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Biomedical subjects

E Vytiska-Binstorfer

Publications and source records attributed to E Vytiska-Binstorfer.

At least 19 recordsLinked to original sources
PubMed2003

Thyroxine treatment modified in infertile women according to thyroxine-releasing hormone testing: 5 year follow-up of 283 women referred after exclusion of absolute causes of infertility.

BACKGROUND: Mild hypothyroidism may contribute to disturbed reproductive function. We hypothesized that frequent thyroxine-releasing hormone (TRH) testing to fine-tune thyroxine (T4) therapy instituted upon every TRH-induced thyroid-stimulating hormone (TSH) rise above the mean of a healthy population (i.e. 15 mIU/l) would improve fecundity compared with historical data. METHODS: In a cohort of 283 infertile women followed over 5 years, we assessed (i) pregnancy, abortion and delivery rates, (ii) thyroid function over time in women who conceived compared with those who did not, and (iii) various thyroid parameters with respect to fertility. RESULTS: Overall conception rate of 37% was higher (P < 0.05) than previously reported and independent of thyroid function prior to T4 therapy, thyroxine dose or elevated thyroid autoantibodies. Never achieving basal TSH <2.5 IU/l or TRH-stimulated TSH <20 mIU/l with T4 therapy resulted in lower conception rates (P < 0.05). Median time to conception was 6 months, but 18 months in women who declined TRH testing (P < 0.02). Overall abortion rate was 9%. Only first trimester miscarriages occurred. CONCLUSIONS: Based on the presented protocol, high pregnancy and parturition rates were observed. Whether this is due to early T4 therapy remains to be determined. Abortions appeared to be associated with higher TSH but not with elevated thyroid antibodies.

Abortion, Spontaneous↗
PubMed1999

Elevation of inducible nitric oxide synthase activity in human endometrium during menstruation.

Nitric oxide (NO) is a known agonist of programmed cell death (apoptosis). In order to discover its potential role during menstrual shedding, a process associated with extensive apoptosis, we evaluated activity and mRNA levels of the inducible and constitutive isoforms of NO synthase (NOS) in endometrial specimens of the proliferative (n = 11), late-secretory (n = 7), and menstrual (n = 17) phase of the cycle. These levels were compared with the proportion of apoptotic cells by detection of histochemically labeled DNA fragments. Inducible NOS (iNOS) activity during menstruation was six times that of the proliferative or late-secretory phase (p < 0.05), whereas constitutive NOS activity remained unchanged. Competitive reverse transcription-polymerase chain reaction revealed 146% and 77% increases of iNOS mRNA expression in the late-secretory and menstrual phases, respectively, compared to the proliferative phase (p < 0.05), whereas constitutive NOS mRNA expression remained constant. Inducible NOS immunostaining was restricted to epithelial cells, whereas constitutive NOS immunostainig was confined to vascular endothelia. In addition, the proportion of apoptotic cells within the glands of late-secretory or menstrual endometrium was twice that of the proliferative phase (p < 0.05). We conclude that local production of NO is involved in the signal transduction mechanisms leading to endometrial breakdown during menstruation.

Adult↗
PubMed1998

[The role of nitric oxide in reproduction].

Nitrix oxide (NO) is a highly reactive and short-lived radical (half-life time: 10-12 s), which is derived from L-arginine by the NO synthases (NOS) in several organ systems. The release of NO by endothelial cells leads to rapid relaxation of vascular smooth muscle cells, whereas release by several neuronal cells causes neurotransmission. When NOS is actively induced in immune cells or certain epithelia it causes cytotoxicity and/or apoptosis of these cells. In the reproductive organs NO is now considered to be an important trigger molecule for several physiological mechanisms. Follicular synthesized NO is involved in rupture of the follicle during ovulation. Moreover, NO participates in the acrosome reaction of spermatozoa during capacitation. Apoptosis and collagenolysis of the functional endometrium may be involved in endometrial shedding during menstruation. Since NO induces both apoptosis and collagenolysis, the newly discovered production of NO in late secretory endometrium could act as a key mechanism in the process of menstrual disintegration of the endometrium. Additionally, NO is necessary to support and maintain the decidualization process and plays a pivotal role in implantation.

Female↗
PubMed1997

[Premenstrual dysphoric disorder. An overview of diagnosis, epidemiology and therapeutic approaches].

Even though premenstrual symptoms had been already described by Hippocrates, premenstrual dysphoric disorder (PMDD) was first mentioned as a special psychiatric diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in 1994. In DSM-III-R-Appendix A is was called late luteal phase dysphoric disorder (LLPDD), Appendix A. Before this diagnosis was established based on operationalized criteria, the term premenstrual syndrome (PMS) was used for patients with severe premenstrual mood disturbances and physical symptoms. Many hypotheses about the pathophysiological mechanisms underlying PMS and PMDS led to different therapeutic strategies. While PMS was mainly treated by gynecologists, PMDD became of interest in psychiatric research. Several antidepressants, psychotherapy, sleep deprivation and light therapy have been investigated regarding their effectiveness in combatting premenstrual symptoms such as depression, tension, dysphoria and anxiety. Within the anti-depressants the best findings were for selective serotonin reuptake inhibitors (SSRIs).

Antidepressive Agents↗
PubMed1994

[Drug information in hormone substitution drugs].

The package leaflets of hormone preparations used for Hormone Replacement Therapy (HRT) in hypoestrogenaemic women contain contraindications, which are taken from the package insert of oral contraceptives: Clots in the blood vessels (thrombotic disorders), high blood fats, severe diabetes, abnormal red blood cells, deterioration of inherited deafness and jaundice not explained by infections, disturbances of the liver function and of existing or treated hormone-dependent tumours of the breast or of the lining of the womb. Numerous epidemiologic, animal-experimental and also clinical studies proved that the cardiovascular risk, hepatic discomfort and the influence on the blood system of oestradiol 17-beta have to be evaluated completely differently compared to the ethinyloestradiol used in oral contraceptives; therefore, many of the listed contraindications must be reconsidered. In our review we try to emphasise this postulation by scrutinizing recent publications.

Adult↗
PubMed1990

[Contraception in Austria].

952 sexual active women between 15 and 44 years were investigated for their contraceptive behaviour. In 42% the pill was the first choice followed by the condom in 16%. 18% of all sexual active women in this age group did not use any contraceptives. Therefore the rate of unplanned pregnancies was very high: 34% reported about such unplanned pregnancies in their history. The main sources for informations in contraception are the gynecologist and the partner, but not the parents or the newspapers. Nearly half of all women did not know how the pill really works and quite a lot has still the opinion that there are really harmful side effects of oral contraceptives.

Adolescent↗
PubMed1990

Various effects of abdominal and vaginal hysterectomy in benign diseases.

The relative advantages and disadvantages of the transabdominal versus the transvaginal approach to hysterectomy were evaluated and the two procedures were compared for differences in hospitalization, patient age, bowel activity and operating time on the basis of a material of 94 hysterectomized patients. Intestinal complications such as subileus were noted only in subjects who were treated by abdominal hysterectomy. This corresponded with the significant decrease in potassium in abdominally operated patients on the second post-surgical day. Transvaginal hysterectomy was found to be superior in terms of all of these parameters. Complications associated with the two procedures were also compared. Of eight potential complications, seven were found to be confined to laparotomy, while only one occurred after transvaginal hysterectomy which was, however, invariably combined with colporrhaphy. The conclusion from the above should, therefore, be not to select patients indiscriminately for either the transvaginal or the transabdominal approach, but rather to use both routes of access as best fits the circumstances.

Aged↗
PubMed1989

Laparoscopic surgery for tubal pregnancies utilizing laser.

Nine cases of ectopic pregnancy were treated by laser supported tubotomy and subsequent endoscopic evacuation by a forceps. The location of the ectopic pregnancies were as follows: ampulla (one patient); isthmus (five patients); and fallopian tube (three patients, in two of whom the whole tube was a hematosalpinx). The incision in the tube was made on the antimesenteric side according to the position and size of the ectopic pregnancy using an Nd YAG laser. Tissue destruction of the Nd YAG laser was diminished by using a crystal. After the incision, the conceptional debris was removed by a forceps. In all cases the fallopian tube was left open. Three months after the operation an X-ray was performed. In all nine cases, patent tubes could be documented on the affected and on the contralateral side. In the two patients with hematosalpinx, adhesions of the treated tube were found.

Female↗
PubMed1989

[The course of atrial natriuretic peptide, aldosterone and antidiuretic hormone in normal pregnancy].

Atrial natriuretic peptide (ANP), consisting of 28 aminoacids, is a recently discovered cardiac hormone involved in blood-volume homeostasis. Pregnancy is associated with an increase in blood volume expansion, therefore an increase in ANP-concentration would have been expected. To test this hypothesis ANP, Aldosterone and Vasopressin, concentrations of 229 women with normal pregnancies at different gestational ages were measured and compared with values found in a non-pregnant control group of 24 women. Mean plasma ANP was increased during pregnancy, but significant differences were noted only after 36 weeks of gestation. Also plasma aldosterone increased significantly during pregnancy, whilst vasopressin levels showed no significant change compared to the non-pregnant group.

Adolescent↗
PubMed1989

[Initial experiences with a levonorgestrel-ethinyl estradiol combination for interception].

Several authors have reported on reliable postcoital contraception, using an estrogen/gestagen combination. These studies in more than a hundred women showed, that the unprotected intercourse in less than 50% took place around ovulation. Pregnancy rates from 0.7 to 2.6% were observed. From October 1987 to July 88, 50 women after unprotected intercourse around ovulation were included in our study. From one to 44 hours after intercourse, 0.5 mg levonorgestrel + 0.1 mg ethinylestradiol (Tetragynon) were administered orally. The same dose was repeated 12 hours later. Cervical secretion, LH- and E2 and P-serum levels at the time of the first administration were determined and side effects and bleeding patterns were registered. In one third of the women, we observed slight side effects. The bleeding resulted 5 to 29 days after the first tablet administration. Shortened menstruation cycles were seen more often than prolonged cycles. Bleeding duration was only slightly prolonged. Two pregnancies occurred - both women vomited immediately after the first medication and disregarded the order to visit our department again as quickly as possible. Tetragynon is not appropriate for regular contraception and should only be used in emergency situations.

Adolescent↗
PubMed1989

[Peri-ovulatory hormone determination in females with sterility of unknown origin].

In 86 patients with Clomiphen-therapy a daily LH-, E2-monitoring and a sonographic follicle-measurement was performed. In 27 patients a normal endocrine profile, in 12 women a double estradiol arise must be registered. A missing LH peak was noted in 9 cases. In 11 women a double LH peak occurred. 7 patients showed a LH arise two hours after the estradiol peak. In 15 women the ultrasound examination showed an insufficient follicular growth. In 5 cases the typical luf-syndrome was found. Though this variations in cycle-monitoring could be noted their effects in infertility is not really explained.

Clomiphene↗
PubMed1989

[The effect of postpartum tubal sterilization on milk production].

We investigated 64 women after the so called "post partum sterilization" and recorded also retrospectively the milk production within the first seven days. It was performed by at semilunar subumbilical incision and a bipolar coagulation of the fallopian tubes. The total daily milk production, which was compared with the quantity of milk after the previous pregnancy, was on day six and seven significantly lower after tubal ligation than in the normal puerperal phase before.

Adult↗
PubMed1988

[Serum proteins and hormones in vaginal and abdominal hysterectomy].

Postoperative changes in various acute-phase-proteins (alpha 1-Antitrypsin, c-reactive protein), alpha 2-Macroglobulin, haptoglobin, transferrin. c3-c4-complement and myoglobin as well as endocrine parameters were studied in forty healthy women in two groups. Women with malignant neoplasms were excluded. Each group consisted of 20 women who underwent either a vaginal or abdominal hysterectomy. Differences between both collectives could be seen in determinations of alpha 1-antitrypsin, CRP and myoglobin, where decreases were significantly higher in the laparotomy group than in the vaginal operation group.

Acute-Phase Proteins↗
PubMed1988

[Correlation of maternal androgens in early and late pregnancy. A correlation with fetal size and sex].

In the course of prospective investigations blood was withdrawn for steroid analysis in 50 gravidae between 12th and 16th and between 26th and 30th week of gestation. The levels of androstenedione, testosterone, dehydroepiandrosterone sulfate, 17-hydroxyprogesterone and sex hormone binding globuline were determined by radioimmuno-assay evaluating a possible correlation between the androgen values and growth retardation or the sex of the fetus. Neither during the early nor during the late period of pregnancy significant differences concerning the androgen levels could be detected among both sexes. Worth mentioning is the significant decrease of the DHEA-S levels during the late period of gestation, which occurred in both groups, whereas the androstenedione, testosterone and especially the 17-OH-P levels showed a significant increase. The SHBG values almost did not change at all.

17-alpha-Hydroxyprogesterone↗
PubMed1987

[Neuroendocrine changes in the climacteric].

In order to investigate the relationship between hot flushes and LH-peaks, we applied GnRH-Analogon for pharmacological hypophysectomy. Although the gonadotropin serum levels could be normalized, none of the women showed a cessation of the flushes. Therefore it can be assumed that not gonadotropins, but neurotransmitters are involved in the development of flushes. The determination of the serum-level of vasointestinal peptide in the course of a TRH-test showed high VIP levels only in two climacteric women. To verify the suspected relation of VIP to the climacterium, a larger collective of women has to be checked.

Climacteric↗