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Biomedical subjects

Z Tóth

Publications and source records attributed to Z Tóth.

At least 73 records · Page 4Linked to original sources

Prenatal diagnosis policy without routine amniocentesis in pregnancies with a positive family history for neural tube defects.

The recurrence risk for neural tube defects in pregnancies of women with a family history of neural tube defects greatly exceeds the general population risk. In these high risk pregnancies, we used a prenatal diagnostic method differing from that usually employed, relying mainly on the results of maternal serum alpha-fetoprotein (MSAFP) and ultrasound examination, without routine amniocentesis. During the 6 years reviewed in this study, this method was applied in 539 pregnancies. Of a total of 20 neural tube defects, 19 were detected using this combination of MSAFP, ultrasound, and selective amniocentesis, and the authors estimate that about 8-10 spontaneous abortions were avoided because only 28 amniocenteses were carried out instead of 539. The risk of recurrence was found to be lower than that experienced earlier.

Amniocentesis↗

Investigation of trigeminal SEP with scalp and deep electrodes.

A special technique for stimulating and recording trigeminal somatosensory evoked potential (SEP) is described. Eleven healthy subjects and seven patients with chronically implanted deep electrodes have been investigated. Characteristic polyphasic waves were repeatedly observed. The recording of somatosensory evoked potential following trigeminal stimulation is a more difficult technique. This paper describes data in control subjects with scalp electrodes and data on patients with electrodes in the nucleus ventralis posteromedialis and cortical white matter. Depth recording may provide useful information about the origin, nature, and properties of trigeminal SEP.

Electrodes, Implanted↗

Prenatal diagnosis of X linked hydrocephalus without aqueductal stenosis.

The outcome of four successive pregnancies in a woman heterozygous for X linked hydrocephalus is described. The last two were scanned by ultrasound. In one, a good prognosis was given; the fetus was male but there was no evidence of dilated cerebral ventricles. In the other, hydrocephalus was diagnosed. The absence of aqueductal stenosis in this case supports the hypothesis that in this X linked condition communicating hydrocephalus is the primary defect and aqueductal stenosis is secondary.

Adult↗

Prenatal diagnosis and pathoanatomy of iniencephaly.

The authors discuss the diagnostic criteria of iniencephaly based on data from the literature and eleven additional, new cases. The most important differential diagnostic problems involve anencephaly with spinal retroflexion and the Klippel-Feil syndrome. Ultrasound indicated cranio-spinal alterations while amniotic fluid AFP estimation and exfoliative cytology substantiated abnormal closure of the neural tube, thus comprising helpful means for prenatal diagnosis of iniencephaly. The authors emphasize the need for median-sagittal sectioning through the spinal column for accurate evaluation of vertebral abnormalities. This, together with close observation of the occiput and the foramen magnum, helps the precise diagnosis of iniencephaly and once regularly applied will most likely result in more frequent recognition of this developmental abnormality.

Abnormalities, Multiple↗

Exencephaly in human fetuses.

In some anencephalic fetuses exposed neural tissue mass of varied size can be demonstrated. This is known as exencephaly. The authors diagnosed by ultrasound 10 typical exencephalic cases prenatally between 14 and 21 weeks of gestation. Nine singular pregnancies were terminated and in the twin pregnancy a selective feticide of the exencephalic co-twin was carried out. The pregnancy continued to term and a healthy newborn infant and a fetus papyraceus were born. The mummified co-twin was anencephalic and showed only the remnants of the exposed brain. Authors suggest that, as in experiments with animals, the exencephaly in humans, by the degeneration of the exposed neural tissue converts to anencephaly and in this process the macrophages in fetal circulation and in the amniotic fluid may play a significant role. The large number of these actively phagocytic macrophages can be demonstrated in the amniotic fluid samples from exencephalic fetuses.

Amniotic Fluid↗

Fetal malformation and serum alpha-fetoprotein concentration of diabetic mothers.

Diabetic pregnant patients belong to a high-risk group from a genetic counselling point of view. Therefore serum AFP estimation and ultrasound examination was carried out in 36 diabetic pregnancies, between the 16-20 gestational weeks. Healthy infants were delivered in 28 cases, fetal malformations or diseases were diagnosed in 3 cases (2 exencephaly and 1 polycystic kidney disease), 5 pregnancies ended up with stillbirth and/or severe fetopathy. According to our findings, the feto-maternal AFP balance is altered in poorly controlled diabetic pregnant patients. Therefore the maternal serum AFP concentration does not always reflect the AFP content of amniotic fluid. It is supposed that the low serum AFP concentration in diabetic patients is due to the disturbed AFP balance, which cannot be observed in well controlled pregnant diabetics. In the pregnancy of diabetic mothers both serum AFP and ultrasound examination should be carried out. With further improvement in the preconceptional treatment of diabetic patients not only the number of malformations caused by hyperglycaemia should diminish, but the problems of false negative and false positive serum AFP values caused by the disturbance in carbohydrate metabolism should also become less frequent.

Abnormalities, Multiple↗

Examination of the uterine cervix by ultrasound in normal and pathologic pregnancy.

New possibilities of examination of the uterine cervix are provided by sonography in normal and pathologic pregnancy. Basic data of the ultrasonographic anatomy of the non pregnant uterine cervix is presented first: the length of the cervix as well as the diameters at the levels of external and internal os. These data are compared then with those in normal, physiologic pregnancy, and contrasted with those obtained in cases of incompetent cervix. In this group shortening of the cervical length, opening of the internal os and the funnel, or hour-glass-like herniation of the fetal membranes were characteristic findings. The method seems to be suitable for the assessment of the effectivity of cerclage operations for cervical incompetence.

Cervix Uteri↗

Ultrasound surveillance of pregnancies after metroplasty for septate uterus.

Metroplasties were performed on twenty three septate uterus associated with recurrent reproductive wastage (19 cases) or primary infertility (4 cases). The surgical procedure and ultrasound monitoring of pregnancies conceived postoperatively are reported. Eighteen pregnancies occurred in sixteen patients; fourteen ended in live birth and four spontaneous abortions, including two blighted ova and one mole occurred. It appears from the results that uterine anomalies are rarely the sole cause of primary infertility; therefore, selection of patients is emphasized.

Cesarean Section↗