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Biomedical subjects

F Wolff

Publications and source records attributed to F Wolff.

At least 37 records · Page 2Linked to original sources
PubMed1990

[The status of prenatal lung ripening].

Morbidity and mortality of low-weight infants depend mainly on the respiratory-distress syndrome (RDS) and its complications, such as neonatal asphyxia and intraventricular haemorrhage. This underlines the importance of prenatal prevention of RDS. The results of the present multicentre studies demonstrate successful acceleration of fetal lung maturation by glucocorticoids and ambroxol. Both agents lower the RDS-rate two to threefold. The effectiveness in accelerating fetal lung maturation is comparable. In contrast to glucocorticoids, ambroxol seems to have no severe potential maternal or fetal side effects. We believe that prenatal prevention of RDS remains the treatment of choice even if neonatal surfactant therapy is expected to open up new aspects for the future.

Animals↗
PubMed1990

[Pregnancy outcome with intensified insulin therapy in manifest diabetes].

In 1981, the intensified insulin therapy for achievement of euglycaemia in pregnant diabetics was introduced at the University Department of Obstetrics and Gynaecology in Cologne. This study compares the results of 112 pregnancies in women with overt diabetes monitored before (1971-1980) or after (1981-1988) changing the therapeutic regimen. In the period from 1981 to 1988, the proportion of euglycaemic patients (preconceptionally 19%, before delivery 79%) was clearly higher than from 1971 to 1980 (n = 42; 7% and 9%, respectively). The tight blood glucose control resulted in a doubling of hypoglycaemic episodes during pregnancy. The proportion of preterm deliveries was reduced from 47% to 24%. The rate of caesarean sections was nearly constant (1971-1980: 38%, 1981-1988: 34%). The marked success of therapy was the decrease of perinatal mortality from 20.9% to 2.9%. The perinatal morbidity also diminished, as shown by the decreasing rates (30-90%) of foetopathy, macrosomy, respiratory distress syndrome, birth trauma, hypoglycaemia, hypocalcaemia and polycythaemia. The malformation rate, however, remained high (1971-1980 = 7%, 1981-1988 = 11%). The results demonstrate the necessity of a strict blood glucose control during pregnancy, beginning before the time of conception.

Adult↗
PubMed1990

[Pregnancy-induced hypotonia. A prospective study of fetal development, labor and morbidity of newborn infants].

Maternal and foetal risk of hypotension in pregnancy were examined in a prospective study, comprising a total of 770 pregnant women i.e. 700 normotensives and 70 hypotensives. We conducted a minimum of 5 pressure controls beginning after the 20th week of gestation. All pressure controls were conducted by the same person and in each control 4 pressure values were taken (left and right arm, lying, standing). No difference was discovered in the statistical analysis of our data of pregnancy, delivery and foetal outcome. Our special interest was in the frequency of preterm delivery and foetal growth retardation. The rate was similar in the hypotensive group (6.7/3.1%) compared to the normotensive group (6.8/2.8%). From our results we conclude, that maternal hypotension is not a risk factor in pregnancy, and that no therapy is needed.

Acidosis↗
PubMed1989

[Electronic data processing of the patient record for computer-assisted evaluation of pregnancy and labor].

This article describes an EDP-adequate data collection system which can also be used in the conventional way. The relational data base system used is PROFESSIONAL ORACLE, Revision 5.1.; the requisite hardware consists of 3 IBM-AT-compatible personal computers with a main storage comprising 4 MB, system MS/PC-DOS, and a hard disk of at least 20 MB. The standardized case history compiles the user to collect the data carefully and completely. Besides formulating research problems the system automatically prepares the discharge report. By means of statistical analysis a continuous internal quality assessment was realized.

Electronic Data Processing↗
PubMed1987

[Induction of fetal lung maturation using ambroxol and betamethasone. Results of an open multicenter study].

In a randomized open multicenter study the results of antenatal prophylaxis against neonatal RDS by administration of betamethasone were compared with those obtained with the bromhexine VIII metabolite Ambroxol. Ambroxol was administered for a maximum of 5 days - 1000 mg in an infusion solution; betamethasone was injected intramuscularly in 2 daily doses of 8 mg. One of these two substances was given to 123 pregnant women for pulmonary maturation in the fetus, in accordance with a randomization plan. The patients were either being treated for premature labor or pregnancy was terminated on the basis of indication between the 28th and 36th week. Therapy had to be discontinued in 4 cases in each group, because of continued labor and birth, and in one case because of an amniotic infection syndrome. A full analysis of the treatment records of 57 pregnancies in the Ambroxol group was carried out; the corresponding figure for the betamethasone group was 58. In 39 patients the duration of pregnancy was 37 weeks or more, so that no assessment on the basis of neonatal pulmonary maturity was possible. In the remaining pregnancies, RDS morbidity was estimated on the basis of clinical and radiological findings and blood gas analysis. Related to a maximum duration of pregnancy of 34 weeks, RDS morbidity after Ambroxol therapy was 18.2% (2 out of 11), as opposed to 35.7% (5 out of 14) after betamethasone treatment. The results confirm that antenatal administration of Ambroxol can bring about a reduction in neonatal RDS corresponding to that achieved with betamethasone therapy. However, with Ambroxol the occurrence of side-effects is potentially lower; it therefore has advantages over betamethasone while being equally efficacious.

Ambroxol↗
PubMed1987

Capgras delusion and seizures in association with therapeutic dosages of disulfiram.

We have described a patient in whom EEG abnormalities, a seizure disorder, and Capgras syndrome developed two weeks after she started taking disulfiram. That disulfiram has been shown to inhibit dopamine beta-hydroxylase in vitro suggests an etiologic role for dopaminergic pathways in at least some cases of Capgras syndrome. Our experience with this patient suggests that convulsions and psychosis may occur as a side effect of standard dosages of disulfiram in patients with no previous history of psychosis or brain disease. Furthermore, the symptoms may resolve spontaneously without the long-term use of antipsychotic or anticonvulsant medication.

Adult↗
PubMed1987

[Coronarography-scintigraphy comparison of the effects of trinitrin-spray in 15 patients with coronary disease].

15 patients with coronary disease underwent a dual investigation, angiographic and scintigraphic, first without treatment and after administration of 0.8 mg of sub-lingual trinitrin-spray. The radiocinema angiography enables to explore variations of the coronary and stenosic diameter, the duration of the opacification (inverse of circulatory velocity) and the tonality of the network. Plane scintigraphy with T1201 enables to quantify the regional fixation in 9 myocardiac territories, as well as the global fixation with the myocardium/background noise ratio and the index of mean perfusion deficit. The diameter of healthy arteries and the pre- and post-stenotic segments of the diseased arteries are uniformly dilated after trinitrin (11.5-12.5%) while the stenoses are on an average unchanged (+ 1.2% NS). 4 cases of stenotic dilatations were observed, but without any decrease of the degree of stenosis (the pre-stenotic diameter increasing in the same proportions), nor any scintigraphic improvement. On scintigraphy, no difference of the myocardium/background noise ratio nor the mean deficit index was observed after trinitrin, which demonstrates the non-variation of the total coronary output. On the contrary, a redistribution of the regional activity (and therefore of the regional coronary flow) is observed in 10 patients. In comparing the stenotic areas which improve on scintigraphy (group I) and those which do not improve or deteriorate (group II) with the modifications of the arterial diameters under trinitrin, a correlation does not appear to be present. Also, the tonality is uniformly increased in both groups. The circulatory velocity is, however, significantly decreased in group II.(ABSTRACT TRUNCATED AT 250 WORDS)

Aerosols↗
PubMed1987

[Diastolic coronary prolapse in partial left pericardial agenesis].

A few rare cases of coronary artery stenosis and occlusion have been reported in partial left pericardial agenesis. The authors report a privileged observation of partial left pericardial agenesis associated with an atrial septal defect in which diastolic collapse of the left marginal artery was demonstrated; this chronology was confirmed by synchronous analysis. The peroperative findings may explain the pathogenesis of the coronary disease encountered in this type of malformation, providing a new diagnostic sign of partial left pericardial agenesis.

Adult↗
PubMed1987

[Continuous electrocardiogram recording (Holter). Normality criteria].

The interpretation of a continuous electrocardiographic recording according to Holter's method is valid only in terms of well defined standard criteria. These criteria are beginning to become more specific, in spite of uncertainties linked especially to study protocols. Finally, if these criteria were established among healthy populations, their application to pathological situations comes up against the notion of physical condition which may modify all norms.

Arrhythmias, Cardiac↗
PubMed1986

Cardiopulmonary effects of betamimetic tocolytic and glucocorticoid therapy in pregnant women.

In 35 present women, undergoing tocolytic treatment with betamimetics had intensive monitoring by balloon-tipped catheter. After the administration of 2-4 micrograms/min of fenoterol the cardiac output (CO) increased from 8.2 l/min to over 11 l/min with a corresponding increase in mean pulmonary artery pressure (MPAP) from 11.7 mmHg to over 18 mmHg. The correlation coefficient between MPAP/CO was highly significant. In the 10 patients in whom we were able to monitor pulmonary capillary pressure (PCP), we observed no significant increase to suggest compromised cardiac performance. The calculated total resistance of the pulmonary vessels (TPR) decreased during the first 24 h followed by a return to initial values. Our investigations suggest that the principal cardiovascular effect of betamimetics in pregnant women is a volume-dependent increase in pressure in the pulmonary circulation. The simultaneous administration of betamethasone had no additional effects.

Betamethasone↗
PubMed1986

[Incidence and significance of chromosomal translocations in prenatal diagnosis].

In the study reported here the incidence and significance of translocations in antenatal diagnosis are described with reference to data of the cytogenic laboratory of Cologne University Gynecological Clinic. During the last 10 years 19 translocations were found in 4532 amnion cell cultures (0.44%), without exception in single pregnancies. In 18 cases the chromosome aberrations were balanced, i.e., the location of the genetic material was changed without loss or addition of parts of chromosomes. In one case the diagnosis of an unbalanced translocation in the form of a translocation mongolism led to termination of pregnancy. All of the other pregnancies were continued to term. Phenotypically and clinically the children were normal. The translocations were inherited in 78.9% (n = 15; 11 from the mother, 4 from the father), and de novo in 21.1% (n = 4). The results are in agreement with those of the DFG study, which identified 0.66% translocations in over 10,000 antenatal diagnoses. Of the balanced chromosome aberrations all of the newborns but one were clinically and phenotypically healthy. In cases of inherited translocations in particular, no increase in risk to the child could be determined. In cases of de novo chromosome aberrations there is a slight increase in the residual risk due to loss of minute portions of the gene. With careful technique this risk may be assumed to be very slight, so that in such cases also there is no indication for termination of pregnancy.

Amniocentesis↗
PubMed1986

[The contribution of magnetic resonance imaging in congenital heart diseases].

The diagnostic value of magnetic resonance imaging (MRI) was assessed in 30 patients with congenital heart disease, including 7 patients with postoperative sequellae. The images obtained by synchronizing the MRI spectrometer with the electrocardiogramme were recorded in 2 or 3 different planes (sagittal, frontal and transverse) and compared to clinical, angiographic and/or echocardiographic data. The MRI provided high resolution tomographic images enabling spatial reconstitution of the heart by the use of different planes. These images were particularly useful for showing the position and dimensions of the ventricles (both chamber size and wall thickness) and their relationship to the atria and great vessels. These results confirm the value of this new non-invasive imaging technique in the diagnosis of congenital heart disease, not counting the additional information on blood flow and tissue characterisation that will soon become available.

Heart Defects, Congenital↗
PubMed1986

[Septal subaortic hypertrophy. Apropos of 23 cases].

Septal subaortic enlargement is seen by two-dimensional echography and involves localized hypertrophy of the basal part of the interventricular septum, the thickness of which is greater than or equal to 13 mm. The present study relates to 23 septal subaortic enlargements. Means thickness of the enlargement was 17.0 mm and the longitudinal parasternal length was 22.1 mm. SAM was noted in 2 cases and mesosytolic closure of the sigmoid sinuses in one case. Left ventricular volume was much reduced in one third of cases, especially when enlargement was great. Compliance disorders were marked in one third of cases. Only the longest and thickest enlargements caused obstruction, which was noted in 18% of cases. Enlargement was most often associated with valvular (56% of cases) or hypertensive (48 P of cases) pathologies. No specific clinical, radiologic or electrical signs were noted; anomalies were due to pathology associated with the enlargements. A stable trend was generally seen in subaortic hypertrophy after a mean period of 33 months. Nevertheless, moderate increases in hypertrophy were seen in 20% of cases. In the great majority of cases, enlargement did not correspond to obstructive hypertrophic cardiomyopathy according to Goodwin's criteria, and etiology remains uncertain due to lack of histological data.

Adult↗