PubMed Health⌕ Search

Biomedical subjects

S Yarkoni

Publications and source records attributed to S Yarkoni.

At least 37 records · Page 2Linked to original sources

Role of prolonged stimulation of tamoxifen therapy in the etiology of endometrial sarcomas.

We present the first case of heterologous mixed mesodermal tumor that developed 9 years following tamoxifen therapy in a climacteric woman with no previous pelvic irradiation and was initially treated by total abdominal hysterectomy and bilateral salpingo-oophorectomy. She continued tamoxifen therapy for 2 years, following the initial treatment, until the diagnosis of a recurrent tumor by laparotomy. The patient died of the disease 5 months subsequent to the second surgery. The association of prolonged unopposed estrogenic stimulation, with tamoxifen as a possible etiologic factor in the development of endometrial sarcomas, is discussed.

Aged↗

Clinical detection of BCR-abl fusion by in situ hybridization in chronic myelogenous leukemia.

We describe the use of the fluorescence in situ hybridization (FISH) technique to detect residual Philadelphia chromosome-positive (Ph+) cells in a patient with blastic phase chronic myelogenous leukemia (CML) after aggressive cytoreductive treatment. The analysis was made in interphase nuclei because of the very small number of recognizable metaphases in leukemic patients. FISH was a reliable tool for the detection of chromosome translocations in interphase nuclei as compared with conventional cytogenetic and polymerase chain reaction (PCR) techniques.

Adult↗

Fluorescent in situ hybridization for the detection of t(8:14) in Burkitt's lymphoma.

Burkitt's lymphoma cells exhibit the reciprocal balanced chromosomal translocation t(8:14) in 75% of patients. Cytogenetic analysis is time-consuming, requires in vitro culture with mitogens and enables to analyse a relatively small number of cells. We evaluated the role of multicolor fluorescent in situ hybridization (FISH) in the rapid detection of t(8:14) in Burkitt's lymphoma cells. FISH detected the JH/myc translocation in 100% of the cells of five cell lines carrying the classical t(8:14) and in fresh cells obtained from a newly diagnosed Burkitt's lymphoma patient. In contrast, the translocation was not detected in the Bajb cell line that does not carry t(8:14). We conclude that FISH is a rapid and reliable diagnostic tool for the detection of the JH/myc translocation in Burkitt's lymphoma patients.

Biopsy, Needle↗

A prospective longitudinal study of growth in twin gestations compared with growth in singleton pregnancies. I. The fetal head.

Since the available data on growth in twin gestations have been derived from retrospective cross-sectional studies with varying results, a prospective longitudinal study was initiated to assess fetal head growth in twin gestations as compared to singleton pregnancies. In uncomplicated twin gestations, growth of the fetal head, based on the increment in growth over time and the rate of growth throughout pregnancy, was found not to be significantly different than in singleton pregnancies. In light of these findings, current nomograms derived from measurements obtained in singleton pregnancies remain useful for evaluating fetal head growth in twin gestations.

Cephalometry↗

A prospective longitudinal study of growth in twin gestations compared with growth in singleton pregnancies. II. The fetal limbs.

The assessment of fetal growth is crucial in twin gestations, since the information gained often has an impact on pregnancy management. The measurement of the fetal anatomy by ultrasound enables us to follow the growth and development of the fetus. However, the pattern of fetal growth in twin gestations has not yet been precisely characterized in prospective studies. In this light, we initiated a prospective longitudinal study and sonographically examined 35 patients with twin gestations every 3 weeks from the 15th week until delivery. Multiple biometric parameters were measured, including the femur length, humerus length, ulna length, and tibia length. The results of our study showed that growth of these long bones was not significantly different between twins A and B throughout gestation and that the growth velocity between twins and singletons was not significantly different. The incremental growth, although significantly less in twins than in singletons, was so small that it was judged not to be of clinical importance to warrant the generation of separate nomograms for the evaluation of growth in twin gestations.

Anthropometry↗

The value of the leukocyte esterase test in diagnosing intra-amniotic infection.

This communication examines the diagnostic value of the leukocyte esterase activity (LEA) test in the detection of intra-amniotic infection. Amniotic fluid from 171 consecutive patients with premature rupture of membranes (n = 149) and preterm labor (n = 22) was obtained through amniocentesis. Gram stain, bacterial and mycoplasma cultures, and LEA tests were performed. The LEA had a sensitivity of 19%, a specificity of 86.7%, a positive predictive value (PPV) of 42.3% and a negative predictive value (NPV) of 67.6% in the prediction of a positive amniotic fluid culture (prevalence of positive cultures = 33.9%). The Gram stain had a sensitivity of 36.2%, specificity of 94.7%, PPV of 77.8%, and NPV of 74.3%. When both tests were combined, a significant increase in sensitivity to 50% was observed. This was associated with a drop in specificity to 81.4%. There was a correlation between the number of white blood cells in the amniotic fluid and the result of the LEA test. A positive LEA assay was associated with an increased likelihood of postpartum endometritis, but not with clinical chorioamnionitis or neonatal infectious morbidity.

Amniocentesis↗

Intrapartum fetal activity.

Fetal activity throughout pregnancy has been thoroughly studied. Relatively little informations regarding intrapartum fetal activity is available. Richardson et al. [8] found no fetal respiratory movements. While Boylan et al. [2] and Whittman et al. [12] reported decreased fetal breathing movements in active labor. This study was undertaken to evaluate the normal pattern of fetal activity in labor. Fetal movements (FM) and fetal breathing movements (FBM) were monitored by realtime ultrasound during active labor at term. The incidence of FM and FBM were measured in 18 fetuses. Results were correlated with simultaneous fetal heart rate (FHR) changes, postpartum cord blood pH and Apgar score. Recordings were made for one hour on every patient. The mean percentage incidence (PI) of FM was 19.5 per cent (range: 10.1-28.6 percent) and FBM was 8.5 per cent (range: 0-27 percent). All FM were associated with FHR accelerations, stronger movements were associated with higher FHR accelerations. No FHR accelerations were observed with FBM alone, unless accompanied by fetal movement. The lowest PI of total fetal activity (TFA, i.e. FM plus FBM) was 12.1 per cent. Movements decreased as labor progressed, while FBM remained unaltered. All newborns had cord venous blood pH of greater than 7.25 and Apgar scores of greater than or equal to 7, at five minutes. Our data suggest that in the normal uncompromised fetus, FM and FBM continue during labor at term. However, while FM tends to decrease as labor progresses. FBM tends to be constant throughout labor. This finding might indicate the autonomous nature of FBM.(ABSTRACT TRUNCATED AT 250 WORDS)

Apgar Score↗

Sonographic visualization of physiologic anterior abdominal wall hernia in the first trimester.

Ultrasonography is able to detect some fetal abnormalities as early as the first trimester of pregnancy. Using high-resolution ultrasound equipment, it is possible to demonstrate physiologic herniation of the midgut, which usually occurs between eight and nine weeks' gestation (calculated by last menstrual period). Fourteen cases have been studied with weekly ultrasound examinations between seven and 12 weeks' gestation. This herniation varied to a large extent in the different embryos depending on the amount of protruding intestine. In embryologic terms, the return of the intestine into the peritoneal cavity, and its rotation and fixation to the posterior abdominal wall, should be concluded at ten to 12 weeks. In all cases studied, the persistence of umbilical herniation could be ruled out by sonographic visualization of the umbilical cord insertion between ten and 12 weeks. Therefore, the suspicion of a severe congenital abdominal wall defect, such as omphalocele, umbilical herniation, or gastroschisis can reliably be confirmed only after 12 weeks' gestation.

Abdominal Muscles↗

Growth of the fetal stomach in normal pregnancies.

Fetal stomach dimensions were measured sonographically in 152 fetuses with gestational ages ranging from nine to 40 weeks. Nomograms of the mean +/- 2 standard deviations (SD) for the longitudinal, anteroposterior, and transverse diameters of the fetal stomach were generated throughout pregnancy. A linear growth function was observed across gestational age, and a high degree of correlation existed between gestational age and the transverse (r = 0.809, P less than .0001), anteroposterior (r = 0.798, P less than .0001), and longitudinal (r = 0.749, P less than .0001) diameters. These data provide a method by which variations from the norm can be assessed, and offer potential prenatal diagnosis of a variety of gastrointestinal lesions.

Embryonic and Fetal Development↗

Estimated fetal weight in the evaluation of growth in twin gestations: a prospective longitudinal study.

A prospective longitudinal study was conducted in order to determine by sonographically estimated fetal weight the patterns of fetal growth in twins. Thirty-five healthy women with normal twin pregnancies were examined every three weeks from the 15th week of gestation to delivery. Among the measurements obtained were the biparietal diameter (BPD), the abdominal circumference, and the calculated fetal weight. From 15-28 weeks, the growth velocity of the BPD and abdominal circumference remained fairly constant, with a steady increase in incremental growth. Beyond this age, we observed a slowing in growth of the BPD, while the abdominal circumference continued at a constant rate. The growth velocity of the weight steadily increased throughout pregnancy. Although greater biologic variability in weight between twin A and B was observed as gestational age progressed, the overall mean weights of twin A and B were not statistically different. We have generated a nomogram of fetal weight gain throughout pregnancy.

Body Height↗

The value of real time ultrasonography in first trimester termination.

The value of real time ultrasonography (RTUS) in the management of first trimester elective pregnancy terminations was studied in 120 consecutive patients. RTUS was found essential in determining accurate gestational ages, identifying incomplete pregnancy terminations, diagnosing abnormal pregnancies, and in performing difficult terminations. It is suggested that RTUS be employed in the routine management of first trimester pregnancy terminations.

Abortion, Incomplete↗

Intrapartum fetal weight estimation: a comparison of three formulae.

To determine the relative accuracy of fetal weight estimation using the biparietal diameter (BPD), the abdominal circumference (AC), and the femur length (FL) in three formulae (BPD/AC, FL/AC, and BPD/AC/FL), 63 patients in labor were examined. All patients delivered within 24 hours of ultrasound examination. A good correlation was found between the estimated fetal weight and the actual birth weight, using the three formulae: BPD/AC (r = 0.96); FL/AC (r = 0.95); and BPD/AC/FL (r = 0.96). The FL/AC formula overestimated fetal weight (P less than 0.01), however, particularly in fetuses weighing more than 2000 g. The mean percentage error with the BPD/AC formula was 0.99 per cent, 3.82 per cent with the FL/AC, and 2.43 per cent with the BPD/AC/FL formula. This study showed that although all three formulae were comparable, the best estimation of the birth weight was obtained when either the BPD/AC or the BPD/AC/FL formulae were used. Additionally, the results demonstrate that reliable estimates of fetal weight can be made even at term or in laboring patients.

Birth Weight↗

Sonographic measurements of the fetal spleen: clinical implications.

Normal values for fetal spleen dimensions are proposed, including longitudinal, coronal, and transverse diameters, the perimeter, and the estimated volume. Similar values were then obtained in cases of Rh-immunization and prolonged premature rupture of the membranes. A good correlation between amniotic fluid optical density and fetal spleen size was found. Only severely affected fetuses showed splenic values above the upper limit. Since sonographic examination can be regarded as a reliable method, nomograms can be useful in detecting growth disorders of the fetal spleen and thus provide a new complementary method to identify possible fetal diseases of genetic disorders.

Embryonic and Fetal Development↗

Clavicular measurement: a new biometric parameter for fetal evaluation.

Fetal clavicular length was measured sonographically in 85 fetuses with gestational ages ranging from 15 to 40 weeks. Biparietal diameter (BPD) and femur length (FL) were also measured. A linear correlation was found between clavicular length and gestational age (coefficient of correlation = 0.81). A simple relation was found: The gestational age in weeks is approximately equal to the length of the clavicle as expressed in millimeters. The measurement of clavicular length can be a useful parameter for the estimation of gestational age and in the detection of congenital anomalies that affect the clavicles. Clavicular measurements may also prove useful in the detection of macrosomic fetuses at high risk for obstructed labor or shoulder dystocia.

Anthropometry↗

The effect of a prostaglandin synthetase inhibitor, indomethacin, on excessive uterine bleeding.

Indomethacin, a prostaglandin synthetase inhibitor given to 94 women suffering from functional menorrhagia, IUD's and sub mucous fibroid related bleeding, reduced menstrual loss and duration of menstruation in 70 patients (74.5 percent). A significant decrease in duration of menstruation of 2.1 days was obtained in the responding group. In functional bleeding, the mean decrease was 1.7 days, in IUD's related menorrhagia 2.9 days and in menorrhagia due to submucous fibroids 2 days. Age, parity and duration of menstruation before treatment had no significant effect on the response or reduction of duration of bleeding. The medication was discontinued only in two patients because of minor gastronntestinal symptoms.

Adult↗

The relationship between fetal heart rate accelerations, fetal movements, and uterine contractions.

The association between fetal heart rate (FHR) accelerations and fetal movements during uterine contractions was studied in 52 pregnant women near term or at the beginning of labor. FHR and uterine contractions were recorded by tococardiograph. At the same time, fetal movements, whether associated or not with contractions, were viewed by real-time ultrasound. During uterine contractions, 95.5% of the FHR accelerations were associated with fetal movements. Also, 90.9% of the accelerations which appeared when the uterus was not contracting were associated with fetal movements. Fetal movements were not seen in 91% of uterine contractions which were not associated with FHR accelerations. The suggestion is made that uterine contractions stimulate both fetal movements and FHR accelerations.

Female↗