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Biomedical subjects

R Wiedemann

Publications and source records attributed to R Wiedemann.

At least 37 records · Page 2Linked to original sources
PubMed1989

A fluorescein angiographic study on patients with proliferative vitreoretinopathy treated by vitrectomy and intraocular daunomycin.

Fluorescein angiographic findings in patients with proliferative vitreoretinopathy treated by victrectomy, silicone oil tamponade and intraocular daunomycin are compared to findings in patients who received the same treatment but no intraocular drug. A difference between drug treated and untreated eyes was not discovered. We observed, however, a delayed arteriovenous passage time, cystoid macular edema, ectopia of the foveolar region and late hyperfluorescence of the optic disk; these findings might partly explain the visual results. Reduction of redetachment and thus prevention of reoperations by treatment with antiproliferative drugs may decrease the rate of cystoid macular edema and thus improve the functional results of surgical treatment.

Adult↗
PubMed1989

[Immunologic assessment in habitual abortion].

Since 1985, after excluding nonimmunological reasons for habitual abortion, we have been performing an MCL, a cross-match, and an HLA typing in these patients. Those with a low MLC response and a negative cross-match are considered to be immunological aborters. Only three out of 42 examined couples showed a low response and in 21 of 24 tested couples the cross-match was negative. Of 36 patients with a high response, 10 had successful pregnancies; seven of them shared more than two HLA antigens. An immunological treatment is indicated in patients with low response and a negative cross-match. High responders should have another pregnancy without stimulation. HLA typing is without any consequences.

Abortion, Habitual↗
PubMed1989

[Intratubal gamete transfer].

Three years' experience with gamete intrafallopian transfer (GIFT) are reported. Between June 1985 and July 1988, 173 clinical pregnancies were achieved in 357 patients over 488 cycles; 34 biochemical pregnancies achieved have not been included. There were 44 spontaneous abortions (25.4%) and 13 ectopic pregnancies (7.5%). Multiple pregnancy occurred in 13.9%. In the group with long-standing sterility without successful treatment, a clinical pregnancy rate of 43.3% was achieved; in cases with andrological subfertility 29.6%; and in cases with genital pathology the pregnancy rate achieved was 31.7%.

Adult↗
PubMed1989

[The value of hormonal and sonographic parameters in the diagnosis of disordered and normal early pregnancy].

In 112 clinical pregnancies after IVF/ET or GIFT, the importance of beta-HCG progesterone and 17 beta-estradiol was evaluated. Additionally, we performed a vaginosonography to confirm an early intrauterine pregnancy. The aim of the study was to define, when a clinical pregnancy can be detected as early as possible and when the differential diagnosis of intact or abnormal pregnancy can be made. By measuring E2 in an HCG substituted cycle, the diagnosis of a clinical pregnancy is possible as soon as day +12 after induction of ovulation. When considering beta-HCG levels alone, the same diagnosis can be made at day +18. Single determinations of HCG level do not offer a satisfactory diagnosis, because of intra-individual variations. A progesterone drop always demonstrates a disturbed early pregnancy. Using a combination of hormonal serial measurements of HCG, E2, progesterone and vaginosonography, the diagnosis of an intact intrauterine pregnancy should be possible as early as day +27 after ovulation induction.

Abortion, Spontaneous↗
PubMed1989

[Differential indications for surgical technics in reproductive medicine--microsurgery, in vitro fertilization and embryo transfer, gamete intrafallopian transfer and tubal embryo transfer].

The birth of the first baby following in-vitro fertilisation and embryo transfer (IVF/ET) in 1978 and the introduction of gamete intrafallopian transfer (GIFT) in 1984 have increased the treatment modalities in operative reproductive medicine. In tubal pathology, there are besides micro-surgery now so-called additive methods available for treating infertility. With regard to the indications, there has been severe confusion, and it is therefore imperative to define special indications for IVF/ET, microsurgery and GIFT. We do not consider these treatment modalities as alternative methods. Reproductive centres should offer all these treatments to guarantee an appropriate individual programme for each couple. Therefore, knowledge of pregnancy rates is a prerequisite for the doctor. The aim of this paper is, to define the optimal therapy while taking into account the individual problems of each couple.

Embryo Transfer↗
PubMed1989

Selection of patients for IVF therapy or alternative therapy methods.

Microsurgery is the treatment of choice for most patients with a tubal factor. In-vitro fertilization--embryo transfer (IVF-ET) is performed in patients with the so-called classical indications: bilateral salpingectomy and tubal damage which is not correctable by means of microsurgery. We also discuss IVF in patients who have not conceived within 1 to 2 years following microsurgery. In women with tubal re-occlusion IVF should be performed. In patients with patent tubes following microsurgery, gamete intra-Fallopian transfer (GIFT) forms part of a controlled clinical study. More clinical experience can perhaps solve the dilemma whether it is beneficial to perform GIFT or to offer IVF primarily to these patients. In patients with andrological infertility, GIFT is offered after six unsuccessful attempts of intrauterine insemination (IUI). In long-standing infertility, GIFT is performed when IUI with ovarian stimulation fails. Patients with genital pathology (patent tubes) are treated with GIFT unless it is not technically feasible. In these cases microsurgery or IVF should be discussed.

Embryo Transfer↗
PubMed1989

Gamete intra-fallopian transfer in male sub-fertility.

Between July 1985 and July 1987, GIFT was performed in 69 out of 255 patients (87 of 333 treatment cycles) treated because of male infertility. In this group a pregnancy rate of 30% per cycle was achieved, compared to an overall pregnancy rate of 35%. Indications for GIFT include long-standing infertility that has not responded to any other method of treatment, andrological sub-fertility and various forms of genital pathology with patent tubes. These results show that the pregnancy outcome after GIFT in couples with severe male infertility is significantly lower than that following GIFT in patients with long-standing infertility. The pregnancy rates seem, however, much higher than those achieved using intrauterine insemination. In this paper, the results of treating couples with male sub-fertility by GIFT are discussed in detail.

Adult↗
PubMed1989

[Differentiation of existential guilt and compassion in relation to responsibility induction: a film experiment].

Feelings of existential guilt are assumed to depend on the perception of a causal relationship between one's own behavior or (privileged) situation and the disadvantages of others. By contrast, pity should not depend on such perceptions. This hypothesis, which has been supported so far only by correlational studies, was tested experimentally. Eighty students were shown a film about a developing country. The film was provided with four different comments, each representing one experimental condition (between-subjects design). Experimental factors were "amount of misery of the people shown" and "subject's responsibility for these peoples' conditions of life". As expected, subjects in the condition "misery and responsibility" reported higher feelings of guilt, though no more pity than subjects in the remaining three treatment conditions (experiment 1, n = 40). This mean difference, however, was statistically significant for men only. Contrary to our theoretical expectations--and to finding from other experiments on vicarious reparation--the induction of guilt had no effect on willingness to help a third party (experiment 2, n = 40). Possible reasons for this unexpected finding are suggested.

Adult↗
PubMed1987

[Pathology of proximal tubal occlusion--morphologic evaluation. Results following microsurgical anastomosis].

Even today, the etiology of proximal tubal occlusion is still a controversial subject. The introduction of microsurgery in gynecology has provided a method of eliminating the main symptom of proximal tubal occlusion, i.e., sterility. Pregnancy rates of 25-30% can be achieved in overall patient collectives. Accurate histologic analyses of the specimens are essential for clinicopathological classification in three prognosis groups. For stage I patients, pregnancy rates of up to 50% (patient-related) can be achieved. Postoperative counseling can thus be differentiated on the basis of the histological results. For stage III patients the pregnancy rate is unlikely to be acceptable, even after waiting for a prolonged period of time. It has not been established whether reconstructive tubal surgery or alternative therapeutic procedures (I.V.F. and E.T.) have better chances of success in stage II. Accurate histologic analysis of the surgical specimens is an essential prerequisite for individualized sterility counseling and therapy.

Constriction, Pathologic↗
PubMed1987

[Intratubal gamete transfer--results of 219 treatment cycles in idiopathic sterility, andrologic subfertility and selected forms of genital pathology].

Gamete Intra Fallopian Transfer was performed in 175 patients in 219 treatment cycles during the period July 1985 to December 1986. This resulted in a total of 82 clinical pregnancies. Multiple pregnancy occurred in 16 cases, two of which were triplet pregnancies and one a quadruplet pregnancy. There were 16 abortions and five pregnancies were extrauterine. Besides presenting the technique of intratubal transfer of gametes, the authors give detailed information (with discussions) on pregnancy rates in idiopathic sterility, on andrological subfertility and on selected forms of genital pathology.

Adult↗
PubMed1985

[Pregnancy following intrafallopian gamete transfer].

Gamete intrafallopian transfer has been performed since April 1985 in our hospital. In patients with a long history of infertility despite proved tubal patency, the follicles present at laparoscopy are aspirated. The oocytes thus obtained are introduced together with the prepared sperm via a special catheter directly into the ampulla. We would like to report on the first pregnancy for which we used this technique.

Adult↗
PubMed1982

Effectiveness of behavioral treatment methods compared to pharmacological therapy and self recordings of blood pressure in essential hypertensives (preliminary report).

48 essential hypertensives were randomly assigned to (1) a behavioral treatment (n = 20), (2) a pharmacological treatment (n = 20), or (3) self recordings of BP (n = 8). Group 1 and 2 showed during 1 year of therapy comparable significant decreases of systolic and diastolic BP, whilst group 3 showed significant increases after 3 months of therapy.

Behavior Therapy↗
PubMed1982

Specificity of phasic heart rate responses to visual attention in essential hypertensives.

A preliminary report is given concerning phasic heart rate responses in hypertensive individuals. There is some evidence, that the expected accelerative drive appears under visual attention conditions. That is demonstrated in two typical reactions of a hypertensive and a normotensive subject and in a marked higher acceleration at several points of the response curves for the hypertensive group. Z-scores of heart periods are discussed as the appropriate measurement of phasic HR-changes from rest to stimulus conditions.

Adult↗