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Biomedical subjects

M J Haller

Publications and source records attributed to M J Haller.

4 recordsLinked to original sources
PubMed2004

Blood lymphocyte chimerism associated with IVF and monochorionic dizygous twinning: case report.

We report on dizygotic (DZ) twins, conceived by IVF and ICSI with assisted hatching, who each had a mixture of 46,XX and 46,XY cells in blood lymphocytes. The female twin had mild genitalia abnormalities but further study revealed anatomically normal reproductive anatomy. Chromosome and fluorescence in situ hybridization studies of buccal, skin and ovarian tissue were normal, as were buccal tissue DNA studies. Fetal ultrasound and fetal membrane pathology were consistent with a monochorionic, diamniotic placenta (MCDAP). These twins thus have blood chimerism but are not chimeric in the other tissues studied. The mechanism for the chimerism could be due to either placental vascular anastamoses (after the development of the haematoblast stem cells) or due to an admixture of trophoblast cells during early blastocyst development. Such trophoblast cell admixtures would be restricted to the extraembryonic tissues so that general physical development in the fetus is normal and without somatic cell chimerism. This case in combination with others previously reported suggests that in IVF conceptions, the prevalence of blood chimerism associated with twinning, and the occurrence of DZ twinning associated with MCDAP, may be higher than previously thought.

Adult↗
PubMed1992

Need for primary care.

OBJECTIVE: This paper is a renewed call for medical schools to address the societal need for more primary care physicians. DATA SOURCES: Numerous studies from the literature are cited as background for this paper. DATA SYNTHESIS: The Author retraces the historical beginnings of the specialty of Family Practice and some of the more recent events which highlight the need for more primary care physicians. CONCLUSIONS: The author concludes that there is a societal need for more primary care physicians and that medical schools should respond to this need.

Education, Medical, Undergraduate↗
PubMed1978

A case report in a Rural Health Center.

An experiment utilizing nurse practitioners in the delivery of health care in a rural Nebraska community is described. In spite of several reorganizations, over a 2 1/2-year period of study, the project failed in terms of patient utilization. Visit rates began at 300 per month and increased to a high of 825 until the community perceived that the nurse practitioner was interposed between themselves and the primary physician. Rates then dropped to 375 and the community withdrew from the project. Implications for rural health projects using ancillary personnel are discussed.

Delivery of Health Care↗