Biomedical subjects

A Huch

Publications and source records attributed to A Huch.

259 records · Page 15Linked to original sources

PubMedDate not supplied

A triple electrode for simultaneous investigations of transcutaneous oxygen tension, laser-Doppler flowmetry and dynamic fluorescence video microscopy.

A newly designed triple probe is introduced for measurements of transcutaneous oxygen tension, laser Doppler flowmetry (LDF) and microangiodynamics of skin capillaries by dynamic video microscopy with and without fluorochromes. The performance of the triple probe was checked in 9 healthy volunteers (6 women, 3 men; mean age: 34 years) and 9 patients (5 women, 4 men; mean age: 67 years) with peripheral arterial occlusive disease (PAOD). The mean Doppler ankle/arm pressure ratio was 0.54 +/- 0.30. Six patients suffered from severe claudication, 2 from rest pain and 1 patient had toe and forefoot necrosis. The foot dorsum was selected as measuring site. After recording baseline values of skin surface PO2 (ssPO2) at 37 degrees C, LDF and capillary images, a suprasystolic compression at the ankle level was performed for 4 min. Thirty seconds before cuff opening 0.2 ml/1 l blood volume of 20% sodium fluorescein was injected in an antecubital vein. Sodium fluorescein arrival times, filling times and maximum fluorescent light intensity times were measured, and ssPO2 and LDF were recorded continuously during postocclusive reactive hyperemia (PORH). The results indicate an adequate function of the triple probe. The mean resting ssPO2 was 2.0 +/- 1.9 mm Hg in PAOD patients and 4.0 +/- 3.9 mm Hg in controls (p = 0.185). Maximum ssPO2 during PORH was significantly reduced (p = 0.008) in patients (3.1 +/- 2.1 mm Hg) compared to healthy subjects (11.8 +/- 7.7 mm Hg). Resting LDF values were 6.5 +/- 6.4 perfusion units (PU) in PAOD patients versus 10.3 +/- 8.2 AU in controls (p = 0.295). Peak LDF during PORH was significantly reduced (p = 0.005) in patients (19.5 +/- 6.4 PU) versus healthy subjects (33.8 +/- 11.5 PU.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

A large unilateral contained urinoma in a fetus: an indication for intrauterine urinary shunting.

A large contained urinoma measuring 12 x 8 x 8 cm3 was diagnosed in the left kidney of a female fetus at 28 weeks gestation. Analysis of fluid from serial punctures of the cyst indicated that renal function on that side was poor, but because ultrasound findings of the thorax suggested lung growth impairment, a shunt was inserted. After 3 weeks the shunt dislocated into the fetal abdominal cavity and urinous ascites developed. The ascites was found to have resolved spontaneously on ultrasonography 3 weeks later. The infant was delivered at 37 weeks gestation and appeared normal except for bilateral pelvi-ureteric obstruction. This was much worse in the left kidney, the renal function of which was only 10% of normal. A left nephrectomy was carried out when the infant was 6 months old, when the inner part of the shunt was discovered in perinephric fibrous tissue. The renal pelvis was greatly enlarged and fibrotic; no site of rupture could be identified. The infant's respiratory function was normal. This case suggests the use of intrauterine shunting to decompress a large unilateral urinoma resulting in marked elevation of the fetal diaphragm to prevent impairment of fetal lung growth.

Adult↗

PubMedDate not supplied

[Doppler sonographic determination of specific hemodynamic changes in fetal circulation during the last four weeks before birth].

The observation of characteristic flow changes measured by Doppler ultrasound in the fetal descending aorta a short time before delivery led us to systematically analyse our measurement data. For the retrospective analysis, records with a total of 115 measurements taken in the last four weeks prior to spontaneous onset of labour from 90 women with normal pregnancies were used. For each of the four weekly periods there were between 15 and 50 measurements. Both qualitative and quantitative flow parameters were evaluated. The findings showed: 1. No significant changes in the blood flow characteristics of the uteroplacental and fetoplacental vessels; 2. A clear widening of the diameter of the aorta; 3. A decrease in the mean flow velocity in the descending aorta; 4. A steep decrease in maximum velocity during late systole, sometimes so pronounced that a notch in the flow envelope was observed. The time when the changes occurred was found to be 2 weeks prior to spontaneous onset of labour. These changes in the fetal circulation, which can be called "term effect", occur along with other developments taking place towards the time of birth. They are probably related to the beginning of spontaneous contractions and indicate an adaptation to the changing supply conditions occurring a few days before the onset of labour.

Aorta, Thoracic↗

PubMedDate not supplied

[Is orthostatic circulatory regulation more difficult in multiple pregnancy? Results of a prospective longitudinal study].

In 7 multiple pregnancies the changes in maternal and fetal cardiac-circulation parameters resulting from a passive change in presentation from left lateral to steady upright were measured for the duration of pregnancy and the puerperium and compared with corresponding data from a single-fetus collective. The hypothesis that in multiple pregnancies the greater uterine contents lead to more severe problems of return flow from the lower extremities, and that these problems tend to lead a more pronounced form of uterovascular syndrome, was confirmed on the basis of the physiological data. The fact that the uterine contractions usually correlate with the maternal cyclic heart rate accelerations and peak toward the end of the third trimester of pregnancy supports the view that these contractions play a role in regulating circulation.

Blood Pressure↗

PubMedDate not supplied

[Single intrauterine fetal death in twin pregnancy].

During a 11 year period (1984-1994) we identified and analysed at the Department of Obstetrics, University Hospital of Zurich, among 541 twin pregnancies 19 with single intrauterine death (SIUD) in the second and third trimester. The preterm delivery rate was 68% and much higher compared to singleton pregnancies at the same institution (17%). The caesarean section rate was 47% and also higher compared to singleton pregnancies (21%) but lower than in a normal twin collective (61%). Two of the surviving twins showed malformations. One of them has in addition of porencephaly, probably due to disruption syndrome. In 12 out of 19 case a monochorionic placenta was found including 5 with twin-twin transfusion syndrome. Surprisingly 8 out of 19 dead fetuses had a velamentous insertion of the umbilical cord. This might suggest a causal relationship to SIUD. 95% showed the same sex. Maternal blood coagulation disorders are rare. From our results we conclude that SIUD is associated with an increased preterm delivery and caesarean section rate. Monochorionic twins and twins with concordant sex demonstrate the highest risk for SIUD. The twin-twin transfusion syndrome is the main single cause for SIUD. The pathophysiologic role of velamentous insertion remains unclear.

Adult↗

PubMedDate not supplied

[Kinetocardiotocography--KCTG--during pregnancy in an ambulatory care patient sample and in hospitalized patients with special reference to tocolysis].

With kinetocardiotocography (KCTG), fetal movements can be registered parallel to the fetal heart rate. Hewlett Packard equipment of the series 1350 A allows the movements to be registered an quantified on the CTG paper. In this study, hospitalized pregnant women > 26 gestational weeks (GW) on i.v. tocolysis, and out-patients > 34 GW at the out patient department were examined with KCTG and the results compared. A wide distribution of fetal activity was seen in both groups. With advancing pregnancy, the number of fetal movements as well as the duration of activity per time unit decreased, whereas the length of time of individual movements slightly increased, in both groups. No statistically significant difference was seen between different gestational ages nor between the two groups. KCTG is being increasingly used to monitor the fetal condition, especially for risk pregnancies. It can provide additional information in the form of a biophysical variable.

Adult↗

PubMedDate not supplied

[Sodium concentration and pre-eclampsia: is salt restriction of value?].

UNLABELLED: The significance of sodium metabolism with respect to preeclampsia is discussed in the literature with a wide range of diverging opinions. The presented work analyses the influence of a low salt diet on the symptoms of preeclampsia and the consequences for the newborn. MATERIAL AND METHODS: 160 patients with preeclampsia between 1989 and 1993 were retrospectively studied. Serum sodium values (at hospital admission, lowest prepartal level, immediate and 3-8 days postpartum) were compared with the corresponding gestosis symptoms. RESULTS: The mean sodium serum concentration at admission was 135.6 mmol/l (lower norm: 136 mmol/l). This was significantly different from the mean lowest prepartal value of 134.9 mmol/l (p < 0.0001). Postpartum the mean fell again significantly to 134.0 mmol/l (p < 0.0001). None of the parameters for gestosis symptoms, which were investigated (diastolic blood pressure, edema, proteinuria, serum protein levels and hyperreflexia) showed any statistically significant association with the serum sodium concentration. Five patients had very low serum natrium values, 130 mmol/l, either at admission or during hospitalisation. Three of the five infants of these patients had hyponatremia; two needed sodium supplementation. CONCLUSION: There seems to be no reason supporting a low salt diet as therapy for preeclampsia, since it does not affect the symptoms and might lead to hyponatremia in the newborn.

Adult↗