William Pomerance

Studies on the origin of amniotic fluid lipids: I. Normal composition

Abstract A specially adapted technique of microquantitation of lipids of human amniotic fluid was used to obtain a lipid profile at different stages of pregnancy. The amounts and the percentage composition of the various lipid classes were the same in the three groups examined: 27 to 33 weeks, 34 to 40 weeks, and labor. Phospholipids constituted the only lipid class that increased in amount, from 3.15 mg. per 100 ml. in Group I to 5.19 mg. per 100 ml. in Group III. Total nonpolar lipids amounted to about 10 mg. per 100 ml. The average values for the other lipid classes were (mg./100 ml.): monoglycerides, 0.23; diglycerides, 0.90; triglycerides, 1.40 (less in earlier group); free fatty acid, 2.11; free cholesterol, 1.41; cholesterol ester, 1.97; hydrocarbon, 1.74. Sediment obtained from labor amniotic fluid was very rich in lipids. Comparisons with maternal plasma, fetal plasma, placenta, and vernix caseosa emphasized a highly characteristic specificity of the amniotic fluid lipid composition. Variations from this normal pattern were shown in some pathologic conditions.

Cervical conization for diagnosis and treatment of carcinoma in situ

Abstract In a study of 210 specimens obtained by cervical conization, the abnormal cytology correlated closely with the cervical neoplasia in the biopsies. Complete pathologic study of all tissue removed should be carried out, so that carcinoma in situ may be graded and classified with complete evaluation of the margins of the lesion. The extended cone biopsy may be used as the definitive treatment for carcinoma in situ in selected patients. Cytologic follow-up of patients having had this procedure is an intrinsic part of the procedure.

Oxymorphone re-evaluated. The addition of a respiratory antagonist.

Abstract 1. In a double blind study, 1,022 patients in labor were given meperidine and oxymorphone with and without simultaneous administration of a respiratory antagonist. 2. No statistical difference was found in infant breathing and crying time or perinatal survival regardless of analgesic employed, with or without the addition of the respiratory antagonist. 3. Oxymorphone compares well with meperidine as an obstetric analgesic.

A new computerized, multidisciplined, multihospital storage and retrieval system for patient discharge summaries

We have written and successfully tested, on a pilot off-line basis, a series of computer programs for the accurate creation, storage, and rapid retrieval of gynecologic patient discharge summaries. The system has produced periodic reports for the evaluation of the experience of our department. The system also has the capacity for instantaneous on-line retrieval of any specific persons record or records as needed. The records are printed out in English and are keyed in by use of the standard social security number. The system is able to search, tabulate, and select all patient records from the entire file that meet any specific set of criteria. The user also receives a detailed analysis of those records selected. This application is available on both an on-line basis for conference purposes and an off-line basis for research purposes. We believe that our system is readily adaptable for the evaluation of the experience of any specific clinical department. The solution to the problem of incomplete or inaccurate discharge summaries and better and faster utilization of our medical information, as well as the elimination of dictation of charts by the physician, is the logical outcome of total implementation of this sytsem. The need for such a solution is especially demonstrated by the provision of new health legislation such as the HR-1 amendments to the Social Security Act.