Biomedical subjects
Publications and source records attributed to M Ron.
Abdominopelvic actinomycosis associated with the use of an intrauterine contraceptive device (IUD) is described. The diagnosis is usually made after exploratory laparotomy for severe abdominal pain and signs of an acute abdomen, or for prolonged lower abdominal pain and findings consistent with pelvic malignancy. 3 women aged 33, 44 and 52 years, respectively, are presented.
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The association between disappearing brain lesions, psychosis and epilepsy in two patients is reported for the first time. Mechanisms to explain the underlying pathogenesis are postulated.
In a pair of male monozygotic twins discordant for schizophrenia, MRI revealed no abnormality in the ill proband, but extensive white-matter damage of likely congenital origin in the psychiatrically normal twin. These findings are difficult to reconcile with multifactorial models of schizophrenia, and raise the possibility that some forms of brain damage may preclude expression of the schizophrenia genotype.
Cesarean sections performed for the delivery of the premature infant are known to be prone to dangers to the fetus, primarily due to contraction of the incised but as yet undelivered uterus upon the fetus, which thus entraps it. Reported is our technique for performing a cesarean section in prematurity, describing two simple yet helpful measures-halothane administered to the mother and controlled entrance to the amniotic sac, after having completed the whole uterine incision without rupturing the membrances. These measures are designed to avoid or at least, it is hoped, to reduce the occurrence of the previously mentioned severe complication.
The occurrence of a nuchal arm during vaginal breech delivery is a potentially traumatic event associated with high perinatal morbidity and mortality. This problem usually cannot be anticipated and must be overcome immediately on diagnosis during the second stage of labor. The results of a retrospective analysis of radiologic studies of 115 cases of term singleton breech deliveries are presented here. A nuchal arm in the first stage of labor was diagnosed in five cases, an incidence of 4.35%. Of four vaginal breech deliveries, one case resulted in severe handicapping neonatal trauma. We suggest that radiologic diagnosis of a nuchal arm in the first stage of labor should indicate abdominal delivery.
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Prematurely ruptured amniotic membranes at term, and membranes from normal term pregnancies were studied. The membranes were analyzed for neutral sugars, hexosamines, sialic acid, uronic acid, DNA, RNA, cholesterol, phospholipids, calcium, magnesium, sodium and potassium. The only significant difference found between the normal and the prematurely ruptured membranes was a significantly lower concentration of calcium and magnesium in the latter group. (Calcium 0.32 +/- 0.07, vs. 0.24 +/- 0.07, p less than 0.05; Magnesium 0.30 +/- 0.19 vs. 0.15 +/- 0.04, p less than 0.05; in mg/100 mg protein). The possible metabolic effects of low calcium and magnesium may be of relevance to the pathogenesis of premature rupture of the amniotic membranes.
A 23-yr-old splenectomized female developed an isolated ovarian abscess, a very rare complication, following a normal delivery. Apart from the palpated 'cyst', findings on pelvic examination were unremarkable, as is often the case with ovarian abscess. The patient recovered after conservative 'cystectomy'. We suggest that the asplenic state plays a role in the development of this very rare complication.
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Blood residue levels of some organochlorine pesticides (DDT and its analogues, lindane, dieldrin, heptachlor epoxide) and polychlorinated biphenyls were measured in maternal and cord blood in 20 cases of premature rupture of fetal membranes at term and in 15 matched controls. No evidence of a possible organochlorine compounds role in the pathogenesis of premature rupture of the membrane was found.
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This study reviews data on the changes with time of the blood levels of some organochlorine compounds (OCCs) in the general Israeli population. All the studied OCC residues, except for p,p'-DDD, were significantly lower in 1985-1986 than in 1975. A decline in blood residues of organochlorine pesticides was observed mainly in the second half of the 1970s, whereas a fall in the polychlorinated biphenyl residue levels took place in the first half of the 1980s. During the latter period, unexplained increases in p,p'-DDD, dieldrin and heptachlor epoxide residue levels were seen. A significant decrease in the blood levels of OCCs quickly metabolized in the body (p,p'-DDT, tetrachlorobiphenyls) indicated a considerable reduction of environmental exposures. The clear decline in OCC contamination of the environment and, in particular, of the human body during the reviewed period (1975-1986) resulted from the restrictions imposed in Israel on the use of OCCs. Nevertheless this does not mean that this problem has been solved. Some health implications of low-level life-long OCC exposure are discussed, and further environmental and biological monitoring and control measures are recommended.
The concentration of 25-hydroxyvitamin D3 (25(OH)D3), 24,25-dihydroxyvitamin D3 (24,25(OH)2D3) and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) were determined in amniotic fluid, fetal cord serum and maternal serum in 26 cases of elective cesarean sections at term. All the women had a normal pregnancy and did not get any vitamin D fortified preparations. The samples were collected during December 1982-April 1983, at 37-40 weeks of pregnancy. The respective levels (+/- S.D.) of 25(OH)D3, 24,25(OH)2D3 and 1,25(OH)2D3 in maternal serum were: 18.03 +/- 10.8 ng/ml, 1.473 +/- 1.562 ng/ml and 36 +/- 21.5 pg/ml; in fetal cord serum: 13.15 +/- 8.3 ng/ml, 0.9 +/- 0.76 ng/ml and 29.2 +/- 18.55 pg/ml and in amniotic fluid: 0.732 +/- 0.508 ng/ml, 0.212 +/- 0.104 ng/ml and 14.3 +/- 10.0 pg/ml. The levels of the three metabolites in maternal and fetal cord serum were not statistically different. There was a statistically significant correlation between maternal and fetal serum levels of 25(OH)D3 and 24,25(OH)2D3 (r = 0.79, p less than 0.01 and r = 0.743, p less than 0.01 respectively). No significant correlation was found in 1,25(OH)2D3 levels between maternal and fetal cord sera. This lack of correlation may well be in agreement with the recent findings of Kouppala, et al. who demonstrated that the fetus contributes to its own pool of 1,25(OH)2D3. A significant difference was found between maternal serum and amniotic fluid levels of the three metabolites. A statistically significant difference was also found between fetal serum levels of 25(OH)D3 and 24,25(OH)2D3 and amniotic fluid levels.(ABSTRACT TRUNCATED AT 250 WORDS)
Herd-years of Israeli-Holsteins were stratified into three groups by two criteria: mean annualized milk yield [365 (total lactations yield/calving interval)] and mean persistency, estimated as the ratio of daily milk production at the 5th mo postpartum to daily production during the postpartum peak period. The latter was taken as an indication of the relative environmental stress on the cow. Primi- and multiparous cows were analyzed separately. Genetic parameters were estimated for annualized milk and fat production at each production and persistency group. Heritabilities increased with a rise in production for both primiparous and multiparous cows, but the effect was greater for multiparous cows. Even though persistency and production were correlated, no clear trends were evident for stratification by persistency; thus, a relationship between stress and heritability was not established. Genetic correlations among stratification groups were between .7 and .9 for persistency and between .6 and .86 for production; thus, sire x environmental interaction was greater for production than for persistency stratification. Production in a given year can be used as a criterion for selecting herds to test progeny of young sires in the following year.
Fluoride concentrations were determined in plasma of 50 pregnant women, 44 samples of amniotic fluid and fetal cord blood of 29 fetuses at various stages of normal pregnancies, from an area with a relatively low water fluoride (less than 0.5 ppm) content. The mean concentrations of fluoride from maternal plasma, cord plasma and amniotic fluid (+/- S.D.) were 0.033 +/- 0.003, 0.028 +/- 0.005 and 0.017 +/- 0.003 ppm, respectively. Maternal and fetal plasma fluoride concentrations did not differ significantly. In the older age group fetal cord plasma fluoride concentration was significantly lower than maternal plasma levels (0.012 +/- 0.08 ppm vs. 0.023 +/- 0.001, respectively; p less than 0.05). Amniotic fluid fluoride levels were significantly higher at term than in midtrimester pregnancy, 0.017 +/- 0.0018 vs. 0.010 +/- 0.009 ppm (P less than 0.05), respectively. This higher concentration may imply higher fetal urinary excretion of fluoride at term due to the lower sequestration of fluoride as the process of bone calcification is more complete.
Four patients with oligoamenorrhea manifesting hormonal and clinical features of polycystic ovarian disease (PCOD) were selected for treatment. All patients had high luteinizing hormone (LH) levels and a basal LH/follicle-stimulating hormone (FSH) ratio of greater than 3. Three of them had high androgen levels with normal adrenal cortical function. The four patients were treated for 12 cycles by pulsatile LH-releasing hormone (LH-RH) subcutaneously. Frequency of pulses varied between once in every 120 to once in every 400 minutes in consecutive cycles, in an attempt to reverse LH/FSH ratio. The dose of LH-RH varied between 20 and 40 micrograms/pulse. Treatment was monitored hormonally by the determinations of LH, FSH, 17 beta-estradiol, prolactin, progesterone, testosterone (T) (total and free), androstenedione (delta 4A), dehydroepiandrosterone sulfate (DHEA-S), and sex hormone-binding globulin (SHBG) every 2 days. The most striking change was the lowering of the LH/FSH ratio to the normal range, due to LH decrease and FSH increase with a pulse frequency of 180 to 240 minutes. DHEA-S levels reversed to normal in two patients and were reduced in one patient. T and delta 4A levels returned to normal with elevation to normal of SHBG. These hormonal improvements did not result in ovulation as expected (2 of 12 cycles). It may be assumed that either subcutaneous administration is inadequate in PCOD patients or that the frequency of pulses needed to correct the hormonal disturbances in PCOD patients differs from that needed for ovum maturation and ovulation.