Biomedical subjects
Publications and source records attributed to S T Liang.
Ultrasound was useful for the diagnosis of advanced pregnancy in the non-communicating rudimentary horn of a bicornuate uterus. The role of ultrasonography in early diagnosis of this condition in order to improve fetal salvage was discussed.
The occurrence of Hb H hydrops fetalis is reported for the first time. The mother has zeta-alpha thalassemia 1 (zeta zeta alpha alpha/----) and the father has non-deletion alpha thalassemia [zeta zeta alpha alpha/zeta zeta (alpha alpha)T]. The complete deletion of the zeta alpha cluster on one chromosome was confirmed by quantitation of alpha and zeta gene numbers, the normal alpha and zeta gene patterns arising from the remaining normal chromosome, and the decreased alpha/beta globin chain ratio of 0.57. The non-deletion alpha thalassemia defect could only be identified by the imbalanced alpha/beta globin chain ratio of 0.65 in the presence of normal gene numbers and patterns. The newborn was markedly anemic, unlike those with classical Hb H disease, because the non-deletion alpha thalassemia defect is more severe than alpha thalassemia 2. The decreased zeta genes during fetal life might have additional deleterious effects. In this family, the distinct BamHI restriction fragment length polymorphism in the hypervariable region of the zeta genes may be used for future prenatal diagnosis.
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The efficacies of ultrasonic abdominal circumference (AC) and abdominal area (AA) measurements in the evaluation of intrauterine fetal growth were compared. The intraobserver random and technical errors were found to be significantly higher with AA measurements. The correlation with intrauterine fetal weight was observed to be better with AC as compared with AA measurements, the fetal weights being expressed as either linear regressions or multiple regressions involving the two parameters. Between 32 and 38 weeks, a single AC measurement detects 74 per cent of small-for-date fetuses, while a single AA measurement detects only 58 per cent of such fetuses. The false-positive rates were similar for the two parameters. It is concluded that AA measurements are no more useful than AC measurements in the routine assessment of intrauterine fetal growth.
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The effect of a prostaglandin E1 analogue on the cervix prior to termination of first trimester pregnancy was studied in a double-blind placebo-controlled trial with 70 primigravid and 125 multigravid patients in the Hong Kong University Gynaecological Unit. One mg of 16, 16-dimethyl-trans-delta 2-prostaglandin E1 methyl ester (ONO 802) in the form of vaginal pessary was inserted 3 hours before vacuum aspiration. The cervical dilatation in patients receiving ONO 802 pessaries was significantly greater than that in patients who received no treatment or placebo pessaries but the difference in dilatation between patients who received no treatment or placebo was not significant. The blood loss during operation in patients receiving ONO 802 pessaries was also significantly less than that in patients receiving placebo pessaries. The side effects due to ONO 802 pessaries were mild and infrequent.
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Ultrasonography is a reliable method in the detection of free fluid in the abdomen. In 2 patients with severe pre-eclampsia, maternal ascites was diagnosed by ultrasound. Both babies were delivered prematurely by Caesarean section, indicated by deteriorating maternal condition. One of the babies died in the early neonatal period. The sonologist should be aware of the possible presence of peritoneal free fluid in patients with severe pre-eclampsia, and be able to demonstrate this accordingly in the ultrasonogram.
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