PubMed Health⌕ Search

Biomedical subjects

G Sher

Publications and source records attributed to G Sher.

69 records · Page 4Linked to original sources
PubMed1978

Midtrimester intra-aminotic administration of prostaglandin F2alpha in combination with an hyperosmolar urea solution: effect upon plasma levels of estradiol, progesterone, and human placental lactogen (HPL).

A study was undertaken in order to investigate the clinical observation that patients who underwent midtrimester abortion using intra-amniotic PG F2alpha in combination with hyperosmolar urea, always aborted a dead fetus. Ten Caucasian primigravidae, aged between 16 and 22 years old and whose pregnancies ranged between 14 and 23 weeks in duration, were studied. The patients were randomly divided into two equal groups. The one group received urea and PG F2alpha intra-amniotically whereas the other received PG F2alpha alone. Blood was drawn for measurement of plasma estradiol, progesterone and human placental lactogen (HPL) prior to injection of the abortifacients and at regular intervals thereafter for a period of 120 min. The five patients who received the combination regime of treatment (urea + PG F2alpha) showed a rapid decline in the plasma concentrations of these hormones and induction of abortion was followed by fetal death within 35 min in all cases. In contrast, the five patients who received intra-amniotic PG F2alpha alone, did not (with a single exception), demonstrate this rapid decline in the plasma concentrations of the placental hormones measured. Also with the same single exception, these fetuses, although stillborn, were alive two hours after inducing abortion.

Abortion, Induced↗
PubMed1978

Rational basis for foam-stability assays of amniotic fluid surfactant.

We evaluated the relative contributions of various phospholipids to the formation of foam in the amniotic fluid "foam stability test", by use of an artificial system of saline, ethanol, and dipalmitoyl 3-sn-phosphatidylcholine to determine the relationship between dipalmitoyl 3-sn-phosphatidylcholine concentration, ethanol volume fraction, and the threshold of formation of stable foam. At dipalmitoyl 3-sn-phosphatidylcholine concentrations of 20, 40, and 80 mg/liter, the threshold ethanol volume fraction was 0.46, 0.48, and 0.51, respectively. We similarly evaluated the ability of other phospholipids to form stable foam at various concentrations and ethanol volume fractions and found: bovine brain sphingomyelin greater than dipalmitoyl 3-sn-phosphatidylcholine greater than egg sphingomyelin greater than egg lecithin greater than phosphatidylglycerol. The corresponding propensities of different chemical species of phosphatidylcholine to form foam at 40 mg/liter were: dipalmitoyl 3-sn-phosphatidylcholine greater than dioleoyl phosphatidylcholine greater than dimyristoyl phosphatidylcholine greater than dilauroyl phosphatidyl-cho-line.

Amniotic Fluid↗
PubMed1978

Assessing fetal lung maturation by the foam stability index test.

An assay has been developed and evaluated that quantifies the surface tension lowering ability of amniotic fluid surfactant. The formation of stable foam following vigorous shaking of amniotic fluid was evaluated by the addition of various amounts of dipalmitoyl lecithin in a solution of ethanol and saline and by fine adjustments of the ethanol volume fraction in the final assay mixture. The foam stability index (FSI) for a particular sample of amniotic fluid was defined as the highest ethanol volume fraction that would permit the formation of stable foam after vigorously shaking a mixture of ethanol and amniotic fluid. The assay is referred to as the FSI test. We report the FSI values in amniotic fluid specimens from 59 patients obtained within 72 hours of delivery. The L/S ratio was measured in 50 of the same 59 specimens. We observed 6 cases of neonatal hyaline membrane disease (HMD) and 2 cases of transient tachypnea of the newborn (TTNB) in this study. No cases of HMD or TTNB occurred with FSI values of greater than 0.47, while 2 cases of HMD were recorded in association with L/S ratios of 2.5 and 2.8, respectively. The potential clinical value of the FSI test is discussed.

Amniotic Fluid↗
PubMed1976

Therapeutic midtrimester abortion by the intra-uterine administration of prostaglandins. Experience of Groote Schuur Hospital, 1974-1975.

During the period from 1 January 1974 to 31 December 1975, 71 therapeutic midtrimester abortions were performed at Groote Schuur Hospital by the intra-uterine administration of prostaglandins. Both the extra- and intra-amniotic routes of administration proved to be uniformly successful but the latter route was associated with fewer side-effects. The intra-amniotic administration of 30 mg prostaglandin F2alpha in combination with 60 g urea is the recommended method for achieving midtrimester abortion. If the method described is strictly adhered to, it provides a single-dose regimen which is uniformly successful and which is associated with few complications.

Abortion, Therapeutic↗
PubMed1976

The alleviation of uterocornual spasm of the Fallopian tubes during hysterosalpingography by intravenous administration of orciprenaline.

A simple, safe and reliable method of differentiating between organic obstruction spasm at the uterocornual junction of the oviduct during routine hysterosalpingography is described. Seventeen patients were studied. In all patients uterocornual obstruction was found during hysterosalpingography, which was performed without general anaesthesia. In 8 patients the apparent obstruction was alleviated within 30 seconds of the intravenous administration of 0.25 mg orciprenaline. Surgical and endoscopic findings confirmed the presence of the obstruction in all the other 9 patients. These findings are discussed on the basis of the neuro-anatomy of the Fallopian tube. It is suggested that this form of treatment, in many cases, eliminates the need to perform the procedure under general anaesthesia, which is the only other method of consistently alleviating such a 'spasm'. The use of orciprenaline may facilitate a rapid turnover of patients in units where hysterosalpingography is performed as a screening investigation for infertility. Furthermore, it is suggested that the oral administration of beta-adrenergic agents during the peri-ovulatory period to patients in whom 'tubal spasm' has been diagnosed might offer a rational approach to treatment.

Diagnosis, Differential↗
PubMed1976

Intra-amniotic use of urea and prostaglandin F2 alpha to induce labour in pregnancies complicated by death of the fetus.

A simple, safe and efficient method of inducing labor in patients in whom pregnancy is complicated by intrauterine death of the fetus is described. The technique involves a single intra-amniotic infusion of 30 mg of prostaglandin F2alpha with 60 g of urea. Fourteen pregnancies complicated by intra-uterine fetal death (ranging in duration from 1 to 7 1/2 weeks) were successfully terminated by this method. Side-effects and complications were minimal. It is submitted that this method provides the obstetrician with a valuable addition to his therapeutic armamentarium. If correctly employed, it provides rapid delivery with minimal risk of discomfort to the patient.

Amnion↗
PubMed1976

Meigs' syndrome. A case report.

A case of Meig's syndrome is reported and the rarity of this condition is emphasised. The need for exploratory laparotomy in patients with solid ovarian tumours associated with ascites and pleural effusion, and free of malignant cells, is stressed.

Aged↗
PubMed1976

Inadequate cervical mucus--a cause of "idiopathic" infertility.

The purpose of this study was to investigate and treat a group of patients referred for "idiopathic" infertility in whom no apparent cause for infertility, apart from inadequate cervical mucus, was found. Hormone investigations revealed that these patients could be divided into two groups: those with low sex steroid profiles despite apparent ovulation, and a second group with normal sex steroid profiles. All patients were treated with ovulation-inducing agents in an attempt to produce "controlled" ovarian hyperstimulation and an improved cervical mucus. Four of six patients conceived. The rationale behind the use of ovulation-inducing agents in this situation is discussed.

Adult↗
PubMed1975

The diagnosis and management of accidental haemorrhage with associated coagulopathy.

An approach to the diagnosis and management of accidental haemorrhage with associated coagulation failure is discussed and outlined. It is stressed that special investigations play a minor role in planning management. The main aim should be to achieve rapid delivery, preferably via the vaginal route. About 50% of these cases are associated with uterine atony and inertia. This is probably due to raised local and circulating levels of fibrin/fibrinogen degradation products (FDP). In such cases uterine activity can be restored by the administration of large intravenous doses of Trasylol (Bayer). Life-endangering complications such as acute respiratory and renal failure should be prevented by prophylactic management and by treatment aimed at rapid delivery. The indications for Caesarean section are outlined. The need for careful assessment prior to discharge of these patients and for re-assessment throughout the puerperium is stressed.

Aprotinin↗
PubMed1975

Pregnancy, pre-eclampsia and disseminated intravascular coagulation.

A prospective evaluation of the haemostatic mechanism was undertaken in 15 normal primigravidas and in 12 primigravidas with mild to moderately severe pre-eclampsia in order to further examine the possibility that disseminated intravascular coagulation may occur in this clinical syndrome. The only coagulation abnormality demonstrated was a prolongation of bleeding time. The data do not support the suggestion that significant disseminated intravascular coagulation is associated with pre-eclampsia. The addition of the heparinoid drug sodium pentosan polysulphate to the therapeutic regimen resulted in a significant fall in platelet factor 3 availability and in decreased aggregation against ADP but conferred no objective clinical improvement. We conclude that the drug has no place in the management of established pre-eclampsia.

Adenosine Diphosphate↗