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O Segal

Publications and source records attributed to O Segal.

11 recordsLinked to original sources
PubMed2001

The effects of maternal and fetal parameters on the quality of nuchal translucency measurement.

OBJECTIVE: To evaluate the influence of maternal and fetal parameters on the quality of fetal nuchal translucency measurement. DESIGN: This was a prospective study in 227 consecutive pregnant women undergoing nuchal translucency screening by transabdominal sonography. The same well-qualified sonographer performed all the scans and in each case the best-quality image was selected and scored according to an image scoring system (total maximum score, 9). The quality of the image was examined in relation to maternal age, weight, abdominal wall thickness, amniotic sac diameter, posterior uterine wall depth (distance between abdominal wall surface and posterior uterine wall surface), placental location, fetal crown-rump length and nuchal translucency thickness. Correlation coefficients were calculated and stepwise linear regression was used to adjust for confounders and to define the predictors for image score. RESULTS: The only two parameters that provided a significant independent contribution to the prediction of the image score were posterior uterine wall depth and fetal crown-rump length. Intravariable analysis of these two parameters demonstrated that the cut-off associated with a significant change in the image quality was 80 mm for posterior uterine wall depth (score difference, 1.06; P < 0.001) and 70 mm for crown-rump length (score difference, 0.77; P = 0.001). In the group of women with two values above these cut-off points, an average score decrease of 1.90 (P < 0.001) was observed. CONCLUSIONS: The quality of fetal nuchal translucency measurement is poorer when the fetal crown-rump length is > 70 mm and the posterior uterine wall depth is > 80 mm.

Crown-Rump Length↗
PubMed2001

Speech perception results--the first 10 years of a cochlear implant program.

Long-term speech perception test results for prelingually deaf children were compared with those of postlingually deafened adults, both groups having undergone cochlear implant at our Center. Average open-set score results of adults were similar to those of the children. However, some qualitative differences were demonstrated on the perception of phonological contrasts between the groups.

Adolescent↗
PubMed2000

Verotoxin targets lymphoma infiltrates of patients with post-transplant lymphoproliferative disease.

Post-transplant lymphoproliferative disease (PTLD) is an invasive, EBV expressing B lymphoma and a major cause of morbidity and mortality following organ transplantation. Presently there is limited therapy available; rather the patient often loses the allograft or succumbs to the malignancy. CD77 (or globotriaosyl ceramide -Gb(3)) is a germinal center B cell marker [Gregory et al. Int J Cancer 1998;42:213-20; Gregory et al., J Immunol 1987;139:313-8; Mangeney et al. Eur J Immunol 1991;21:1131-40], expressed on most EBV infected B cells and is the receptor for the E. coli derived verotoxin (VT) [Lingwood CA. Advances in Lipid Research 1993;25:189-212]. We present the basis of a possible novel approach to PTLD therapy utilizing the specific targeting of VT to the infiltrating lymphoma cells. Biopsies of adenoid, kidney or liver tissue of four PTLD patients were stained with verotoxin to determine expression of CD77. VT is a potent inducer of necrosis/apoptosis of receptor positive cells. In each PTLD case, the infiltrating EBV positive B lymphoma cells were strongly and selectively stained with VT, identifying CD77 as a new marker for these cells. For such individuals, VT might provide the basis of an approach to control their malignancy.

Adolescent↗
PubMed1999

Sonographically diagnosed pelvic hematomas and postcesarean febrile morbidity.

OBJECTIVE: To evaluate the incidence of ultrasonographically-diagnosed postcesarean hematomas and correlate their presence with febrile morbidity. METHODS: Prospective study of 111 consecutive patients who had a pelvic ultrasound 4-6 days post-operatively. Ultrasonographic findings were correlated with clinical data. RESULTS: Postoperative fever was diagnosed in 28 (25%) patients. Fifteen (13.5%) women had hematomas; 10 (9%) had bladder-flap and five (4.5%) had subfascial hematomas. Only subfascial hematomas were significantly associated with post-operative fever (P = 0.01). CONCLUSIONS: Postcesarean bladder-flap hematomas are not predictive of post-operative fever. The presence of subfascial hematomas should be specifically sought in the evaluation of a febrile postcesarean patient.

Adult↗
PubMed1996

Budd-Chiari syndrome complicating severe preeclampsia in a parturient with primary antiphospholipid syndrome.

A 27-year-old primipara with severe preeclampsia and primary antiphospholipid syndrome developed right upper quadrant pain, massive ascites, HELLP syndrome, and disseminated intravascular coagulation shortly following vaginal delivery. Computed tomography and color Doppler studies were compatible with complete thrombosis of the right hepatic veins, the Budd-Chiari syndrome. Anticoagulation was initiated, along with supportive measures, and the patient recovered completely. Imaging studies 6 months later were normal. This case demonstrates that nearly fatal forms of venous thrombosis may complicate preeclampsia in women with antiphospholipid syndrome; Doppler studies of the hepatic vein are of value in establishing the diagnosis.

Adult↗
PubMed1993

Acanthosis nigricans and hyperandrogenism in a pregnancy complicated by diabetes.

BACKGROUND: Acanthosis nigricans and hyperandrogenism have been associated with diabetes mellitus accompanied by insulin resistance. However, these manifestations have rarely been reported to occur as a result of the insulin resistance of pregnancy. CASE: A 31-year-old woman with diabetes mellitus exhibited severe insulin resistance during pregnancy. At 32 weeks, daily administration of 500 U insulin was required to maintain glycemic control. Skin lesions typical of acanthosis nigricans appeared, and free testosterone levels were elevated (10.3 pg/mL). These manifestations resolved after delivery. CONCLUSION: This case may demonstrate a correlation between reversible gestational insulin resistance and acanthosis nigricans.

Acanthosis Nigricans↗
PubMed1990

Metastases to the endometrium from breast carcinoma.

Three patients with primary breast carcinoma and metastases to the endometrium presented with postmenopausal bleeding. All patients had locally advanced breast cancer at the time of diagnosis, and all developed other distant metastases concomitantly or shortly after the diagnosis of endometrial involvement. The treatment of breast carcinoma metastatic to the endometrium is palliative. Distinguishing metastatic carcinoma from primary endometrial carcinoma is of great practical clinical significance, since in the latter surgical intervention is indicated.

Breast Neoplasms↗
PubMed1987

Immunoreconstitution of T-cell impairments in asymptomatic male homosexuals by thymic humoral factor (THF).

The feasibility of using Thymic Humoral Factor (THF) for immunomodulation in asymptomatic male homosexuals was evaluated in a study on fifteen subjects with T-cell impairments, selected on the basis of a 2SD reduction in T helper/inducer (T4+) cells and one additional lymphocytic defect. Following two biweekly courses of treatment, mean relative increments of T4+ (P less than 0.002), T3+ (P less than 0.02) and total lymphocyte (P less than 0.05) populations of the group receiving THF (n = 7) were significantly increased when compared to the placebo group (n = 8). In addition, a transient increase in T4+ lymphocytes was observed after the first course in the two individuals of the THF-treated group who were seropositive for HTLV-III/LAV but not in those who were seronegative. No difference was found between the groups in fluctuations of serum interferon (IFN) or proliferation of peripheral mononuclear cells to mitogens. The results of this limited trial demonstrate that THF is capable of correcting T-cell impairments that may predispose asymptomatic homosexuals to infection by HTLV-III, without affecting IFN production. These findings suggest that future strategies for AIDS prevention in high-risk groups should include institution of large controlled trials in immunodeficient, asymptomatic, HTLV-III/LAV-seronegative male homosexuals to study the potential of selective immunoreconstitution as a preventive measure against HTLV-III/LAV infection.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Utilization of the nuchal translucency image-scoring method during training of new examiners.

Training of new examiners, utilizing 1st-trimester nuchal translucency ultrasound screening, is mandatory for obtaining reproducible measurements. This study examined the contribution of the nuchal translucency image-scoring method to the process of training and its utilization as an objective tool of image evaluation and a tool for approving qualification. The study included an evaluation of the performance of two new examiners (examiners A and B) before and after intervention, using the image-scoring method. The preintervention period included 75 images evaluated by two reviewers using general evaluation and the scoring method. The report of the scoring method was submitted to the examiners and was applied to 55 images performed afterwards. The agreement between two reviewers in classifying the first 75 images as 'accepted' or 'rejected' was tested using general evaluation versus the scoring method. The effect of the intervention was examined by comparing the quality of the images between the two time periods. A chart indicating final scores of 80 successive images analyzed by examiner A was used to set criteria for assessing qualification. Using general evaluation, the reviewers disagreed on 19 (25%) of the images, whereas using the scoring method they disagreed on only 5 (7%, p < 0.01). Comparison before and after application of the intervention demonstrated significant improvement expressed by the increased rate of better quality groups (p < 0.001) and improved mean scores from 4.31 +/- 0.31 to 6.15 +/- 0.32 (p < 0. 001). Enhanced improvement of examiner's A performance could be attributed to the intervention rather than to his learning curve. Improvement was demonstrated in all the criteria examined; however, it was significant only for images size (from 33 to 98%), amnion demonstration (from 13 to 42%), and caliper placement (from 49 to 71%). Examiner's A chart enabled us to set standards for assessing competence, based on the scoring method. These included a minimum of 40 scans, followed by more than ten sequential images of acceptable quality. The scoring method contributed to the process of training, as it made possible to objectively evaluate the images, pointed out specific errors, served as an efficient tool of intervention, and might be used for ascertaining competence. We recommend to consider its utilization in centers running 1st-trimester ultrasound screening during training new examiners.

Education, Medical, Continuing↗