摘要:

Blood velocity waveforms were obtained by a combination of real-time B-mode and pulsed Doppler (2 MHz) ultrasound from the umbilical artery. In a prospective study, velocity waveforms of the umbilical artery were analyzed from 36 patients with single pregnancies. Sonograms were performed every 2nd week from the 18th week menstrual age onwards till labor. A total of 331 velocity profiles were obtained. Reference values were obtained from 27 patients with uncomplicated pregnancies. Abnormal waveforms were found in 9 cases. A comparison was made between the normal and abnormal group with regard to placental impedance indices [resistance index (RI), A/B ratio and pulsatility index (PI)]. The sensitivity, specificity, predictive values of each mentioned index were determined. The sensitivity of the PI and the RI is the same: 77.8 %, the sensitivity of the A/B ratio is 66.7%. The specificity is also slightly higher for the PI and RI than for the A/B ratio (81.5, 81.5 and 77.5%, respectively). The same can be said for the predictive values (predictive value with positive result, 58.3, 58.3 and 50.0%, predictive value with negative result, 91.2, 91.2 and 87.5%). On the basis of these results and theoretical considerations, the PI is preferable to the other two placental impedance indices. It was shown once more that, with certain restrictions, this noninvasive transcutaneous technique reflects fetal well-being.

ISSN:0378-7346    

DOI:10.1159/000298864

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Fetal heart rate and fetal movements were recorded over a 24-hour interval in a totally adrenalectomized pregnant woman at term. Cortisol, ACTH, unconjugated estriol and 17β-estradiol were contemporaneously measured every 2 h in the maternal peripheral plasma. Owing to the substitution therapy the patient showed a loss of circadian variations of all the hormones investigated. Moreover, the circadian rhythms of fetal heart rate and fetal movements, usually present at term, were no longer evident. We can thus suggest that the circadian variations of plasma maternal cortisol could affect the alternations of fetal behaviour.

ISSN:0378-7346    

DOI:10.1159/000298865

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Antithrombin III (AT III) is known to be the most important inhibitor of serine protease in the coagulation system. In the presence of heparin, AT III is converted from its progressive activity state to an immediate activity state. In disseminated intravascular coagulation (DIC) in the field of obstetrics, the treatment has to be initiated very early. Heparin treatment, on the other hand, is critical since frequently postpartal or postoperative wound bleeding is present. We, therefore, established diagnostic criteria for the early diagnosis of DIC and investigated the clinical efficacy of a therapy with AT III in a well-controlled comparative study versus the injectable synthetic protease inhibitor FOY®. The results of the trial showed that the AT III group (92%; n = 24) was signifiacantly (p < 0.001) superior in clinical efficacy to the FOY group (60%; n = 15). No side effects whatsoever were observed after treatment with AT III concentrate (Behring Institute). From these results, it could be concluded that a single therapy with AT III concentrate can sufficiently control the symptoms of DIC in the filed of obstetrics without the risk of increased bleeding.

ISSN:0378-7346    

DOI:10.1159/000298866

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Progesterone receptor (RP) levels were measured in the cytosol and in the 0.4 M KCl nuclear extract of human uterine leiomyoma, myometrium and endometrium; the synthetic progestin [3H]-R5020 was used as a ligand. The women were divided into groups A-D as follows: A, 7 women with no treatment; B, 7 women who received progesterone injection 1–3 h before tissue collection; C, 4 women who received conjugated estrogens 7–11 days before tissue collection; D, 5 women who received both conjugated estrogen and progesterone treatments. The following results were demonstrated: (1) Total RP levels in the leiomyoma were significantly higher than the corresponding levels in the myometrium of the same uterus; after estrogen treatment these differences diminished. (2) Leiomyoma challenged with progesterone expressed significantly lower RP levels in their nuclei than did the corresponding endometrium and myometrium. These results indicate the possibility of a defect of RP dynamics in human uterine leiomyoma.

ISSN:0378-7346    

DOI:10.1159/000298867

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

This study was carried out to determine whether the ovulatory response with clomiphene citrate and bromocriptine in 20 amenorrheic women with normoprolactinemia and gestagen withdrawal bleeding is influenced by the pretreatment pattern of pulsatile luteinizing hormone (LH) secretion. Two patients who had no LH pulse for 3–5 h failed to respond to clomiphene. One of them was treated with bromocriptine, but ovulation did not occur. Eleven of 12 patients who had one or more LH pulses and LH pulse/h ratios of < 1 for 3–5 h ovulated with clomiphene. One clomiphene nonresponsive patient ovulated with combined therapy of bromocriptine and clomiphene. All 6 patients who had LH pulse/h ratios of > = 1 for 3–5 h failed to ovulate with clomiphene. Three of them were treated with bromocriptine. Two of 3 patients ovulated with bromocriptine alone and 1 ovulated with combined therapy of bromocriptine and clomiphene. These results suggest that the pretreatment pattern of pulsatile LH secretion may predict the clinical response to clomiphene and bromocriptine treatment in amenorrheic women with normoprolactinemia and gestagen withdrawal bleeding.

ISSN:0378-7346    

DOI:10.1159/000298868

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

We measured serum levels of CA 125 in 26 patients with external endometriosis, using CA 125 RIA Kits. The normal range was instituted below 39 U/ml. The mean CA 125 level ( ± SD) was 55.1 ± 24.9 U/ml in patients with external endometriosis, the positive rate being 71.4%. Considering the clinical stage of external endometriosis, the mean CA 125 level and positive rate increased to 64.5 ± 23.2 U/ml and 93.3%, respectively. The CA 125 levels in these patients gradually decreased after surgery and/or Danazol treatment and the levels were below 39 U/ml within four weeks. Thus, progressive external endometriosis can be accurately diagnosed by determining the serum levels of CA 125, and appropriate clinical treatment designed.

ISSN:0378-7346    

DOI:10.1159/000298869

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The effects of the β2-adrenergic agonist hexoprenaline were studied on the progesterone production of rat and human corpora lutea and compared to hCG-induced hormone production. Human corpora lutea were obtained from healthy patients, rat corpora lutea were harvested on day 6 of pseudopregnancy. Corpora lutea were digested by trypsin and homogeneous luteal cell suspension (6 × 105 cells/ml) was incubated for 2 h. Hexoprenaline and hCG were added to the medium and progesterone production was measured by RIA. Hexoprenaline or hCG dose-dependently increased the progesterone production of rat luteal cells and of human cells in mid- and late luteal phase. Moreover, hexoprenaline further increased the hCG-induced hormone production. The stimulatory effect of hexoprenaline could be prevented by propranolol. It is supposed that β2-adrenergic stimulation induces an increase in progesterone production of luteal cells and potentiates the effects of gonadotropic hormones.

ISSN:0378-7346    

DOI:10.1159/000298870

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Changes in norepinephrine following a bimanual handgrip contraction test were used to evaluate the contribution of static physical effort exerted by the parturient on the rise in adrenergic stimulation observed during ongoing labor. Noradrenaline baseline values were 306.71 ± (SE) 21.5 pg/ml); and after a maximal effort handgrip contraction test rose to 345.07 ± 29.11 pg/ml (p = 0.11). This increase was less pronounced than found generally in nonpregnant subjects under similar test conditions and suggests a protection of the maternal organism from excessive adrenergic output during labor.

ISSN:0378-7346    

DOI:10.1159/000298871

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Serum levels of dehydroepiandrosterone sulfate (DHEAS) were measured in 41 postmenopausal women with ovarian tumor (16 with ovarian cancer, 6 with borderline malignant and 19 with benign ovarian tumor) and in 21 postmenopausal women without ovarian neoplasm. Circulating DHEAS levels were significantly lower in patients with ovarian cancer than in women with benign ovarian tumor and in control subjects. Women with advanced ovarian cancer had lower DHEAS levels than those with local ovarian cancer. An age-related decrease in DHEAS levels was noted in the control group, while circulating DHEAS levels were independent of age in the ovarian cancer group. The results indicate the effect of ovarian cancer on this adrenal androgen and the possible presence of ovarian factor in malignant ovarian neoplasm.

ISSN:0378-7346    

DOI:10.1159/000298872

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Severe cancer pain was relieved by a simple custom-built microautoinjector. Its injecting power is derived from the decomposition and expansion of medical-grade 3.3% hydrogen peroxide. The injection speed is controlled by the addition of a microamount of medical-grade iodide which catalyzes the hydrogen peroxide. The amount of potassium iodide used is so small that decomposition and expansion speeds are nearly constant. The size of the power device is 1 cm3; it may be inserted into the injector, which then does not need a gasket any more. This means that this microinjector with the solution to be injected is only half the size of an ordinary disposable syringe. It is convenient for epidural anesthesia of untreatable cancer pain.

ISSN:0378-7346    

DOI:10.1159/000298873

出版商:S. Karger AG    

年代:1987

数据来源: Karger