[A minor birth injury with an unexpected late effect].
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Adult↗
Biomedical subjects
P Thomassen
Publications and source records attributed to P Thomassen.
Prenatal diagnosis of distal arthrogryposis type I by ultrasonography.
Two consecutive pregnancies in a woman with initially undiagnosed type I distal arthrogryposis (DA) are reported. A prenatal diagnosis of the condition was made by ultrasound in the 17th week of gestation in one of the pregnancies, whereas in the subsequent pregnancy the disorder was excluded as early as 13 weeks' gestation. The diagnoses were verified at birth. The feasibility of prenatal diagnosis of DA type I in the second trimester is thus confirmed and its possibility in the late first trimester is suggested.
Adult↗
Allo-immunization during pregnancy. Clinical results from 1983 to 1989 in a Scandinavian university hospital.
From 1983 to 1989, 147,068 pregnancies were analyzed for allo-immunization against erythrocyte antigens. Approximately half of the cases were due to immunization against factor D and the others were due to allo-immunization against other antigens (K, c, E, etc.). In 61 cases exchange transfusion of the newborn was needed and in 115 cases diagnostic amniocentesis was done during pregnancy. Intrauterine transfusions were performed in 10 cases. Fetal and neonatal mortality was 4% in these moderate to severe cases, all due to immunization against D. Immunization against D was due to failure to give immunoglobulin anti-D in about 2/3 of the cases. Systematic prophylactic treatment with anti-D during pregnancy would probably not be cost-effective in this population.
Amniocentesis↗
Six cases of massive feto-maternal bleeding causing intra-uterine fetal death.
Six patients in whom intra-uterine fetal death (IUFD) near term resulted from massive feto-maternal hemorrhage are reported. Two of the mothers were Rh-negative, which necessitated the administration of large volumes of anti-D. In order to detect such patients, the Kleihauer-Betke test should be performed in all cases of IUFD of unknown etiology.
Adult↗
Viability of the human cervical epithelium with dysplasia and carcinoma in situ.
Autoradiograms of histologic slides of 58 human cone specimens with dysplasia and carcinoma in situ were analyzed after tissue samples were incubated with labeled RNA precursors. Both the vertical and lateral distributions of labeled cells were rather uniform in the major part of the epithelium, which suggested that the tissue remained metabolically active during incubation. Only the uppermost epithelial cells in heavily labeled areas were devitalized as deduced by the morphologic appearance of the cells, the absence of labeling in the cells, the trypan blue exclusion test, and the trypsin digestion test. The viability of large epithelial areas suggested that the previously reported focal distribution of proliferating and nonproliferating areas in the cervical epithelium is a genuine phenomenon and not the result of focal epithelial devitalization acquired during incubation.
Carcinoma in Situ↗
Big cones and little cones.
To investigate whether the amount of tissue removed at conization could influence the frequency of inadequate excision of cervical atypias, 354 cone specimens were measured. The data indicate that the frequency of lesions incompletely removed at conization increased with decreasing size (ie. length and volume) of the specimen. The parameters influencing the detection of epithelial atypias at the surgical margin of the specimens are discussed. A plea is made for international standardization in reporting results of conization (size of cone and number of sections) in order to permit objective comparison between clinics of the results of the conization procedure.
Carcinoma in Situ↗
Analysis of metabolic profiles of bile acids in urine using a lipophilic anion exchanger and computerized gas-liquid chromatorgaphy-mass spectrometry.
A method is described for quantitative analysis of bile acids in urine. Urine is acidified and bile acids are extracted on an Amberlite XAD-2 column. Bile salts are converted to acids on an Amberlyst A-15 column and are separated into groups of unconjugated, glycine, taurine, monosulfated, and polysulfated conjugates using the lipophilic anion exchanger diethylaminohydroxypropyl Sephadex LH-20 (DEAP-LH-20). After solvolysis and hydrolysis, the deconjugated bile acids are purified on DEAP-LH-20, and are converted to methyl ester trimethylsilyl ether derivatives. Identification and quantitation of the individual bile acids is accomplished by computerized gas-liquid chromatography-mass spectrometry. The daily excretion of bile acids in urine from healthy subjects was 6.4-11 micro moles. The mixture of bile acids was quite complex and differed from that in bile. About 30 bile acids were identified or partially characterized. Three of these were monosubstituted: lithocholic, allolithocholic, and 3beta-hydroxy-5-cholenoic acids. Fourteen disubstituted bile acids included epimers of deoxycholic, allodeoxycholic, chenodeoxycholic, allochenodeoxycholic, and hyodeoxycholic acids. 3alpha-Hydroxy-12-keto-5beta-cholanoic acid was the major ketonic bile acid and 3beta,12alpha-dihydroxy-5-cholenoic acid was the major unsaturated bile acid in this group. Nine trihydroxy bile acids included cholic and allocholic acids, epimers of these compounds, hyocholic acid, and a 1-hydroxylated bile acid tentatively characterized as 1,3,12-trihydroxycholanoic acid. Cholestatic subjects excreted tetrahydroxycholanoates carrying hydroxyl groups in positions 1, 3, 6, 7, 12, or 23. All monohydroxy and the predominant part of dihydroxy bile acids were present in the monosulfate fraction. Exceptions were 3alpha,12beta-dihydroxy- and 3alpha-hydroxy-12-keto-5beta-cholanoic acids, which were found mainly in the glycine conjugate fraction. Most of the trihydroxy bile acids were nonsulfated, and cholic and norcholic acids were the major unconjugated bile acids. The tetrahydroxy bile acids and hyocholic acid were present mainly in the taurine conjugate fraction, while 1,3,12-trihydroxycholanoic acid was predominantly found in the glycine conjugate fraction. Sulfation of trihydroxy bile acids was increased in patients with marked cholestasis. All bile acids in the monosulfate fraction were conjugated and carried the sulfate ester group at C-3. Significant amounts of di- and trisulfates were not found. The results indicate selective mechanisms for sulfation, hydroxylation, and renal elimination of bile acid conjugates. Analysis of metabolic profiles of bile acids in urine may be a useful method in studies of the function of organs involved in bile acid metabolism.
Bile Acids and Salts↗
A critical evaluation of the Schiller test in patients before conization.
The results of the Schiller test were recorded in 87 patients before conization and in 100 healthy control women having normal cytologic examinations. Large proportions of quadrants with iodine-unstained areas were found in both the experimental and the control series. In the 87 patients, the histologic examination of the cone specimens revealed false positive Schiller tests in 32 per cent of the patients with unstained quadrants, and false negative tests in 60 per cent of the patients with iodine-stained quadrants. The Schiller test proved to be unreliable in detecting or rejecting dysplasia or carcinoma in situ at the surgical margin of the conization specimens.
Biopsy↗
Influence of the size of cone specimens on postoperative hemorrhage.
To investigate whether the amount of the tissue removed at conization could influence the frequency of postoperative hemorrhage, the size of 221 cone specimens was measured in two different series. The 119 patients in the first series were operated upon mainly during 1972 and the second series of 102 patients mainly during 1973. The cones in Series II were empirically reduced following the technique proposed by Crisp and associates. Actual measurements demonstrated that the specimens in Series II were smaller than in Series I. The frequency of bleeding following conization was 4 per cent in the second series but as high as 21 per cent in the first series. Postconization hemorrhages, however, were unrelated to the size of the individual cone specimens in the different series. The operative technique used in Series II appears to be responsible for the decrease in the amount of postconization hemorrhages.
Adult↗
[The false negative cytological test].
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Carcinoma in Situ↗