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Biomedical subjects

M Berland

Publications and source records attributed to M Berland.

At least 19 recordsLinked to original sources
PubMed1992

Home uterine activity monitoring in France: a randomized, controlled trial.

OBJECTIVES: We assessed the effectiveness of ambulatory tocodynamometry in reducing the preterm delivery rate in women at risk of preterm delivery such as women with risk factors and women previously hospitalized and discharged. STUDY DESIGN: In four public maternity units these women were randomly allocated to two groups: 84 had home uterine activity monitoring and daily midwife contact and 84 were given the standard care for high-risk women, which generally includes home visits by community midwives. RESULTS: The proportion of deliveries before 37 weeks' gestation was slightly higher in the monitored group than in the control group (32% vs 22%). The corresponding odds ratio was 1.7 (95% confidence interval: 0.9 to 3.5). CONCLUSION: Although the sample was small, these results suggest that home uterine activity monitoring was probably not beneficial to the population studied, or at least that any benefit would have been too small to justify extending this monitoring in this high-risk population.

Cardiotocography↗
PubMed1992

[Prenatal screening for cysts of choroid plexus. Evolution and interpretation of 30 cases].

The authors report thirty cases in which they diagnosed a cyst of the choroid plexus antenatally between the 18th and the 36th week of amenorrhoea (mean 21 weeks). Choroid plexus cysts show up in some pictures as round or oval cysts clearly visible in the region of the choroid plexus. They appear in the lateral cerebral ventricles. They frequently occur between the 15th and 25th week of amenorrhoea (0.6 to 2.5% of pregnancies), unilaterally or bilaterally (46%) either on the right of left side and varying in size (3 to 20 mm). These characteristics do not influence the way they evolve. If a single choroid plexus cyst is found a control ultrasound should be carried out four weeks later. 96% of them have disappeared by the end of the second trimester; but if they do persist in the third trimester (4%) they are not necessarily pathological. On the other hand if a choroid plexus cyst is associated with some other morphological biometric abnormality antenatal chromosome testing should be carried out because trisomy 18 is more common in this situation (4.8%) than in the general population.

Adolescent↗
PubMed1991

The effects of bilateral enucleation in the primate fetus on the parcellation of visual cortex.

Bilateral enucleation in the macaque fetus causes an areal reduction of an otherwise normal striate cortex. Here we show that in early operated animals this reduction is accompanied by a separation of striate and prostriate cortices which are normally contiguous. However this induced separation does not correspond to the areal reduction of striate cortex, indicating that extrinsic signals regulate either the proliferation and/or survival of striate cortical neurons.

Animals↗
PubMed1991

Segregation of callosal and association pathways during development in the visual cortex of the primate.

The segregation of callosal and association pathways in the developing visual cortex of the monkey was studied using the retrograde tracers fast blue and diamidino yellow. Quantitative analysis of the laminar distribution of labeled callosal and association neurons made it possible to reveal the shifting pattern of connections that characterizes the development of these two pathways. In the adult, callosal neurons are restricted to supragranular layers, where they are concentrated at the bottom of layer 3. Association neurons are located both in infra- and supragranular layers. Supragranular layer association neurons are concentrated in layer 2, with limited spread into layer 3 so that there is little overlap with callosal neurons. In the immature brain, callosal neurons are characterized by a tangential distribution that is more widespread than in the adult, while their laminar distribution undergoes little developmental change. Association neurons show two types of changes in their laminar distribution: (1) in the early fetus, there is a large excess of association neurons in supragranular layers, the adult distribution being achieved some time after birth; and (2) during maturation there is a selective elimination of at least 50% of the projections originating from the lower part of layers 2/3. Hence, the adult radial segregation of association and callosal pathways is achieved in part by regressive phenomena. The developmental reduction of bihemispheric projections is largely independent of changes in the organization of association neurons. Quantitative analysis of the morphology and spatial location of neurons sending axon collaterals to both hemispheres suggests that they constitute a subset of callosal neurons and that their frequency is determined by factors that regulate directly this population. These results are discussed with respect to the specification of visual cortical pathways during ontogenesis.

Amidines↗
PubMed1991

[Genital herpes and childbirth].

Neonatal herpes is a serious infection due to the risk of diffusion and damage to the central nervous system. Depending on the author, the incidence of herpetic infection reported ranges from 1/7,500 to 1/1,000,000 neonates. type II herpes virus is responsible for three quarters of infections. The risk or in-utero damage is low, and does not exceed 5 percent of cases. Contamination usually occurs during delivery or during the immediate post-partum period. The clinical forms of neonatal infection consist essentially of diffuse forms, located in the central nervous system, and localized forms in the integuments and the eye. The prognosis for diffused forms and for damage to the central nervous system was particularly serious (two thirds mortality and a high risk of sequelae amongst survivors); but these results involve children who received anti-viral treatment too late. Primary maternal herpetic infection during the month preceding birth is the most serious risk for the neonate due to the high level of virus in the lesions and the absence of neutralizing antibodies. In this situation, the risk of neonate infection appears to be 75 percent. Fortunately, this situation is unusual. Recurrent infection is accompanied by a lower viral titer, viral elimination is rapid and the patient has neutralizing antibodies. The risk of neonatal involvement in the case of recurrence at the time of childbirth is thought to be less than 5 percent. In cases with a history of genital herpes in the mother or her partner, the risk of neonatal contamination is reported to be 1/1,000.(ABSTRACT TRUNCATED AT 250 WORDS)

Antiviral Agents↗
PubMed1991

[Ehlers-Danlos syndrome and pregnancy. Apropos of a case].

Ehlers-Danlos Syndrome is a hereditary dysplasia of connective tissue with an abnormality in collagen synthesis. The syndrome consists of increased elasticity and fragility of the skin, increased laxity of the ligaments of the joints and fragility of the blood vessels. It is rarely associated with pregnancy but when it is several problems arise which are demonstrated in our case. Our patient had a type III syndrome (hypermobility of the joints) or a type IV syndrome (echymoses, Sack-Barabas Syndrome). In the literature the following are reported: premature rupture of the membranes with premature delivery, tears, perineal haematomas and type IV ruptures of the great vessels of the uterus. The best way of delivering and anaesthetising the patient are discussed. The prognosis depends above all on the type of the disease (25% of mothers die in type IV disease). Strict rest and Pfannestiel lower segment Caesarean section operation under general anaesthetic allowed us to achieve a favorable outcome for the mother and for her child.

Adult↗
PubMed1990

Incidence of visual cortical neurons which have axon collaterals projecting to both cerebral hemispheres during prenatal primate development.

Fast blue was injected massively in extrastriate cortex of one hemisphere Diamidino yellow in area 17 of the other hemisphere, in adult and prenatal cynomolgus monkeys. After a suitable survival period the brains were processed for fluorescent dyes. Counts were made of the total number of labeled neurons and of those neurons which were labeled by both dyes and which project therefore to both hemispheres by means of bifurcating axon collaterals. At 122 and 135 days after conception (E122 and E135), shortly after cortico-cortical pathways are established, double-labeled neurons constituted 0.45% and 0.46% of the total population of labeled neurons in area V2. In V2 in the adult the range of values of double-labeled neurons was 0.03-0.08%.

Animals↗
PubMed1990

[The significance of the level of C-reactive protein in gynecologic infections].

C-reactive protein, synthesized by the liver, belongs to the group of proteins in the acute stage of inflammation. It has a very short half life of 6 to 8 hours with rapid evolution kinetics. The CRP level has been measured 959 times by the immuno-turbidimetric method in 500 in-patients of the Gynaecology Department of Claude Bernard Hospital. It was measured every 48 hours. The CRP level increases in the immediate post-operative period, reaches its maximum on D3 and falls back to normal between D5 and D7. The CRP level seems to be the most reliable parameter for the diagnosis of pelvic infections (namely salpingitis). It represents the best criterium to assess the effectiveness of the treatments administered to the infected patients (adnexitis, post-operative complications).

Abscess↗
PubMed1989

Maturation and connectivity of the visual cortex in monkey is altered by prenatal removal of retinal input.

In several species, the peripheral input from the eyes partly determines the pattern of interconnections between the visual areas of the two cerebral hemispheres through the fibre tract termed the corpus callosum. In the macaque monkey, the neurons projecting through the callosum are largely restricted to area 18 throughout ontogeny, whereas area 17 is characterized by few or no callosal projections. Here, we show that suppressing the peripheral input by prenatal removal of the eyes leads to a marked reduction in the extent of area 17, resulting in a large shift in the position of the histologically identifiable boundary between the two areas. Even so, the boundary continues to separate an area rich with callosal connections (area 18) from one poor in such projections (area 17), indicating there is no effect on the callosal connectivity of area 17. In contrast, in area 18, eye removal results in many more neurons with callosal projections than in normal animals. The results suggest that the factors that determine the parcellation of cortical areas also specify their connectivity.

Animals↗
PubMed1988

Absence of interhemispheric connections of area 17 during development in the monkey.

Our understanding of the development of cortical connectivity largely stems from studies of the ontogeny of interhemispheric pathways in carnivores, rodents and lagomorphs. Early in development, cortical neurons projecting to the contralateral hemisphere through the corpus callosum (callosal projection neurons) have a widespread distribution. As maturation proceeds, callosal projection neurons become restricted to those cortical regions that are connected in the adult. In newborn cats and rats, for example, callosal projection neurons are not restricted to the 17-18 border as in the adult, but are found throughout areas 17 and 18. The macaque monkey is an exception, because at birth it has an adult-like distribution of callosal projection neurons in area 18, with practically none in area 17. Here we show that whereas area 17 is devoid of interhemispheric connections throughout prenatal development, the distribution of callosal projection neurons in area 18 shows the common sequence of an early widespread distribution followed by regression. The absence of callosal projection neurons in area 17 throughout ontogeny may well be a feature unique to Old World primates.

Animals↗
PubMed1986

[Risks of cesarean section].

Despite improvements in medical and surgical techniques, complications are not unusual in cesarean sections and may, in some cases, be life-threatening. Complications affecting the mother can be divided schematically into 3 groups: immediate surgical complications essentially represented by hemorrhages usually involving local factors (tearing of lower segment, placentation disorders), and anesthetic complications; secondary post-operative complications, dominated by the most common infections and occasionally very severe cases of thromboembolism; late complications involving weakening of the uterus. Complications affecting the fetus are much rarer and are generally linked to the indication of cesarean section rather than to the section itself. Nevertheless, fetal morbidity can be affected by cesarean section: transient respiratory distress, retention of anesthetic and even some traumas have been noted during fetal delivery.

Adult↗
PubMed1985

Serum vitamin K1 concentration and vitamin K-dependent clotting factor activity in maternal and fetal cord blood.

The serum concentration of phylloquinone (vitamin K1) was measured in 34 healthy mothers and in the arterial cord blood of their newborn infants. In addition, the activities of factor II and of factors VII plus X were determined simultaneously in 16 paired maternal and fetal bloods. The serum vitamin K1 concentration was similar to that of control subjects in 27 mothers: 9.03 +/- 4.9 micrograms/L (mean and SD), with a simultaneous concentration of 10.4 +/- 5.3 micrograms/L in cord blood. Six mothers exhibited high serum vitamin K1 concentrations from 40 to 240 micrograms/L (median, 82) and the concentration in cord blood ranged from 25 to 115 micrograms/L (median, 71). One mother had a normal concentration of vitamin K1: 9 micrograms/L while no vitamin K1 was detectable in the serum of her infant. The activity of factor II and factors VII plus X was 7% and 7%, respectively, in this infant and 100% in the mother. All other mothers showed normal factor II and factors VII plus X activity, while the median activity was 47% (28%-56%) for factor II and 65% (35%-100%) for factors VII plus X in cord blood. These data suggest that vitamin K1 can cross the placental barrier but not in every case. Therefore the systematic administration of vitamin K1 to the newborn infant seems to be required to prevent the occurrence of the hemorrhagic disease.

Blood Coagulation Factors↗
PubMed1984

[Fever during labor].

The authors have studied the progress of labour and the neonatal consequences for 100 patients who started labour with a high temperature. A control group consisted of 100 patients with normal temperature and the comparison showed that there was a raised risk of dystocia and of fetal distress during labour. The maternal and neonatal complications were studied in relationship to the aetiology, which was most frequently premature rupture of the membranes. The authors suggest the way these cases should be managed to lessen the maternal and neonatal risk which is associated with pyrexia in labour. These are: culturing blood, urine and a vaginal or, better still, endocervical swab; giving penicillin with gentamycin and metronidazole throughout the labour and in the first few days after delivery. Very careful monitoring should also be carried out.

Bacterial Infections↗