Biomedical subjects

T Cunze

Publications and source records attributed to T Cunze.

10 recordsLinked to original sources

PubMed1999

Pulsatile vs. continuous parenteral tocolysis: comparison of side effects.

Bolus tocolysis has been developed to reduce the dose of fenoterol compared to continuous tocolysis. Whereas the high efficacy of pulsatile application of fenoterol has been shown, the proof of reduced side effects is still lacking. A total of 59 patients with preterm labor were divided in three groups: (1) continuous tocolysis and oral application of magnesium (n=19), (2) continuous tocolysis and parenteral application of magnesium (n=20), (3) pulsatile tocolysis (bolus tocolysis) and oral application of magnesium (n=20). Heart rate, systolic and diastolic blood pressure, serum K+ and serum Mg++ were quantified before tocolysis and after 2, 8 and 24 h. Beta-blockers and water balance were recorded over 24 h. Subjective side effects were quantified using a questionnaire with scales graduated covering palpitations, tremor, diaphoresis, thirst, precardialgia and nausea/vomiting. The analysis of the data revealed significantly fewer side effects concerning heart rate, plasma K+ level and the subjective side effects among patients treated with bolus tocolysis than among those treated with continuous tocolysis. Between the latter two groups, no significant difference was found. Concerning blood pressure and need for beta-blockers, no significant differences were found between the three groups. The results of the present study show that especially the side effects subjectively found to be disagreeable by the patients are reduced by pulsatile tocolysis, whereas other side effects show only slight differences between the study groups.

Adrenergic beta-Antagonists↗

PubMed1998

Fenoterol increases erythropoietin concentrations during tocolysis.

AIMS: The present study was carried out to assess the effect of the selective beta2-adrenoceptor agonists on erythropoietin (EPO) production. METHODS: Routine tocolysis with fenoterol (using the regular rate of 2 microg min[-1]) was used as a clinically easily accessible model. RESULTS: EPO concentrations had doubled 24 h after the start of tocolysis (P < 0.001). This increase lasted over the entire observation period of 48 h. Potassium concentrations fell significantly during the first hours of fenoterol infusion. There was no increase of human placenta lactogen during the period of EPO increase. CONCLUSIONS: The data confirm our earlier results that fenoterol increases EPO concentrations following haemorrhage. In this model it was not necessary to stimulate EPO production prior to pharmacological treatment.

Adrenergic beta-Agonists↗

PubMed1998

Changes in plasma elastase during pregnancy and sub partu.

Elastase is produced and released by polymorphonuclear leukocytes (PNMs) during inflammatory processes. Thus, elastase is assumed to be a sensitive marker of infections similar to the well-established C-reactive protein (CRP). It is deactivated predominantly in tissues by alpha1-proteinase inhibitor which forms stable complexes with the elastase molecule (EAPI) that can be detected for several hours. Premature rupture of membranes is often correlated with an early increase in elastase, occurring earlier than the increase in leukocyte count or CRP. Elastase might be a sensitive marker of beginning amnion infection syndrome after premature rupture of membranes. For the present study, plasma EAPI levels of 335 healthy pregnant women as well as 47 healthy nonpregnant pre- and postmenopausal women were analyzed. No significant differences were found in the latter group or in pregnant women until the beginning of labor. Women at the beginning of labor but without rupture of membranes showed a significant increase in plasma EAPI from 97.7 to 338.3 ng/ml (p < 0.001). With opening of the os uteri to more than 2 cm, elastase concentrations decreased to values comparable to those before the beginning of labor (p < 0.001). The use of elastase as a marker for a rupture of membranes or beginning amnion infection syndrome as suggested by a number of studies might need some restriction. As a consequence, serial monitoring of plasma elastase to detect a persisting increase might give more reliable results. The increase in plasma elastase during beginning of labor may be explained by the role of PMNs in the physiology of delivery. However, serial monitoring to detect a persisting increase in plasma EAPI may be more helpful.

C-Reactive Protein↗

PubMed1996

Fibronectin in the plasma during pregnancy and parturition.

Fibronectin can be detected in the plasma and the extracellular matrix of the uterus of pregnant women. Studies so far have compared individual observations, whilst serial investigations during pregnancy, and during and after parturition have not been carried out. Plasma fibronectin levels were measured in 153 women with healthy pregnancies in relation to the gestational age. During parturition, blood was taken from the inception of labor through to parturition, and on the 1st, 3rd, and 5th days after parturition. The investigations of the plasma fibronectin level in pregnant women show constant concentrations up to the 35th week of pregnancy. From the 36th week onward the fibronectin rises significantly before dropping to the initial values at the start of labor. The elevated fibronectin concentration in the last 4 weeks before delivery could be explained both by renewed, elevated synthesis in the uterus and placenta as well as by lower consumption. The decline in the fibronectin level with the onset of labor could be caused by an elevated enzymatic induction in the uteroplacental unit in connection with the start of parturition.

Adolescent↗

PubMed1995

Magnesium and calcium concentration in the pregnant and non-pregnant myometrium.

OBJECTIVES: To investigate the effect of labor on the magnesium and calcium concentrations in the human myometrium and to compare them with the concentrations in the non-pregnant uterus. METHOD: Samples of the isthmic part of the uterus were taken from 42 patients not in labor, 31 patients in regular labor during a cesarean section, and 37 premenopausal patients on whom a hysterectomy was performed. RESULTS: (i) The magnesium concentration dropped significantly during labor; (ii) the calcium concentration in the tissue showed no significant changes during labor; (iii) the magnesium and calcium concentrations were significantly higher during pregnancy; (iv) the distribution of electrolytes in the myometrium differed significantly in the corpus, isthmus and cervix uteri. CONCLUSIONS: The electrolyte concentration in the myometrium depends on the place of removal. A low magnesium concentration in the pregnant human myometrium could be a cause of premature labor.

Calcium↗

PubMed1995

[Comparative study of maternal side effects of various forms of intravenous therapy with fenoterol in premature labor].

OBJECTIVE: The aim of the present study was to compare different regimes of intravenous fenoterol tocolysis concerning their side effects. METHODS: A total of 59 patients with intravenous tocolysis due to preterm labor has been studied. They were chronologically alternating and thus randomly stratified into three groups: (a) continuous i.v.-tocolysis and oral application of magnesium sulfate (b) continuous i.v-tocolysis and i.v.-application of magnesium sulfate (c) pulsatile i.v.-application of fenoterol (bolus tocolysis) and oral application of magnesium sulfate. For all groups, heart rate, systolic and diastolic blood pressure, need for beta-blockers, K+, water balance over 24 hours as well as different subjective side effects were quantified. RESULTS: The side effects were found to be significantly less among patients treated with bolus tocolysis and they were also found to be slightly less in continuous tocolysis with i.v.- application of magnesium compared to continuous tocolysis with oral Mg2+ substitution; however, the difference between the two groups treated with continuous tocolysis was not significant. CONCLUSION: The present results suggest that bolus tocolysis shows significantly less side effects compared to the continuous tocolysis and thus it should be favored in clinical practise.

Administration, Oral↗

PubMed1994

[Termination of pregnancy in the 2nd trimester by serial administration of gemeprost vaginal suppositories. A prospective study (corrected)].

In a prospective study termination of pregnancy was performed between the 16th and 24th week of gestation by serial applications of a 1 mg gemeprost containing vaginal pessary at 6h intervals. The reasons for termination were medical and fetal indications in 20 cases and missed abortion in 14 cases. The median induction to abortion interval was 17.4 hours (range: 3.7 - 73.0h) in the therapeutic abortion group, and a median of 3 applications were necessary to terminate pregnancy. In cases of missed abortion the median induction to abortion intervals was 11.0h (range: 3.5 - 32.5h) with a median of 2 necessary applications. Expulsion of the fetus occurred in 31 out of 34 patients (91.2%) within 24 hours. Spontaneous or surgically induced cervical lesions and blood loss > 500 ml were not observed, systemic prostaglandin-induced side effects were documented in 7 cases (20.6%). Epidural anesthetic gave a painless induction of abortion in all of patients. Our experience has shown that serial application of gemeprost vaginal pessaries is a feasible and efficient method for termination of second trimester pregnancies.

Abortifacient Agents, Nonsteroidal↗

PubMed1994

[Plasma and myometrium electrolyte changes in the last trimester of pregnancy].

It is well known, that magnesium can positively influence preterm labour and that the magnesium level in the plasma is significantly lowered whereby magnesium excretion increases during pregnancy. These results lead to the question, whether the magnesium content in the myometrium is also reduced during pregnancy and whether blood parameters correlate with the concentration of magnesium in the myometrium. Myometrial tissues and blood samples from 127 patients, who underwent a Caesarean section, were analysed for magnesium, calcium, sodium and potassium. Erythrocytes, haemoglobin, haematocrit and the hormones oestradiol, oestriol and progesterone were analysed in the serum. We found a decrease in magnesium in the myometrium (p < 0.01) and in the plasma (p < 0.05) during pregnancy. Magnesium in the plasma correlates with magnesium in the myometrium (p < 0.001). These results indicate, that hypomagnesinaemia during pregnancy decreases the magnesium level in the myometrium.

Cesarean Section↗

PubMed1992

[The magnesium and calcium content of pre- and postmenopausal myometrium].

Magnesium and calcium, as well as sodium and potassium, have an important influence on the physiology of contraction of the uterus. The ionic concentrations in the pre- and postmenopausal myometrium were examined. We assumed, that there are differences in the electrolytic contents because of the different functions of the corpus, isthmic part and cervix uteri during pregnancy and throughout labour. Small tissue samples from 37 premenopausal and 20 postmenopausal patients, who underwent an operation with different indications, were dissected after hysterectomy. Magnesium and calcium levels were determined by atomic absorption spectrophotometry and potassium and sodium by emission spectrometry in the wet tissue. In both groups, we found significant differences of the electrolytic contents of the myometrium. In the premenopausal uteri, the magnesium levels decrease significantly (p < 0.001) from the corpus (mean = 4.14 mmol/kg) to the cervix (mean = 2.14 mmol/kg). The same scenario can be observed for the potassium levels (Corpus mean = 56.2 mmol/kg and cervix mean = 25.4 mmol/kg). In contrary, the calcium levels (Corpus mean = 1.60 mmol/kg and cervix mean = 2.26 mmol/kg) and sodium levels (Corpus mean = 69.3 mmol/kg and cervix mean = 93.0 mmol/kg) increase significantly (p < 0.001). In the postmenopausal group, we found slightly elevated concentrations of magnesium, sodium and potassium. Only the calcium content of the corpus uteri rises up to three times about 20 years after the menopause (from mean = 1.60 mmol/kg) (p < 0.001). The electrolytic contents in the myometrium were shown to be different in the corpus, isthmus and cervix uteri.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

[Labor contraction-dependent changes in magnesium and calcium in the myometrium].

Magnesium is commonly used in the therapy and prevention of preterm labor. Therefore the differences of the concentrations of magnesium and its antagonist calcium were measured in the human myometrium to examine the interaction of labour and ionic changes. The ionic concentration in the myometrium of 37 patients without labour are determined and the values are compared to the data of 26 patients in active labour. Women of the first group without labour had a magnesium concentration of mean = 4.1 mmol/kg wet weight and a calcium concentration of mean = 2.9 mmol/kg wet weight. Women of the second group with active labour have a significantly lower (p < 0.01) magnesium concentration (mean = 3.5 mmol/kg wet weight). However, the calcium level (mean = 2.7 mmol/kg wet weight) does not show significant differences. These results indicate that the decrease of magnesium plays an important role in the physiology of parturition. A low magnesium concentration in the myometrium might have a considerable influence on premature labour in the third trimester of pregnancy. Therefore a prophylactic application of magnesium seems to be useful.

Adult↗