Stanley Gall - Academia.edu (original) (raw)
Papers by Stanley Gall
Gynecologic Oncology, 1989
One hundred eighty-six patients with minimal residual Stage III ovarian cancer (tumor mass G3 cm)... more One hundred eighty-six patients with minimal residual Stage III ovarian cancer (tumor mass G3 cm) were treated in a prospective randomized protocol (melphalan with or without Corynebucterium parvum). As per protocol 84 patients were eligible and underwent a second-look laparotomy with 41 (49%) having negative findings for persistent malignancy. Factors which affected survival after second look were presence or absence of macroscopic disease, age, and grade. Depending upon these prognostic factors, survival at 4 years after second look ranged from 31 to 100%. The role of second-look laparotomy is examined relative to these results.
4900 Objectives: We have previously shown in a primary efficacy study [580299/001] and its extend... more 4900 Objectives: We have previously shown in a primary efficacy study [580299/001] and its extended follow-up phase (EFU) [580299/007] that the HPV-16/18 L1 VLP AS04 candidate vaccine is immunogenic and provides protection up to 4.5 years against HPV-16/18 incident and persistent infections and associated cytohistological outcomes (1;2). Furthermore, we have shown preliminary evidence of cross-protection against incident infections with oncogenic HPV types 31 and 45, which are not included in the vaccine (1). We report a second interim analysis of the EFU now up to 5.5 years evaluating long-term immunogenicity, vaccine efficacy, and safety. Methods: In the primary efficacy study 1113 women 15-25 years of age in North America and Brazil were randomized to receive 3 doses of HPV vaccine or control (Al[OH]3) on a 0, 1, 6 month schedule and evaluated for up to 27 months. During the EFU phase, 776 original participants who were seronegative for HPV-16 and HPV-18, and DNA negative for 14 ...
Obstetrics and Gynecology Clinics of North America
Comprehensive Therapy, Aug 1, 1983
Anaerobic organisms are the predominant etiologic agents in female genital tract infections. This... more Anaerobic organisms are the predominant etiologic agents in female genital tract infections. This article describes the conditions necessary for anaerobic growth, cites the diseases in which these organisms play a role, and outlines therapy for anaerobic genital infections. As interest in anaerobic bacteria has increased and culture techniques have improved, the number and variety of species of organisms has grown. Infections generally consist of several anaerobic species with 1 or more aerobic species. It is unclear whether additional organisms such as mycoplasma species or chlamydia impact on the establishment of genital tract infections, and whether multiple anaerobic organisms are needed to establish and maintain infection. For clinical infection to develop, an alteration in either host resistance or numbers of bacteria present must occur. Infections are usually associated with a compromised host whose defense mechanisms have been altered by natural causes or medical interventions such as trauma, surgery, irradiation, steroid treatment, immunosuppressive agents, cytotoxic agents, and certain antibiotics. Infections are classified as either hospital-acquired or community-acquired. The latter category includes pelvic inflammatory disease, pelvic thrombophlebitis, septic abortion, and premature rupture of the membranes. Hospital-acquired infections include postcesarean section endometritis, postoperative pelvic infections, wound infections, hospital-terminated pregnancy, septic thrombophlebitis, and pelvic abscess. Most diseases caused by anaerobic bacteria are characterized by tissue necrosis and abscess formation and an indolent or chronic course. Therapy options include supportive therapy with fluids and blood, administration of antibiotics, and surgical drainage. Initial therapy with full supportive endeavors and full-dose antimicrobial therapy is preferable to planned sequential antibiotic management. In vitro activity against anaerobes and aerobic organisms, tissue penetration, and toxicity should be considered in selecting antimicrobial agents. High-dose single agent chemotherapy is effective in early infections, whereas late infections require double or triple therapy.
Obstetrics and Gynecology, 2002
Cancer Research, Jul 1, 1979
disease (3, 4, 31) and in ascites from several murine tumor models (14, 19, 30â€"32, 36). These f... more disease (3, 4, 31) and in ascites from several murine tumor models (14, 19, 30â€"32, 36). These factors are similar in their range of activity to those described in serum and could account for the depressed immune status of these patients (1 , 3, 30, 31). Studies by Badger et aI. (3) have shown that high levels of lymphocyte-inhibitory activity could be found in AF's in the absence of any serum immunosuppressive activity. On this basis, they postulated that tumor cells may locally produce or induce the formation of factors capable of inhibiting lymphocyte function, thus effecting local immunosuppression. It follows that immunosuppressive activity should be frequently found in ascites and in other effusions of neoplastic origin. The present investigations were undertaken to examine the immunosup pressive activity in cystic and ascitic fluids associated with ovarian neoplasms and to determine its range and mode of action. MATERIALS AND METHODS Preparation of Samples. Ascitic fluids and cystic effusions were obtained aseptically during surgery at Duke University Medical Center from patients suspected of having ovarian cancer. Serum samples were obtained at the same time when ever possible. These patients were not on cytotoxic drug chem otherapy or radiation therapy at the time the samples were taken. The samples were centrifuged at 1800 x g for 30 mm to remove cellular debris, numerically coded, aliquoted, and stored at â€"20°. Priorto testing, all samples were sterile filtered through a Millex O.22-j.tm filter (Millipore Corp. , Bedford, Mass.). Protein concentrations of AF's and cystic effusions ranged from 10 to 50 mg/mI as estimated spectrophotometri cally by absorbance at 280 nm. The mean protein concentra tion for positive (containing lymphocyte-inhibitory activity) and negative fluids were 32.8 ±13.1 and 44.5 ±9.7 (S.D.) mg/ ml, respectively. There was no relationship between the initial protein concentration and the presence of lymphocyte-inhibi tory activity in original ascites and cystic fluids. Heat sensitivity of the suppressive activity was tested by heating samples to 56, 62, or 100°for 30 mm. Sensitivity to pH was tested by using 3-mI aliquots of the samples, adjusted to pH 3.0 with 1.0 N HCI or to pH 13.0 with 1.0 N NaOH, and incubating at room temperature for 30 mm. Samples were then neutralized to pH 7.0. A control sample was adjusted for the slight change in volume by adding an equivalent amount of 1.0 M NaCI. Dialysis of the ascitic fluids was carried out in dialysis tubing (Union Carbide Corp. , Chicago, III.) for 24 hr against 3 liters of PBS(GrandIslandBiologicalCo., Grand Island,N. V.). Approximate molecular size was determined by Diaflo ultra filtration with Amicon XM 1OOA, PM 50, and UM 10 mem
Cancer Research, Jun 1, 1980
American Journal of Obstetrics and Gynecology, 1974
Background: Current guidelines to prevent pertussis recommend that infants be immunized with Tdap... more Background: Current guidelines to prevent pertussis recommend that infants be immunized with Tdap at 2, 4, and 6 months leaving infants highly susceptible to contracting pertussis between birth and 2 months. This study investigated if administrating Tdap to mothers during the third trimester of pregnancy provides newborns protection against pertussis, when compared to newborns born from mothers who did not receive Tdap during pregnancy. Methods: Pregnant women were randomly assigned to receive (n=53) or not receive (n=51) Tdap during pregnancy. Antibody responses to filamentous hemagglutinin (FHA), pertactin (PRN), pertussis toxin (PT), and the toxoids of tetanus and diphtheria were measured in maternal and infant serum. Protection was defined as follows: if an individual's diphtheria antitoxin level was >0.10, and if an individual's pertussis antitoxin level was >5. Results: Newborns born from mothers who received Tdap during pregnancy have significantly higher concen...
Principles of Medical Therapy in Pregnancy, 1985
Several methods exist to prevent infections. These methods may include (1) reducing the exposure ... more Several methods exist to prevent infections. These methods may include (1) reducing the exposure to the offending microorganism, (2) acquiring immunity either by active or passive regimens, and (3) using antimicrobial agents to prevent colonization or enhance host resistance during possible exposure periods. For individuals active immunization is the preferred method to obtain protection against infectious diseases. Unfortunately, vaccines are not available for many infectious diseases, and those that are available must be used with care during pregnancy. This chapter summarizes current recommendations for immunization, the impact on pregnancy, and current guidelines for using antimicrobial prophylaxis during pregnancy.
American Journal of Reproductive Immunology, 1983
Papers presented in the session "Reproductive Tumor Immunology" of the Third Annual Int... more Papers presented in the session "Reproductive Tumor Immunology" of the Third Annual International Symposium on the Immunology of Reproduction represented the range of the research occurring in the field of reproductive tumor immunology. A significant factor to keep in mind in considering reproductive tumor immunology is that there is no evidence that the immunology of tumors of the reproductive tract is unlike the immunology of tumors elsewhere. This is an important concept because the bulk of all tumor research is done on nonreproductive tract tumors, and the information obtained must be transposed to genital tumors. An area of prime interest in reproductive tumor immunology was exemplified at the meeting by a paper by Taylor, Homesley, and Doellgast (Am J Reprod Immunol issue 3:1), in which they describe the presence of membrane fragments in cyst, ascites, and sera of ovarian cancer patients which contain significant amounts of bound IgG. Current efforts are directed toward identifying the antigens responsible for their reactivity. A major thrust and interest in immunological research is directed toward defining tumor antigens as well as toward refining our ability to measure these antigens. To date, no tumor-specific human antigen has been described, but many tumor-associated antigens are known. It has been recognized that one specific antibody molecule among a million other Ig molecules in serum can be detected by serological tests, and the use of monoclonal antibodies should provide additional feasibility in the typing of tumors. Monoclonal preparations should yield serums retaining activity to dilutions of one in 100,000. This has led to an enthusiastic search for monoclonal antibodies which define antigens on both experimental and human tumors. This is a far cry from our past experience of the preparation of antitumor antiserum using xenogeneic immunization. The inevitable comparison of the monoclonal technology to past experience with more nonspecific techniques will cause some confusion. Kohorn and colleagues (Am J Reprod Immunol; in press) have encountered this in their report "Investigation of peripheral blood mononuclear cells in patients
Protocols for High-Risk Pregnancies, 2005
Principles of Medical Therapy in Pregnancy, 1985
A number of microorganisms in addition to such common viral diseases as measles, rubella, and var... more A number of microorganisms in addition to such common viral diseases as measles, rubella, and varicella are associated with skin manifestations of disease. A partial listing is included in Table 84–1. Each disease entity has its own importance and is discussed in its own chapter. However, some of the viruses, especially the enteroviruses, have particular obstetric significance and are discussed here in more detail.
American journal of obstetrics and gynecology, 1984
Cyst and ascites fluid was obtained from 31 different patients with ovarian epithelial neoplasms ... more Cyst and ascites fluid was obtained from 31 different patients with ovarian epithelial neoplasms and was analyzed for the molecular forms and quantities of IgG, IgM, and IgA. The fluids were grouped on the basis of the pathologic diagnosis of the tumor tissue for investigation of the possibility that immunoglobulin levels in fluids from ovarian neoplasms varied with the type of tumor. Immunoglobulin concentrations in most cyst fluid samples were comparable to amounts detected in normal human serum; however, significant reductions in the amounts of IgA in fluids from mucinous cystadenocarcinomas and in the amounts of both IgA and IgM in fluids from mucinous cystadenoma were demonstrated. The cyst fluid immunoglobulins were present in the same molecular forms as serum immunoglobulins, that is, pentameric IgM, predominantly monomeric IgA, and monomeric IgG. The usefulness of cyst effusions as a source of autologous antibodies in the investigation of the immune response to tumors is dis...
American journal of obstetrics and gynecology, Jan 15, 1985
Lymphoblastoid interferon, Wellferon, was used to treat patients with resistant and persistent co... more Lymphoblastoid interferon, Wellferon, was used to treat patients with resistant and persistent condyloma acuminatum at initial doses of 5, 3, and 1 million unit/square meter (Mu/M2). The objectives of this study were to evaluate the efficacy and toxicity of, and tolerance to, intramuscular and intralesional interferon. Seventeen patients were treated with 5 Mu/M2, 14 patients with 1 Mu/M2, and 37 patients with 3 Mu/M2; daily administration was followed by three-times-a-week dosing. The complete response rate in patients receiving initial dose of interferon of 5 Mu/M2 was 69%, that for doses of 1 Mu/M2 was 43%, and that for doses of 3 Mu/M2 was 57%. All patients given interferon developed initial elevations of temperature of limited duration, whereas all patients given the 5 Mu/M2 dose had to have the amount reduced because of biologic side effects. However, only five of 37 (14%) of the patients given 3 Mu/M2 required a reduction in the dosage, and no patient given 1 Mu/M2 needed to ...
Clinics in perinatology, 1988
Twin gestations have higher morbidity and mortality than singleton pregnancies. This is related t... more Twin gestations have higher morbidity and mortality than singleton pregnancies. This is related to the teratogenic event of twinning itself, as well as to physiologic changes associated with twinning. Early diagnosis, careful monitoring, and knowledge of potential problems may help the alert obstetrician to improve outcome.
Gynecologic Oncology, 1989
One hundred eighty-six patients with minimal residual Stage III ovarian cancer (tumor mass G3 cm)... more One hundred eighty-six patients with minimal residual Stage III ovarian cancer (tumor mass G3 cm) were treated in a prospective randomized protocol (melphalan with or without Corynebucterium parvum). As per protocol 84 patients were eligible and underwent a second-look laparotomy with 41 (49%) having negative findings for persistent malignancy. Factors which affected survival after second look were presence or absence of macroscopic disease, age, and grade. Depending upon these prognostic factors, survival at 4 years after second look ranged from 31 to 100%. The role of second-look laparotomy is examined relative to these results.
4900 Objectives: We have previously shown in a primary efficacy study [580299/001] and its extend... more 4900 Objectives: We have previously shown in a primary efficacy study [580299/001] and its extended follow-up phase (EFU) [580299/007] that the HPV-16/18 L1 VLP AS04 candidate vaccine is immunogenic and provides protection up to 4.5 years against HPV-16/18 incident and persistent infections and associated cytohistological outcomes (1;2). Furthermore, we have shown preliminary evidence of cross-protection against incident infections with oncogenic HPV types 31 and 45, which are not included in the vaccine (1). We report a second interim analysis of the EFU now up to 5.5 years evaluating long-term immunogenicity, vaccine efficacy, and safety. Methods: In the primary efficacy study 1113 women 15-25 years of age in North America and Brazil were randomized to receive 3 doses of HPV vaccine or control (Al[OH]3) on a 0, 1, 6 month schedule and evaluated for up to 27 months. During the EFU phase, 776 original participants who were seronegative for HPV-16 and HPV-18, and DNA negative for 14 ...
Obstetrics and Gynecology Clinics of North America
Comprehensive Therapy, Aug 1, 1983
Anaerobic organisms are the predominant etiologic agents in female genital tract infections. This... more Anaerobic organisms are the predominant etiologic agents in female genital tract infections. This article describes the conditions necessary for anaerobic growth, cites the diseases in which these organisms play a role, and outlines therapy for anaerobic genital infections. As interest in anaerobic bacteria has increased and culture techniques have improved, the number and variety of species of organisms has grown. Infections generally consist of several anaerobic species with 1 or more aerobic species. It is unclear whether additional organisms such as mycoplasma species or chlamydia impact on the establishment of genital tract infections, and whether multiple anaerobic organisms are needed to establish and maintain infection. For clinical infection to develop, an alteration in either host resistance or numbers of bacteria present must occur. Infections are usually associated with a compromised host whose defense mechanisms have been altered by natural causes or medical interventions such as trauma, surgery, irradiation, steroid treatment, immunosuppressive agents, cytotoxic agents, and certain antibiotics. Infections are classified as either hospital-acquired or community-acquired. The latter category includes pelvic inflammatory disease, pelvic thrombophlebitis, septic abortion, and premature rupture of the membranes. Hospital-acquired infections include postcesarean section endometritis, postoperative pelvic infections, wound infections, hospital-terminated pregnancy, septic thrombophlebitis, and pelvic abscess. Most diseases caused by anaerobic bacteria are characterized by tissue necrosis and abscess formation and an indolent or chronic course. Therapy options include supportive therapy with fluids and blood, administration of antibiotics, and surgical drainage. Initial therapy with full supportive endeavors and full-dose antimicrobial therapy is preferable to planned sequential antibiotic management. In vitro activity against anaerobes and aerobic organisms, tissue penetration, and toxicity should be considered in selecting antimicrobial agents. High-dose single agent chemotherapy is effective in early infections, whereas late infections require double or triple therapy.
Obstetrics and Gynecology, 2002
Cancer Research, Jul 1, 1979
disease (3, 4, 31) and in ascites from several murine tumor models (14, 19, 30â€"32, 36). These f... more disease (3, 4, 31) and in ascites from several murine tumor models (14, 19, 30â€"32, 36). These factors are similar in their range of activity to those described in serum and could account for the depressed immune status of these patients (1 , 3, 30, 31). Studies by Badger et aI. (3) have shown that high levels of lymphocyte-inhibitory activity could be found in AF's in the absence of any serum immunosuppressive activity. On this basis, they postulated that tumor cells may locally produce or induce the formation of factors capable of inhibiting lymphocyte function, thus effecting local immunosuppression. It follows that immunosuppressive activity should be frequently found in ascites and in other effusions of neoplastic origin. The present investigations were undertaken to examine the immunosup pressive activity in cystic and ascitic fluids associated with ovarian neoplasms and to determine its range and mode of action. MATERIALS AND METHODS Preparation of Samples. Ascitic fluids and cystic effusions were obtained aseptically during surgery at Duke University Medical Center from patients suspected of having ovarian cancer. Serum samples were obtained at the same time when ever possible. These patients were not on cytotoxic drug chem otherapy or radiation therapy at the time the samples were taken. The samples were centrifuged at 1800 x g for 30 mm to remove cellular debris, numerically coded, aliquoted, and stored at â€"20°. Priorto testing, all samples were sterile filtered through a Millex O.22-j.tm filter (Millipore Corp. , Bedford, Mass.). Protein concentrations of AF's and cystic effusions ranged from 10 to 50 mg/mI as estimated spectrophotometri cally by absorbance at 280 nm. The mean protein concentra tion for positive (containing lymphocyte-inhibitory activity) and negative fluids were 32.8 ±13.1 and 44.5 ±9.7 (S.D.) mg/ ml, respectively. There was no relationship between the initial protein concentration and the presence of lymphocyte-inhibi tory activity in original ascites and cystic fluids. Heat sensitivity of the suppressive activity was tested by heating samples to 56, 62, or 100°for 30 mm. Sensitivity to pH was tested by using 3-mI aliquots of the samples, adjusted to pH 3.0 with 1.0 N HCI or to pH 13.0 with 1.0 N NaOH, and incubating at room temperature for 30 mm. Samples were then neutralized to pH 7.0. A control sample was adjusted for the slight change in volume by adding an equivalent amount of 1.0 M NaCI. Dialysis of the ascitic fluids was carried out in dialysis tubing (Union Carbide Corp. , Chicago, III.) for 24 hr against 3 liters of PBS(GrandIslandBiologicalCo., Grand Island,N. V.). Approximate molecular size was determined by Diaflo ultra filtration with Amicon XM 1OOA, PM 50, and UM 10 mem
Cancer Research, Jun 1, 1980
American Journal of Obstetrics and Gynecology, 1974
Background: Current guidelines to prevent pertussis recommend that infants be immunized with Tdap... more Background: Current guidelines to prevent pertussis recommend that infants be immunized with Tdap at 2, 4, and 6 months leaving infants highly susceptible to contracting pertussis between birth and 2 months. This study investigated if administrating Tdap to mothers during the third trimester of pregnancy provides newborns protection against pertussis, when compared to newborns born from mothers who did not receive Tdap during pregnancy. Methods: Pregnant women were randomly assigned to receive (n=53) or not receive (n=51) Tdap during pregnancy. Antibody responses to filamentous hemagglutinin (FHA), pertactin (PRN), pertussis toxin (PT), and the toxoids of tetanus and diphtheria were measured in maternal and infant serum. Protection was defined as follows: if an individual's diphtheria antitoxin level was >0.10, and if an individual's pertussis antitoxin level was >5. Results: Newborns born from mothers who received Tdap during pregnancy have significantly higher concen...
Principles of Medical Therapy in Pregnancy, 1985
Several methods exist to prevent infections. These methods may include (1) reducing the exposure ... more Several methods exist to prevent infections. These methods may include (1) reducing the exposure to the offending microorganism, (2) acquiring immunity either by active or passive regimens, and (3) using antimicrobial agents to prevent colonization or enhance host resistance during possible exposure periods. For individuals active immunization is the preferred method to obtain protection against infectious diseases. Unfortunately, vaccines are not available for many infectious diseases, and those that are available must be used with care during pregnancy. This chapter summarizes current recommendations for immunization, the impact on pregnancy, and current guidelines for using antimicrobial prophylaxis during pregnancy.
American Journal of Reproductive Immunology, 1983
Papers presented in the session "Reproductive Tumor Immunology" of the Third Annual Int... more Papers presented in the session "Reproductive Tumor Immunology" of the Third Annual International Symposium on the Immunology of Reproduction represented the range of the research occurring in the field of reproductive tumor immunology. A significant factor to keep in mind in considering reproductive tumor immunology is that there is no evidence that the immunology of tumors of the reproductive tract is unlike the immunology of tumors elsewhere. This is an important concept because the bulk of all tumor research is done on nonreproductive tract tumors, and the information obtained must be transposed to genital tumors. An area of prime interest in reproductive tumor immunology was exemplified at the meeting by a paper by Taylor, Homesley, and Doellgast (Am J Reprod Immunol issue 3:1), in which they describe the presence of membrane fragments in cyst, ascites, and sera of ovarian cancer patients which contain significant amounts of bound IgG. Current efforts are directed toward identifying the antigens responsible for their reactivity. A major thrust and interest in immunological research is directed toward defining tumor antigens as well as toward refining our ability to measure these antigens. To date, no tumor-specific human antigen has been described, but many tumor-associated antigens are known. It has been recognized that one specific antibody molecule among a million other Ig molecules in serum can be detected by serological tests, and the use of monoclonal antibodies should provide additional feasibility in the typing of tumors. Monoclonal preparations should yield serums retaining activity to dilutions of one in 100,000. This has led to an enthusiastic search for monoclonal antibodies which define antigens on both experimental and human tumors. This is a far cry from our past experience of the preparation of antitumor antiserum using xenogeneic immunization. The inevitable comparison of the monoclonal technology to past experience with more nonspecific techniques will cause some confusion. Kohorn and colleagues (Am J Reprod Immunol; in press) have encountered this in their report "Investigation of peripheral blood mononuclear cells in patients
Protocols for High-Risk Pregnancies, 2005
Principles of Medical Therapy in Pregnancy, 1985
A number of microorganisms in addition to such common viral diseases as measles, rubella, and var... more A number of microorganisms in addition to such common viral diseases as measles, rubella, and varicella are associated with skin manifestations of disease. A partial listing is included in Table 84–1. Each disease entity has its own importance and is discussed in its own chapter. However, some of the viruses, especially the enteroviruses, have particular obstetric significance and are discussed here in more detail.
American journal of obstetrics and gynecology, 1984
Cyst and ascites fluid was obtained from 31 different patients with ovarian epithelial neoplasms ... more Cyst and ascites fluid was obtained from 31 different patients with ovarian epithelial neoplasms and was analyzed for the molecular forms and quantities of IgG, IgM, and IgA. The fluids were grouped on the basis of the pathologic diagnosis of the tumor tissue for investigation of the possibility that immunoglobulin levels in fluids from ovarian neoplasms varied with the type of tumor. Immunoglobulin concentrations in most cyst fluid samples were comparable to amounts detected in normal human serum; however, significant reductions in the amounts of IgA in fluids from mucinous cystadenocarcinomas and in the amounts of both IgA and IgM in fluids from mucinous cystadenoma were demonstrated. The cyst fluid immunoglobulins were present in the same molecular forms as serum immunoglobulins, that is, pentameric IgM, predominantly monomeric IgA, and monomeric IgG. The usefulness of cyst effusions as a source of autologous antibodies in the investigation of the immune response to tumors is dis...
American journal of obstetrics and gynecology, Jan 15, 1985
Lymphoblastoid interferon, Wellferon, was used to treat patients with resistant and persistent co... more Lymphoblastoid interferon, Wellferon, was used to treat patients with resistant and persistent condyloma acuminatum at initial doses of 5, 3, and 1 million unit/square meter (Mu/M2). The objectives of this study were to evaluate the efficacy and toxicity of, and tolerance to, intramuscular and intralesional interferon. Seventeen patients were treated with 5 Mu/M2, 14 patients with 1 Mu/M2, and 37 patients with 3 Mu/M2; daily administration was followed by three-times-a-week dosing. The complete response rate in patients receiving initial dose of interferon of 5 Mu/M2 was 69%, that for doses of 1 Mu/M2 was 43%, and that for doses of 3 Mu/M2 was 57%. All patients given interferon developed initial elevations of temperature of limited duration, whereas all patients given the 5 Mu/M2 dose had to have the amount reduced because of biologic side effects. However, only five of 37 (14%) of the patients given 3 Mu/M2 required a reduction in the dosage, and no patient given 1 Mu/M2 needed to ...
Clinics in perinatology, 1988
Twin gestations have higher morbidity and mortality than singleton pregnancies. This is related t... more Twin gestations have higher morbidity and mortality than singleton pregnancies. This is related to the teratogenic event of twinning itself, as well as to physiologic changes associated with twinning. Early diagnosis, careful monitoring, and knowledge of potential problems may help the alert obstetrician to improve outcome.