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Biomedical subjects

F K Klöck

Publications and source records attributed to F K Klöck.

At least 19 recordsLinked to original sources
PubMed1988

[Results following anterior levator-plasty].

In this study we report about 172 patients who underwent modified anterior repair in the time from october 1983 up to april 1985 because of vaginal prolapse and/or incontinence. 125 patients could be examined clinically, in the middle 14.2 months after operation. In 64% the modified anterior repair was combined with a colporrhaphia anterior and hysterectomy, and in 20% a colporrhaphia posterior was made additionally. Dehiscence of the anterior vaginal wall occurred in 19.2%, severe pelvic infections in 8.8%. Because of bleeding complications a chirurgical intervention was necessary in 5.6%. A descent of the anterior vaginal wall was seen in 30.4%, 76.8% of the women developed a descent of the posterior vaginal wall, and 8% a stenosis of the vagina. Problems at sexual intercourse were frequent, followed by pain in the lower abdomen. The principle of the operation is presented including the changed anatomy. Many of the adverse effects can be understood and the necessity of prophylaxis of a descensus of posterior vaginal wall was described.

Adult↗
PubMed1987

Fenoterol depot and fenoterol in premature uterine contractions--a multicentric double-blind comparative study.

In a double-blind randomized study, the effect of a single dose of a fenoterol preparation with delayed release of active substance (designated as fenoterol depot) was compared with a fenoterol product with undelayed release of active substance (designated as fenoterol) in two groups respectively comprising 66 and 65 female patients with premature uterine contractions. The fenoterol depot was administered p.o. in a single total dose of 21 mg at the beginning of an investigation period of 360 minutes and the fenoterol was administered p.o. within 235 minutes in three identical consecutive doses resulting in a total dose of 22.5 mg. The increased uterine activity present at the beginning was markedly lowered by an initial intravenous infusion of Partusisten. After administration of the two oral preparations, the uterine contractions remained at the low level achieved. The fenoterol depot was slightly superior to fenoterol with regard to the reduction of the duration of contractions: the difference in the inhibition of the duration of the contraction between the two preparations was a maximum of 25.7% in favor of fenoterol depot. The frequency of uterine contraction was substantially reduced by both preparations, but to a greater extent by the depot form. The tocolytic efficacy and the tolerance were rated as "good" in 70% and 75% respectively with fenoterol depot and in 69% and in 71% respectively in the case of fenoterol. The maternal pulse rate remained at the level reached at the end of Partusisten infusion with the two preparation, and the blood pressure fluctuated slightly within the normal range.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1985

[Suprapubic urinary diversion following gynecologic operations].

In a prospective study the results of postoperative urinary discharge by suprapubic catheterisation (SC) are compared with those of transurethral catheterisation (TC) in a randomised collective of gynaecological patients after vaginal hysterectomy with front (resp. front and back) plastic. During November 1979 and September 1980 157 patients were examined, 88 patients by suprapubic catheterisation and 69 by transurethral catheterisation, with random distribution. Additionally, 430 other patients with suprapubic aspiration after vaginal hysterectomy with front and/or back plastic performed between September 1980 and October 1982 were examined retrospectively especially under the aspect of possible complications. The advantages of suprapubic urinary discharge are shown in the significantly reduced rate of primary infections. 20.5 per cent of infections are opposed to 67.1 per cent in the comparative group with TC. Spontaneous miction was possible in the SC group two days earlier than in the group of TC (5.2 days opposed to 7.35 days). Additional drug treatment for restitution of the bladder function was more often necessary for patients with TC, although the results with 43.5 per cent against 29.5 per cent in the SC collective are not significant. The number of renewed catheterisations after removal of the catheter was higher by 27 per cent in the group of patients with SC. Subjective complaints were stated by patients with TC in 66.7 per cent against 18.2 per cent of women with SC. This result is significant. In the TC collective there were significantly more patients with leucocyturia (88.5 per cent against 48.7 per cent). Antibiotic treatment of an urinary tract infection with typical symptoms was necessary in 35.8 per cent for patients with TC and in 14.1 per cent for women with SC.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed1985

[Prenatally diagnosed fetal hydrothorax].

A predominantly unilateral hydrothorax in an unborn child was diagnosed by sonography during the 34th gestational week. Because of a pathologic cardiotocogram it was necessary to make a primary caesarean section one day later. The premature baby was intubated immediately and the pleural discharge was removed. Later developmental of the child was uneventful. The hydrothorax was interpreted as a partial factor of a hydrops fetalis. Controlling the fetal pleural discharge by ultrasound examination and regular cardiotocogram a caesarean section should be done between the 34th and 36th week of pregnancy.

Cesarean Section↗
PubMed1984

[Malaria relapse in the puerperium].

During the last six years we observed four malaria relapses shortly after delivery. In three cases the relapse occurred subsequent to Caesarean section, and in one case shortly after normal uncomplicated delivery. Case histories revealed that these women had previously stayed in the tropical or subtropical zones. The longest period without relapse was five years, the shortest interval four months. In all cases, microscopic examination revealed a relapse of Malaria tertiana. All the patients were cured within a short time by administration of chloroquine; the clinical signs disappeared. If, in fever of unknown origin, malaria is suspected, diagnosis and therapy will be an easy matter. Good anamnesis will provide a pointer to appropriate therapeutic action.

Adult↗
PubMed1980

[Comparative monitoring of pre-ejection-period and transcutaneously measured pO2 in neonatal period (author's transl)].

UNLABELLED: Pre-ejection period (PEP) and transcutaneous measured pO2 (tc pO2) were monitored simultaneously with the beat-to-beat ECG in 55 cases of unselected neonates. In addition body weight, acid-base-status and body temperature were registered 11 neonates were monitored immediately post partum, the others at various times until 9 days after delivery. RESULTS: The mean value of PEP after delivery is 63,3 msec. There is a negative correlation between neonatal heart rate and Pre-ejection-period. Increases of body temperature leads to a decrease of the PEP and vice versa. There are no direct significant alterations in PEP in connection with changes in neonatal tc pO2. Only when tc pO2-values beyond 20 mmHg were registered in distressed neonates PEP shortened significantly. PEP shortened also in periods of neonatal crying PEP is not correlated to birth weight or the actual neonatal weight when measurement of PEP and tc pO2 was performed.

Body Temperature↗
PubMed1979

[The pre-ejection-period of the humen fetal heart: significance of base-line alterations in perinatal period].

The Pre-ejection period of the cardiac cycle, fetal heart rate and uterine contractions were monitored in a series of 115 unselected fetus sub partu. A new one-line technique permits a continuous registration of PEP patterns simultaneously with the CTG. Any change in base-line of the PEP war related to heart rate, acid-base-status and gestational age. The average value of PEP in fetus was 72,93 +/- 7,9 msec. The base-line of PEP increased paralelly with gestational age of fetus and decreased rapidly beyond normal values after the 41. week of gestation. Within normal values alterations in base-line of the PEP were negativly correlated to alterations in base-line of the heart rate. Abnormal high and low base-lines of the PEP were observed in fetal acidosis, hypoxemia, and in uteroplacental insufficiency. The prolonging or shortening of the PEP base-line seems to signalize an acute injury of the utero-feto-placental unit in perinatal period.

Acid-Base Equilibrium↗
PubMed1979

[The pre-ejection-period of the human fetal heart: patterns of change during labour and heart-frequency alterations (author's transl)].

UNLABELLED: The Pre-ejection period (PEP) of the cardiac cycle, fetal heart rate, and uterine contractions were monitored in a series of 115 unselected fetus sub partu. PEP was detected by a new on-line technique using EKG and DKG. This method permits a continuous registration of PEP patterns simultaneously with the fetal CTG. Any change in PEP was related to fetal status and fetal heart rate patterns. RESULTS: Absolute PEP was prolonged and relative PEP (PEP/cardiac cycle) did not alter during decelerations due to a fetal head compression. The absolute PEP and the relative PEP were prolonged (rarely relative PEP was shortened) during alterations of fetal heart rate patterns based on the alteration in hemodynamics of fetal circulation. A first increase of the PEP was followed by a second increase of the PEP during severe variable decelerations conducting to a secondary chemoreceptor-reflex caused of fetal hypoxemia and acidosis; the duration between the two prolongation peaks of the PEP is directly correlated of fetal blood oxygenation: hypoxemia decreases this duration. These changes are essentially independent of heart rate and therefore PEP can be considered as an independent parameter for fetal assessment.

Deceleration↗
PubMed1979

[Comparative study of pre-ejection period and trans-cutaneously measured pO2 sub partu (author's transl)].

UNLABELLED: Transcutaneously measured pO2 (tc pO2), Pre-ejection-period (PEP) fetal heart rate (FHR) and intrauterine pressure were registered simultaneously in 5 cases of fetuses having umbilical cord complications. In addition a punctual measurement of acid-base-status was performed during intra partal registration and after delivery. RESULTS: In each fetus there is a relative correlation of basic PEP and basic tc pO2. An almost parallel pattern of PEP and tc pO2 occurred during uterine contractions, while both parameters are strictly correlated. There is always a prolongation of the PEP and a rise in tc pO2 of the fetal scalp during deceleration and uterine contractions. PEP changes due to a decrease of preload and increase of afterload of the fetal heart, the relative better oxygenation of the fetal scalp during uterine contractions and decelerations due to a redistribution of circulating blood volume caused by a selective peripheral vasoconstriction.

Female↗
PubMed1977

[Acute reduction of uterine blood flow and fetal heart rate changes in pregnant sheep near term].

Five merino sheep near term were used for acute preparations to investigate the influence of basal uterine blood flow (UBF), basal fetal oxygenation and basal fetal heart rate (FHR) on FHR changes elicited by acute reduction of UBF. The ewes were anaesthesized with pentobarbital and Alloferin was given for relaxation. Ventilation was maintained via a tracheal tube by a Starling pump. Maternal heart rate, arterial pressure and intrauterine pressure as well as fetal heart rate and umbilical artery pressure were recorded continously. Initially blood flow was recorded by cuff flow meter sequentially in both uterine arteries for a short time in order to determine total UBF and the ratio of flows. During the UBF reduction sequence flow was recorded in the artery of the gravid horn continously and measurement was corrected according to the initial ratio of flows in both arteries, presuming that this ratio would remain constant throughout the course of the experiment. Repetitive and progressive acute reduction of UBF (approximately 25%, 50% and 100% from basal UBF value) was achieved three times, lasting 120 sec each and each approximatly 12 min apart, by flow meter controlled partial or total occlusion of the aorta abdominalis of the ewe with a balloon catheter inserted into the aorta. (In some cases the lateral abdominal section was left open and the aorta was compressed manually). Before, 90 sec after the beginning and 10 min after the end of UBF reduction blood samples were taken from the fetal catheters (Fig. 3). In two preparations this sequence was repeated once after complete recovery of FHR.

Animals↗
PubMed1976

[Comparison of serum lipid concentrations in umbilical artery, umbilical vein and maternal vein blood (author's transl)].

Maternal serum lipids and lipids in umbilical artery and umbilical vein blood were examined immediately after delivery in order to relate maternal and fetal lipid metabolism. Total lipids, phospholipids, triglycerides, total cholesterol, cholesterol esters and free cholesterol were determined. The comparison of arterial and venous umbilical lipid levels showed a significantly higher concentration of phospholipids in the umbilical vein, indicating an enhanced flux of phospholipids from the placenta to the fetus. A positive correlation is established for the amounts of total lipids (p less than 0,05), triglycerides (p less than 0,01), phospholipids (p less than 0,05) and free cholesterol (p less than 0,005) between maternal and umbilical vein blood. It is suggested that free cholesterol passes the placental barrier unchanged. The other correlations are discussed as the expression of a factor influencing simultaneously the maternal and fetal lipid metabolism.

Cholesterol↗
PubMed1975

[Possibilities and limits of the intrauterine reanimation (author's transl)].

Intrauterine reanimation means the removal of acute maternal or fetal distress. Beside of maternal shock (traumatic, hoaemorrhagic, supine hypotension syndrome) all acute distress situation are seen during labour. The therapeutical possibilities and premises on the one side, the limits and dangers on the other are discussed. There are the change of position in bed, infusion of low molecular dextrane, O2- breathing, buffering of the mother, infusion of vasodilatators and beta-stimulators to the mother. The main therapeutical principle for intrauterine reanimation are change of side position and beta-stimulator therapy in case of disturbances in feto-maternal respiration because of an acute utero-placental insufficiency or a cord complication. As to an own patient group with intrauterine reanimation with the beta-stimulator "Partusisten" in 174 deliveries with cardiotocographic signs of fetal distress in the first stage of labour there is shown that threatened fetal distress because of uterine hyperactivity and cord complication is successfully treated by tocolysis. In case of chronic placental insufficiency there is no therapeutical success by intra partum tocolysis in 30%.

Acid-Base Equilibrium↗