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Biomedical subjects

L Westergaard

Publications and source records attributed to L Westergaard.

27 records · Page 2Linked to original sources

Gastrin and gastrointestinal dyspepsia in pregnancy.

Fasting serum gastrin (SG) concentration and the SG response to a standard protein meal were investigated in 8 women with upper gastrointestinal dyspepsia in the 36th week of pregnancy and again 8 weeks after parturition, when the dyspepsia had disappeared. The fasting SG concentration was significantly higher (p less than 0.05) during pregnancy than post partum, whereas no statistically significant difference was found between the SG response to a protein meal stimulation during pregnancy vs. post partum. The demonstrated variations in gastrin secretion during and after pregnancy offer no explanation for the upper gastrointestinal dyspepsia of our patients.

Adult↗

Mannitol-induced rebleeding from intracranial aneurysm. Case report.

A case is presented in which rebleeding from an intracranial saccular aneurysm occurred a few minutes after intravenous administration of mannitol during surgery. The relationship between the reducing effect of mannitol on elevated intracranial pressure and the increased pressure gradient across the aneurysm wall, causing risk of rebleeding, is discussed. Procedures that can reduce this risk are summarized.

Cerebral Hemorrhage↗

Abnormal growth of ovarian antral follicles in breast cancer patients.

Ovarian antral follicles from patients with breast cancer were compared with follicles from healthy women. Steroid levels in the follicular fluid and the health status of the follicles were evaluated. Follicles were judged to be healthy or atretic by flow cytometric determinations of the deoxyribonucleic acid content of aspirated granulosa cell nuclei. Fifteen of the 25 follicles (60%) from the cancer patients contained unmeasurable or abnormally low steriod levels (i.e., less than 100 ng/ml) which were significantly (P less than 0.001) lower than in follicles of the same health status from healthy women (500 to 1000 ng/ml). It is speculated whether substances other than the usual follicular steriods are produced by the cancer patients, which stimulate mitotic activity of the granulosa cells.

Adult↗

Flow cytometric deoxyribonucleic acid analysis of granulosa cells aspirated from human ovarian follicles. A new method to distinguish healthy and atretic ovarian follicles.

Granulosa cell aspirates from human ovarian follicles were analyzed by flow cytometry to determine the fraction of cells in the DNA S-phase of the mitotic cell cycle. The aim of the study was to evaluate if the percentage of granulosa cells in S-phase (the S-fraction) could be used to indicate whether a follicle was healthy or atretic. A highly significant relationship was found between the S-fraction and the concentration of estradiol in the follicular fluid (r = 0.6, P less than 0.001). More than 85% of the follicles having an S-fraction of 16% or greater contained intrafollicular levels of estradiol equal to or greater than 200 ng/ml and had a low androstenedione:estradiol ratio. Conversely, 95% or more of the follicles that had an S-fraction of less than 16% contained low estradiol (less than 200 ng/ml) and had a high androstenedione to estradiol ratio. We conclude that flow cytometric DNA measurements on follicular aspirates provide a reliable and rapid method by which to distinguish healthy and atretic ovarian follicles. Since only a small fraction (less than 5%) of an entire granulosa cell population is required for S-phase analysis, the technique allows the majority of cells to be immediately available or other biochemical studies. Moreover, since excision of ovarian tissue is avoided, the technique may be acceptable for studies on women with normal ovarian function but who are undergoing laparotomy or laparoscopy for some reason.

Adolescent↗

Significance of cervical Chlamydia trachomatis infection in postabortal pelvic inflammatory disease.

The prevalence of Chlamydia trachomatis infection of the cervix uteri and its possible association with postabortal pelvic inflammatory disease (PID) were investigated in women subjected to first-trimester-induced abortion. None of the women had signs or symptoms of genital infection at the time of abortion. Chlamydia organisms were isolated from the cervix/urethra in 33 (10%) of 333 women. Women with a positive Chlamydia culture were comparable to women with a negative culture in regard to gestational age at the time of abortion. However, Chlamydia-positive women were significantly younger and had gonorrhea more often than Chlamydia-negative women. Two hundred seventy (81%) of the women were followed up 1 month after the abortion. Thirty-two of these developed postabortal PID. Eight (28%) of 29 women with a positive Chlamydia culture and 24 (10%) of 241 women with a negative culture developed postabortal PID. This difference is significant (P less than .025) and indicates that the presence of Chlamydia in the cervical canal at the time of abortion in asymptomatic women increases the risk of postabortal PID.

Abortion, Induced↗

Severe cervical dysplasia. Control by biopsies or primary conization? A comparative study.

During the period 1967-75 severe cervical dysplasia was diagnosed in 87 consecutive cases by means of colposcopically directed biopsies of the portio and by cervical curettage. Thirty-eight of the patients were treated, 3-6 weeks after diagnostic biopsy, by conization (conization group) and subsequently followed with smears and colposcopy. The remaining 49 patients (the biopsy group) were followed up at regular intervals by colposcopically directed biopsies of the portio and cervical curettage. The follow-up period for all 87 patients ranged from 9 to 106 months, mean 47.6 months. The groups were comparable with respect to the most important epidemiological factors. During the follow-up period progression to carcinoma in situ and to microinvasive carcinoma was found in 57.1% of the biopsy group but in 0% of the conization group. Of the whole material, 69 patients had conization (the 38 patients of the conization group plus 31 of the biopsy group). In 3 cases (4.35%) the cone diagnosis was 1 grade more serious than the biopsy diagnosis. The mean transit time of progression from severe dysplasia to CIS/MIC was 12-15 months. It is concluded that severe dysplasia is a rapidly progressing state which can be safely diagnosed by colposcopically directed biopsies of the portio and cervical curettage and effectively treated by conization. In view of the fact that not less than 32.7% of the cases with severe dysplasia in the biopsy group regressed during follow-up, we recommend that the diagnosis be established by portio biopsies and cervical curettage, twice with an interval of 3 months to restrict the number of superfluous conizations.

Biopsy↗

Spontaneous rupture of the liver in pregnancy.

A case of spontaneous rupture of the liver in pregnancy, fatal to mother and child, is described. The patient, a multiparous, 36-year-old diabetic, presented in the 27th week of pregnancy with upper abdominal pains resembling biliary dyskinesia. After 8 hours' observation in the hospital she suddenly developed hypovolaemic shock and fetal heart tones disappeared. On acute cesarean section a dead fetus was delivered. Hemoperiteoneum was present, arising from a huge subcapsular hematoma of the right lobe of the liver, with rupture of Glisson's capsule. The hematoma was evaluated and tears in the liver parenchyma sutured. Disseminated intravasal coagulation complicated the early postoperative cause. A bacterial infection supervened later and the patient died in a septic stage on the 19th postoperative day. The literature is reviewed, and it is pointed out that greater awareness of the diagnosis could lead to better timing of surgery and an improved prognosis for mother and child.

Adult↗