Biomedical subjects
Publications and source records attributed to A Beck.
In order to investigate the use of fibrin glue in reconstructive surgery of the oviduct, tubal reanastomosis was performed with homologous fibrinogen concentrate in 26 rabbits. The contralateral tube was clamped. The pregnancy rate was 25%. No adhesions were seen in the area of the anastomosis on examination of the abdomen 3 months after operation.
The effects of indomethacin on changes in renal blood flow induced by adenosine, NECA (adenosine-5'-N-ethyl-carboxamide) and 2',3'-dinitro-NECA were investigated in 6 chronically instrumented conscious dogs. Adenosine (187.5, 375 and 750 nmol/kg, i.v.) induced a dose-dependent initial decrease, followed by a reactive increase in renal blood flow. NECA (1.5 nmol/kg, i.v.) also induced an initial decrease, which was, however, followed by a prolonged reactive increase in renal blood flow. 2',3'-dinitro-NECA (50 nmol/kg, orally) induced only an increase in renal blood flow. Indomethacin (27.9 mumol/kg, i.v.) caused no relevant change of the initial decrease and a significant attenuation of the reactive increase in renal blood flow induced by adenosine. NECA-induced changes in blood flow were affected by indomethacin in the same direction but to a greater extent than were adenosine-induced changes in blood flow. Indomethacin reversed the increase to a decrease in renal blood flow induced by 2',3'-dinitro-NECA. Thus, prostaglandins seem to be involved in mediating the response of renal blood flow to adenosine, NECA and 2',3'-dinitro-NECA.
We examined the site of experimental reanastomosis with fibrin glue in rabbit oviducts 3 months after the operation with light and scanning electron microscopy. Local tissue reaction was minimal, no fibrin clots were seen and inflammatory reactions were almost absent. On scanning electron microscopy ciliated cells were reduced in number. Morphologic changes at the site of anastomosis after the use of fibrin glue appear comparable to the alterations seen after the use of microsutures.
Chlamydia trachomatis is a common cause of sexually transmitted disease in adolescent girls. Of 366 adolescent patients screened, 15.3% were found to have chlamydial endocervical infections, with an infection rate of 23.3% in blacks, 14.3% in Hispanics, and 10.3% in whites (P = 0.01, excess for blacks). Of Chlamydia-positive patients, 63.6% had a diagnosis of lower genital tract infection, compared with 35.4% of Chlamydia-negative patients (P = 0.004). Oral contraceptive users had a higher prevalence of infection (23.8%) compared with those using a barrier method (16.2%) or with nonusers (9.3%) (P = 0.004). Inflammatory changes on Papanicolaou smears were associated with chlamydial infection (P = 0.0001). Other variables identified as risk factors for chlamydial infection included both a younger age at first intercourse (P = 0.02) and more years of sexual activity (P = 0.02). Chronologic, menarchal, and gynecologic age, biologic age of the cervix, the number of sexual partners in the last month and during a lifetime, and parity were not found to be associated with recovery of Chlamydia.
55 deaths following a Caesarean section occurred in Austria during 1975-1982 (41,7% of all maternal deaths). 45 deaths (82%) were directly related to the Caesarean section, in 9 cases (16%) a severe underlying disease was found which had contributed to the fatal outcome (indirect deaths). In one case the diagnosis could not be clarified. Among the direct deaths the indication for the Caesarean section was in 12 cases (27%) severe bleeding, in 12 cases gestosis, in 12 cases predominantly foetal causes, in 6 cases previous Caesarean section and in 3 cases poor obstetric history. Complications were in 18 cases (40%) severe bleeding, in 7 cases (16%) pulmonary embolism, in 4 cases complications as a consequence of anaesthesia and in 4 cases abdominal infections. In 14 cases (31%) post Caesarean hysterectomy was performed. The mortality of Caesarean section during 1975 to 1982 was 6.3/100.000 live births, whereas case fatality was 0.1%.
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The magnitude and the persistence of blood pressure reduction by dihydralazine and urapidil were investigated following treatment over a period of 4 days. The experiments were performed on six normotensive dogs, trained to submit to puncture of the femoral artery and to stand quietly in a special frame. The first-dose effects of orally administered dihydralazine (1.42, 7.1 mg X kg-1) and urapidil (2.0, 10.0 mg X kg-1) on heart rate, arterial blood pressure and plasma renin activity (PRA) were compared with the effects of the substances after 4 days of treatment. Both compounds caused a dose-dependent decrease in blood pressure but in contrast to urapidil the effect of dihydralazine was accompanied by large increases in heart rate and PRA. Dose-dependent tolerance to dihydralazine but not to urapidil was observed after treatment over only 4 days. However, basal blood pressure was significantly lowered after 4 days of treatment with urapidil at the high dosage and no further reduction was achieved on the fifth day. The importance of persistent counterregulation in the development of tolerance to the antihypertensive effect of dihydralazine is discussed.
Report on 22 cases of inverted papilloma. The common site of origin of the tumours is the lateral nasal wall and with a few exceptions they are benign. They become dangerous if they invade the bony structures of the face skeleton, especially the hard palate and the orbit. The therapy of choice is lateral rhinotomy with an "en bloc" resection of the lateral wall of the nose and the ethmoid of the invaded side. In that case the prognosis is good. The classifications by Schneider and Skolnik only define the size of the tumour but do not give an indication of prognosis; they are, therefore, unnecessary.
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Surgical interventions in early pregnancy are an important contribution to the Rh IgG utilization gap in Rh-negative women. Ectopic pregnancy, spontaneous and induced abortion and amniocentesis call for IgG prophylaxis. In abortions no immunization was found before the sixth week of pregnancy, thereafter the standard dose of 200 to 300 micrograms Anti-D should be applied, a reduced dose of 50 micrograms is recommended in early abortions before 12 weeks. In ectopic pregnancy prophylaxis is omitted in a high percentage. A further reduction of Rh-immunization in pregnant women can only be achieved by prophylaxis on large scale in early pregnancy.
The relevance of the steric configuration to the effects of two non-selective beta-adrenoceptor antagonists without intrinsic sympathomimetic activity (+)- and (--)-bupranolol (10 and 50 micrograms/kg i.v.) and (4)- and (--)-propranolol (100 and 500 micrograms/kg i.v.) on the i.v. glucose tolerance test (IVGTT) were investigated in conscious, normoglycemic dogs. The effects of the beta-adrenoceptor antagonists on plasma glucose, and insulin levels and insulin-glucagon ratio following IVGTT were evaluated by calculating the respective areas under the curve (AUC). The AUC values for plasma glucose were significantly increased by the (--)-configuration of both beta-adrenoceptor increased by the (--)-configuration of both beta-adrenoceptor antagonists. In the (+)-configuration only propranolol (500 micrograms/kg i.v.) increased the AUC value for plasma glucose significantly. The AUC values for plasma insulin and also for the plasma insulin-glucagon ratio were significantly increased by (--)-propranolol (500 micrograms/kg i.v.) and by (--)-bupranolol (10 and 50 micrograms/kg i.v.). Thus the impairment of glucose tolerance, due to suppression of the plasma insulin level, depends mainly on the beta-adrenoceptor antagonistic activity of the (--)-configuration.
The effects of morphine (2 mg/kg i.v.) on the carotid baroreceptor control and the carotid chemoreceptor control of the circulation were examined in 12 chronically instrumented dogs. Bilateral carotid occlusion in conscious dogs with spontaneous ventilation increased heart rate (decrease in cardiac cycle length by 19 +/- 2%; mean +/- S.E.M.), mean arterial pressure (38 +/- 3%) and mean iliac resistance (33 +/- 11%). Morphine, however, failed to change these reactions significantly. Chemoreceptor stimulation, accomplished by intracarotid injections of nicotine (4-8 micrograms), in conscious dogs with spontaneous ventilation elicited complex effects on heart rate and mean iliac resistance--due to secondary stimulation of pulmonary inflation reflexes. Chemoreceptor stimulation in conscious dogs with ventilation controlled increased cardiac cycle length (246 +/- 17%) and elicited intense iliac vasoconstriction, i.e. mean iliac resistance rose by 288 +/- 25%. Morphine significantly (p less than 0.01) attenuated the increase in cardiac cycle length and in iliac resistance with chemoreceptor stimulation (42 +/- 10% and 64 +/- 9%, respectively). Thus, morphine interferes with the carotid chemoreceptor control of the circulation while the efficacy of the carotid-sinus-reflex seems to be well maintained.
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1032 women had their first Copper-T inserted, 204 became pregnant, had an expulsion or a removal for medical reasons (19.76%). Of 299 women with their second Copper-T only 15 reported these events (5.02%). Gross-rates show no difference for pregnancy, expulsion, removal because of bleeding or pain or for other medical reasons in different time-intervals of the first year of use, but in total lower event rates for the second year of use. The risk for pregnancy is not reduced for a woman with her second IUD (second segment). Other events and side-effects are reduced and explain the higher continuation-rate for the second segment. If the second IUD is not inserted immediately after removal of the first IUD, the event rate is again increasing.
While enflurane is generally held to induce arterial hypotension, its overall effects on left ventricular (LV) performance are less clear. Accordingly, mongrel dogs were chronically instrumented with miniature LV pressure transducers, with aortic and left atrial catheters and with electromagnetic flow probes and hydraulic cuff occluders on a common iliac artery. A pair of ultrasonic transducers was implanted on opposing endocardial surfaces to measure LV internal minor axis diameter. Experiments were performed 2 to 9 weeks after surgery when the animals were resting quietly without premedication. Enflurane (2 and 4 vol.-%) decreased mean arterial pressure by 27% and 36% and led to a progressive, dose-dependent decrease in myocardial contractility and induced striking peripheral vasodilatation, i.e. LV-dP/dtmax was reduced by 32% and 54% and iliac conductance rose by 101% and 163%. However, the decrease in contractility was not associated with an increase in LV preload, i.e. LV-end-diastolic diameter was decreased by 2 vol.-%, while it was not significantly different from control values with 4 vol.-%. Thus, in intact chronically instrumented dogs the direct negative inotropic effect of enflurane is modified by a synchronous decrease in myocardial loading conditions.
The effect of beta-adrenoceptor antagonists on the intravenous glucose tolerance test was investigated in conscious dogs. dl-Celiprolol (cardioselective with ISA = intrinsic sympathomimetic activity) 200 and 1000 microgram/kg i.v., dl-metoprolol (cardio-selective without ISA) 200 and 1000 microgram/kg i.v., dl-pindolol (non-selective with ISA) 5 and 25 microgram i.v. and l-bupranolol (non-selective without ISA) 10 and 50 microgram/kg i.v. were used in the study. The influence of beta-adrenoceptor antagonists on the plasma glucose and immunoreactive insulin following intravenous glucose tolerance test were evaluated by calculating the respective areas under the plasma curve. The present investigation clearly demonstrates the marked difference between the various beta-adrenoceptor antagonists on heart rate and, especially on metabolic parameters. dl-Metoprolol, a beta-adrenoceptor antagonist with cardioselectivity and without ISA can be assumed not to alter plasma insulin level and glucose assimilation. l-Bupranolol, a non-selective beta-adrenoceptor antagonist without ISA reduces plasma insulin level and probably enhances peripheral glucose uptake, resulting in an "unchanged" glucose tolerance. dl-Celiprolol or dl-pindolol, beta-adrenoceptor antagonists with ISA, but cardioselective or non-selective enhance both, basal insulin level and insulin level after glucose stimulation but must be assumed to decrease peripheral glucose uptake since here too glucose tolerance was unchanged.
The effect of the volatile inhalational anaesthetic enflurane (2 vol% and 4 vol%) on the cardiovascular response to carotid chemoreceptor stimulation (CCRS) was studied in 8 chronically instrumented dogs. Intracarotid injections of nicotine were used to evoke CCRS. Ventilation was held constant during the unanaesthetized state as well as the anaesthetized state. In the unanaesthetized state CCRS evoked an increase in iliac vascular resistance, and an increase in cardiac cycle length. Enflurane 2 vol% significantly attenuated the increases both in iliac vascular resistance as well as in cardiac cycle length. Enflurane 4 vol% abolished the response to CCRS.
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