PubMed Health⌕ Search

Biomedical subjects

A Bichler

Publications and source records attributed to A Bichler.

33 records · Page 2Linked to original sources
PubMed1979

[Investigations of the effect and mechanism of action of the beta-sympathomimetic ritodrine on the synthesis and release of dipalmitoyl-lecithin in the fetal rabbit lung (author's transl)].

For a period of 8 days, pregnant white New Zealand rabbits were treated either with the beta-sympathomimetic Ritodrine (1 mg/kg) body weight daily) or with 0.9% saline solution. The fetuses were delivered by caesarian section on the 25th and 30th day of gestation (term being 31 days). No significant difference was found between the Ritodrine and saline treated groups with respect to the levels of dipalmitoyl-lecithin (DPL) obtained from the homogenates as well as the alveolar lavages of the fetal lungs. These results indicate that with this experimental model, prepartum treatment with Ritodrine has no effect either on DPL synthesis or its release into the alveolar spaces. Furthermore, treatment with the beta-sympathomimetic produced no significant change in the concentrations of the specific glucocorticoid receptors in the cytosol and nuclei of the fetal lungs, and in addition, the lung cytosol glucose concentrations as well as the plasma corticosteroid levels were unaffected. These findings support the conclusion that the synthesis of DPL in the fetal lung is not stimulated by Ritodrine.

Animals↗
PubMed1979

[Caesarean section: low transverse (pfannenstiel) or midline incision? (author's transl)].

In 67 elective Caesarean sections and 70 emergency sections the effect of the duration of anaesthesia upon the condition of the newborn was examined. The induction-delivery time (IDT), the operation time (OT), and the difference between these, delta t, were correlated with the 1-, 5- and 10-minute Apgar scores and the pH's of the venous and arterial umbilical cord blood. A highly significant negative association was found for the pH in the umbilical vein and delta t in the series of primary sections. Analysis of the emergency sections showed a negative association between the operation time and the 5 minute Apgar score, and a positive association between the delta t and 1 minute Apgar score. Despite these findings we have observed that the induction-delivery time which we are able to achieve in our hospital has no negative effect upon the biochemical condition (pH) of the newborn. A comparison of 619 sections performed by low midline incision with 328 section by Pfannenstiel incision showed no difference with regard to postoperative complications such as disturbance in wound healing or haematoma formation. In conclusion, with respect to the IDT and postoperative complications we have found no contraindication to the use of the low transverse Pfannenstiel incision for Caesarean section.

Apgar Score↗
PubMed1979

[Diagnosis of poor intrauterine fetal growth in twin pregnancies (author's transl)].

In 11 cases both twins were of normal weight. In 7 cases one twin and in 12 cases both twins were underweighed (the growth retardation was classified according to the intrauterine growth curves after Hohenauer applicable to our area). The determination of total 24 hours urinary estrogens and serial ultrasonic measurements of biparietal diameters appeared in our study to be the best parameters for the detection of intrauterine growth retardation. Serum HPL determination was unreliable. In addition 2 types of growth retardation in twins could be recognized from the estrogen values. In one, a dysfunction of the fetoplacental unit existed; in the other, the etiology of the growth retardation could not be determined by the methods used in the study (genetic origin?).

Birth Weight↗
PubMed1978

[Specific glucocorticoid receptor activity in the lungs and concentration of corticosteroids in the plasma of newborn rabbits during the first hours of life (author's transl)].

Nine pure-bred albino New Zealand white rabbits were delivered on the 30th day of gestation (term 31 days) by Caesarean section. The concentration of dexamethasone binding receptors in the cytosol and nucleus of the lungs as well as the total plasma corticosteroid levels were measured in the newborns before the first breath, after 30 min, 1, 2, 4, 6 and 24 h after birth. The level of plasma corticosteroids increased after birth while the concentration of the receptors in the cytosol and nucleus decreased but was still present after 24 h as well as in the lungs of adult animals. A temporary increase in the concentration of the nuclear receptors after 1 and 2 h is explained by the translocation and binding of the abundantly produced steroid-receptor-complex to the nucleus. The stress of hypo- and hyperthermia on the newborns showed variable behaviour with respect to receptor activity. However, the relationship between the corticosteroid levels in the plasma and the concentrations of the receptors in the cytosol and the nucleus of the lungs was similar as in fetuses kept under "physiological" conditions. It may be concluded from these results that in the rabbit the specific glucocorticoid receptor activity in the lungs decreases after birth but is present throughout life.

Adrenal Cortex Hormones↗
PubMed1978

[Examination of two sampling methods (pistolet and jet washing) for endometrial tissue (author's transl)].

The Pistolet-Aspiration and Gravlee Jet-Wash Techniques were used to examine 112 patients at random and the efficacy of each technique compared. The Pistolet-Aspiration technique is more often applicable and significantly provides sufficient material for cytologic and histologic evaluation. The histologic diagnosis was compared with the histologic diagnosis of the uteri after hysterectomy in all cases. In consideration of our results, the easier practicability and because of its economy we prefer the Pistolet-Aspiration technique versus Gravlee Jet-Washing. A catalogue of indications for Pistolet-Aspiration is also given in the discussion.

Adenocarcinoma↗
PubMed1977

Determination of amniotic fluid palmitic acid concentration for the estimation of fetal lung maturity.

Palmitic acid concentrations in amniotic fluid (AF) were determined in 135 patients with normal and pathological pregnancies between the 27th and 42nd week of gestation. There was a sharp rise in the mean palmitic acid concentration after the 34th weeks of gestation from 2.7 mug/ml to 9.9 mug/ml at term. This increase is almost identical with the rise of AF-lecithin. It was found that between 70% and 100% of AF-palmitic acid originates from lecithin. 65 patients were delivered within 24 h after amniotic fluid sampling. 7 infants of these patients developed a respiratory distress syndrome (RDS). In all cases with RDS AF-palmitic acid concentration was far below 5 mug/ml. Assuming an AF-palmitic acid concentration greater than 5 mug/ml for characterising fetal lung maturity (=no RDS), there were no false negative results, but 16% false positive results. However, the determination of AF-palmitic acid concentration seems to be a most reliable method for the assessment of fetal lung maturity.

Amniotic Fluid↗
PubMed1977

[Influence of the age of old primiparae on the perinatal infant morbidity and mortility (author's transl)].

157 old primiparae (greater than 30 a) have been compared to a randomised control group of primiparae between the 16th and 30th year of age. In addition to the perinatal infant mortality rate, the number of children with malnutrition, the frequency of premature babies, the presence of a low Apgar score (less than or equal to 7) and pathological pH-values in the umbilical artery (pH less than or equal to 7,10) were cheked. Moreover the frequency of early neonatal morbidity (presence of one of the following criteria: 1 minute Apgar score less than or equal to 7, pH of the umbilical artery less than or equal to 7, 10, a transitoric or severe RDS and neurological complications during the newborn period) was investigated in both groups. In the group of the old primiparae a significantly higher perinatal infant mortality rate was found compared to the control group (3,8% versus 0,6%, p less than 0.05). The rate of small for date babies was remarcably higher than in the control group (14,6% versus 6,4%, p less than 0.05). There was no difference in the prematurity rate in both groups. The children of old primiparae had more frequently a low Apgar score (less than or equal to 7) than infants of the randomised control group (18,5% versus 11,5%), but the difference is statistically not significant. Furthermore no difference in the number of pathological pH values in the umbilical arteries (pH less than or equal to 7, 10) were found in the both groups. The children of old primiparae show a higher early neonatal morbidity rate compared to the control group (21.7% versus 14.0%); however, the difference is statistically not significant. According to our results the risk for the newborns is increased already with primiparae over 30 rather than 35 years of age.

Adult↗
PubMed1977

[Treatment of severe Rhesus erythroblastosis].

Report about the management of cases of severe Rhesus erythroblastosis. One case is specially discussed because of it's actuality. This was a patient with severe Rh-sensitization (OOD at 450 mm from the beginning of the 30th week of gestation in zone III according to Liley). Because of the haemolytic disease and the chronic fetal distress the Caesarean section was already performed in the 32nd week of gestation after Betamethason treatment of the mother. The Lecithin-Sphingomyelin (L/S) ratio in the amniotic fluid as a criterium of fetal lung maturity raised almost twicefold (from 0.9 to 1.6) after Cortison treatment. The intensive care (assisted ventilation with PEEP, correction of the acidosis and transfusion of packed red cells) of the severely anaemic (Hb 3.5 g%, Hk 15 vol.%) and hydropic newborn was already started in the delivery room. The newborn developed no RDS and was discharged healthy. With reference to this and other cases the management of severe Rh-sensitization before the 34th week of gestation is discussed. Premature infants are mainly susceptable to the development of a Respiratory Distress syndrome (RDS). After antepartum Cortison treatment for prevention of an RDS the date of confinement should be arranged earlier. The value of an early Caesarian section after antepartum Glucocorticoid treatment as compared to the application of intrauterine transfusions in cases of severe erythroblastosis is discussed. It is also reported about recent methods of treatment of severe conditions of hydrops fetalis.

Austria↗
PubMed1977

[Vaginalcytology and late pregnancy (determination of term, fetal monitoring, correlation with hormon patterns) (author's transl)].

The "before term" pattern allows to exclude over-maturity with probability of 95--100%. The "at term" pattern lets expect spontaneous labour in next five days just so with great probability. We attribute no importance to cytology as a method of control for high risk pregnancies. At last we didn't find any correlation with statistical methods between the alterations of the cell patterns some days before delivery and values of hormons.

Female↗
PubMed1976

[The problem of Caesarean section (author's transl)].

The Caesarean sections at the Universitäts-Frauenklinik Innsbruck from January 1st, 1969 to December 31st, 1974 have been surveyed. Related to the total number of 12 579 deliveries 627 Caesarean sections have been performed. Two 3-year-intervals have been compared: 1969-1971 (group I) without and 1972-1974 (group II) with modern practices of prenatal supervision. There was a high significant increase of the section rate in group II (5,8% versus 4,1% which has been related to the increasing number of mainly fetal indications. The maternal morbidity didn't rise with the increasing section rate. A significant decrease in total infant mortality rate and mortality rate at vaginal deliveries has been found with the increasing incidence of Caesarean sections; whereas the number of depressed infants (Apgar score less than 7) was increased in group II. The reasons therefore have been discussed. The rise of the number of Caesarean sections in group II performed because of breech presentation (14,2% versus 6,2%) was correspondent with a statistically significant decrease in the mortality rate from 11,7 to 4,1%. A Caesarean section rate between 7% and 10% seems to be the limit at least in our hospital--the total infant mortality rate cannot be reduced by further increasing the section frequency: the infant mortality rate possibly could be lowered by a better and more wide spread prenatal care especially by taking more care for prematurity and by intensifying the perinatal period.

Apgar Score↗
PubMed1975

[The value of various investigations of amniotic fluid in the estimation of fetal maturity (author's transl)].

The amniotic fluid lecithin-spingomyelin (L/S) ratio, creatinine and uric acid concentrations, percentage of organe-stained fat cells and the foam test by Clements and coworkers have been compared in 82 samples of amniotic fluid from 66 patients. The specimens were obtained by transabdominal amniocentesis or amniotomy between the 24th and the 42nd week of pregnancy. The determination of the L/S ratio and the foam test seem to be reliable methods of estimating pulmonary surfactant and, hence, of predicting the respiratory distress syndrome (RDS) in the newborn infant. There was no RDS with an L/S ratio greater than 1.6 to 1.8. Positive foam tests also seem to be a valuable indicator of pulmonary maturity, no cases of RDS being found. However, false negative foam tests are not rare. The amniotic fluid concentration of creatinine correlated well with gestational age and birth weight. The determination of uric acid in the amniotic fluid is an unreliable test of fetal maturity on account of the large scatter. The percentage of orange-stained cells did not rise above 10% before the 39th week of pregnancy in most cases.

Amniotic Fluid↗
PubMed1975

[Significance of various oxytocin challenge tests in monitoring pregnant women at risk (author's transl)].

Three different oxytocin challenge tests were used for the anssessment of placentar function in pregnant women at risk: For the oxytocin test after Ray et al. Oxytocin was given in continuity with rising doses. In the two other tests Oxytocin was given intermittently with identical doses. The test described by Ray et al. Proved useful for predicting respiratory insufficiency of the placenta. The two other intermittent tests are, according to our investigations, less suitable as tests of placentar function because their significance is limited or non-existent. The continuous oxytocin challenge test takes more time (one hour on average). Essential for exact interpretation are a careful technique and surveillance of the patient throughout the test by trained personel. In our opinion the indications for the continous oxytocin challenge test are pregnancies at risk, where antepartum cardniotocography shows suspect or hard-to-interprete results (e.g. non-classifiables decelerations, loss of fluctuation, absence of Braxton-Hicks contractions) or when other monitoring techniques indicate placentar insufficiency (e.g. low oestriol excretion). The test is not suitable in placenta previaprevia, threatened premature birth and premature ruptur of the membranes. In contrast to other authors we cannot decide with certainly whether patients with a positive oxytocin challenge test should in every case be treated with Caesarean section [9]. This decision will depend not only on the result of the test but on the assessment of all parameters, mainly on the clinical picture. In any case delivery of patients with positive oxytocin challenge tests will have to be carried out under strict technical and biochemical supervision.

Cesarean Section↗
PubMed1975

[An unusual cause of sensitization against the Rh factor].

A case of Rh-sensitization is reported which was caused by the intra-muscular injection of blood from the patient's husband during the first pregnancy as treatment for hyperemesis gravidarum. The first infant showed a mild erythroblastosis. The second infant suffered of a severe erythroblastosis. The literature is reviewed and the causes of Rhesus sensitization are discussed.

Adult↗
PubMedDate not supplied

Prevention of perinatal morbidity by tight metabolic control in gestational diabetes mellitus.

In a prospective controlled trial, we studied the effect of tight metabolic control on the outcomes of 102 gestational diabetes mellitus (GDM) pregnancies compared with outcomes of 102 matched nondiabetic control pregnancies. Women with GDM were treated to achieve and maintain a blood glucose concentration of less than 130 mg/dl at 1 h after breakfast. Treatment consisted of a diet low in oligosaccharides and fat and, if necessary, once daily insulin. By the end of gestation, 88 of the 102 women with GDM received insulin at a mean dose of 18 U/day. Duration of insulin therapy ranged from 3 to 32 wk with a median of 11 wk. Perinatal outcome of GDM pregnancies under this management equaled that of control pregnancies. The full spectrum of excess morbidity from GDM was prevented, and normal distribution of birth weight and normal rates of macrosomia, dystrophy, hypoglycemia, hypocalcemia, hyperbilirubinemia, fetal acidosis, and low Apgar scores were achieved. No mortality was observed. In addition to the two main study groups, we also studied a third group of 24 women with GDM whose treatment lasted less than or equal to 5 wk due to late diagnosis. This suboptimally treated group demonstrated a significant (P less than .05) increase of macrosomia and umbilical artery acidosis compared with the well-treated GDM group. The study reported herein demonstrates that excess mortality and morbidity typically observed in GDM can be prevented by early institution of tight metabolic control, which required insulin in 86% of our patients.

Birth Weight↗