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Biomedical subjects

M Endler

Publications and source records attributed to M Endler.

At least 37 records · Page 2Linked to original sources
PubMed1988

Successful outcome of a complicated pregnancy in a renal transplant recipient taking cyclosporine A.

The successful outcome of a pregnancy complicated by reversible renal failure secondary to total ureteral obstruction caused by a pregnant uterus and treated temporarily with nephrostomy is reported. The cyclosporine A (CsA) and prednisone treated female recipient of a cadaveric renal allograft gave birth to a male child, which at 2080 grams was small for gestational age (35 weeks of pregnancy). The child presented neither signs of congenital anomalies or chromosome aberrations nor nephrotoxicity, hepatotoxicity or anemia. Simultaneous measurement of trough CsA blood levels (CsA RIA, Sandoz) displayed reduced values in the child's blood (mother 864 ng/ml-4 hours after oral CsA intake; son 312 ng/ml). Beside postrenal failure the patient's pregnancy was complicated by 7 rejection episodes treated with high doses of methylprednisone (total dose 5 g) with reversible damage of the transplant function, two episodes of a urinary tract infection and increasing anemia necessitating blood transfusions. The HIV negative patient had developed a Kaposi's sarcoma 6 weeks after grafting. The progression of infiltrating skin lesions during pregnancy was not seen.

Adult↗
PubMed1987

[Pregnancy and labor following kidney transplantation with cyclosporin A. Case report and review of the literature].

We report on a 22-year old patient who received a cadaveric renal transplant following haemodialysis treatment for five months due to endstage chronic glomerulonephritis. 14 months after successful transplantation while on stable renal function (serum-creatinine 1.0-1.4 mg%) the patient became pregnant. As an immunosuppressive therapy the patient got cyclosporine A and cortisone. The monitoring of the immunosuppressive therapy (Cyclosporine A) was performed by daily measurement of serum concentration by radioimmunoassay. Drug administration was adjusted to maintain serum levels of 250-550 ng/ml. Increased dosages were required from 25th week until delivery. Until the 25th week of gestation the pregnancy was uncomplicated from both the nephrological and obstetrical points of view. At the 25th week of gestation the patient became anuric. This was caused by a postrenal failure due to the compression of the transplantar ureter by the pregnant uterus. Nephrostomy was installed and was used until the end of pregnancy. In the third trimester the foetus showed growth retardation. For this reason a Caesarean section was necessary at the 36th week of gestation. A healthy boy was delivered weighing 2080 g and measuring 45 cm. No congenital malformations were observed, the chromosomal analysis showed no aberrations. After the delivery cyclosporine concentrations in the blood of the mother and the newborn were simultaneously measured. A remarkable difference in these concentrations was observed particularly in the mother's blood 864 ng/ml whereas in the baby's blood the concentration was 312 ng/ml. Three days after the delivery the patient was able to urinate normally so that the nephrostomy could be removed.

Cyclosporins↗
PubMed1986

[Smoking in pregnancy].

The course of pregnancy and delivery and the foetal outcome of women who smoked during pregnancy (n = 1751) were compared with nonsmokers (= 4937). The following variables were studied in retrospect: Duration of pregnancy, maternal weight gain, mode of delivery, foetal birthweight and the maturity of the newborn, Apgar scores, pH of the umbilical artery, perinatal mortality, frequency of foetal malformations, amount of amniotic fluid and the incidence of meconium staining, placental weight and the occurrence of placental infarctions. Birth weight, foetal length and head circumference were significantly smaller in the group of women who smoked. The incidence of babies with low birth weight and clinical signs of prematurity as well as placental infarctions was significantly increased in the same group. Gestational age was not different in smoking and nonsmoking gravidae. No statistical difference was found in the rate of C-sections, in Apgar scores, umbilical arterial pH, the incidence of malformations, perinatal mortality, and placental weight. Social factors were not considered in this study.

Apgar Score↗
PubMed1984

[Changes in the clinical picture, morphology and therapy of endometrial carcinoma over 3 decades].

In the years 1952 to 1980 724 women were treated at the 2nd Department of Gynecology and Obstetrics, University of Vienna, for carcinoma of the endometrium. The mean age of the 463 (64%) women operated on rose from 56 to 62 years within three decades; the mean age of the 254 (35%) patients who received primary radiation therapy rose from 68 to 72 years; 7 women (1%) were treated symptomatically only. Looking at constitutional factors an increase of the number of women with manifest diabetes from 4% to 22% was noticed above all. Body weight and mean blood pressure increased slightly although not significantly. Irregular bleeding was the most common symptom, occurring in 90% of all cases and did not show any change in frequency. During the first decade of the period under consideration 86% of the women underwent primary operation, but that percentage decreased to 51% after 1970. Equally distinct was the decrease of 34% to 4% of the vaginal in favor of the abdominal operation. The number of cases with carcinomas with deep myometrial invasion and low differentiation increased. The high significance of these parameters for prognosis is shown by survival curves. The 5-year survival rates of patients primarily operated were about 75%, that of women receiving primarily radiation therapy at about 54%. These results remained approximately the same within the observation period. The increase of complicating factors such as higher age and more frequent incidence of diabetes mellitus accounts apparently for the increase in the number of women receiving primary radiation therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

[Prognostic significance of morphological parameters in endometrial carcinomas].

A retrospective analysis of 163 cases of operations for carcinoma of the endometrium performed at the 2nd Department of Gynecology and Obstetrics, University of Vienna, demonstrates that the clinical staging as recommended by FIGO is not conclusive, and that the subdivision according to the size of the uterus is of no prognostic significance. On the other hand, the morphological parameters listed below have a strong prognostic relevance as is shown by survival curves and survival rates: Grading parameters (histological and cytological degree of differentiation as well as the number of mitotic figures); parameters of the extent of the tumor (histologically proven involvement of the cervix; depth of invasion in relation to the thickness of the myometrium; invasion of lymphatics). In addition, patients with suspicious or positive cytological vaginal smears have less propitious survival chances, whereas the age and the menopausal status of the women as well as the type of carcinoma were only of subordinate significance within this sample. The grading parameters are closely correlated, the determination of several parameters, however, increases the weight of the prognosis. Furthermore, they show a close correlation to the parameters of the extent of the tumor. Since the grading parameters can be ascertained pre-operatively from the curetting they should be taken into consideration when planning further therapy. The post-operative staging of the carcinoma has to take into account above all the depth of the invasion. A classification to that point is proposed.

Adenocarcinoma↗
PubMed1984

Effects of smoking on uteroplacental blood flow.

The effects of nicotine consumption on uteroplacental blood flow were studied in 20 pregnant women by means of placental blood flow measurements using indium-113m-transferrin. Smokers were found to have a higher rate of poor perfusion patterns than subjects of a control group. In addition, the number of cigarettes smoked daily was significantly correlated with the placental perfusion type. The mean birth weight of infants born by smokers was 250 g lower than in the control group. The results suggest that smoking during pregnancy may compromise uteroplacental blood flow and thus result in poor fetal development.

Adult↗
PubMed1982

[Bladder dysfunction in pregnancy (author's transl)].

105 primiparous and 125 multiparous women have been asked for complaints of incontinence during their pregnancies. Multiparae suffered more often from stress incontinence, nullips reported a higher rate of urgency. The reasons and the influence of episiotomy, operative deliveries (forceps and vacuum) and pelvic floor training on incidence and recurrency of urinary incontinence during pregnancy are discussed.

Adult↗
PubMed1982

[Antibiotic concentrations in wound secretions and bone during the simultaneous administration of mezlocillin and oxacillin].

Mezlocillin and oxacillin have been used in combination for short-term antibiotic prophylaxis in orthopedic surgery. Antibiotic concentrations were measured in serum, wound secretions from subcutaneous tubings and bone. Half an hour after the i. v. application of 4 g mezlocillin + 2 g oxacillin, the concentrations in wound secretions were 20% of the serum levels. After four hours the levels of both antibiotics in wound secretions increased to 2.66 times the serum levels of mezlocillin, and 5.37 times those of oxacillin. After eight hours the concentrations in wound secretions dropped to about one half, but remained well within therapeutic levels. The parallel course of the concentrations of both antibiotics in wound secretions indicates that mezlocillin and oxacillin have very similar half-lives in wound secretions, although the serum half-lives (t 50% beta) of the two antibiotics are different. The concentrations obtained from cancellous bone were approximately. 10% of the serum levels one to two hours after the antibiotic infusion.

Aged↗
PubMed1982

Influence of hip arthroplasty upon chemotactic behaviour of leucocytes.

Fourteen patients treated with total hip endoprosthesis were investigated for leucocyte defects. A chemotactic assay was used as an indicator of leucocyte function. Tests were carried out preoperatively and on postoperative days 1, 3 and 6. The chemotactic index started to decline on the first postoperative day, reached a peak on the third day after surgery and returned to almost preoperative values on the sixth day. The results might provide a clinical explanation for the data showing a high postoperative infection rate in total hip surgery.

Aged↗
PubMed1982

[Carbon monoxide in mother and newborn infant from smoking during pregnancy].

COHb-values of 24 newborn infants investigated (cord blood) were higher altogether than the corresponding maternal concentrations (venous) at birth. COHb in percent of saturable Hb ranged from 0.3 to 0.7 in 10 infants of nonsmokers and from 0.8-11.9 in 14 infants of smokers. Correlations between maternal and infant COHb were statistically significant. At birth the mean infant/maternal COHb ratio was 2.5. The significant correlations between maternal COHb during pregnancy (32.-38. week) and infant COHb at birth (cord blood) is an indication for the predictive value of such tests.

Carbon Monoxide↗
PubMed1981

[Congenital abnormalities--risk, incidence and etiology. Catamnestic studies on causal teratogenesis].

Questionnaires were sent to the mothers of infants with congenital malformations delivered at the Second Department of Obstetrics and Gynecology, Vienna University Medical School, between 1972 and 1978 and to a group of controls. The response rate was 48%. On evaluation, the incidence of maternal disease and therapeutic drug intake was found to be significantly higher in the group with congenital malformations. In addition, malformations were significantly more common in planned pregnancies. A teratogenetic role of emotional stresses was not verifiable with statistical significance. As inheritance of numerous malformations tends to be multifactorial, endogenous factors were equally considered, but failed to show significant differences.

Alcohol Drinking↗
PubMed1981

[Control of IUD-position (author's transl)].

The correct position of an IUD in the uterine cavity is essential for the effectiveness of the method. Ultrasound examination of the thickness of the anterior and posterior wall of the uterus were carried out and their relation to a correct position of the IUD calculated. It was found that the position of the IUD is correct, if the distance between fundus and the cranial end of the IUD does not exceed the thickness of the uterine wall by more than one-third; i. e. in all 4/3 of the thickness. The correlation between the ultrasound results of length, version and flexion of the uterus and complaints and side-effects like bleeding and pain are discussed, especially if the IUD is not in correct position.

Adolescent↗
PubMed1981

[Incidence of congenital malformations among births of foreign workers (author's transl)].

From 1967 to 1972 7.83% of the parturients delivered at the Department of Obstetrics and Gynecology II of the University of Vienna were foreign workers. From 1972 to 1978 the part of the foreign workers come to 21.31%. From 1967 to 1972 there was a highly significant prevalence of so-called "non-viable malformations" (p less than 0,001) among foreign workers and "severe external malformations" were significantly more common at the 5% level. In the period from 1972 to 1978 these differences were no longer as pronounced. Statistical significance was not reached for the so-called "non-viable malformations" in the period from 1972 to 1978. Only dysrhaphism continued to be significantly more common at the 1+ level. Among these malformations incomplete ventral fusion was significantly more frequent at the 5%.

Adult↗
PubMed1981

[Experiences with a new questionnaire for preoperative evaluation of female urinary incontinence (author's transl)].

A new questionnaire with an urge-score and stress-score described by Gaudenz was put before 90 incontinent women scheduled to undergo vaginal repair. In addition to the history cystometry and simultaneous urethral pressure profilometry was done. According to the questionnaire 70 patients had evidence of stress-incontinence and 20 patients of urge-incontinence. A good correlation was found with the results of the urodynamic evaluation. The score does not reflect the severity of urinary incontinence. In patients with symptoms of both stress- and urge-incontinence the score emphasizes urge-incontinence. When a urodynamic work-up is not possible the questionnaire with the urge-score and stress-score is a very helpful tool for differentiating between stress- and urge-incontinence.

Diagnosis, Differential↗
PubMed1981

[Continuous evaluation of the incidence of congenital malformations (author's transl)].

In a previous retrospective analysis the rate of congenital malformations in the infants delivered at the Department of Obstetrics and Gynecology II of the University of Vienna between 1961 and 1971 was found to be 4.52%. In a retrospective cross-sectional study conducted under identical conditions concerning the period from 1972 to 1978 a rate of 4.47% was computed. As the difference of 0.07% is below statistical significance, the incidence of malformations has apparently remained unchanged, the rate being approximately 4.5%.

Abnormalities, Multiple↗
PubMed1980

[Spinal deformities and their mechanopathology in oarsmen (author's transl)].

Motional analysis of the spinal segments with an x-ray amplifyer and studies of mechanical stress in the spine at oarsmen show, that during the phase of driving through with the oars immersed, the direction of the resulting load in the spine is approximately vertical to the next vertebral body. While referring to the vertebral bodies the direction of the resulting load does not change essentially, the size of the load differs conspicuously during active motion. In rowing the quantity of stress in the spine is limited by the torque of the counterforce, the erector trunci. Using an exact and correct rowing technique the quality of stress is compatible with the physiologically axial stresspattern of the vertebral body and the intervertebral disque. The frequency of peakstress in active rowing may possible lead to early and augmented degenerative changes in the vertebral bodies. In 45 Austrian top oarsmen the spine was examined clinically and radiologically, 68% showed signs of a previous Scheuermann's disease, while degenerative changes of vertebral bodies were found in 48%. Comparing spinal damages in different sports used in the training of the examined oarsmen, only in bicycling a similar pathomechanical effect on the spine could be observed.

Adolescent↗