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Biomedical subjects

F C Greiss

Publications and source records attributed to F C Greiss.

At least 19 recordsLinked to original sources
PubMed1991

Vulvar pyoderma gangrenosum.

Pyoderma gangrenosum is an idiopathic dermatologic disease manifested by painful cutaneous ulceration. The ulcers are characterized by their undermined, violaceous borders and necrotic tissue at the ulcer base. The lesions may have an unusual response to physical manipulation known as pathergy, a phenomenon that is manifested by rapid progression following debridement. Pyoderma gangrenosum is frequently associated with systemic diseases such as inflammatory bowel disease, rheumatoid arthritis, chronic active hepatitis and hematologic malignancies. Conservative wound care and systemic corticosteroids are usually effective therapy. We report the second case in the gynecologic literature of a patient with vulvar pyoderma gangrenosum.

Adult↗
PubMed1990

MRI findings of sciatic endometriosis.

Endometriosis is a rare cause of sciatic mononeuropathy. We report a woman with cyclic, menstruation-related hip pain associated with right leg weakness and sensory loss. Examination and electrodiagnostic studies suggested sciatic nerve dysfunction. Magnetic resonance imaging (MRI) revealed abnormal signal consistent with endometriotic tissue in the region of the right sciatic nerve. The abnormal signal partially regressed after treatment of the endometriosis. This case further illustrates the utility of MRI in the assessment of rare pelvic disorders.

Adult↗
PubMed1989

Maternal mortality in North Carolina: a forty-year experience.

An analysis of 67 maternal deaths from January 1, 1981, through December 31, 1985, are reported in detail and in the perspective of 3780 maternal deaths previously reviewed in North Carolina since January 1, 1946. Although the direct obstetric mortality rate has decreased 95% over the 40 years, within causal mortality groups the rates have changed variably during the past 5 years. For the first time, no deaths from obstetric infection occurred. Whereas deaths from toxemia continue to decline, those from hemorrhage, embolism, and anesthetic complications remain unchanged. Within the hemorrhage causal group, deaths from ectopic pregnancy have risen to 70%. The maternal death rate after 20 weeks' gestation is almost 10 times that associated with pregnancy interruptions. Of particular concern is the relative risk of death between the nonwhite and white patients. The North Carolina data are reviewed in the light of those in the South Atlantic region and in the nation as a whole.

Abortion, Induced↗
PubMed1988

The effect of placental location on uterine artery flow velocity waveforms.

We examined the effect of placental location with regard to flow velocity waveforms in the uterine arteries in 84 control and 28 hypertensive women during the third trimester of pregnancy. The ratio of systolic peak to end-diastolic frequency was obtained with a continuous-wave Doppler device and the placental location was determined by real-time ultrasonography. In both normal and hypertensive pregnancies with unilateral placental location the systolic/diastolic ratio of the ipsilateral uterine artery was significantly lower than the contralateral artery ratio [1.73 +/- 0.35 (systolic/diastolic ratio) versus 2.46 +/- 0.73, p less than 0.001, and 2.38 +/- 1.01 versus 4.04 +/- 1.77, p = 0.0012, respectively]. The physiologic and clinical significance of this finding is discussed.

Arteries↗
PubMed1986

Temporal and receptor correlates of the estrogen response in sheep.

Uterine blood flow and uterine cytosol and nuclear estrogen receptors were measured at critical times during estradiol-induced vasodilatation in acute anesthetized and chronic conscious sheep preparations at estradiol bolus injection frequencies from 1 to 24 hours. During acute experiments, the uterine blood flow response was muted and cytosol estrogen receptor replenishment did not occur whereas full replenishment occurred in 12 hours in conscious ewes. In ewes treated with daily estradiol that had a stable daily uterine blood flow response, the uterine blood flow response 24 hours after uterine biopsy was similar to the preoperative one. Analysis of the duration of peak uterine blood flow levels and the rate of uterine blood flow descent from peak levels showed that an interval of 18 hours between estradiol injections was necessary for the uterine blood flow response to approximate that observed after 24 hours. These observations suggest: (1) that uterine vascular receptor replenishment is delayed compared with that of the total uterus; (2) that operative stress compromises cytosol estrogen receptor metabolism and possibly nuclear estrogen receptor function; (3) that the delayed maximum uterine blood flow response to estradiol in ewes previously untreated with estradiol is due to a trophic uterine effect of daily estradiol stimulation.

Animals↗
PubMed1979

Responses of the gravid uterine vasculature to arterial levels of local anesthetic agents.

Responses of the uterine vasculature and myometrium to uterine arterial infusions of local anesthetic agents were evaluated in chronically prepared conscious ewes between 86 and 141 days of gestation. Decreases in uterine blood flow (UBF) with increasing levels of anesthetic drugs were similar to those previously observed in nonpregnant ewes. A 25% decrease in UBF occurred at 7 micrograms of bupivacaine, 11.5 micrograms of 2-chloroprocaine, and 19.5 micrograms of lidocaine per milliliter of control UBF. Myometrial tonus did not change significantly except with bupivacaine where an increase occurred (P less than 0.001). These data indicate that local anesthetic agents may lower gravid UBF by a direct vascular effect and by stimulation of myometrial contractility. The possible clinical implications of these observations are discussed.

Anesthetics, Local↗
PubMed1978

Maternal deaths from ectopic pregnancy in the South Atlantic region, 1960 through 1976.

The authors have calculated the maternal mortality rates from ectopic pregnancy in the Southeastern United States. Between 1960 and 1975 81 per cent of 207 ectopic deaths occurred in nonwhite women. A more detailed study of 24 deaths from ectopic pregnancy in North Carolina shows that from 1961 to 1976 4.2 per cent of all direct obstetric deaths and 15.9 per cent of deaths from hemorrhage were due to reptured ectopic gestation. The most striking observation was the dramatic reduction in deaths from ectopic pregnancy among nonwhite women. Maternal mortality rates for ectopic pregnancy should properly be based on the conception rate, consisting of live births plus abortions rather than live births alone. Missed diagnosis of ectopic pregnancy as a factor in maternal mortality rate requires more intensive educational efforts directed toward primary-care physicians.

Black or African American↗
PubMed1978

The effect of prostaglandins and other vasoactive substances on uterine blood flow and myometrial activity.

The effects of prostaglandins (PG's), bradykinin, and adenosine on uterine blood flow (UBF) and intrauterine pressure (IUP) were investigated in conscious oophorectomized ewes. PGE1 and adenosine increased UBF to levels comparable to those induced by estradiol-17beta, whereas PGE2 and PGA1 achieved only 20 and 36 per cent of peak estradiol-induced levels, respectively. PGE1, PGE2, and adenosine all caused transient increases in IUP while PGA1 had no effect on myometrial activity. Bradykinin increased UBF to 60 per cent of peak estradiol-induced levels, with concomitant increases in IUP tonus. PGE2 and PGF2alpha decreased peak estrogen-induced UBF by 50 and 70 per cent, respectively, while inducing related increases in IUP. When compared with oxytocin, the effects of PGE2 at high flow appeared to be mediated only my myometrial activity, whereas PGF2alpha apparently caused vasoconstriction as well. These findings support the concept that PGE1 could play a role in mediating estrogen-induced uterine vasodilatation.

Adenosine↗
PubMed1977

Differential reactivity of the gravid uterine vasculatures: effects of norepinephrine.

Norepinephrine dose-conductance-response relationships were determined for the placental and nonplacental vasculatures of ewes between 95 and 130 days of gestation with the use of radioactive-labeled microspheres injected under flow meter guidance. The regression line for the placental circulation differed significantly from that for the nonplacental circulation (P less than 0.01). The decrease in nonplacental conductance was 30 to 45% of control greater than the decrease in placental conductance. These responses are consistent with the hypothesis that the site of placental vascular resistance is in vessels of larger caliber than those which are usually the primary site of resistance to blood flow.

Animals↗
PubMed1977

Uterine blood flow and its distribution after chronic estrogen and progesterone administration.

The rates and distributions of uterine blood flow (UBF) were measured in conscious castrated ewes during estradiol, progesterone, and combined-hormone regimens. Supplemental progesterone decreased the magnitude of UBF observed on estradiol alone. Progesterone favored distribution of UBF to the uterine caruncles and estradiol favored distribution to the myometrium and uterine cervix. Proportionate endometrial blood flows were similar on all hormone regimens. These observations suggest that estradiol secretion may not be responsible for the definitive increase in UBF observed during ovine pregnancy.

Animals↗
PubMed1977

Ovarian tumors.

Explore the source record for details and available documents.

Endometriosis↗
PubMed1976

Uterine pressure-flow relationships during early gestation.

Placental and myoendometrial pressure-flow relationships were determined in 17 gravid ewes between 29 and 110 gestational days with the use of radioactive-labeled microsphere injections under flow meter guidance. Myoendometrial relationships were consistently curvilinear with convexity toward the flow axis. From 29 to 40 days, caruncular-cotyledonary relationships were similar to myoendometrial ones. After 50 days, the relationship was slightly but significantly curvilinear with convexity toward the pressure axis. From 42 to 50 days, responses were intermediate. The changes in caruncle-cotyledon vascular reactivity correlated with the onset and maturation of interdigitation of fetal and maternal tissues during definitive placentation. A hypothesis for these changes in vascular reactivity is presented.

Animals↗
PubMed1976

Effects of local anesthetic agents on the uterine vasculatures and myometrium.

Intravascular procaine, lidocaine, mepivacaine, and bupivacaine decrease blood flow to the placental and nonplacental vascular beds of gravid ewes by stimulating vasoconstriction and myometrial contractility. These effects appear to be direct ones since they are not affected by alpha-adrenergic blockade. Dose-response curves determined in nonpregnant ewes indicate that significant decreases in blood flow may occur at arterial blood concentrations encountered clinically. It is proposed that reduced placental blood flow is the cause of fetal bradycardia following paracervical block anesthesia. The implications of these findings in obstetric anesthesia are discussed.

Anesthesia, Conduction↗