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1.
Rev Sci Instrum ; 83(10): 10E525, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23127032

RESUMO

Hohlraums are employed at the national ignition facility to convert laser energy into a thermal x-radiation drive, which implodes a fusion capsule, thus compressing the fuel. The x-radiation drive is measured with a low spectral resolution, time-resolved x-ray spectrometer, which views the region around the hohlraum's laser entrance hole. This measurement has no spatial resolution. To convert this to the drive inside the hohlraum, the size of the hohlraum's opening ("clear aperture") and fraction of the measured x-radiation, which comes from this opening, must be known. The size of the clear aperture is measured with the time integrated static x-ray imager (SXI). A soft x-ray imaging channel has been added to the SXI to measure the fraction of x-radiation emitted from inside the clear aperture. A multilayer mirror plus filter selects an x-ray band centered at 870 eV, near the peak of the x-ray spectrum of a 300 eV blackbody. Results from this channel and corrections to the x-radiation drive are discussed.

2.
Phys Rev Lett ; 106(8): 085003, 2011 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-21405579

RESUMO

The first soft x-ray radiation flux measurements from hohlraums using both a 96 and a 192 beam configuration at the National Ignition Facility have shown high x-ray conversion efficiencies of ∼85%-90%. These experiments employed gold vacuum hohlraums, 6.4 mm long and 3.55 mm in diameter, heated with laser energies between 150-635 kJ. The hohlraums reached radiation temperatures of up to 340 eV. These hohlraums for the first time reached coronal plasma conditions sufficient for two-electron processes and coronal heat conduction to be important for determining the radiation drive.

3.
Rev Sci Instrum ; 81(10): 10E321, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21034019

RESUMO

The first 96 and 192 beam vacuum Hohlraum target experiments have been fielded at the National Ignition Facility demonstrating radiation temperatures up to 340 eV and fluxes of 20 TW/sr as viewed by DANTE representing an ∼20 times flux increase over NOVA/Omega scale Hohlraums. The vacuum Hohlraums were irradiated with 2 ns square laser pulses with energies between 150 and 635 kJ. They produced nearly Planckian spectra with about 30±10% more flux than predicted by the preshot radiation hydrodynamic simulations. To validate these results, careful verification of all component calibrations, cable deconvolution, and software analysis routines has been conducted. In addition, a half Hohlraum experiment was conducted using a single 2 ns long axial quad with an irradiance of ∼2×10(15) W/cm(2) for comparison with NIF Early Light experiments completed in 2004. We have also completed a conversion efficiency test using a 128-beam nearly uniformly illuminated gold sphere with intensities kept low (at 1×10(14) W/cm(2) over 5 ns) to avoid sensitivity to modeling uncertainties for nonlocal heat conduction and nonlinear absorption mechanisms, to compare with similar intensity, 3 ns OMEGA sphere results. The 2004 and 2009 NIF half-Hohlraums agreed to 10% in flux, but more importantly, the 2006 OMEGA Au Sphere, the 2009 NIF Au sphere, and the calculated Au conversion efficiency agree to ±5% in flux, which is estimated to be the absolute calibration accuracy of the DANTEs. Hence we conclude that the 30±10% higher than expected radiation fluxes from the 96 and 192 beam vacuum Hohlraums are attributable to differences in physics of the larger Hohlraums.

4.
Rev Sci Instrum ; 81(10): 10E538, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21034065

RESUMO

The static x-ray imager at the National Ignition Facility is a pinhole camera using a CCD detector to obtain images of Hohlraum wall x-ray drive illumination patterns seen through the laser entrance hole (LEH). Carefully chosen filters, combined with the CCD response, allow recording images in the x-ray range of 3-5 keV with 60 µm spatial resolution. The routines used to obtain the apparent size of the backlit LEH and the location and intensity of beam spots are discussed and compared to predictions. A new soft x-ray channel centered at 870 eV (near the x-ray peak of a 300 eV temperature ignition Hohlraum) is discussed.

5.
Science ; 327(5970): 1228-31, 2010 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-20110465

RESUMO

Indirect-drive hohlraum experiments at the National Ignition Facility have demonstrated symmetric capsule implosions at unprecedented laser drive energies of 0.7 megajoule. One hundred and ninety-two simultaneously fired laser beams heat ignition-emulate hohlraums to radiation temperatures of 3.3 million kelvin, compressing 1.8-millimeter-diameter capsules by the soft x-rays produced by the hohlraum. Self-generated plasma optics gratings on either end of the hohlraum tune the laser power distribution in the hohlraum, which produces a symmetric x-ray drive as inferred from the shape of the capsule self-emission. These experiments indicate that the conditions are suitable for compressing deuterium-tritium-filled capsules, with the goal of achieving burning fusion plasmas and energy gain in the laboratory.

6.
Rev Sci Instrum ; 79(10): 10E303, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19044465

RESUMO

A novel time, space, and energy-resolved x-ray spectrometer has been developed which produces, in a single snapshot, a broadband and relatively calibrated spectrum of the x-ray emission from a high-energy density laboratory plasma. The opacity zipper spectrometer (OZSPEC-1) records a nearly continuous spectrum for x-ray energies from 240 to 5800 eV in a single shot. The second-generation OZSPEC-2, detailed in this work, records fully continuous spectra on a single shot from any two of these three bands: 270-650, 660-1580, and 1960-4720 eV. These instruments thus record thermal and line radiation from a wide range of plasmas. These instruments' single-shot bandwidth is unmatched in a time-gated spectrometer; conversely, other broadband instruments are either time-integrated (using crystals or gratings), lack spectral resolution (diode arrays), or cover a lower energy band (gratings). The OZSPECs are based on the zipper detector, a large-format (100x35 mm) gated microchannel plate detector, with spectra dispersed along the 100 mm dimension. OZSPEC-1 and -2 both use elliptically bent crystals of OHM, RAP, and/or PET. Individual spectra are gated in 100 ps. OZSPEC-2 provides one-dimensional spatial imaging with 30-50 microm resolution over a 1500 microm field of view at the source. The elliptical crystal design yields broad spectral coverage with resolution E/DeltaE>500, strong rejection of hard x-ray backgrounds, and negligible source broadening for extended sources. Near-term applications include plasma opacity measurements, detailed spectra of inertial fusion Hohlraums, and laboratory astrophysics experiments.

7.
Transplant Proc ; 40(2): 638-40, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18374150

RESUMO

Interleukin (IL)-4 has been shown to induce protection in porcine vascular endothelial cells (ECs) from killing by human complement. This protection is dependent on the PI3K/Akt signaling pathway. In this study, we investigated mechanisms downstream of Akt and found that activation of the lipid biosynthesis pathway is required for protection from complement in ECs treated with IL-4. Cells incubated with IL-4 for 48 hours contained increased fatty acids and phospholipids but cholesterol was not increased when compared with medium-treated controls. The transcription factor SREBP-1, which regulates fatty acid synthesis, was found to be activated in extracts of ECs incubated with IL-4 for 6 hours. Finally, induction of protection from complement killing with IL-4 was fully prevented by the presence of the SREBP inhibitor 25-OH cholesterol. This study showed that IL-4 induces lipid biosynthesis in porcine ECs through activation of SREBP-1 and that the activation of this pathway is critical for IL-4 to induce protection of porcine ECs from killing by human complement. Further study of these mechanisms may provide new strategies for the prevention of complement-mediated vascular injury as it occurs in xenograft rejection.


Assuntos
Proteínas do Sistema Complemento/fisiologia , Endotélio Vascular/metabolismo , Ácidos Graxos/biossíntese , Interleucina-4/farmacologia , Animais , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Endotélio Vascular/citologia , Endotélio Vascular/efeitos dos fármacos , Lecitinas/biossíntese , Espectroscopia de Ressonância Magnética , Fosfatidilgliceróis/biossíntese , Proteína de Ligação a Elemento Regulador de Esterol 1/metabolismo , Suínos
8.
Phys Rev Lett ; 99(19): 195001, 2007 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-18233081

RESUMO

We present a series of benchmark measurements of the ionization balance of well-characterized gold plasmas with and without external radiation fields at electron densities near 10{21} cm{-3} and electron temperatures spanning the range 0.8 to 2.4 keV. We have analyzed time- and space-resolved M-shell gold emission spectra using a sophisticated collisional-radiative model with hybrid level structure, finding average ion charges Z ranging from 42 to 50. At the lower temperatures, the spectra exhibit significant sensitivity to external radiation fields and include emission features from complex N-shell ions. The measured spectra and inferred Z provide a stringent test for non-local-thermodynamic-equilibrium models of complex high-Z ions.

9.
Phys Rev Lett ; 96(19): 195001, 2006 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-16803105

RESUMO

A hot radiation environment, produced by maximizing laser-energy deposition into a small, high- "can," is a platform being developed for investigations of material properties under extreme conditions. In such small targets, almost doubling the laser energy results in only an incremental increase in the x-radiation flux, and almost no increase in the maximum achieved radiation temperature. That most of this additional laser energy is not deposited within the target is a direct consequence of laser-plasma interactions (LPI) outside of the target, which result in high-angle beams never entering the target late in the laser pulse. Accounting for these processes in the modeling results in quantitative agreement for the first time with experiments using very small cans. These findings have provided the scientific foundation for modifying the target geometry to mitigate the LPI and to achieve higher radiation temperatures.

10.
Phys Rev Lett ; 95(21): 215004, 2005 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-16384150

RESUMO

The first hohlraum experiments on the National Ignition Facility (NIF) using the initial four laser beams tested radiation temperature limits imposed by plasma filling. For a variety of hohlraum sizes and pulse lengths, the measured x-ray flux shows signatures of filling that coincide with hard x-ray emission from plasma streaming out of the hohlraum. These observations agree with hydrodynamic simulations and with an analytical model that includes hydrodynamic and coronal radiative losses. The modeling predicts radiation temperature limits with full NIF (1.8 MJ), greater, and of longer duration than required for ignition hohlraums.

11.
Am J Physiol Endocrinol Metab ; 288(2): E298-306, 2005 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15367395

RESUMO

Compensatory adrenal growth after unilateral adrenalectomy (ULA) leads to adrenocortical hyperplasia. Because zonal growth contributions are not clear, we characterized the phenotype of cortical cells that proliferate using immunofluorescence histochemistry and zone-specific cell counting. Rats underwent ULA, sham adrenalectomy (sham), or no surgery and were killed at 2 or 5 days. Adrenals were weighed and sections immunostained for Ki67 (proliferation), cytochrome P-450 aldosterone synthase (P450aldo, glomerulosa), and cytochrome P-450 11beta-hydroxylase (P45011beta, fasciculata). Unbiased stereology was used to count proliferating glomerulosa and fasciculata cells. Adrenal weight increased after ULA compared with sham and no surgery at both time points, and there was no difference between sham and no surgery. However, either ULA or sham increased Ki67-positive cells in the outer fasciculata at both time points compared with no surgery. Outer fasciculata-restricted proliferation is thus associated with adrenal weight gain in ULA but not sham. Experiment repetition using proliferating cell nuclear antigen and bromodeoxyuridine showed similar results. After ULA, adrenal DNA, RNA, and protein increased at both time points, whereas after sham, only adrenal DNA increased at 2 days. Compensatory growth thus results from hyperplasia and hypertrophy, whereas sham induces only a transient adrenal hyperplasia. Dexamethasone pretreatment prevented the increase in adrenal weight after ULA and blocked Ki67 labeling in the outer fasciculata but not zona glomerulosa in all groups. These results clearly show that the outer fasciculata is the primary adrenal zone responsible for compensatory growth, responding to steroid-suppressible stress signals that alone are ineffective in increasing adrenal mass.


Assuntos
Proliferação de Células , Dexametasona/análogos & derivados , Zona Fasciculada/citologia , Zona Fasciculada/crescimento & desenvolvimento , Zona Glomerulosa/citologia , Zona Glomerulosa/crescimento & desenvolvimento , Glândulas Suprarrenais/citologia , Glândulas Suprarrenais/efeitos dos fármacos , Glândulas Suprarrenais/crescimento & desenvolvimento , Glândulas Suprarrenais/cirurgia , Adrenalectomia , Animais , Dexametasona/farmacologia , Masculino , Tamanho do Órgão/efeitos dos fármacos , Tamanho do Órgão/fisiologia , Ratos , Ratos Sprague-Dawley , Zona Fasciculada/efeitos dos fármacos , Zona Fasciculada/cirurgia , Zona Glomerulosa/efeitos dos fármacos , Zona Glomerulosa/cirurgia
12.
J Matern Fetal Neonatal Med ; 16(4): 235-40, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15590453

RESUMO

OBJECTIVE: Currently, physicians manage preterm premature rupture of membranes (PPROM) by expectant management or termination of the gestation. A therapy aimed at sealing membranes would be optimal to maintain the pregnancy and achieve a normal neonate. Our objective was to compare an endoscopic technique for intrauterine closure of fetal membrane defects after both iatrogenic and spontaneous rupture of membranes. METHODS: Our technique was performed on four patients experiencing PPROM spontaneously and four patients after genetic amniocentesis. Intrauterine endoscopy allowed direct visualization of membrane defects. Rapid sequential injections of platelets, fibrin glue and powdered collagen slurry were administered at the site of the defect and of trocar placement. Sonography for amniotic fluid index, nitrazine and fern testing and pad count were performed after each procedure at three intervals: immediately post-procedure, and after 24 and 48 h. RESULTS: Eight patients underwent endoscopic intrauterine sealing of ruptured membranes between 16 and 24 weeks of gestation: four were spontaneous ruptures and four were ruptures post-amniocentesis. In the post-amniocentesis group, three patients delivered viable infants at 26, 32 and 34 weeks. In one patient, the membranes ruptured again 12 h after the sealing procedure and she decided to undergo termination of pregnancy. Of the four spontaneous rupture patients, two experienced preterm labor and delivery within 2 days of the procedure. One patient was diagnosed with fetal demise 12 h post-procedure, and one patient delivered a neonate at 31 weeks of gestation with severe respiratory distress syndrome. CONCLUSIONS: This technique for sealing ruptured membranes is effective after amniocentesis, but may not be of benefit with spontaneous rupture.


Assuntos
Amniocentese/efeitos adversos , Endoscopia , Membranas Extraembrionárias/lesões , Ruptura Prematura de Membranas Fetais/cirurgia , Doença Iatrogênica , Ferimentos Penetrantes/etiologia , Ferimentos Penetrantes/cirurgia , Aborto Induzido , Adulto , Feminino , Humanos , Gravidez , Recidiva , Resultado do Tratamento
13.
J Matern Fetal Neonatal Med ; 13(6): 414-21, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12962268

RESUMO

OBJECTIVE: A comprehensive review of monoamniotic twin gestations reported between 1990 and 2002 was performed to estimate current perinatal mortality and morbidity rates, as well as the predictive value of an antenatal diagnosis of cord entanglement for poor obstetric outcomes. METHOD: A Medline literature review using the search term 'monoamniotic' and limited to articles published in the English language between 1990 and 2002 was performed. RESULTS: A total of 133 continuing, non-conjoined twin monoamniotic pregnancies with delivery information were identified. Perinatal loss per 2-week interval was relatively constant at 2-4% from 15 to 32 weeks. However, of the 131 fetuses reaching 33 weeks, the percentage loss significantly increased to 11.0% at 33-35 weeks and 21.9% at 36-38 weeks compared to that at 30-32 weeks. Overall perinatal mortality was 23.3%. Of all losses, 61.2% involved both twins and 38.8% involved only one fetus. Cord entanglements were documented antenatally in 22.6% of reports. There was a statistically significant decrease in the average number of neonatal intensive care unit days for non-anomalous neonates (10.6 +/- 7.7 vs. 32.6 +/- 32.0), average gestational age at the time of delivery (30.4 +/- 7.6 vs. 32.6 +/- 4.1), as well as a decrease in the prevalence of total (8.3% vs. 27.7%) and non-anomalous (7.0% vs. 21.6%) perinatal mortality in pregnancies with an antenatal diagnosis of cord entanglement compared to those without the antenatal diagnosis of cord entanglement. The presence of fetal anomalies was associated with a 42.9% perinatal mortality rate. CONCLUSIONS: Contrary to previous reports, there is a significant increase in the incidence of perinatal loss beyond 32 weeks among monoamniotic twins, suggesting that delivery after corticosteroid therapy should be strongly considered at this gestational age.


Assuntos
Morte Fetal , Mortalidade Infantil , Resultado da Gravidez , Gravidez Múltipla , Gêmeos , Feminino , Feto/anormalidades , Idade Gestacional , Humanos , Recém-Nascido , Gravidez , Diagnóstico Pré-Natal/estatística & dados numéricos , Distribuição por Sexo , Cordão Umbilical/patologia
14.
Fetal Diagn Ther ; 16(1): 61-4, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11125255

RESUMO

We report the first attempt of reduction of monoamniotic twins, discordant for hypoplastic left heart syndrome, using a new fetoscopic technique. Employing sonographic guidance and endoscopic visualization, cord ligation was accomplished, but significant cord entanglement, not previously appreciated, resulted in the ligation of the umbilical cord of the normal fetus. Cord entanglement may frustrate endoscopic techniques in monoamniotic twins.


Assuntos
Fetoscopia/métodos , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Redução de Gravidez Multifetal/métodos , Ultrassonografia Pré-Natal/métodos , Cordão Umbilical/cirurgia , Adulto , Evolução Fatal , Feminino , Humanos , Síndrome do Coração Esquerdo Hipoplásico/diagnóstico por imagem , Ligadura , Gravidez , Redução de Gravidez Multifetal/efeitos adversos , Gêmeos
15.
J Perinat Med ; 28(4): 326-30, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11031705

RESUMO

We report only the 3rd case of closure of amniorrhexis following genetic amniocentesis. Our technique is the first to use endoscopic visualization of the rupture site and apply maternal platelets and fibrinogen/thrombin (Hemaseel Haemacure Corp Sarasota F1). The patient underwent repair at 20.6 weeks, 26 days after spontaneous rupture of membranes post-amniocentesis. At the time of the procedure the amniotic fluid index was 1 cm. Patient was delivered at 32.3 weeks secondary to complications of diabetes and severe preeclampsia. The neonate had APGARS of 7 at 1 min and 8 at 5 min and was discharged home on Day 21 of life.


Assuntos
Ruptura Prematura de Membranas Fetais/cirurgia , Fetoscopia , Adesivo Tecidual de Fibrina/uso terapêutico , Resultado da Gravidez , Adulto , Amniocentese/efeitos adversos , Líquido Amniótico , Plaquetas , Cesárea , Membranas Extraembrionárias/patologia , Feminino , Ruptura Prematura de Membranas Fetais/etiologia , Ruptura Prematura de Membranas Fetais/patologia , Adesivo Tecidual de Fibrina/administração & dosagem , Idade Gestacional , Humanos , Recém-Nascido , Injeções , Trabalho de Parto Induzido , Masculino , Placenta/patologia , Pré-Eclâmpsia/complicações , Gravidez , Gravidez em Diabéticas , Resultado do Tratamento
16.
Obstet Gynecol ; 96(3): 346-50, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10960624

RESUMO

OBJECTIVE: To determine whether the degree of cervical lengthening after cerclage and whether serial follow-up measurements of cervical length after cerclage are predictive of pregnancy outcome. METHODS: Eighty women whose primary physician determined that a prophylactic (n = 50) or urgent cerclage (n = 30) was indicated had transvaginal ultrasonographic evaluation before and after cerclage. Thereafter, most women had three additional transvaginal ultrasound examinations until 32 weeks' gestation. At each examination, the mean of three measurements was calculated. Statistical analyses were done by t test, analysis of variance, and logistic regression, with significance set at P <.05. RESULTS: The mean +/- standard deviation precerclage cervical length was 27.2 +/- 10.3 mm and after cerclage was 34.1 +/- 9.9 mm (n = 80, P <.001, paired t test). No significant association was found (r = -0.26) between the difference in cervical length (postcerclage - precerclage lengths) and pregnancy outcome. Patients with a prophylactic cerclage had a mean cervical length that was consistently longer in patients delivering at term compared with those who delivered preterm at 20 to 32 weeks' gestation. In the urgent cerclage group a significant difference in cervical length between those who delivered at term compared with preterm was evident only at 28 to 32 weeks. CONCLUSION: The increase in cervical length after cerclage is not predictive of term delivery. Serial cervical length measurements in the late second or early third trimester predict preterm birth but could provide earlier warning in patients with a prophylactic cerclage than in patients with urgent cerclage.


Assuntos
Colo do Útero/diagnóstico por imagem , Endossonografia , Trabalho de Parto Prematuro/diagnóstico por imagem , Ultrassonografia Pré-Natal , Incompetência do Colo do Útero/cirurgia , Adulto , Feminino , Seguimentos , Idade Gestacional , Humanos , Recém-Nascido , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Gravidez , Prognóstico , Estudos Prospectivos , Técnicas de Sutura , Incompetência do Colo do Útero/diagnóstico por imagem
17.
J Perinat Med ; 28(6): 453-7, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11155431

RESUMO

OBJECTIVE: To assess the risks and benefits to patients who carry to term after undergoing a Shirodkar cerclage where the cerclage is not removed until the patient presents in labor. METHODS: A retrospective analysis was conducted examining all patients who underwent a Shirodkar cerclage employing a 5 mm Mersilene band. All the cerclages were placed by a single operator over a twenty five year span, from 1/01/74 till 10/01/98. Only patients who delivered vaginally or were allowed a trial of labor were included. In all cases, the cerclage was removed under regional anesthesia after the patient presented to the hospital in labor. RESULTS: Ninety six cerclage procedures were performed over that period. Eighty two pregnancies qualified for review. Sixty two patients delivered vaginally (76%). Nine cesareans were indicated for failure to progress in labor (11%) with cervical dystocia possibly implicated in one. There were no cases of ruptured uteri or the development of uterine windows. Of the 82 pregnancies there were five cases (6%) of minor cervical laceration. CONCLUSION: Allowing patients to proceed to labor with a Shirodkar, cerclage in place, does not increase the risks of cervical dystocia, cervical laceration, or uterine rupture above the reported incidence for these complications in patients in whom the cerclage is removed prophylactically.


Assuntos
Colo do Útero/cirurgia , Trabalho de Parto , Técnicas de Sutura , Incompetência do Colo do Útero/cirurgia , Colo do Útero/lesões , Cesárea , Parto Obstétrico , Distocia/etiologia , Feminino , Morte Fetal , Idade Gestacional , Humanos , Gravidez , Suturas/efeitos adversos , Hemorragia Uterina/etiologia , Ruptura Uterina/etiologia
18.
J Perinat Med ; 27(4): 253-62, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10560076

RESUMO

We present a case of mid pregnancy loss with retained intrauterine contraceptive device associated with fetal Candida infection. Review of English literature identified 53 additional cases of fetal candidal infection, with 17 associated with an IUCD in situ. The presence of an IUCD was associated with delivery at a statistically significant earlier gestational age when compared to cases not associated with an IUCD (23.3 +/- 4.9 vs 31.6 +/- 7.0, p < 0.001). Seventy-seven percent of fetal candidal infections associated with an IUCD were systemic (heart, brain, liver, gastrointestinal, lung) compared to 33% of cases not associated with an IUCD. In contrast to bacterial intraamniotic infections there was a low incidence of maternal febrile morbidity. An hypothesis as to the pathogenesis of Candidal infections in the presence and absence of an IUCD is offered as well as a paradigm for the management of the gravid patient with an IUCD in situ.


Assuntos
Âmnio/fisiopatologia , Candidíase/fisiopatologia , Doenças Fetais/fisiopatologia , Dispositivos Intrauterinos de Cobre/efeitos adversos , Complicações Infecciosas na Gravidez/fisiopatologia , Adulto , Âmnio/microbiologia , Peso ao Nascer , Feminino , Ruptura Prematura de Membranas Fetais/microbiologia , Ruptura Prematura de Membranas Fetais/fisiopatologia , Feto/microbiologia , Feto/fisiopatologia , Febre , Idade Gestacional , Humanos , Masculino , Gravidez , Resultado da Gravidez
19.
Obstet Gynecol ; 94(1): 117-9, 1999 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10389730

RESUMO

OBJECTIVE: To determine changes in length of incompetent cervices after cerclage, using transvaginal ultrasound. METHODS: Patients were enrolled in a prospective, observational study under an Institutional Review Board-approved protocol. McDonald or Shirodkar sutures were placed according to physician preference. Pre- and postcerclage cervical lengths were measured within 72 hours of the procedure. At each examination, the first measurement was discarded, and a mean of the subsequent three measurements was calculated. RESULTS: Twenty-one Shirodkar and ten McDonald operations were done. The mean (+/- standard deviation) precerclage cervical length was 2.7+/-0.9 cm and the postcerclage cervical length was 3.6+/-0.9 cm (P<.001, paired t test). CONCLUSION: Prophylactic cerclage results in measurable increases in cervical length, which might contribute to the success of the procedure. Further study is needed to determine whether the degree of cervical lengthening after cerclage predicts term delivery.


Assuntos
Colo do Útero/diagnóstico por imagem , Ultrassonografia Pré-Natal , Incompetência do Colo do Útero/diagnóstico por imagem , Incompetência do Colo do Útero/prevenção & controle , Adulto , Colo do Útero/patologia , Feminino , Humanos , Gravidez , Estudos Prospectivos
20.
Am J Physiol ; 276(5): R1374-82, 1999 05.
Artigo em Inglês | MEDLINE | ID: mdl-10233030

RESUMO

In situ hybridization was used to examine cellular differentiation during rat adrenal regeneration, defining zona glomerulosa [cytochrome P-450 aldosterone synthase (P-450aldo) mRNA positive], zona fasciculata [cytochrome P-450 11beta-hydroxylase (P-45011beta) mRNA positive], or zona intermedia [negative for both but 3beta-hydroxysteroid dehydrogenase (3beta-HSD) mRNA positive]. After unilateral adrenal enucleation with contralateral adrenalectomy (ULE/ULA), the expression of all mRNA was reduced at 2 days. From 5 to 10 days, P-45011beta and 3beta-HSD mRNA increased while P-450aldo remained low; at 20 days, all mRNA were increased. From 2 to 10 days, cells adjacent to the capsule showed intermedia cell differentiation; by 20 days, the subcapsular glomerulosa cells reappeared. This suggests that after enucleation the glomerulosa dedifferentiates to zona intermedia. The experiment was repeated in rats where the postenucleation ACTH rise was prevented. Rats underwent ULE with sham ULA (ULE/SULA) or ULE/SULA with ACTH treatment. Adrenals from ULE/SULA rats expressed increased P-450aldo mRNA at 10 days and reduced P-45011beta mRNA and adrenal weight at 30 days. ACTH treatment reversed the pattern toward that seen in ULE/ULA. These findings show that the enucleation-induced dedifferentitation of the glomerulosa cell may result in part from elevated plasma ACTH and that prevention of dedifferentiation may result in impaired regeneration.


Assuntos
Citocromo P-450 CYP11B2/genética , Regeneração/fisiologia , Zona Glomerulosa/citologia , Zona Glomerulosa/enzimologia , 3-Hidroxiesteroide Desidrogenases/genética , 3-Hidroxiesteroide Desidrogenases/metabolismo , Hormônio Adrenocorticotrópico/sangue , Aldosterona/sangue , Animais , Corticosterona/sangue , Citocromo P-450 CYP11B2/metabolismo , Regulação Enzimológica da Expressão Gênica/fisiologia , Masculino , Fenótipo , RNA Mensageiro/metabolismo , Ratos , Ratos Sprague-Dawley , Zona Glomerulosa/cirurgia
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