Isolation of Chlamydia trachomatis from amniotic fluid.

A 26-year-old white woman had premature rupture of membranes at 35 weeks' gestation. Cervical specimens initially demonstrated group B streptococci and Chlamydia trachomatis. Amniocentesis was performed and the amniotic fluid was positive for chlamydia by direct fluorescent antibody stain.

Antepartum management of twin gestation: ultrasound.

1. The use of ultrasound may improve perinatal outcome in twin pregnancy. 2.

Antepartum management of twin gestation.

Twin gestation is now an area of vital concern to the perinatologist. Within the last decade a substantial reduction in perinatal mortality has been achieved, largely through advances in neonatal intensive care. However, preterm birth and its consequences remain the most important causes of perinatal morbidity and mortality.

Malignant hypertension presenting as acute pancreatitis.

We report a patient who was admitted to hospital with acute pancreatitis but who also had malignant phase hypertension. Whilst his alcohol intake was high, there was no objective evidence of alcoholic liver disease and no other underlying cause for pancreatitis was found. The pancreatitis may therefore have been due to pancreatic infarctions associated with fibrinoid necrosis.

Hereditary angioedema and immunoglobulin A deficiency in pregnancy.

Hereditary angioedema is a rare immunologic disorder, and immunoglobulin A deficiency is the most common isolated immunodeficiency. These rarely coexisting conditions may affect pregnancy. We report a gravida with the combination who developed severe acute laryngeal edema.

The prenatal sonographic diagnosis of lethal multiple pterygium syndrome: a heritable cause of recurrent abortion.

Presumably, a large number of recurrent abortions are caused by lethal recessive syndromes whose diagnosis depends either on a known family history or on the identification of characteristic fetal phenotypic features on pathologic examination. Because these conditions are rare, family histories are seldom helpful, and nondirected postmortem examinations on degenerating samples are seldom enlightening. Serial ultrasonography beginning early in pregnancy may provide important information in the evaluation of recurrent abortion caused by lethal recessive disorders.

Bulimia nervosa in pregnancy: a case report.

Bulimia nervosa is an eating disorder characterized by secretive binge eating and purging with induced vomiting, laxatives, and diuretics. The disorder primarily afflicts young white women between 18-35 years of age. We report the case of a 30-year-old pregnant woman with a 17-year history of bulimia that involved up to six episodes of binging and purging daily.

Group B streptococcus and preterm rupture of membranes.

The effect of cervical group B streptococcus on the conservative management of preterm premature rupture of membranes was examined in 140 consecutive patients. Upon the patient's admission, we obtained cervical cultures for group B streptococcus, genital mycoplasmas, and chlamydia. Patients with and without group B streptococcus were compared.

Antimicrobial activity of amniotic fluid against Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum.

Amniotic fluids obtained by amniocentesis at 16 weeks to term were examined for the presence of Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum. Of 140 fluids tested, none harbored chlamydiae, and only one harbored mycoplasma, M. hominis.

Mode of delivery in multiple birth of higher order.

A retrospective review of triplets delivered at a Boston perinatal center from 1977 to 1986 was performed. Comparison was made between this group (study group) and previously published data on triplets in our institution (control group). Since 1977 there was a more liberal use of abdominal delivery.

Fetal lung to liver reflectivity ratio and lung maturity.

A pilot study examined 23 patients who underwent simultaneous ultrasound and amniocentesis to determine whether the ratio of densitometrically determined tissue densities of fetal lung and liver correlate with the L/S, the OD 650, or phosphatidylglycerol levels. The incidence of a lung/liver ratio greater than 1 of 65% was similar to that of maturity levels of the standard tests. However, there was no statistically significant correlation between an L/L greater than 1 and/or any maturity parameter tested, nor was there any correlation with the absence of pulmonary maturity.

Ventricular septal rupture with "normal" coronary arteries.

A 73-year-old woman was admitted to St. Margaret's Hospital with a history of an acute anteroseptal infarction, a loud cardiac murmur, and low cardiac output. Cardiac catheterization revealed a large, high ventricular septal defect and normal coronary arteries.

Role of the Phagocyte in Host-Parasite Interactions XXVII. Myeloperoxidase-H(2)O(2)-Cl-Mediated Aldehyde Formation and Its Relationship to Antimicrobial Activity.

Evidence is presented which suggests that the mechanism of action of the myeloperoxidase-H(2)O(2)-Cl(-) antimicrobial system in the phagocyte is by the formation of aldehydes. Aldehyde production resulting from myeloperoxidase-mediated decarboxylation and deamination of alanine was quantitated with 20,000-g granules from guinea pig polymorphonuclear leukocytes serving as the enzyme. Equimolar quantities of acetaldehyde and CO(2) were obtained.

Role of the Phagocyte in Host-Parasite Interactions XXIV. Aldehyde Generation by the Myeloperoxidase-H(2)O(2)-Chloride Antimicrobial System: a Possible In Vivo Mechanism of Action.

Myeloperoxidase (MPO), H(2)O(2), and chloride ions in the presence of bacteria form aldehydes and are bactericidal. The use of heat-inactivated MPO prevented both killing and aldehyde generation. Decarboxylation and deamination of carboxyl and amino group substrates arising from the bacterial surface may participate in the reaction which yields aldehydes.

Function of h(2)o(2), myeloperoxidase, and hexose monophosphate shunt enzymes in phagocytizing cells from different species.

The effect of phagocytosis on the H(2)O(2) production and myeloperoxidase (MPO) activities of leukocytes from various species was investigated. The intracellular distribution of MPO, reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, glucose-6-phosphate dehydrogenase, and 6-phosphogluconate dehydrogenase (6PGDH) of resting and phagocytizing guinea pig polymorphonuclear leukocytes has also been studied. Phagocytizing cells produce more H(2)O(2) than the corresponding resting cells.