The presence of pinopodes in the human endometrium does not delineate the implantation window.

Objective: To assess pinopode formation in human endometrium during the luteal phase of the menstrual cycle and in the first trimester of pregnancy.

Design: Prospective clinical study.

Setting: Outpatient infertility clinics and outpatient family planning clinic.

Laparoscopic ultrasound-guided radiofrequency ablation of uterine fibroids.

Four patients with symptomatic uterine fibroids measuring less than 6 cm underwent laparoscopic ultrasound-guided radiofrequency ablation (RFA) using multiprobe-array electrodes. Follow-up of the treated fibroids was performed with gadolinium-enhanced magnetic resonance imaging (MRI) and patients' symptoms were assessed by telephone interviews. The procedure was initially technically successful in 3 of the 4 patients and MRI studies at 1 month demonstrated complete fibroid ablation.

Perinatal factors associated with the respiratory distress syndrome.

Perinatal factors related to the incidence of respiratory distress syndrome were analyzed by the multiple logistic regression statistical method in 263 mothers and their 298 offspring delivered between 24 and 35 weeks' gestation in a 1-year period in a regional referral perinatal center. The risk of respiratory distress syndrome in white infants rose with decreasing gestational age (p less than 0.0001) while prolonged rupture of membranes of greater than 24 hours in the absence of maternal infection (28% of cases) was highly protective (p less than 0.

Premature rupture of membranes: the role of C-reactive protein in the prediction of chorioamnionitis.

A group of 52 patients with premature rupture of the membranes (PROM) before 34 weeks' gestation were evaluated prospectively and managed expectantly. Of 42 patients who were delivered of their infants, 26 (61.9%) had significant chorioamnionitis on histopathology, and 18 had positive microbial cultures at delivery.

Short-term antibiotic prophylaxis in high-risk patients following cesarean section.

A prospective, blinded, placebo-controlled study was performed to determine the minimum effective duration of short-term antibiotic prophylaxis following cesarean section. Cefoxitin was selected as the study drug, and 189 women at high risk for postoperative infectious morbidity were randomly assigned to three cohorts, each receiving intravenous infusions at cord clamping and at 4 and 8 hours postoperatively. The incidence of endometritis in the placebo group was 29.

What happened to VIM thalamotomy for Parkinson's disease?

A prospective review of 75 of 190 parkinsonian patients undergoing unilateral thalamotomy was displayed with a computer graphics technique examining three equal consecutive groups from the pre-, early, and late L-dopa eras. Histograms for average function and scattergrams of individual patient's performance preoperatively and up to 2 years postoperatively were prepared. No ipsilateral effects or consistent iatrogenic deterioration of any function were identified.

Twin pregnancies--a continuing perinatal challenge.

A 5-year retrospective analysis of the management of 177 twin pregnancies was undertaken. Despite increased use of bed rest and ultrasonography as currently recommended, the perinatal mortality among twins (13.2%) remained almost 10 times that for singleton births.

Risk factors associated with infection following cesarean section.

A retrospective study by means of multivariant discriminant analysis was performed on 496 deliveries (250 vaginal and 246 cesarean sections) is identify risk factors which predispose to postoperative febrile morbidity, in particular, endometritis. The infection rates for endometritis by type of delivery were: vaginal, 3.6%; elective repeat cesarean section, 6.

The pre-ejection period as an antepartum indicator of fetal well-being.

A preliminary study was made of the potential usefulness of the pre-ejection period (PEP) as an antepartum indicator of fetal well-being. PEP was evaluated in 108 subjects over a 2-year period. It is essential to correct for the effects of heart rate and gestational age on PEP before attempting to relate it ot fetal status.

A new computer technique for continuous measurement of the pre-ejection period in the human fetus: physiologic significance of pre-ejection period patterns.

A new interactive computer graphics system was developed for continuous online or offline measurement of the pre-ejection period (PEP) in the human fetus during both the antepartum and the intrapartum period. A significant feature is the system's ability to accurately measure PEP from the onset of QRS complex to the beginning of aortic opening with a resolution of less than 2 milliseconds. Normal patterns of PEP prolongation were observed with fetal movement and occlusion of the umbilical cord, whereas progressive shortening of PEP was noticed with late decelerations associated with acute hypoxia.

Visual phenomena evoked by electrical stimulation of the human brain stem.

19 visual effects have been elicited out of 9,383 sites during stimulation mapping for physiological localization during stereotactic surgery. It is proposed that three visual pathways can be recognized during subcortical electrical stimulation in man. The optic tract and geniculocalcarine pathway, projecting to area 17, are recognizable by the production of contralateral coloured phosphenes.

Deafferentation and causalgia.

The concept of deafferentation pain has been developed as an entity distinct from somatic pain which can arise in the course of both cancerous and nonmalignant disease. Its distinctive clinical features and responses to diagnostic and therapeutic manipulations have been reviewed. Evidence is marshalled to show that it results from gradually developing alterations in the central nervous system, which, once established, persist despite removal of the original stimulus.

Vestibulothalamic projections in man--a sixth primary sensory pathway.

1. Responses suggesting activation of the vestibular system, elicited by electrical stimulation of the human thalamus during 22 routine stereotaxic neurosurgical procedures, were examined in a retrospective study to determine the possible existence of vestibulothalamo-cortical projections in man. 2.

Quantitative indices of short- and long-term heart rate variability.

Two quantitative indices of heart rate variability are proposed. Instantaneous variability is defined as the average of the absolute value of instantaneous rate differences over a 30 second interval. It is sensitive to short-term variability changes.

Computerized graphic display of physiological data collected during human stereotactic surgery.

An on-line computerized graphic display has been developed for use during stereotactic operations. This depicts in the form of figurine charts and alph-numeric symbols, appropriately oriented on saggital brain diagrams, the results of serial threshold stimulation of the brain. The display facilitates choice of target sites and the data can be stored in a tape library from which search-and-plot programs can be activated for any type or combination of types of response.

Computerized graphic display of results of subcortical stimulation during stereotactic surgery.

An on-line computer programme is described and illustrated which is capable of displaying graphically in the form of Woolsey-type figurine charts stimulation-induced responses obtained during stereotactic surgery. Not only can these data then be optimally utilized for lesion localization but also the programme includes facilities for a variety of types of analysis of the tape-stored data pooled from all patients studied.

Computer mapping of brain-stem sensory centers in man.

A computer program is described for use on-line with a two--stage stereotaxic technique in man. It has four capabilities. It transposes coordinates between a brain atlas and a stereotaxic frame, simultaneously adjusting for variations in individual brain dimensions.

Sensory organization of the human thalamus.

A computerized program has been developed for on-line display and tape-library storage of stimulation-mapping data collected during stereotactic procedures. Using computer-generated displays of pooled clinical physiological data it has been possible to map through the upper midbrain and thalamus the lemniscal, spinoquintothalamic, auditory, vestibular, visual, extrapyramidal, and motor pathways, as well as the location of the pia. Each system is recognizable by a stereotyped, artificial, somatotopically organized stimulation-induced response that is devoid of modality information and independent of the site and parameters of stimulation.

Third ventricular width and the thalamocapsular border.

65 patients were selected to assess variations in third ventricular width. The patients suffered from various extrapyramidal movement disorders, and all had undergone stereotactic VL thalamotomies. Third ventricular width was correlated with age, sex, diagnosis and intercommissural distance.