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Biomedical subjects

G Grospietsch

Publications and source records attributed to G Grospietsch.

35 records · Page 2Linked to original sources
PubMed1986

[Current aspects of therapy of ovarian cancer. Surgical therapy of epithelial ovarian cancer at the Göttingen University Gynecologic Clinic. A retrospective analysis of 82 patients 1981-1984].

The most important step in the treatment of epithelial ovarian carcinoma is radical surgery which should be as radical as possible, since this can exercise a decisive influence on the effectiveness of subsequent chemotherapy or radiotherapy. During 1981-1984 98 patients with an ovarian carcinoma were operated upon. 82 of these patients had epithelial tumours that will be discussed in the article. The mean age was 59.9 years. 88% of the patients were additionally at risk by one or several risk factors. Surgical approach was standardised: longitudinal incision, hysterectomy, adenectomy, resection of omentum and, if necessary, maximum possible removal of the peritoneum of the pelvis. In 28 cases additional surgery became necessary at the intestine. 77% of the patients (n = 63) were in the advanced stages FIGO III and IV. In 50 patients the operation lasted for up to 4 hours, in 24 up to 6 hours and in 8 for more than 6 hours. Intraoperative complications occurred in 37% (twice lesion of the ureter, in 5 cases intestinal lesion, in 23 cases anaesthesiological problems due to preexisting risks). In stages I and II reduction of tumour size below 2 cm was achieved in 100% of the cases, in stage III in 87.5%, in stage IV in 45%. Two patients died postoperatively. The postoperative complication rate was 48%. Almost 30% of these were represented by cardiopulmonary disturbances. Although the percentage appears high, most of the problems were well manageable, so that the patients could be transferred to follow-up therapy within 2-3 weeks. For type of follow-up therapy, tumour response.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1986

[Fenoterol (Partusisten)-associated lung edema. A case report].

The side effects of a beta 2-mimetic tocolytic therapy are of importance for anaesthesiologists who administer anaesthesia for obstetric operations, as our case report illustrates. In a healthy 28 year old pregnant woman during the 32nd week of pregnancy i.v. fenoterol was started because of premature labor. After two days severe respiratory failure developed and cesarean section was performed. The patient needed mechanical ventilation with positive endexpiratory pressure and high inspiratory oxygen concentrations (F1O2 greater than 0.7) for 5 days thereafter. The chest x-ray revealed a fluid lung. With artificial respiration and a consequent diuretic therapy with dopamine and furosemide (10 mg . h-1 continuously, negative water balance--5,000 ml on the 4th day) gas exchange improved and extubation was possible on the 6th postoperative day. After exclusion of cardiac or renal disease as well as aspiration of gastric content, the diagnosis of a fenoterol-associated pulmonary edema was thought probable. From the literature it is known that beta 2-mimetics can aggravate the increased water and sodium retention during pregnancy and cause pulmonary edema by an additional increase in pulmonary artery pressure. Therapy consists of adequate oxygenation and induction of diuresis with continuous furosemide and dopamine to achieve negative water balance. When administering anaesthesia to patients on tocolytic therapy positive water balance has to be avoided and great care must be directed to the postoperative gas exchange.

Adult↗
PubMed1984

Urinary excretion, osmolarity and electrolytes after bolus-injection of fenoterol in female rabbits.

The effects of bolus injections of 1.0-80.0 micrograms/kg body weight fenoterol on urinary excretion, osmolarity and electrolytes were studied in unanesthetized, water-loaded rabbits. In animals infused initially with isotonic solution over 2 h with 60 ml/h and thereafter over 10 h with 45 ml/h, urine excretion was 538 ml/12 h, sodium excretion was 65.4 mmol/12 h, and potassium excretion was 4.8 mmol/12 h. In animals injected with 5.0-80.0 micrograms/kg body weight fenoterol, a strong antidiuresis occurred, lasting for 2 (10.0 micrograms/kg) to 4 h (80.0 micrograms/kg). Due to the strong antidiuresis, urinary osmolarity was significantly elevated for 2 (10.0 micrograms/kg) to 3 h (80.0 micrograms/kg). The changes of sodium excretion after fenoterol injection were very similar to those of urine excretion. Maximum reduction of sodium excretion was found after injection of 10.0-80.0 micrograms/kg body weight fenoterol, the effect lasting for 1 h (10.0 micrograms/kg) to 4 h (80.0 micrograms/kg). Potassium excretion was significantly reduced after injection of 5.0-80.0 micrograms/kg body weight fenoterol. In contrast to all the other parameters measured, potassium excretion remained significantly reduced until the end of the infusion period in animals treated with 10.0-80.0 micrograms/kg body weight fenoterol and was not dose dependent. Our data presented in this work extend earlier findings in the rabbit in that bolus injection of fenoterol also results in a drastic decrease of urine and electrolyte excretion. The results are discussed with special reference for the management of acute fetal distress with betamimetics and to the development of pulmonary edema that has been shown to occur under therapy with betamimetics on both female rabbits and humans.

Animals↗
PubMed1983

[The effect of metoprolol on fenoterol-induced kidney function disorders].

The effect on renal function of a combination of a beta 2 receptors stimulating tokolytic agent (Fenoterol) with a so-called cardioselective beta 1 blocker (Metoprolol) which is able to antagonise the cardiac side effects of beta 2 stimulation, was examined in femaLe rabbits in a 24-hour test. Infusing 31.5 ml/h isotonic solution, 20 micrograms/kg/min Fenoterol and 3.125 micrograms/kg/min Metoprolol, excretion, creatinine clearance, electrolyte elimination, the serum electrolyte levels, Hb, HK and the weight were determined. The combination of Fenoterol and Metoprolol antagonised almost completely the massive water retention occurring under Fenoterol alone. At the latest after 12 hours, normal values were obtained in respect of the creatinine clearance reduced under Fenoterol, the urine excretion rate and, consequently, the Hb concentration and haematocrit reading. The reduction of sodium elimination caused by Fenoterol was completely reversed under the combination, whereas the reduced excretion of potassium was not influenced. Water retention in tocolysis with beta 2 stimulants is one of the most important causes for the information of a pulmonary oedema. The danger of the occurrence of such pulmonary oedemas, especially in risk pregnancies (gestosis), is drastically reduced by antagonising water retention, and hence the combination of Fenoterol and Metoprolol seems to be very favourable from both the cardiac and renal viewpoints. In a group of 17 pregnant women, the drastic improvement of urine excretion under the combination could be confirmed.

Animals↗
PubMed1982

Effects of the tocolytic agent fenoterol on body weight, urine excretion, blood hematocrit, hemoglobin, serum protein, and electrolyte levels in nonpregnant rabbits.

Infusion of an isotonic solution and increasing doses of the beta 2-sympathomimetic agonist fenoterol (0.6, 20, or 80 micrograms/kg/min) into female rabbits led to a reduction in urine excretion and a concomitant dose-dependent increase in body weight. Although an infusion at 2.5 ml/hr of an isotonic solution that contained 0.6 or 20 micrograms/kg/min of fenoterol did not significantly change the hematocrit, hemoglobin, or serum protein levels, they were significantly decreased by a similar infusion that contained 80 micrograms/kg/min of fenoterol and by giving 20 ml/hr of an isotonic solution that contained 0.6, 20 or 80 micrograms/kg/min of fenoterol. The central venous pressure remained unchanged in animals that received 2.5 ml/hr of an isotonic solution alone or in combination with 0.6 to 80 micrograms/kg/min of fenoterol. It was significantly elevated in animals treated with 30 ml/hr at similar doses. These data support our hypothesis that the development of pulmonary edema which has been reported with the use of tocolytic therapy is mainly due to hypervolemia related to the antidiuretic effect of the beta 2-sympathomimetics. The intravascular hypervolemia leads to an increased fluid content of the lung and may explain the development of pulmonary edema.

Animals↗
PubMed1982

Fenoterol-induced changes of urine excretion, body weight, blood hematocrit, hemoglobin, total protein values and serum electrolyte levels in pregnant rabbits.

Infusion of the beta 2-sympathomimetic agonist fenoterol into pregnant rabbits at a dose of 20 micrograms/kg/min + 2.5 or 30 ml/h isotonic solution significantly reduced urine excretion. Body weight changes of animals infused with 20 micrograms/kg/min fenoterol + 2.5 or 30 ml/h isotonic solution were inversely correlated to the reduction of urine excretion. The urinary potassium excretion per 24 h was not significantly altered after the infusion of fenoterol + 2.5 or 30 ml/h isotonic solution. On the other hand, the urinary sodium excretion per 24 h was significantly decreased in animals infused with 20 micrograms/kg/min fenoterol + 30 ml/h isotonic solution. Infusion of 20 micrograms/kg/min fenoterol + 2.5 ml/h isotonic solution did not significantly change hematocrit, hemoglobin or total protein values. In contrast, increasing the volume of isotonic solution to 30 ml/h resulted in significantly decreased hematocrit, hemoglobin and total protein levels at 6, 12 and 24 h after starting infusion. Serum potassium concentrations were reduced at 2-24 h after infusion of 20 micrograms/kg/min fenoterol + 2.5 or 30 ml/h isotonic solution was started. The serum sodium concentrations did not change significantly during the infusion of 20 micrograms/kg/min fenoterol + 2.5 or 30 ml/h isotonic solution. While in animals infused with isotonic solution alone or with 20 micrograms/kg/min fenoterol + 2.5 ml/h isotonic solution the central venous pressure did not change significantly, it was strongly increased in animals infused with 20 micrograms/kg/min fenoterol + 30 ml/h isotonic solution at 12-24 h after start of infusion. The results of this study are discussed with respect to those obtained from pregnant women under tocolytic therapy and to the possible pathomechanism of the development of pulmonary edema.

Animals↗
PubMed1981

Plasma glucocorticosteroid and aldosterone levels during physiological and stress conditions in rabbits. II. adult animals.

The pattern of adrenal steroid secretion under basal and stress conditions and the response to tetracosactid (20.0 micrograms/kg body weight) were studied in adult male rabbits. In animals repeatedly stressed by artery puncture, plasma glucocorticosteroid levels were slightly higher than those found in unstressed control animals. The combined stress of repeated exposure to ether vapor for 60 sec, followed by artery puncture, significantly stimulated glucocorticosteroid release, concentrations progressively increasing with the number of ether exposures applied. A much faster and more pronounced stimulation of glucocorticosteroid release was seen in animals treated with 20.0 micrograms/kg body weight tetracosactid. Plasma aldosterone levels in animals stressed by artery puncture were higher, although not significantly, than those of unstressed control animals. Repeated exposure to ether vapor for 60 sec, followed by artery puncture, on the other hand slightly decreased plasma aldosterone concentrations. A strong stimulation of aldosterone release at 20--60 min after injection could be elicited only by intravenous administration of 20.0 micrograms/kg body weight tetracosactid. Because of the insensitivity of the zona glomerulosa cells to increased ACTH levels under stress conditions, it is concluded that ACTH is only of minor importance both under basal and stress conditions in the regulation of aldosterone secretion in the rabbit.

Adrenocorticotropic Hormone↗
PubMed1980

[Pulmonary edema during tocolytic treatment (author's transl)].

During tocolytic treatment with Beta 2-Sympathomimetic drugs pulmonary edema is occasionally observed. The cause remains uncertain. Within 48 hours after the onset of treatment marked water retention is observed. The weight increases, the hemoglobin decreases the hematocrit decreases, the albumin concentration decreases, the water and sodium excretion decreases. The pathogenesis is discussed and recommendations for the management are proposed. Water retention due to tocolytic treatment in addition to the physiologic water retention of pregnancy or in addition to pre-eclampsia cortisone treatment, renal insufficiency, or treatment with intravenous infusions may lead to a hypervolemia which can no longer be compensated by diuresis and therefore can lead to pulmonary edema. A list of 10 groups of patient with a high risk is described. These require thorough observation following tocolytic treatment.

Blood Proteins↗
PubMed1980

Basal plasma aldosterone levels and tetracosactid-induced increase of aldosterone secretion in conscious male rabbits: lack of correlation with glucocorticosteroid levels.

The adrenocortical secretory activity under basal conditions and after treatment with tetracosactid (1-24ACTH) has been investigated in chronically cannulated male rabbits. Basal plasma concentrations of glucocorticosteroids (0.74 micrograms/100 ml) and aldosterone (78 pg/ml) have been determined in a greater number of animals. No significant positive correlation between basal glucocorticosteroid and aldosterone plasma levels could be found. After intravenous injection of 2.5, 5.0, 10.0 and 20.0 micrograms/kg body weight tetracosactid glucocorticosteroid concentrations were significantly elevated between 40--100 min after administration; aldosterone release, on the other hand, was significantly increased only after injection of 10.0 or 20.0 micrograms/kg body weight tetracosactid between 20--60 min after injection. After administration of high tetracosactid doses glucocorticosteroid and aldosterone plasma concentrations were significantly correlated (10.0 micrograms/kg: r = 0.62; 20.0 micrograms/kg: r = 0.26). Because of the relative insensitivity of the zona glomerulosa cells to tetracosactid administered intravenously, it is concluded that ACTH is only of minor importance in the regulation of aldosterone secretion in the rabbit.

Adrenocorticotropic Hormone↗
PubMed1980

[Occurrence of pulmonary oedemas without myocardial necroses under beta 2-sympathomimetic therapy with fenoterol (experimental investigations in the rabbit (author's transl)].

Experimental investigations in the rabbit were aimed at solving the question whether the development of a pulmonary oedema during tocolytic therapy with beta 2-sympathomimetics can be explained by hyperhydration, since myocardial necroses are not likely to be the cause of a pulmonary-oedema at the standard clinical dosage level. Fenoterol is infused over a period of 24 hours in combination with low (2.5 mgl/h) and high (30 ml/h) supply of liquid (isotonic solution, Sterofundin). Essential changes in the measured parameters occur only if the quantity infused is high. The following findings were established: 1. an increase in the liquid content of the lung and heart from 80 to 90%. 2. blood gas analysis revealed marked signs of a ventilatory disturbance, 3. histologically, the lungs showed partly massive changes pointing to the presence of an interstitial and intraalveolar oedema. Since no myocardial necroses can be histologically identified, the pulmonary insufficiency cannot be due to cardiac decompensation as a result of myocardial necroses.

Animals↗
PubMed1978

[Behçet's syndrome (author's transl)].

Descriptions of Behçet's syndrome have been appearing more and more frequently in dermatological, ophthalmological, neurological, and pathological literature as well as in the literature in the field of internal medicine. Only two reports (1, 8) have appeared in gynecological journals during the last 15 years, even though the second most frequent symptom of the disease is vulval and/or vaginal aphthae and/or ulcers (80%-90% of the patients). For this reason, the diagnostic problems, therapeutic possibilities and prognosis were explained with the help of this casuistic contribution.

Adrenal Cortex Hormones↗
PubMed1976

[Genital malformations in thalidomide-damaged girls (author's transl)].

Due to the close morphological relationships and the dependence of the genital system on inductive impulses from the uropoietic system, the possibility of an increased incidence of malformations in the area of the female genitals for thalidomide-damaged children is to be expected. This suspicion is supported by the accumulation of reports of genital malformations in deceased children from mothers who took thalidomide-containing medicaments during the early weeks of pregnancy. - A 14-year-old patient with malformations of both upper extremities whose mother had taken thalidomide during the 6th to the 9th week of pregnancy presented at our hospital with complaints of cyclic pain in the lower abdomen. Although the ovaries and fallopian tubes were normally developed, the uterus and the vagina were absent in this patient. After this manuscript had been completed, we heard of 3 additional cases of genital malformation with a known thalidomide anamnesis.

Abnormalities, Drug-Induced↗
PubMed1975

[Constriction ring dystocia: a special form of uterine dystocia (author's transl)].

Constriction Ring Dystocia means a rare form of uterine dystocia (0.1%--1.7%). Pathophysiologically it means a hypertonic incoordinate anomaly of labor. The paper reports two cases of constriction ring, which had been recognized first during sectio cesarean. As the measure of choose is suggested to use tocolytica, although there do not exist any experiences and there was yet no chance to utilise these medicines because of lack of early recognition.

Adult↗
PubMedDate not supplied

The renin-angiotensin-aldosterone system, antidiuretic hormone levels and water balance under tocolytic therapy with Fenoterol and Verapamil.

The effects of long-term infusion of fenoterol (a beta 2-sympathomimetic drug) in combination with the calcium antagonist verapamil on water balance, the renin-angiotensin-aldosterone system and antidiuretic hormone during pregnancy were studied. Within two hours of the start of infusion, plasma renin and antidiuretic hormone levels were significantly increased, but plasma aldosterone was strongly decreased. There was a concomitant marked reduction of urinary, sodium, and potassium excretion and a decreased creatinine clearance. The long-lasting reduction of urinary excretion which resulted in an elevated water retention is apparently due to other unknown factors. Results are discussed with special regard to the relationship between water balance disturbances and pulmonary edema.

Blood Chemical Analysis↗