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Biomedical subjects

D W Hershey

Publications and source records attributed to D W Hershey.

At least 19 recordsLinked to original sources
PubMed1991

Incidence of nonbacterial intraamniotic infections in abnormal pregnancies.

Amniotic fluids from 41 abnormal and 47 control pregnancies were examined for viruses, Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis. Abnormal pregnancies included those with fetal abnormalities, maternal complications, suspected chorioamnionitis and premature labor. Two percent of cultures were positive, including cytomegalovirus from one case of fetal growth retardation and U urealyticum from two patients with chorioamnionitis and from two controls. The abnormal pregnancies studied generally were not associated with nonbacterial intraamniotic infections.

Amniocentesis↗
PubMed1989

Familial abdominal wall defects.

We report 2 families, each having multiple sibs with abdominal wall defects. In family 1, normal parents gave birth to identical (monochorionic, diamniotic) twins. This is the first reported case of gastroschisis occurring in monozygotic twins. In family 2, a normal mother gave birth to a son with omphalocele. Two subsequent pregnancies with a different husband resulted in a stillborn girl with partial atresia of the colon and a liveborn girl with gastroschisis. In neither case were there any associated anomalies. In neither of the 2 families was there consanguinity or history of other abdominal wall defects. The familial occurrence of these defects suggests that 1) multifactorial determination should be considered in at least some cases of abdominal wall defects, 2) the bowel atresias that occasionally accompany gastroschisis may also have a genetic (multifactorial) cause, and 3) some cases of gastroschisis and omphalocele may have the same genetic cause.

Abdominal Muscles↗
PubMed1989

On a type of heterosexuality, and the fluidity of object relations.

This paper delineates a form of heterosexuality whose underlying psychological structure resembles that of perversions. It is characterized by: idealization of instinctual processes, whereby the ego subordinates the object to the actualization of the instinctual event itself; heightened narcissism in an otherwise neurotic ego organization; multiple intrapsychic uses of the object; a special kind of defensive organization; an experienced victory over the superego and associated elevation of certain aspects of the ego ideal; and a resultant alteration in the nature of close interpersonal relationships. I use clinical vignettes from both male and female patients in psychoanalysis to focus on the phenomena in question. The thinking of Chassequet-Smirgel, Freud, Khan, Rangell, Socarides, and others is used in an attempt to gain an encompassing perspective. It is emphasized that patients demonstrating this form of heterosexuality do not possess a perversion per se, but demonstrate a character neurosis which integrates certain perverse mechanisms into its defensive organization. These mechanisms can be isolated and studied in psychoanalytic treatment, with the potential for illuminating their defensive and mood-regulating functions, and eventual working through and resolution of the intrapsychic conflicts underlying them. Some comments on the implications of this form of sexuality for our contemporary culture are included.

Adult↗
PubMed1987

Low prevalence of Toxoplasma infection in a Rocky Mountain prenatal population.

Congenital toxoplasmosis is rarely diagnosed in Colorado. To better determine whether this was the result of under-reporting or a valid observation, the sera of 120 consecutive prenatal patients from a lower-income clinic population were tested for antibodies to Toxoplasma gondii. Four of the patients had positive Sabin-Feldman dye tests, for a 3% incidence of past infection. None had immunoglobulin M (IgM) antibody. This rate is considerably lower than that in other populations, perhaps because the high-altitude, arid environment shortens oocyst survival in soil. A questionnaire designed to detect risk factors for Toxoplasma infection, such as exposure to cats or undercooked meat, did not indicate any differences between the antibody-positive and antibody-negative groups.

Adult↗
PubMed1986

Combining maternal age and serum alpha-fetoprotein to predict the risk of Down syndrome.

Twenty-eight cases of Down syndrome with maternal serum alpha-fetoprotein (AFP) measured at second trimester were added to 137 previously reported cases. Seventy-eight percent of affected pregnancies had levels at or below the median AFP value, compared with 50% of unaffected pregnancies. Maternal age at delivery and serum AFP levels by multiples of the median were used to construct a table to determine the risk of Down syndrome. This was compared with the risk for a 35-year-old woman (one in 365). Similar risks were estimated for a 21-year-old with AFP below 0.4 multiples of the median, a 23-year-old below 0.5, a 26-year-old below 0.6, and a 29-year-old below 0.7 multiples of the median. This study provides guidelines for counseling pregnant women who have low serum AFP levels.

Adult↗
PubMed1985

Maternal serum alpha-fetoprotein screening of fetal trisomies.

Thirty-two trisomy pregnancies were retrospectively studied in which the maternal serum level of alpha-fetoprotein was determined prior to amniocentesis. Median levels of alpha-fetoprotein in serum (0.83 multiples of the median) and in amniotic fluid (0.72 multiples of the median) were lowered, but this was statistically significant only in the case of amniotic fluid.

Adult↗
PubMed1982

The incidence of pregnancy-induced hypertension is increased among Colorado residents at high altitude.

Both pregnancy-induced hypertension and high-altitude residence are associated with fetal growth retardation, thereby leading us to hypothesize that pregnancy-induced hypertension would be more common at high than at low altitude. Retrospectively collected data in Colorado revealed that pregnancy-induced hypertension was more common at 3,100 m (12%) than at 2,410 m (4%) or 1,600 m (3%) (P less than 0.001). Proteinuria and edema in the upper extremities were also more frequent at 3,100 m than at 1,600 m (proteinuria = 28% versus 9%, P less than 0.001; edema of upper extremities = 22% versus 13%, P less than 0.01). Blood pressure during pregnancy increased with altitude among all women and those without pregnancy-induced hypertension (analysis of variance, P less than 0.05). In a prospective study at 3,100 m, women with pregnancy-induced hypertension had no change in blood pressure during pregnancy prior to the onset of hypertension (analysis of variance, P = NS), whereas blood pressure decreased in the normal women (analysis of variance, P less than 0.05). Arterial oxygen saturation during the third trimester was inversely related to the degree of hypertension in women with pregnancy-induced hypertension at 3,100 m (r = 0.8, P less than 0.05), thus suggesting that maternal hypoxia may play a previously unsuspected role in the etiology of pregnancy-induced hypertension.

Adult↗
PubMed1981

Primary carcinoma of the fallopian tube.

The present report of 16 new cases of fallopian tube carcinoma also includes 2 new cases of adenoacanthoma, an exceedingly rare tumor. The histologic evaluation of tubal carcinoma is discussed. A meticulous search at surgery for occult disease is urged, because penetration of the tubal serosa seems to be the most important determinant of prognosis. Suggestions are made for adjunctive therapy, although the authors believe the time has come for a multicentered attempt to evaluate treatment protocols randomly.

Adenocarcinoma↗
PubMed1980

Management of the patient with an intrauterine device and a unilateral adnexal mass.

Patients wearing the intrauterine contraceptive device (IUD) and presenting with an unilateral adnexal mass may have a pelvic abscess in the absence of the typical dramatic stigmata that usually accompany an acute pelvic infection. Three such patients are presented, each receiving a different surgical management. An elevated erythrocyte sedimentation rate helps make the diagnosis in these relatively asymptomatic patients. IUD removal and prompt hospitalization for intravenous antibiotics are the appropriate management.

Adult↗