Interruption of a severe hydrocephalic pregnancy.
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Biomedical subjects
Publications and source records attributed to M Ron.
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Twenty-one fertile and 103 infertile patients with oligospermia, azoospermia, impaired sperm motility and hypogonadism were evaluated for prolactin concentrations in serum, seminal plasma and split seminal plasma of two fractions. Prolactin concentration in the seminal plasma was two to three times higher than serum prolactin levels in fertile and infertile men. Prolactin concentration of the fraction 2 of the split ejaculate was higher than that of the fraction 1 and of the serum. Excessive high levels of serum prolactin and/or seminal plasma were found only among infertile patients with oligo- and azoospermia, impaired motility and hypogonadotropic hypogonadism. Prolactin is selectively accumulated in fraction 2 of the split ejaculate and affects the constituents of the seminal vesicular fluid, and excessive high prolactin concentrations of either seminal plasma or serum may be associated with male infertility.
An improved apparatus for measuring the electrical size (shape factor times volume) of particles based on the Coulter counter principle was used to characterize 110 subfertile semen specimens; size distributions were attainable in the 97 cases with a count above 1 x 10(6) spermatozoa/ml. The typical size distribution was unimodal and positively skewed. Spermatozoa maintained a constant profile during their passage through the orifice of the sizing apparatus, with an effective shape factor of 1.28. Two groups of cells were found. The larger one consisted of 68 specimens with a modal volume of 18.1 +/- 2.0 cu micron and a cell count of 27.5 +/- 9.2 x 10(6) spermatozoa/ml (mean +/- 1 SD). The smaller group contained 29 cases and had a modal volume of 6.6 +/- 0.9 cu micron and a count of 10.2 +/- 7.8 x 10(6). Samples with cell counts below 10 x 10(6) spermatozoa/ml tended to have low modal volumes (less than one-half the normal), but those above showed no particular trend.
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THe thromboplastic activity of amniotic fluid was correlated with the lecithin sphingomyelin (L/S) ratio in 59 pregnancies. It was shown that the thromboplastic activity and the L/S ratio in amniotic fluid had a coefficient of correlation of r = --0-73 (P less than 0-004). The thromboplastic activity was estimated by a modified method for prothrombin time, and a time of 113 seconds appeared to correspond to an L/S ratio of 2, in that it was the border line between maturity and immaturity of the fetal lungs. Thirty women were delivered within 24 hours of a sample of amniotic fluid being obtained. In the three patients whose babies developed the respiratory distress syndrome, the thromboplastic activity was estimated as being slower than 113 seconds.
A retrospective comparison was made between two groups, each consisting of 30 depressed patients, one in which the outcome following discharge had been good, the other where it had been poor. A previous psychiatric history, earlier admission for psychiatric illness, particularly for affective disorders and a poorer performance on routine intelligence tests were found in the poor prognosis group. In this group the duration of the index admission was longer and the condition of the patient was less improved at the time of discharge. Several symptom variables also discriminated between the groups. These findings are discussed.
Organochlorine insecticides and polychlorinated biphenyls (PCB's were assessed in human blood and milk collected from Israeli mothers 2-4 days ater childbirth during 1975. The concentration of total DDT (sigma DDT) was similar in whole plasma and milk (74 ppb versus 72 ppb) and higher in plasma-extracted lipids than in milk-extracted lipids: 15.12 ppm versus 5.77 ppm. Levels of gemma-BHC, dieldrin, and heptachlor epoxide were higher in whole plasma and plasma-extracted lipids than in whole milk or in milk-extracted lipids. PCB's had similar concentrations in extracted lipids of plasma and milk but were significantly higher in whole milk than in whole plasma. Higher percentages of organochlorine insecticides and PCBs were excreted in milk from mothers between 20 and 29 than between 30 and 39, although the younger group had lower levels of these compounds in plasma. Overweight women excreted lower quantities of organochlorine insecticides and PCB's than did women of normal weight
Ten cases of severe fetal heart rate deceleration following maternal vaso-vagal reflex during amniocentesis were presented. The good outcome of these fetuses suggests that this transient phenomenon has no adverse effect on the fetus. This type of FHR response should be recognized so as to avoid unnecessary Caesarian sections done because of severe FHR bradycardia following amniocentesis.
Fetal heart rate monitoring during 107 amniocenteses suggested that acceleration of the fetal heart rate indicated fetal well-being. Eight out of the 19 fetuses who did not show this response (as against 2 out of the 88 others) had a low Apgar score at birth.
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Eleven women with fetal distress as manifested by a decrease of fetal movements up to cessation underwent amniocentesis for amniotic fluid evaluation under continuous FHR monitoring. All the fetuses showed abnormal heart rate response, manifested by absence of FHR acceleration or early or late deceleration. The pathologic response, or lack of response of fetal heart rate during amniocentesis is suggested as an additional test to evaluate the severity of fetal distress.
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The unusual clinical course of three cases of dilatation of ureters and renal pelvises in pregnancy was reported. The presenting symptom in each case was acute abdominal pain, which was at first attributed to other surgical or obstetric emergencies like premature separation of placenta, acute appendicitis and acute hydramnion.
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Two cases of uncomplicated fetal baseline tachycardia in postterm pregnancies that resulted in fetal death are reported. The tachycardia was the only sign of fetal distress in both cases. Although the condition is not usually considered and ominous sign of fetal outcome, the authors recommend immediate cesarian section in postterm cases of severe fetal baseline tachycardia occurring before or during labor.