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Biomedical subjects

A Funk

Publications and source records attributed to A Funk.

28 records · Page 2Linked to original sources
PubMedDate not supplied

[Cerebral blood flow during labor].

The successful results obtained using Doppler sonography for antepartal diagnosis gave cause to use the method during labor. For this purpose doppler measurements of the intern fetal carotid artery of a group of 7 patients with normal course of pregnancy were made and a continuous direct CTG was recorded simultaneously. The Doppler parameter, the S/D-ratio, for the contraction phases were compared with those of the contraction--free phases. During the contraction phase the S/D-ratio was higher than during the relaxation period of the uterus. The difference between these values were proved to be statistically significant. A comparison of the doppler parameter of the patients at onset of labor and the patients at the end of labor showed, that the S/D-ratio increased significantly at the end of labor. This result demonstrates, that the intravascular resistance in the fetal carotid artery increased due to the cephalic pressure.

Blood Flow Velocity↗
PubMedDate not supplied

[Transvaginal sonography: the differential diagnostic significance of the secondary vitelline sac in early pregnancy].

In the study reported here, yolk sac size and vertex-breech length were determined by transvaginal sonography, in addition to other parameters relevant to early pregnancy. Vital pregnancy was found without abortion symptoms in 72 cases, and with these symptoms in 35 cases; in 29 cases a missed abortion was found. The secondary yolk sac, which was detectable and measurable in 95 of 107 vital early pregnancies, showed constant growth from the fifth (diameter 3.9 mm) to the twelfth completed gestational week p.m. (diameter 6.5 mm). From the tenth completed gestational week p.m. onward, the yolk sac was not always detectable. Of the yolks sacs in the group of missed abortions, seven were found to be too small and 15 rudimentary. The correlation coefficients determined between yolk sac size and gestational age on the one hand and vertex-breech length on the other indicate that there is a significant relationship between the development of the yolk sac and that of the embryo up to the tenth completed gestational week p.m. Where a normally developed secondary vitelline sac is sonographically detected up to the tenth gestational week, the prognosis may be regarded as good. However, any finding which deviates from the norm must be verified, and the prognosis must be considered poor even when a living embryo is detected.

Abortion, Missed↗
PubMedDate not supplied

[Improved diagnosis of extrauterine pregnancy by endosonography].

Between July 1987 and January 1988, 44 patients with a tentative diagnosis of ectopic pregnancy underwent sonographic examination by means of vaginal probe at the Department of Gynecology and Obstetrics of the RWTH Aachen. The sonographic findings, all of which were confirmed by subsequent clinical and or surgical clarification, were as follows: an ectopic pregnancy was diganosed in 16 cases, an early intrauterine pregnancy in seven, an intrauterine abortion in seven, and in one case a uterine malformation-a dermoid cyst and a functional cyst. In 11 cases sonographic examination showed the interior genital region to be normal, with no sign of pregnancy. In the 16 ectopic pregnancies diagnosed, it was possible in 13 cases to visualize the pregnancy directly by sonography, including the amniotic sac, and to make measurements. In one case a normally developed ectopic pregnancy with living embryo was seen at the end of the seventh week of gestation post menstruationem. In the remaining three cases the diagnosis was established on the basis of an empty cavum uteri associated with a slightly enlarged uterus and demonstration of fluid in the pouch of Douglas. In two cases the ectopic pregnancy was correctly localized by "feeling" with the intravaginal probe to establish the cause of circumscribed pain. In three case the tentative diagnosis of an ectopic pregnancy made on the basis of sonographic findings was not confirmed by subsequent clarification procedures. The results described show that in most cases ectopic pregnancies can be demonstrated directly by sonography using an intravaginal probe.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosis, Differential↗
PubMedDate not supplied

[Sampling of the chorionic villi: transcervical fine-needle and endoscopic aspiration].

In 63 cases chorionic villi sampling has been performed under complete anesthesia just before legal abortion; nine of them were endoscopic transcervical and 54 transcervical by means of a catheter under direct ultrasonic control. 81% offered useful chorionic villi, 17.4% only decidual material. The last 21 aspirations by means of a catheter between the 8th and the 12th week of gestation (p.m.) caused no problem at all. From the first punction on useful chorionic material has been obtained.

Abortion, Legal↗
PubMedDate not supplied

[Ultrasound echographic imaging and measurement of the amniotic cavity and yolk sac in early pregnancy: comparative study of intact and disordered pregnancies].

The chorionic cavity, vertex-breech length, yolk sac, and amnion were systematically demonstrated and measured in 50 early pregnancies, i.e., between the end of the sixth and the tenth week of gestation post menstruationem (p.m.). This was done in 23 cases with clinically and sonographically intact pregnancies without symptoms of abortion, in 12 cases with living embryos with symptoms of abortion, and in 15 cases of retained miscarriage. The thin amniotic membrane is sonographically demonstrated as a narrow, sharply defined reflected band in the chorionic cavity. In addition to direct demonstration of the amniotic membrane, the amniotic cavity can be demonstrated by a density difference in the echogenicity of the chorionic and amniotic fluids. While there are delicate, homogenously distributed inner echoes in the chorionic cavity, the amniotic cavity is empty save for the embryo structure. Sonographically, therefore, the amniotic cavity stands out as a spherical structure within the chorionic cavity. In all pregnancies with a living embryo it was possible to demonstrate the yolk sac sonographically as a sharply defined ring structure in the chorionic cavity. In 10 of the 15 cases of retained miscarriage only a rudimentary remnant of the yolk sac could be detected. The development of the amniotic and chorionic cavities and vertex-breech length was constant in the pregnancies with living embryos, the amnion developing synchronously with the vertex-breech length.(ABSTRACT TRUNCATED AT 250 WORDS)

Amnion↗
PubMedDate not supplied

[Non-invasive diagnosis of pre- and postpartum urination disorders].

Postpartal disorders of urinary discharge due to birth trauma are frequently the cause of rising infections of the urinary tract during the puerperium. In diagnosis, noninvasive methods should be preferred. Bladder-emptying function was checked by means of uroflowmetry and sonographic measurement of residual urine in 83 patients at the Department of Gynecology and Obstetrics at the RWTH, Aachen, in the third trimester and post partum. A considerable restriction of urine flow was found both prepartally as well as on the third day post partum. In contrast, there was practically no disturbance of bladder emptying on the sixth day post partum. This function is restored more quickly in cases of cesarean section than in cases of vaginal delivery. As early as the third day post partum no further influence of subpartal analgesia could be demonstrated. The findings failed to show any difference between the group with vaginal/surgical delivery and that with spontaneous birth. Generous use of these noninvasive diagnostic methods to identify postpartal micturition disorders can be recommended.

Cesarean Section↗
PubMedDate not supplied

[Ultrasonic diagnosis of congenital uterine abnormalities].

1-2% of women has abnormal uterine development due to nonunification of the Müllerian ducts in the embryonal period. At the RWTH Aachen, in the department of gynaecology and obstetrics, between January and June 1987, we had searched systematically for maldevelopment of the uterus in 2299 echosonografies. In 13 cases we found maldevelopment of internal genital; 5 of these cases were diagnosed by an echosonografic routine-examination. The echografic criteria of the different grades of uterine malformations have been determined, systematized and discussed in relation to the symptoms. The most frequent malformations as uterus subseptus, uterus septus, uterus bicornis and uterus duplex are subject of a detailed discussion. This work demonstrates that echosonografic is a very efficient instrument to diagnose uterine malformations and gives us a very exact anatomic interpretation of malformations.

Abortion, Incomplete↗
PubMedDate not supplied

[Initial studies of 3-dimensional imaging using ultrasound].

In the study reported here three-dimensional sonographic imaging of organs was achieved for the first time. To make this possible it was first necessary to ensure, by appropriate guidance of the probe, that the sequence of sonographic sections was coordinated in their spatial arrangement. This was accomplished by constructing a probe guide with which parallel sonographic sections could be demonstrated. The distance between these sections was known, so that with the aid of suitable computer programs three-dimensional reconstruction of a kidney examined in a water bath was possible. Since, however, due to the uneven surface of the body, it will hardly be possible to obtain parallel sonographic sections of an organ, a new solution had to be found to ensure the necessary coordinated sequence of sections. The solution lay in rotating the probe. A further device was constructed in which the probe could be rotated farther, by known angles, from section to section. The pivotal point was at the center of the probe tip. The computer knew the angular distance between these sections and reconstruction to a three-dimensional image was therefore possible. Prior the three-dimensional reconstruction the ultrasonographic sections had to be contoured, since only the surface of the organ was available for three-dimensional image construction. Three-dimensional imaging of an organ can be achieved on the one hand by binary representation and on the other with a continuous organ surface. The advantage of binary representation is that the original sonographic data are incorporated in the image-producing process without any computer manipulation; with a continuous surface the distance between the individual sections has to be interpolated.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Simulation↗