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P F Rust

Publications and source records attributed to P F Rust.

67 records · Page 4Linked to original sources
PubMed1981

Observer variation in the angiocardiographic diagnosis of mitral valve prolapse.

The purpose of this study was to assess the reliability of the angiocardiographic diagnosis of mitral valve prolapse by measuring agreement between observers using defined diagnostic criteria. Sixty high-quality left ventriculograms, selected to include many that showed possible mitral valve prolapse, were reviewed by three angiocardiographers. Disagreement between observers as to positivity occurred in 26 percent and 30 percent of the cases on two reviews, and disagreement as to specific scallop involvement occurred in 68 percent and 78 percent of the cases. A specific observer agreed with himself in interpretation of positive 78 to 82 percent of the time and in the interpretation of specific scallop involvement 55 to 90 percent of the time. These results indicate that in the absence of generally agreed upon quantitative angiocardiographic criteria for the diagnosis of mitral valve prolapse, there is considerable variability among observers in the interpretation of mitral valve prolapse by angiocardiographic studies.

Angiocardiography↗
PubMedDate not supplied

Sperm immunity in infertile couples: antibody titers are higher against the husbands' sperm than to sperm from controls.

Titers of hemagglutination and cytotoxic antibodies to sperm were determined in the sera, seminal plasma, cervical mucus, and vaginal secretions from 69 infertile couples, using sperm from the husbands and from normal control subjects. Titers of hemagglutination and cytotoxic antibodies were significantly higher (p = 0.002 and p less than 0.001, respectively) against autologous sperm as contrasted with sperm from control subjects in sera from 55 autoimmune males. Hemagglutination and cytotoxic antibody titers were also significantly higher (p = 0.044 and p less than 0.001, respectively) against their husbands' sperm as contrasted with control sperm in sera from 46 females with isoimmunity to sperm. Ninety percent of males and females with sperm immunity were positive for histocompatibility antigens HLA-B7, HLA-B8, and/or HLA-BW35. In males, the presence of increased serum cytotoxic antibody titers against autologous versus control sperm was significantly associated with the presence of HLA-B7 allele (p = 0.0017) and with HLA-B7, HLA-B8, and/or HLA-BW35 in general (p less than 0.05). In the females, increased serum antibody titers to their own husbands' versus control sperm were not preferentially associated with HLA-B7, HLA-B8, or HLA-BW35 antigens.

Antibodies↗
PubMedDate not supplied

Effects of nicotine on sperm attachment and penetration of zona-free hamster eggs.

A previous study from this laboratory showed that nicotine in vitro has deleterious effects on sperm motion characteristics. This study was conducted to evaluate the effects of nicotine on the ability of human spermatozoa to attach and penetrate zona-free hamster eggs. Spermatozoa from fertile donors, washed free of seminal plasma, were incubated with medium (control) and 0.1, 1, 5, and 10 mM concentrations of nicotine (concentrations estimated to approximate residual concentrations of nicotine in the testes of heavy smokers) for 18 h at 37 degrees C in a humid 5% carbon dioxide incubator. The sperm preparations were then mixed with enzymatically denuded hamster eggs and incubated for 3 h at 37 degrees C. The oocytes were examined by phase-contrast microscopy to enumerate the rates of sperm attachment and penetration. The data were analyzed by a paired t test and repeated measures analysis of variance using the arcsine transformation of the percentages. The percentages of eggs with attached spermatozoa significantly declined in a dose-dependent manner, the highest inhibition being at 10 mM (F = 24). The rate of sperm penetration was even more significantly decreased with the increase in nicotine concentrations in the following order: 10 mM (F = 56) > 5 mM (F = 30) > 1 mM (F = 44) > 0.1 mM (F = 12). Nicotine concentrations of 0.1 mM and above negatively affected sperm penetration of zona-free hamster eggs.

Adult↗
PubMedDate not supplied

The predictive value of posterior pole vessels in retinopathy of prematurity.

Dilation and tortuosity of the posterior pole vessels "(plus disease)" is a sign of poor prognosis and may be associated with threshold or prethreshold retinopathy of prematurity (ROP). We have found that normal posterior pole vessels are a reliable marker for the absence of stage 3 ROP. One hundred thirty-two consecutive premature infants weighing less than 1600 g at birth underwent ROP examinations between 32 and 40 weeks' postconceptional age. The status of the posterior pole vessels was compared to peripheral retinal pathology. Vascular findings in the posterior pole were graded 0, 1, 2, or 3, with 0 representing normal arterioles and venules and 3 representing plus disease. The remainder of the fundus examination was recorded using the international Classification of ROP, then converted to a severity scale based on zone and stage of ROP. For each infant, only one examination representing the most severe stage of ROP reached prior to treatment or spontaneous regression was used for data analysis. There was a highly significant Spearman's rank correlation (rs = 0.65) between the posterior pole vascular abnormalities and the severity of ROP in the retinal periphery. Clinically important ROP was not found in any patient with normal posterior pole vessels (grade 0) and stage 3 disease was usually associated with both venous and arterial vascular abnormalities (grades 2 or 3). When ocular examination of premature infants is difficult because of poor dilation of the pupil, hazy media, or medical instability, normal appearance of the posterior pole vessels can be a reassuring finding if it is necessary to postpone complete fundus examination in infants at risk for ROP.

Fundus Oculi↗
PubMedDate not supplied

Can non-ophthalmologists screen for retinopathy of prematurity?

BACKGROUND: Dilation and tortuosity of the posterior pole vessels ("plus disease") is a poor prognostic sign and may indicate the presence of threshold or pre-threshold retinopathy of prematurity (ROP). Because stage 3 ROP appears rarely in the absence of posterior pole vascular abnormalities, we prospectively evaluated the ability of non-ophthalmologists (4th-year medical students, pediatric residents, and nurse practitioners) to identify abnormalities in the retinal blood vessels of infants undergoing examinations for ROP. METHODS: Fifty infants weighting less than 1600 g at birth were examined between 32 and 40 weeks after conception. Prior to ophthalmological examination, non-ophthalmologist examiners graded posterior pole vessels as normal or abnormal based on ophthalmoscopic appearance. One hundred twenty-one ocular examinations were performed using the teaching mirror of the indirect ophthalmoscope, 179 using the direct ophthalmoscope. The indirect ophthalmoscopy was performed simultaneously by an ophthalmologist who evaluated the posterior pole vessels for abnormalities prior to conducting a peripheral fundus examination on either eye. RESULTS: Testing sensitivity for the non-ophthalmologist examiners using direct and indirect ophthalmoscopy was 96% and 92%, respectively. Combining the results from direct and indirect ophthalmoscopy, the Clopper-Pearson 95% sensitivity confidence interval for identifying abnormal arterioles and venules was 82% to 99%, with a point estimate of 95%. CONCLUSION: These data suggest that non-ophthalmologist examiners can detect posterior pole vascular abnormalities in premature infants. If properly trained, they could possibly play a role in screening or follow-up examinations for ROP.

Humans↗
PubMedDate not supplied

Dimensions of the pediatric crystalline lens: implications for intraocular lenses in children.

As surgeons gain more experience with the implantation of posterior chamber intraocular lenses (IOLs) into the capsular bag in children, the minimum age for which implantation is advised may continue to be lowered. Accurate sizing of an IOL intended for in-the-bag fixation may depend on knowledge of the size of the capsular bag. In order to develop a growth curve for the normal crystalline lens and hence the capsular bag, 50 pediatric autopsy eyes ranging in age from 1 day to 16 years were obtained postmortem and measured within 24 hours after enucleation. Mean crystalline lens diameter was 6.00 mm at birth, 6.80 mm at 2 months, 7.1 mm at 3 months, 7.66 mm at 6 to 9 months, 8.4 mm at 21 months, 8.5 mm at 2 to 5 years, and 9.3 mm at 16 years. The post-lensectomy capsular bag size at each respective age is 1 mm larger. While age was a predictor of crystalline lens size, corneal diameter and globe axial length were better predictors of crystalline lens size. These data and accompanying linear regressions may be helpful in designing appropriate IOLs for pediatric patients.

Adolescent↗
PubMedDate not supplied

Factors associated with the frequency of after-hours in-person patient consultations.

In this study, 901 after-hours calls to 26 second- and third-year family practice residents in a university based program were audited to determine patient and physician characteristics associated with after-hours rates of in-person consultation. In-person consultation frequency averaged 25.5%, but ranged from 9% to 53% among physicians (P = .02). Male patients were seen more frequently than female patients (P = .008) Younger patients were seen more frequently than older patients (P = .01). Calls for trauma, obstetrics, and respiratory complaints were more likely to result in in-person consultations than were calls for other problems (P less than .00001). Categorical modeling analysis, used for adjustment, confirmed differences in consultation frequencies both among physicians and due to the nature of the caller's complaint. Neither the time of the call, the patient's race, nor the physician's sex, marital status, level of training, distance lived from the family practice center, or personality type as measured by the Myers-Briggs Type Indicator were associated with the frequency of consultation. Additional research is needed to determine the factors responsible for physician differences in after-hours in-person consultation frequency.

Appointments and Schedules↗
PubMedDate not supplied

Sperm antibodies and human leukocyte antigens in couples with early spontaneous abortions.

Twenty-six couples with two or more early spontaneous abortions and 53 couples with recently proven fertility (control group) were typed for human leukocyte antigens (HLA) of A and B loci and screened for the presence of cytotoxic and hemagglutinating antibodies to sperm. Eighteen other couples with two or more abortions were tested for sperm antibodies alone. Both partners in 24 of 44 (54%) aborting couples were positive (titers of greater than or equal to 32), whereas the control group had sperm antibodies in the negative range (titers of 0 to 16; P less than .0001). Thirty-one husbands (70%) and 24 wives (54%) were positive for sperm antibodies in the study group. Sharing of HLA-A and/or -B antigens between partners was similar in the control and study groups. Fourteen of 26 (54%) couples with two or more abortions did not share HLA-A and/or -B antigens, in contrast to 14 of 53 (26%) in the control fertile group (P less than .02). Antigenic frequencies of HLA-B7 singly and in combination with HLA-B35 were increased in females in the aborting but not in the fertile control group (P less than .001). The combined incidence of HLA-B7, -B8, and -B35 in both partners was significantly higher in the aborting couples as contrasted with the control group. It is suggested that the presence of sperm antibodies is associated with early pregnancy wastage. Histocompatibility antigens B7 and B35 may play a role through their association with sperm antibodies and early spontaneous abortions.

Abortion, Spontaneous↗
PubMedDate not supplied

Immunofluorescence in skin specimens from three different biopsy sites in patients with scleroderma.

Immunofluorescence (IF) data from three different biopsy sites (nailfold, forearm, buttock) were studied in 18 patients with scleroderma (SD, systemic sclerosis) and the results compared with those obtained from 10 normal controls (NC) and 7 patients with systemic lupus erythematosus (SLE). Immunoglobulin (Ig) deposits were detected by direct IF technique at the dermo-epidermal junction (DEJ) in 8/14 nailfolds, 6/15 forearms and in none of the buttock specimens of SD patients. Epidermal nuclear staining was present in 6/14 nailfolds, and in 6/15 forearms and buttocks. The most prominent finding was the observation of multiple Ig deposits in the cuticle of 9/14 patients with SD. NC group was negative in all sites for epidermal nuclear staining and the only DEJ deposit occurred in the forearm of one subject. In conclusion, this study demonstrates that Ig deposits in SD, both at the DEJ and in the epidermal nuclei, occur more often than previously reported and are especially frequent in the nailfold & cuticle area.

Adult↗