OBJECTIVE: To establish guidelines for the management of a pregnancy that is complicated by acute appendicitis. DESIGN: Retrospective study. SETTING: University Hospital, Copenhagen, Denmark. SUBJECTS: 16 patients operated on for symptoms of acute appendicitis during the 15 year period 1974-1988. RESULTS: In 12 patients (75%) the diagnosis was confirmed histologically. ...

Acute severe ventilatory failure from any cause is always a critical emergency. In advanced pregnancy, such an episode is particularly hazardous. The management of a pregnant patient who presented with an acute episode of respiratory distress is described. Although this was though initially to be an asthmatic attack, there was ...

A 7-year-old Indian girl developed complete paralysis of her lower limbs and acute urinary retention 10 days after suffering from mumps. Encephalomyelitis due to mumps was not suspected initially since it is a rare complication of mumps, although relatively well-documented. However, the preceding history of parotitis and the presence of ...

We have studied, by immunohistochemical methods using specific antisera, the development of three glycoproteins of human pancreatic secretion: lipase, carboxyl ester hydrolase (CEH) and the P19 protein (precursor of the non glycosylated protein X or "pancreatic thread/stone protein"). We have compared their development to that of trypsinogens (Tgs) and chymotrypsinogen ...

A case of eruptive xanthomas during two successive pregnancies is reported. These xanthomas developed in association with marked hypertriglyceridemia; complications included severe pancreatitis and acute respiratory distress syndrome. This patient most likely had combined familial hyperlipidemia which usually causes only a modest elevation in plasma lipid levels. However, with the ...

A 34-year-old multigravid woman with symptomatic primary biliary cirrhosis (PBC) of the liver had a successful pregnancy. A healthy baby was born prematurely at 36 weeks of gestation. Six months prior to the conception of this pregnancy, stage III PBC had been diagnosed. Portal hypertension and liver cirrhosis had not ...

We report successful pregnancies in two young women (aged 24 and 20 years) following allogeneic bone marrow transplantation (BMT) for acute non-lymphoblastic leukaemia. Conditioning therapy consisted of cyclophosphamide (120 mg/kg) and total body irradiation (TBI, 12 Gy) in 2 Gy fractions once daily for 6 days or twice daily for ...

The expression and regulation of cytochrome P450IIE1 (CYP2E1) in adult and fetal human liver has been investigated. Three mRNA transcripts of 1.9, 2.7 and 3.8 kb were detected in all adult liver samples after hybridization with a full length cDNA to CYP2E1 whereas no expression was detected in 12 fetal ...

The locomotor rhythm evoked by perineal stimulation in clonidine-treated acute and chronic spinal cats can be produced more easily when the opioid receptor antagonist naloxone is also administered. Naloxone increases the frequency of the locomotor rhythm and decreases the intensity of skin stimulation required for evoking the rhythm. A useful ...

A 29-yr-old patient was diagnosed with acute intermittent porphyria (AIP) during pregnancy. She had a Caesarean section under lidocaine/fentanyl epidural blockade. Because of inadequate analgesia, general anaesthesia was induced with propofol. Postoperatively urinary porphobilinogen excretion (625 mumol.day-1) exceeded the upper limit of normal but no symptoms of porphyria developed. In ...

A structural, ultrastructural, and morphometric study was made of the liver parenchyma of 12 adult tench (Tinca tinca, L.) subjected to acute experimental copper sulfate poisoning. The lesions observed were characterized by the accumulation in the cytoplasm of large amounts of hemoglobinemic pigment produced by intense hemolysis, initially in Kupffer ...

This article discusses two liver diseases that are unique to pregnancy: hepatic rupture and acute fatty liver of pregnancy. Pathophysiology, signs and symptoms, and medical and nursing management during the period of critical illness are addressed for both disorders. Although maternal mortality is associated with these diseases, women often recover ...

A Greek male with acute myeloid leukaemia (AML) developed a pyrexial illness while neutropenic and Trichosporon beigelii was isolated from his skin, blood and urine. This infection appeared to resolve with a rising neutrophil count, but recurred in the next episode of neutropenia. T. beigelii was isolated from an aspirate ...

Dialysis may be needed, either acutely or on a chronic basis, during pregnancy for a variety of reasons. Advances in erythropoietin, transplant, and hormonal therapies may increase the chances of pregnancy in women with chronic renal failure. Providing care to this population of patients is a challenge to nephrology and ...

Acute fatty liver of pregnancy (AFLP) is a potentially fatal disorder that typically complicates the third trimester of pregnancy. Unrecognised, acute fatty liver of pregnancy may rapidly progress to fulminant hepatic failure, disseminated intravascular coagulation, acute renal failure and death. The outcome is highly favourable, with complete hepatic recovery, if ...

A 23-yr-old woman presented in labour and hepatic failure. The clinical diagnosis was acute fatty liver of pregnancy. A Caesarean section was performed under epidural anaesthesia, after correction of a coagulopathy. Epidural anaesthesia was chosen because of the potential deleterious effects of general anaesthesia on liver blood flow and function.

There is an increase in the number of cases of syphilis in pregnancy in the United States. Fetal death may occur in syphilis from acute or chronic infections. A case is presented in which an acute fetal infection occurred. The patient presented at 31 weeks' gestation, with a decrease in ...

Severe hypercalcemia, a potentially life-threatening condition, has been reported rarely during pregnancy. A patient with hypercalcemic crisis associated with excessive ingestion of absorbable calcium antacid was treated successfully with hemodialysis as well as other therapeutic measures, such as saline diuresis. This acute therapy resulted in long-term normalization of maternal calcium ...

Acute renal failure caused from an obstruction by the gravid uterus is a rare complication of pregnancy. Only 13 cases have been reported. We report a case of obstructive acute renal failure in a patient at 34 weeks' gestation with a twin pregnancy complicated by polyhydramnios. The serum creatinine peaked ...

A clinicohistologic study of acute atherosis in late complicated pregnancy was undertaken. Maternal vessels in the placental basal plate, underlying the amniochorial membranes and in placental bed biopsy specimens, were examined histologically. The earliest histologically convincing lesion acceptable as acute atherosis was fibrinoid necrosis with a perivascular mononuclear cell infiltrate, ...

Plasma beta-endorphin levels (PBEL) are known to be elevated in acutely injured adults, but this has not been studied in pediatric patients with trauma. We measured PBEL in 46 children who sustained blunt injury. The mean acute PBEL was significantly elevated compared with the mean convalescent PBEL (40.5 +/- 29.0 ...

During pregnancy, up to 90 percent of women have some degree of asymptomatic dilatation of the renal calyces, the renal pelves and the upper two-thirds of the ureters. Such changes occur in the face of increased renal blood flow and are well tolerated. However, the dilatation may be responsible for ...

During the 26th week of a first pregnancy, a 25-year-old woman presented with pruritus suggesting an intrahepatic cholestasis of pregnancy. The pruritus, however, persisted despite the premature delivery of a normal newborn at the 35th week. Moreover, aspartate aminotransferase activity increased, reaching a maximum of 38 times normal level on ...

A case of intra-hepatic pregnancy is reported. The patient was 32 years old and presented with an acute intra-abdominal hemorrhage. At surgery a spongy 3 x 2 x 1.5 cm mass was removed from the right liver lobe. Microscopically, well developed chorionic villi appeared invading the liver tissue. The patient ...

A case of a 29-year-old woman who has had two episodes both clinically and biochemically consistent with acute fatty liver of pregnancy is described. These episodes occurred in two successive pregnancies, and liver biopsy confirmed the diagnosis in the second pregnancy. Both pregnancies were managed by prompt fetal delivery; on ...

This study investigates the relationships between the incidence and degree of echogenicity of fetal livers and some prognostic variables of pregnancy. This was done by measuring and evaluating the echogenicity of the fetal liver on sonograms and then comparing the degree of echogenicity to tabulations of the incidence of each ...

A team approach combining the skills of obstetrician, internist, and surgeon is required to optimize care for both woman and fetus if an acute surgical event should occur. A well-prepared team can save many pregnancies and reduce both maternal and fetal risk. The challenge of this dual-patient event is a ...

Acute macular neuroretinopathy is a rare disease that has been described mainly in women taking hormonal contraceptives. An association either with a viral illness or with the parenteral use of sympathomimetics was sometimes found. We describe its occurrence in a 22-year-old female following an anaphylactic shock after a bee sting, ...

Appendicitis occurring during pregnancy presents a difficult problem for both the treating gynecological and the surgeon. We studied retrospectively the cases of 52 consecutive patients seen during a four-year period at Riyadh Central Hospital, a large and busy general hospital. The incidence of appendicitis in various stages of pregnancy, along ...

The authors have analysed the relationship between 137Cs radioactivity and pregnancy in cattle with radiometric analysis of muscle, kidney and liver of 24 cattle at various stages of pregnancy, fed with fodder exposed to radioactive fall-out. Also the relative fetal muscle, kidney, liver and myocardium have been analysed. The automatic ...

Severe pregnancy-induced hypertension and markedly elevated levels of serum alkaline phosphatase developed in a 29-year-old-woman in whom one pregnancy resulted in intrauterine death. Acute fatty liver of pregnancy developed with good fetal outcome in the next pregnancy. This case suggests that pregnancy-induced hypertension and acute fatty liver of pregnancy are ...

Adnexal torsion of enlarged ovaries during early pregnancy is an infrequent but serious complication of menotropin therapy. Over 4 years, we encountered four cases of adnexal torsion among 648 menotropin-induced pregnancies. Multiple gestation may be a predisposing factor. The history of exogenous gonadotropin use, the acute clinical presentation, and the ...

The first reported case of recurrent acute fatty liver of pregnancy confirmed by biopsy is described. In this case a high index of suspicion led to an early diagnosis and intervention with resultant improved maternal and fetal outcome. Electron microscopic examination of a liver biopsy specimen proved more beneficial in ...

Acute fatty liver of pregnancy is associated with complications that can influence antepartum management and necessitate delivery. To date, liver biopsy has been regarded as the "gold standard" for diagnosis. Radiologic evaluation of the liver has been suggested as a less invasive means of diagnosing this entity. Five patients with ...

Five female patients, ranging in age between 22 and 36 years, presented with myelodysplastic syndromes during pregnancy between June 1982 and March 1987. Three of these five cases evolved into acute leukemia. A bone marrow transplant was attempted in the fourth. It is suggested that the association of myelodysplastic syndromes ...

Ninety pregnant women admitted to the high-risk pregnancy unit with a diagnosis of acute pyelonephritis were randomized to receive either oral (cephalexin 500 mg every 6 hours) or intravenous (IV) (cephalothin 1 g every 6 hours) antibiotic therapy. All patients were initially hydrated with 1 L of normal saline IV ...

Three patients in their 20s suffered from chickenpox while in an immunocompromised state: one in pregnancy, one during a long course of corticosteroid for severe nephrotic syndrome, and the third with repeated upper airway infection due to bronchiectasis. They developed acute retinal necrosis about three weeks after the onset of ...

Extrahepatic biliary obstruction by gallstones during pregnancy is a difficult management problem. We present five patients--four with acute cholangitis and one with gallstone pancreatitis--in whom a surgical procedure was avoided by endoscopic sphincterotomy. All five women delivered healthy babies at term. Endoscopic retrograde cholangiopancreatography and sphincterotomy can be performed safely ...

Pregnancy is associated with altered liver function, particularly in serum enzymes. Anabolic steroids are responsible to some degree in mediating the physiologic and biochemical changes that occur during an uncomplicated pregnancy. However, several liver disorders are unique to pregnancy and include intrahepatic cholestasis of pregnancy, acute fatty liver of pregnancy, ...

The purpose of this study was to evaluate the capacity of specific anti-digoxin Fab fragments to bind to and neutralize scilliroside and proscillaridin in acute poisoning. Apparent affinity constants were determined with values of 2.6 10(8)M-1 for scilliroside and 3.8 10(7)M-1 for proscillaridin. These results are in accordance with a ...

The expression of four integral membrane glycoproteins was examined in detail utilizing monospecific antibodies during liver development. These included asialoglycoprotein receptor, a hepatocyte glycoprotein residing in the sinusoidal domain, and three bile canalicular glycoproteins, leucine aminopeptidase, dipeptidyl peptidase IV, and a Mr 110,000 glycoprotein denoted GP 110. It was observed ...

The porphyrias are inherited disorders of haem metabolism, acute attacks of which may be precipitated by anaesthesia, surgery and pregnancy. The principal clinical feature of the disease is an acute neuropathy. A patient with acute intermittent porphyria was given bupivacaine as part of a regional anaesthetic for Caesarean section. The ...

We report three pregnancies with successful outcomes in two women following allogeneic bone marrow transplantation (BMT) for acute leukaemia using high dose melphalan alone as conditioning therapy. The increasing application and success of BMT together with the instigation of conditioning regimens that do not include total body irradiation should increase ...

Application of Stewart-Hamilton's formula to the activity-time curve recorded over a left ventricular region of interest following an intravenous bolus injection of a radioactive indicator in gamma camera hepatography has resulted in a new method for determination of the clearance rate constant of the indicator (i.e. the ratio of the ...

Liver disease in pregnancy is uncommon, acute viral hepatitis being the most frequent. The latter has a normal prognosis in pregnancy, with the possible exception of NANB hepatitis in India and North Africa. Immunization of neonates born of mothers suffering from acute or chronic HBV is essential and effective. Acute ...

Megakaryocytes of the yolk sac, liver and bone marrow were cytometrically observed by light microscopy using semithin plastic sections. In the yolk sac at 10 and 11 days of gestation, megakaryocytes contained an irregularly round nucleus and clearly stained short lines corresponding to the demarcation membranes. All yolk sac megakaryocytes ...

To evaluate gonadal function and pregnancy outcome after treatment for acute lymphoblastic leukemia during childhood or adolescence, 44 former patients who were less than 20 years of age at diagnosis, 5 or more years from diagnosis, and 18 or more years of age were contacted. Thirty-nine (88%) provided information regarding ...

Acute appendicitis is the commonest nongynaecological surgical problem occurring during pregnancy. Almost 10 year's experience at a large teaching hospital is supplemented with an extensive review of the literature to offer guidelines for diagnosis and management. Symptoms, signs and investigations are unhelpful in diagnosis. The overwhelming message is that because ...

The neurohumoral changes induced by electroconvulsive therapy (ECT) in pregnancy have not been described previously. In the nonpregnant adult, ECT causes an acute rise in prolactin, adrenocorticotropic hormone (ACTH), cortisol, norepinephrine, epinephrine and beta-endorphin. Because pregnancy alters the production and release of these hormones, consideration should be given to how ...

As increasing numbers of children and adults with leukemia have become long-term survivors, the impact of an existing pregnancy on leukemia treatment, as well as the significance of prior leukemia therapy on future pregnancies, have become sources of concern. The information presently available, derived from small, retrospective series or case ...