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Biomedical subjects

S Ballas

Publications and source records attributed to S Ballas.

At least 19 recordsLinked to original sources
PubMed1992

Intrauterine PGF2 alpha infusion for termination of pregnancies with second-trimester rupture of membranes.

Intrauterine prostaglandin (PG) F2 alpha infusion and intravenous (IV) oxytocin infusion were compared to evaluate the effectiveness of the two methods for termination of pregnancies with second-trimester rupture of membranes. Twenty-two women with this complication were randomly allocated to receive either 20 mg PGF2 alpha, diluted in 500 mL of NaCl 0.9% and administered through a Foley catheter inserted through the cervix, or IV oxytocin infusion in increasing doses. All subjects in the PGF2 alpha group aborted after the first administration. Repeat infusion was necessary in three oxytocin-treated subjects. The mean (+/- SD) induction-abortion interval was significantly shorter in those receiving PGF2 alpha (6.7 +/- 1.2 hours) than in those receiving oxytocin (8.8 +/- 2.7 hours). Minor side effects, such as nausea and vomiting, were observed in three women during PGF2 alpha infusion and were treated symptomatically and by temporary interruption of the infusion. Uterine hypertonus, observed in one subject in each group, was treated by temporary cessation of the infusion. We conclude that intrauterine PGF2 alpha infusion seems more effective than IV oxytocin for termination of pregnancies with second-trimester rupture of membranes.

Abortion, Therapeutic↗
PubMed1988

Facilitation of Hb S polymerization by the substitution of Glu for Gln at beta 121.

In an effort to clarify the role of Glu-beta 121 of Hb S molecules in polymerization, we studied the solubility and kinetics of polymerization of various mixtures of deoxyhemoglobins S (Glu-beta 6----Val) and D Los Angeles (Glu-beta 121----Gln). It is known that patients with Hb S-D Los Angeles have a relatively severe clinical course. Mixtures of Hb S and Hb D Los Angeles polymerized after a distinct delay time, the length of which depended on the initial hemoglobin concentration and the fraction of Hb S in the mixture. There was a linear relationship between the logarithmic plot of delay time and initial hemoglobin concentration. The line for a 1:1 mixture of Hb S and Hb D Los Angeles shifted to the right of that for deoxy-Hb S by 0.08. This shift is much smaller than the shift of 0.32 for 1:1 AS mixtures. From these data, the probability factor for nucleation of S-D Los Angeles hybrid hemoglobin was calculated to be 1.16, which is higher than that of Hb S (1.0) and AS hybrid hemoglobin (0.5). The degree of co-polymerization of Hb D Los Angeles in S-D Los Angeles mixtures was similar to that of Hb A in AS mixtures. The critical concentration for the polymerization of Hb D Los Angeles was between that of Hb A and Hb Machida, which has the same amino acid substitution (Glu----Gln) at the beta 6 position. These results suggest that the protein interaction of Hb S molecules during nucleation involves at least two steps. First, the Val-beta 6 of a Hb S molecule interacts hydrophobically with the Phe-beta 85 and the Leu-beta 88 of an adjacent Hb S molecule. In the second step, Glu-beta 121 weakens the interaction with His-beta 116 and Pro-alpha 114. The substitution of Glu-beta 121----Gln may strengthen this second reaction and facilitate nucleation as well as polymerization.

Glutamates↗
PubMed1988

Breast electrostimulation for the induction of labor.

The use of breast stimulation to promote cervical ripening and initiate labor has been studied frequently. However, the various mechanical methods that have been suggested cannot be adequately controlled by the physician. We studied breast electrostimulation as a controllable method of initiating labor in 21 women. This technique successfully induced labor in 15 women, including all nine with premature rupture of membranes. The six (of 12) women without premature rupture of membranes who failed to go into labor each had a Bishop score of 4 or less. All of the successfully induced women delivered vaginally. The time interval from the start of stimulation to birth ranged from 2-13.5 hours, and all infants were born in good condition. Uterine hyperactivity occurred in five cases, but was controlled easily by adjusting the electrical variables of the stimulation. Further work will be needed to establish clearly the indications and safety of breast electrostimulation for induction of labor.

Breast↗
PubMed1979

Midtrimester placenta previa: normal or pathologic finding.

During the years 1974-1977 ultrasonic placentography demonstrated midtrimester placenta previa (MTPP) in 123 women. The procedure was performed because of vaginal bleeding in 65 cases and prior to amniocentesis in 58 asymptomatic cases. Eighty-eight patients were found to have grade I placenta previa (PP), 12 to have grade II, 14 to have grade III, and 9 patients to have grade IV PP. These different variants of PP were correlated with the ultimate outcome of these pregnancies: Bleeding due to PP or PP at term were reasons for cesarean section in 4 cases of grade I PP, in 2 cases of grade II, in 7 cases of grade III, and in 7 out of 9 cases of grade IV PP. Among those patients who had grades III and IV PP, 13 out of 23 had premature or immature deliveries. These results suggest that finding of MTPP, especially symptomatic MTPP, should alert the physician to the clinical significance of PP later in pregnancy.

Cesarean Section↗
PubMed1979

Early cervical pregnancy: ultrasonic diagnosis and conservative treatment.

Five cases of cervical pregnancy collected over an 8-year period (1971--1978) are analyzed. The incidence of cervical pregnancy at this institution is 1:7040 pregnancies. All cases were diagnosed prior to 12 weeks' gestation, and conservative treatment was instituted in each case. Etiology, criteria, definition, and clinical and pathologic signs are discussed. Several unusual features are emphasized, particularly conservative treatment and the use of ultrasound as a diagnostic aid.

Adult↗
PubMed1978

Traumatic hypomenorrhea-amenorrhea (Asherman's syndrome).

Traumatic damage to the endometrium (corporeal adhesions) and/or to the cervical internal os (cervical stenosis or atresia) may cause hypomenorrhea-amenorrhea, the only sign of Asherman's syndrome. We demonstrated a close correlation between severity of menstrual insufficiency and extent of corporeal adhesions. Minor adhesions in the lower part of the uterine cavity, however, may cause severe hypomenorrhea, frequently complicated by dysmenorrhea. Secondary amenorrhea may be due either to complete obliteration of the uterine cavity or to stenosis or atresia of the internal os, as proved by radiologic studies. When amenorrhea is due to stenosis or atresia of the internal os, the ovarian cycle continues but the endometrium becomes refractory to horomonal stimuli, and hematometra does not occur. Simple cervical dilatation restores menstruation within 4 to 5 weeks. The menstrual insufficiency of Asherman's syndrome, therefore, may be explained by two pathophysiology mechanisms: (1) reduction of the endometrial bleeding area and (2) trophic changes and unresponsiveness of the endometrium, perhaps caused by a visceral reflex originating in the area of the internal os.

Adult↗
PubMed1978

Deflexion of the fetal head in breech presentation. Incidence, management, and outcome.

The deflexion attitude of the fetal head in 223 consecutive breech deliveries was radiologically evaluated and classified into four grades. Additional x-ray pelvimetry was performed on all primiparas (136 cases). Extended (35 cases with deflexion angle of 90 degrees or less) and hyperextended (2 cases with angle of more than 90 degrees) variants were found in 16.4%. In the cases of hyperextension, the patients had elective cesarean section, while in cases of other variants they were delivered vaginally in the absence of other indications to cesarean section. The overall cesarean section rate was 17.5%. No cases of perinatal mortality were recorded. Two hundred and sixteen babies had a 1-minute Apgar score of 7--10, 6 had a score of 4--6, and 1 had a score of 2. Only 1 of the 7 asphyxiated babies was of the group of 35 patients classified as having an extended variant. These favorable results confirm the importance of the radiologic assessment of the deflexion angle as a clinical tool.

Apgar Score↗