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Biomedical subjects

G Oelsner

Publications and source records attributed to G Oelsner.

At least 55 records · Page 3Linked to original sources
PubMed1987

Adhesion formation to the uterine horn of the rat in response to nylon and a new absorbable clip.

We have evaluated the tissue reactivity as manifested by adhesion formation to the uterine horn of the rat in response to a new absorbable surgical clip. A standard lesion on the uterine horn was created and repaired with either nylon sutures or an absorbable clip. Adhesion formation to the operative site was evaluated using a point based grading system, seven, 21 and 120 days postoperatively. A statistically significant increase in adhesion formation and their severity was seen on the uterine horns repaired with the surgical clips. The adhesions did not improve with time. In two instances, abscesses were formed around the clips. The use of the surgical clips in the peritoneal cavity needs to be investigated further. Their use in women in the reproductive age group who wish to preserve their reproductive potential is discouraged.

Animals↗
PubMed1986

The value of the cervical score in monitoring ovulation induction for in vitro fertilization: a prospective double-blind study.

The present study was designed to determine the accuracy of the cervical score for the timing of human chorionic gonadotropin (hCG) administration in in vitro fertilization patients compared to the timing of hCG administration based upon estradiol and ultrasound measurements. Forty-two patients undergoing ovulation induction with human menopausal gonadotropin (hMG)/hCG for in vitro fertilization were studied. A total of 192 cervical scores was obtained together with plasma estradiol levels and pelvic sonography. hCG was given based on estradiol and ultrasound results without knowing the cervical score. An independent decision to give hCG was made based on the cervical score only following a mean of 2.5 days of a cervical score of 9-12 without the examiner's knowledge of estradiol and ultrasound results. This decision was theoretic and was not considered for the actual timing of hCG. In 16 (38%) of the cases this decision coincided with that based on estradiol and ultrasound. In 24 (57%) of the cases there was a 1-day gap. A direct correlation was found among the cervical score, the plasma estradiol concentration, and the mean diameter of the two leading follicles (P less than 0.001). The overall distribution of the cervical score grouped according to estradiol levels (less than 200, 201-400, and greater than 401 pg/ml) was significantly different (P less than 0.001). The proportion of "mature" cervical scores (score of 11-12) in the three different estradiol groups was 15.6, 34.5, and 68.0%, respectively. In conclusion, independent decisions to give hCG based on cervical score or estradiol and ultrasound were coincident +/- 1 day in 95% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Cervix Uteri↗
PubMed1986

A comparison of three techniques for ovarian reconstruction.

We compared three methods of ovarian reconstruction in 23 mature female New Zealand White rabbits. Each animal was its own control. The right ovary in each rabbit was incised and repaired by placing three 8-0 nylon sutures through and through the base of the defect (method A). The left ovary was repaired without these through-and-through sutures. In 16, hemostasis was achieved by microbipolar cautery (method B); in seven, hemostasis was achieved with three sutures placed entirely inside the defect (method B1). The cortex of each ovary was repaired identically by continuous 8-0 nylon suture. Outcome was evaluated by laparoscopy 14 days after mating. Through-and-through sutures (right ovary) caused a significant increase in adhesion formation and decrease in nidation index. When these animals were put to death 14 weeks later, the right ovaries were significantly smaller. On the left, there was no difference in any outcome variable between methods B and B1. This study clearly shows the detrimental effect of through-and-through sutures for ovarian reconstruction.

Animals↗
PubMed1986

Effect of antihypertensive drugs on catechol-O-methyltransferase and monoamine oxidase activity in human term placental explants.

The effects of therapeutic concentrations of antihypertensive drugs on catechol-O-methyltransferase (COMT) and monoamine oxidase (MAO) activities in term placental explants were studied. The enzyme activities were measured in tissue fractions using radioenzymatic techniques. At 6 h the incubation COMT activity increased significantly following exposure to verapamil and hydralazine, while exposure to alpha methyldopa caused a significant suppression of the enzyme. At 24 h exposure to hydralazine significantly suppressed the COMT activity. By 6 h the MAO activity was significantly suppressed by verapamil. MgSO4 and propranolol had no effect on the activities of COMT and MAO at 6 and 24 h. These results suggest that COMT and MAO activities in the placenta can be modulated by antihypertensive drugs and, therefore, these drugs might affect local catechol metabolism.

Antihypertensive Agents↗
PubMed1986

Progesterone, estradiol, and alpha-human chorionic gonadotropin secretion in patients with ectopic pregnancy.

Plasma free alpha hCG, estradiol (E2), and progesterone (P4) concentrations were measured in 38 patients with histologically confirmed ectopic pregnancy (EP). The menstrual gestational ages ranged from 6-10 weeks. Free alpha hCG levels, although significantly lower than those in women with a normal intrauterine pregnancy, increased markedly during this time period, from 1.5 to 11 ng/ml, a 7-fold increase. In women with an intrauterine pregnancy, only 0.6-fold increase occurred during the same time period. Plasma P4 and E2 concentrations in patients with EP were significantly lower, except at 6 weeks for E2 and in the sixth and seventh weeks for P4. The ectopically implanted trophoblast undergoes impairment of its ability to synthesize beta hCG, but not alpha hCG. The lack of utilization of alpha hCG in EP causes it to increase, while the level of intact hCG is low. These observations suggest that the levels of alpha hCG are a sensitive marker for placental well-being, and that it could serve as an additional diagnostic tool for the early diagnosis of EP. The placenta is only partially able to compensate for the reduced ovarian production of E2 and P4.

Chorionic Gonadotropin↗
PubMed1986

Fertility after nonsurgical treatment of ectopic pregnancy.

There is no question that the treatment of choice for ectopic pregnancy is surgery. However, since some ectopic pregnancies terminate in tubal abortion or complete resorption, it is questionable whether surgery is necessary in every case. Some patients can be managed by monitoring rising or falling levels of beta-human chorionic gonadotropin (beta-HCG) until tubal abortion or resorption occurs. This approach, which may be the best means of preserving tubal function and fertility, was used in 14 patients who fulfilled extremely selective criteria. In some of the patients, surgery later proved to be necessary, but in 11 nonsurgical management was followed by a fall in beta-HCG levels, and there were no further untoward effects. Three of these patients subsequently developed intrauterine pregnancies, and one patient had a repeat ectopic.

Abortion, Missed↗
PubMed1986

Reproductive outcome after microsurgical treatment of tubal pregnancy in women with a single fallopian tube.

Whether restoration of tubal function following conservative surgery for ectopic pregnancy was achieved can only be estimated in patients with a single tube. Between 1978 and 1983, 22 women with a tubal pregnancy in their single tube underwent conservative microsurgical treatment. In 18 women dorsal salpingotomy was performed, in 3 the tube was gently milked (squeezing the products of conception through the fimbria), and in 1 the segment containing the products of conception was excised and the tube anastomosed. Twenty-one patients desired pregnancy. The mean follow-up period was 21.4 months. Of the patients desiring pregnancy, 76% conceived. The intrauterine pregnancy rate was 47.6%, and the repeat ectopic pregnancy rate was 42.8%. This ectopic pregnancy rate was significantly higher than those quoted in recent literature. Although the study group was a very-high-risk group, restoration of tubal function was achieved in a high proportion of cases. The intrauterine pregnancy rate was high and higher than the best results available with in vitro fertilization and embryo transfer, which is the only treatment available after bilateral salpingectomy. Therefore, conservative surgery is definitely indicated in such patients despite the high incidence of repeat ectopic pregnancy.

Adult↗
PubMed1985

The effect of training in microsurgery.

One of the most important and fundamental prerequisites for successful microsurgery is serious and adequate training. This article presents the effect of microsurgical training on the functional end result of reanastomosis in the rabbit fallopian tube and evaluates the appropriate duration of laboratory training. In 50 New Zealand White female rabbits a microsurgical reanastomosis of the fallopian tube in its isthmic portion was performed. The rabbits were divided into five groups. In the first group only 30% of the rabbits conceived on the side operated on. The nidation index was only 0.269 as compared to 0.831 for the control side. Improvement in microsurgical skill following 100 isthmic anastomoses resulted in a 100% pregnancy rate for the last group. The nidation indexes in this group were the same on the side operated on and on the control side, 0.774 and 0.702, respectively. Scanning electron microscopic examination of the anastomosis site revealed a progressive increase in patency rate and in the amount of apposed mucosal folds in the three groups. A training program is recommended, which should bring about a nidation index and pregnancy rate that should not differ from the side operated on to the control side.

Animals↗
PubMed1983

Menarche and puberty in daughters of amenorrheic women.

Twenty-six daughters born to amenorrheic women after gonadotropin-induced ovulation were studied at 10 to 16 years of age. The aim of the study was to assess whether the mothers' condition, namely, amenorrhea and infertility followed by the pharmacologic induction of ovulation, had any effect on their female offspring in terms of endocrine disorders at puberty. The daughters were found to have normal onset of puberty as well as normal physical and mental development. The mean age at menarche, body weight, and height were similar to those of the general female population in Israel. A functioning hypothalamic-pituitary-ovarian axis was evidenced by the appearance of menarche followed by regular cycles. These data form a reassuring sample for the clinicians, the treated mothers, and their offspring.

17-Hydroxycorticosteroids↗
PubMed1983

Permeability of the rat bladder to Cisplatinum under different conditions: comparison with Mitomycin C and Adriamycin.

In 50 female Sprague-Dawley rats the absorption of Cisplatinum through the bladder wall was studied. Under different conditions, including cystitis and electrocoagulation of the bladder mucosa, the absorption was low and the measureable serum concentrations did not exceed 2.64 micrograms/ml. The influence of Tween 80--a non-ionic surfactant--on the absorption is investigated. The results are compared with those found for Adriamycin and Mitomycin C under identical conditions.

Animals↗
PubMed1983

Prolactinomas in women treated in the past for infertility.

This is a retrospective study on 352 infertile women who were treated with HMG-hCG (Human Menopausal Gonadotropin/human Chorionic Gonadotropin) between 1962 and 1977. The purpose of this study was to search for hyperprolactinemia and prolactinomas in these women. Hyperprolactinemia was found in 75 women (21%). The prevalence of hyperprolactinemia increases with age. Asymptomatic pituitary tumors were found in 29 of 31 women evaluated (94%). Three women had macroadenomas and 26 had microadenomas. We were not able to demonstrate that the HMG-hCG treatment and the ensuing pregnancy had any long-term ill effects on the size of the tumor. These findings suggest that prolactinomas were slow growing. An active search for these tumors must be made in women treated for infertility in the past.

Adenoma↗
PubMed1982

Retrospective evaluation of human menopausal gonadotropin and human chorionic gonadotropin induction of ovulation in galactorrheic and hyperprolactinemic women.

A retrospective study on the success of induction of ovulation with human menopausal gonadotropin and human chorionic gonadotropin (hMG/hCG) in 267 women was performed. Galactorrheic women had a higher pregnancy rate (55%) than nongalactorrheic women (22%). Galactorrhea was a far better indicator of the success of the treatment than hyperprolactinemia at present. The results obtained may suggest that in "bromocriptine failure" it is not mandatory to lower prolactin levels prior to induction of ovulation with hMG/hCG, and these women may be treated with menotropins alone.

Adult↗
PubMed1981

Major surgical complications of laparoscopy.

During the 15-yr period from 1965 to 1979, 6 major surgical complications were encountered among 2757 consecutive laparoscopies, yielding a rate of 2.1 per 1000. Five of the complications required exploratory laparotomy (in 2 patients with small bowel perforations, 2 patients with intraabdominal bleeding and 1 patient with severe peritonitis). In the 6th patient perforation of the uterine fundus occurred during laparoscopy performed because the presence of an adnexal mass was suspected at 15 wk gestation. Laparotomy in this patient was not performed since bleeding from the perforation site stopped spontaneously. Exploratory laparotomy rather than laparoscopy should be considered for evaluation of pelvic masses suspected after the first trimester of pregnancy. A small rate of major surgical complications of laparoscopy is to be expected even when accurate technique is used.

Adult↗
PubMed1981

Spontaneous pregnancy and its outcome after human menopausal gonadotropin/human chorionic gonadotropin-induced pregnancy.

The fertility in previously sterile women who conceived at least once following hMG/hCG-induced ovulation is investigated. The study comprises 141 women. The cumulative spontaneous pregnancy rate (CSPR) was calculated using life table analysis and was found to be 30.4% after 5 years. The CSPR for subsequent pregnancies reached 91.3% after 5 years. This figure is similar to that of normal parous women, although the study group (previously infertile women) requires a larger exposure period to attain the figure. The spontaneous abortion rate in the hMG/hCG-induced pregnancies was 29%; whereas in subsequent spontaneous pregnancies this rate was 8.8%. This difference in rate was found to be statistically significant, and the possible reasons are discussed.

Abortion, Spontaneous↗