second case 2150 ml amniotic fluid was drained. Both twins survived and were delivered in good condition in gestational week 35. We recommend ultrasound-guided amniocentesis to be performed in twin pregnancy affected by acute polyhydramniosis.

Adult

Asymptomatic bacteriuria during pregnancy with special reference to group B streptococci.

The relationship between significant bacteriuria (SB), i.e. 2 subsequent voided urine specimens with greater than or equal to 10(5) colony forming units (CFU)/ml, and the occurrence of bacteria in the urinary bladder detected by bladder punction, was investigated in asymptomatic pregnant women. From 30 (70%) of the 43 women with SB studied, bacteria were isolated from the urinary bladder. The same bacteria were found in the bladders of all 21 women with Escherichia coli, the one with Klebsiella pneumoniae, and the one with Staphylococcus saprophyticus in midstream urine. Six of 10 patients with group B streptococci (GBS), 1 of 4 patients with Streptococcus faecalis, and none of 5 patients with Staphylococcus epidermidis in voided specimens had bacteria in the aspirated urine. Serotype III was isolated from 8/10 patients with SB caused by GBS. One child born to a woman with GBS SB but no bacteria in the urinary bladder, got early onset septicaemia. The poor predictive value of SB with GBS, S. faecalis and S. epidermidis necessitates the increased use of bladder puncture for diagnosis of true asymptomatic bacteriuria (AB), i.e. AB with bacteria in the urinary bladder. SB with GBS even without bacteria in the urinary bladder, may constitute a threat to the baby's health.

Adolescent

The advantage of antenatal diagnosis of intestinal and urinary tract malformations.

In a 24-month prospective screening programme 6020 pregnant women were examined with diagnostic ultrasound at 17 and 32 weeks gestation. In a total of 23 (0.38%) abnormalities, four cases of urinary tract and two of intestinal tract abnormalities were discovered. The antenatal diagnosis influenced the management of these disorders both before and after birth.

Abdominal Muscles