Search PubMed⌕ Search

Biomedical subjects

A Hettenbach

Publications and source records attributed to A Hettenbach.

29 records · Page 2Linked to original sources
PubMed1984

[Peridural morphine analgesia for the control of tumor-induced pain in gynecologic cancer patients].

22 gynecological patients suffering from considerable tumor pain in an advanced carcinoma stage had a continuous peridural anaesthesia. 18 patients reported a very good and 4 patients a sufficient analgesia. The average morphine dose per day was 14 mg. The indwelling catheters remained on an average 27 days in site. Side effects, which could be related to the morphine PDA, occurred in one case.

Catheters, Indwelling↗
PubMed1984

[Cervical carcinoma in the T1b stage. Therapy, complications and prognosis].

Records of 256 patients with carcinoma of the cervix uteri stage T1b from the years 1965-1979 were reviewed retrospectively. By screening programs only 21% were detected. Most of the neoplasms were squamous cell carcinoma (81%). The majority of the patients was treated surgically most frequently by radical hysterectomy (Wertheim-Meigs). If the carcinoma was poorly differentiated and/or lymphonodi were positive postoperative radiotherapy was added. Thus only 43 patients had no radiotherapy. 5 year survival rate could be studied in 151 patients. 89% survived 5 years or more following primary treatment. Older women (over 40 years old) showed a better prognosis than those below 40. Patients treated by radiotherapy alone survived 5 years in 88 per cent. Patients treated by radical hysterectomy had a five year survival rate of 94.6%. No difference in prognosis was observed, if radiotherapy was added. There was no significant difference in the frequency of severe complications in both kinds of treatment. The rate of recurrencies was 9.4 per cent.

Adult↗
PubMed1982

Urinary free 18-hydroxycorticosterone, plasma aldosterone, and urinary aldosterone metabolites in normal pregnancy.

The final steps in aldosterone biosynthesis are unclear. Undecided is whether 18-hydroxycorticosterone is a precursor of aldosterone or an end product. 18-Hydroxycorticosterone is secreted in close relationship to aldosterone. To get adequate information on the status of aldosterone in pregnancy, determination of more than one parameter of aldosterone seems to be necessary. Urinary excretion of free 18-hydroxycorticosterone, tetrahydroaldosterone, aldosterone-18-glucuronide, free aldosterone, and the plasma concentration of aldosterone were measured by radioimmunoassay in 16 primigravid women in the last trimester of normal pregnancy and in 13 healthy nonpregnant women. All steroids measured were significantly increased in pregnancy. The ratios of aldosterone-18-glucuronide to tetrahydroaldosterone in the two groups were not significantly different, so that significant changes in renal or hepatic aldosterone metabolism could not be demonstrated in pregnancy. When pregnant women with ankle edema (n = 7) were compared to pregnant women without edema (n = 9), no differences in steroid patterns could be found. The increased excretion of 18-hydroxycorticosterone in pregnancy confirms the state of hyperaldosteronism in normal pregnancy which is associated with an increase in biologically active, free aldosterone. Dissociation in the excretion of the two aldosterone metabolites and free aldosterone was found in three pregnant women, in whom excretion of aldosterone-18-glucuronide was increased but excretion of tetrahydroaldosterone and free aldosterone was in the normal nonpregnant range.

18-Hydroxycorticosterone↗
PubMedDate not supplied

[Internal urinary diversion in complicated pregnancy-induced hydronephrosis].

In 14 women with sympthomatic hydronephrosis of pregnancy (calix diameter 1-2.6 cm) an internal urinary drainage was carried out during the second half of pregnancy. Retrograde stenting was performed following cystoscopy in all cases. Follow up examinations were taken weekly for the first two weeks and further on biweekly. Primary stenting was possible in 12 out of 14 cases and in 2 patients dilatation of the ureteral orifice was necessary. 11 out of 14 patients suffered from complications consisting of severe dysuria (9x), urinary tract infection (7x), persisting lumbar pain plus catheter lumen obstruction (6x each) as well as catheter dislocation (3x). Long term follow up showed that urinary tract obstruction was relieved by stenting in only 6 out of 14 patients. Sufficient urinary drainage by so called double-J-ureteral stents was achieved in less than half of the cases. Moreover, there was a complication rate of more than 75%. Taking these results into consideration, internal drainage of complicated pregnancy hydronephrosis needs careful evaluation.

Catheters, Indwelling↗
PubMedDate not supplied

[Pregnancy-induced changes in adrenergic receptors].

In the 24th and 26th week of pregnancy and also 6 weeks post partum, n = 32 pregnant women were evaluated for the concentration of adrenergic receptors on blood cells by radioligand binding assay and an isoprenaline stimulation of the beta-receptors. The concentrations of estradiol and progesterone in serum were also determined and nephrosonography was carried out. The stimulation and concentration of the beta-receptors were significantly higher during pregnancy than post partum. The alpha-receptors displayed contrary alterations: Here, the concentration evaluated during pregnancy was considerably lower. No connection was determined between the progesterone level in serum and the extent of the receptor alterations. However, one was found with the estrogen level and the dilatation of the upper urinary tract: Pregnant women with pronounced alterations above the median showed a distinct decrease of estradiol and a marked dilatation of the kidney collecting system. Alterations in the adrenergic receptors can therefore be determined during pregnancy. The extent of the receptor fluctuation is connected to the estradiol concentration in serum and the dilatation of smooth muscle hollow organs.

Dilatation, Pathologic↗
PubMedDate not supplied

[Effect of co-medication with magnesium sulfate in beta-mimetic tocolysis on parameters of water-electrolyte balance].

With 2 groups of 10 patients the influence of an additional therapy with 1 g magnesium sulfate/h during i.v. tocolysis with the betamimetic fenoterol (2 micrograms/min) upon parameters of water and electrolyte balance has been investigated. The whole of the magnesium administered during the 24 hours investigational period has been eliminated via the kidneys. Most probably due to a competition within the distal tubulus hypermagnesemia was associated with hypocalcemia and hypercalciuria, followed by a rise in parathyroid hormone. As PTH is able to compensate hypocalcemia not only by means of bone mobilisation but also by an increase in enteral Ca absorption, estimated losses of calcium are minimal. These may be neglected, as additional therapy with magnesium sulfate--besides the advantages yet known (cardioprotection, saving of betamimetic dosage, reduction of drug tolerance development)--reduces betamimetic induced water retention, thus significantly diminishing lung edema hazard during tocolytic therapy.

Adult↗
PubMedDate not supplied

[Lung function during tocolysis with beta-stimulators and beta-1-blockers].

The pulmonary function during pregnancy is foremost changed by the elevated diaphragm, which reduces the functional residual capacity. The lungs are less extended, so that the airway resistance increases. The application of a beta-mimetic drug for tocolytic therapy could reduce the airway resistance. Because an additional selective beta-1-blocking drug for cardioprotection could interfere with this effect, the pulmonary function in pregnancy during tocolytic therapy was investigated by body plethysmography in 20 woman of the third trimester of gravidity. There were no apparent differences in the pulmonary function in these woman when an additional selective beta-1-receptor blockade was performed. The airway resistance even diminished during the beta blockade. This unexpected result is probably due to an stabilizing effect of the betablocker on the body fluid and the permeability of capillary membranes during tocolytic therapy.

Adrenergic beta-Agonists↗
PubMedDate not supplied

[The effect of beta-stimulation and beta-1-blockade on the motility of the upper urinary tract].

18 patients with severe congestion of the urinary tract in pregnancy were treated by implantation of ureteral catheters for intermittend exoneration. Before and during the infusion of 2 micrograms/min Fenoterol the basal tone, the frequency and amplitude of the contractions of the renal pelvis were measured after retrograde filling with increasing volumes. 45 min after the i.v. application of 10 mg Metoprolol the measurements were repeated under the same conditions. During the infusion of Fenoterol there was a significant decrease of the frequency and amplitude of the contractions of the renal pelvis. Whereas at low retrograde filling volumes the basal tone in the renal pelvis decreased, at higher filling volumes - because of the concomittant deteriation of the urine transport capacity - an increase of the basal tone could be found. The relaxant effects of the beta-stimulation on the upper urinary tract could be diminished by the application of the beta-1-blocker Metoprolol; a complete compensation however was not possible.

Adolescent↗
PubMedDate not supplied

[Induced labor with prostaglandins in birth weight below 2,500 g].

In a multicenter study the deliveries of 127 newborn infants with a birth weight less than 2500 grams were evaluated after induction of labour using prostaglandins, among them 90 infants with a birth weight below the 10. percentile in relation to the gestational age. The control group were 1566 deliveries of newborns with normal weight, delivered at term after induction with prostaglandins. The rate of vaginal deliveries was 67.6% in the group of newborns weighing less than 2500 grams and 84.1% in the control group. The rate of acidotic newborns (pH < 7.20) was remarkably higher in newborns below 2500 grams (12.6%), especially in the subgroup of growth retarded newborns (16.7%), when compared to the control group (9.5%). In primaiparae with fetal growth retardation and low Bishop score the induction of labour with prostaglandins resulted in an insufficient progress of labour. In this subgroup the rate of cesarean deliveries was 83.3%. Induction of labour was substantially more successful after premature rupture of membranes. The most favourable results were achieved in multiparae after premature rupture of membranes which resulted in vaginal deliveries in 94.5% of cases independent of gestational age.

Administration, Intravaginal↗