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Biomedical subjects

G Bastert

Publications and source records attributed to G Bastert.

At least 127 records · Page 7Linked to original sources
PubMed1995

[Endoscopic colposuspension ("retziusscopy" versus laparoscopy). An effective extension of the surgical spectrum of stress incontinence?].

Within the framework of "minimal access surgery" a prospective randomised study was initiated at the Dept. of Obstetrics and Gynaecology of Heidelberg University to examine the feasibility of endoscopical abdominal Burch colposuspension for stress incontinence (II-III), at laparoscopy and "retziusscopy". Further, also prospectively randomised, two suspension techniques: needle suspension and suspension by means of alloplastic material with stapler fixation, were compared, irrespective of the endoscopic approach chosen, especially because long-term results of our study population on colposuspension with fibrin glue which are now available, are below expectations, worse than those obtained with conventional techniques. Except for a bladder lesion (during laparoscopic dissection of the space of Retzius) no intra- or postoperative complications occurred in the pilot study group of 20 patients. Both types of endoscopic access proved technically feasible, and presented the typical advantages of minimal access surgery such as short hospitalization and rapid recovery. Short-term follow-up (2-12 months) showed subjective and objective results (continence in 18/20 patients), comparable to conventional abdominal procedures at laparotomy. Detailed evaluation of subgroups is not yet possible, since the number of patients it still too small and follow-up too short.

Fasciotomy↗
PubMed1995

Effect of Leboyer childbirth on cardiac output, cerebral and gastrointestinal blood flow velocities in full-term neonates.

The Leboyer birth method requires that the newly born infant is placed on the mother's abdomen and the cord is clamped when it stops pulsating. This investigation was done to study the effect of Leboyer childbirth on neonatal circulation during the first 5 days after birth. Hematocrit, blood viscosity, left and right ventricular output, and cerebral blood flow velocities in the arteria carotis interna, arteria cerebri anterior, and truncus coeliacus were studied in 15 full-term neonates with early (less than 10 seconds) cord clamping and 15 full-term neonates delivered according to Leboyer (cord clamping after 3 minutes) on day 1 (2 to 4 hours after birth) and day 5. The fetal placental blood volume decreased from 42 +/- 8 mL/kg (mean +/- SD) of neonatal body weight after early cord clamping to 19 +/- 7 mL/kg after Leboyer delivery. Neonatal blood volume, calculated from the fetal placental blood volume, was 32% higher in the Leboyer group compared with the early cord-clamped infants. In the infants with early cord clamping, hematocrit, and blood viscosity did not change significantly during the first 5 days. After Leboyer birth, the hematocrit rose from 0.51 +/- 0.05 in cord blood to 0.62 +/- 0.06 at 2 to 4 hours of age, thereby increasing blood viscosity by 32%. Stroke volume, heart rate, cardiac output, left-to-right shunt across the ductus arteriosus, and blood flow velocity in the truncus coeliacus were similar in both groups and did not change during the first 5 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
PubMed1995

[Ultrasound blood flow measurement in malignant tumors is a possible new prognostic factor].

OBJECTIVE: The aim of the present study was to find a possible relationship between biological behavior of breast cancer and sonographically detectable blood flow. METHODS: 157 patients with ductal invasive breast cancer were examined by means of a new sonographic procedure, the MEM (Maximum Entropy Method), able to detect considerably lower blood flow velocities than doppler sonography. In the absence of objectifyable quantification methods, findings were allotted to 3 classes, depending on the visual color information obtained. Blood flow was correlated to tumor size, lymph node and receptor status, ploidy and S-phase-fraction. RESULTS: Most patients with small tumors, no lymph node metatases, positive receptors, diploid genome and low S-phase found to have low blood flow. CONCLUSION: This close relation between established prognostic factors and results of sonographic blood flow examination with the MEM might indicate a new preoperative prognostic factor, which, however, will have to be proven by larger studies.

Biomarkers, Tumor↗
PubMed1995

[Is co-administration of ethanol to the distension medium in surgical hysteroscopy a screening method to prevent fluid overload? A prospective randomized comparative study of ablative versus non-ablative hysteroscopy and various ethanol concentrations].

OBJECTIVE: Is it possible to diagnose early a beginning fluid absorption during operative hysteroscopy by adding ethanol to the distension medium? METHODS: A prospectively randomised comparative study of ablative versus non-ablative operative hysteroscopy with differing ethanol concentration was performed. Purisole (a mannitol/sorbitol solution) was used as distension medium. RESULTS: The results of the study show that at those hysteroscopical procedures at which the endometrium is not or only minimally injured (e.g. syneciolysis, hysteroscopic proximal tubal catheterisation) an intraoperative screening is not necessary due to the low absorbing amounts. At the hysteroscopical procedures as the resection of myoma, endometriumablation and septumresection, however, an addition of ethanol of 2% to the distension medium has proved to be useful, because with this method absorbing amounts from 400 mls can be established by positive values of breath alcohol. As the result of a further absorption of fluid, but delayed in time compared to the first positive value of breath alcohol, there is an increase of the central venous pressure and a hyponatraemia. CONCLUSION: The intraoperative ethanol-monitoring is a non-invasive procedure which can be performed at ablative-operative hysteroscopies and has no negative influence on the course of the intervention and the general condition of the patients.

Adult↗
PubMed1995

[Immunoscintigraphy of breast cancer xenografts. 99m-Tc-labeled anti-mucin monoclonal antibodies BM-7 and 12H12].

The present study was undertaken to evaluate the correlation of the favorable in vitro characteristics of the anti-mucin Mabs 12H12 and BM-7 with high tumor accumulation in vivo. They were labeled with 99mTc; their biodistribution in nude mice bearing mammary tumor xenograft AR was examined and immunoscintigraphy was performed after 24 h. 99mTc-labeling of the Mabs 12H12 and BM-7 led to tumor uptakes of 20.7% and 8.8% ID/g, respectively, after 48 h. Tumor-to-muscle ratios were 31 (12H12) and 18 (BM-7). Tumor xenografts were clearly visualized in immunoscintigrams. Combination of Mab 12H12 and 99mTc provides high tumor-to-tissue ratios shortly after administration.

Animals↗
PubMed1995

[Ultrasound diagnosis of fetal lung maturity].

The immaturity of the fetal lung and the resulting respiratory distress syndrome are the main problems of obstetrics. Over a long period of time the only possibility to recognize the maturity of fetal lungs certainly was the determination of the L/S-ratio by amniocentesis. Two years ago first results were presented to determine fetal lung maturity by sonography. We examined 428 patients between 29 and 40 completed weeks of gestation. By comparing the characteristics of frequency of fetal lung echoes to those from the fetal liver as a reference organ it becomes possible to standardize fetal lung changes with gestation. In one ultrasound section we depicted lung and liver as well. According the A-mode we registered frequencies of both. The registered frequencies were entered digitally into a computer to evaluate the mean, maximal and minimal frequencies. Afterwards quotients of the frequencies of fetal lung and liver were calculated. For all weeks of gestation, mean values and standard deviations were made. It has been shown, that the liver is an adequate reference organ since the reflection pattern between the different weeks of gestation does not change, however significant changes have been seen in the fetal lungs. Q-mean, the quotient of fetal lung and liver reflection can be calculated. A quotient of Q-mean < 1.10 suggests lung maturity, while values > 1.10 speak for immaturity. Ultrasound examinations with 55 expectant women were compared with the lung conditions after delivery. 30 examinations were correlated with the results of the L/S-Ratio by amniocentesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Amniocentesis↗
PubMed1995

[Effectiveness of beta-hydroxyethylrutoside in patients with varicose veins in pregnancy].

Pregnancy is a critical risk for development of varicosis, therefore early detection and treatment are strongly recommended. In our study we examined 51 patients subdivided into three groups. One group underwent physical therapy (cold foot-baths in the morning an in the evening), the other group was administered beta-hydroxyethyl rutosides, and the patients of the third group had appeared only once for examination. Leg circumference and diameter of vein (by sonography) were measured, and the subjective criteria evaluated. In the group of patients who were additionally given drugs, a significant reduction of all parameters was found: leg circumference was reduced by 3% and diameters of veins were reduced by 15% on average, the reduction of the subjective criteria was by 34%. Provided the veins were prevented from further extension through progressive varicosis, apparent beneficial clinical effects can be achieved by administration of beta-hydroxyethyl rutosides.

Adult↗
PubMed1995

[Experimental microendoscopy of the milk duct system (ductoscopy)].

According to recent reports, the microendoscopic lactiferous duct investigation (ductoscopy) could improve diagnosis in case of pathological nipple discharge. However, the description of a reproducible and reliable methodology, suitable for thorough evaluation of the lactiferous duct is missing so far. Therefore, the pressure study developed a procedure, that may serve now as an experimental basis for further clinical evaluation. Access to the mamillary duct is primarily gained using atraumatic flexible teflon catheters. Corresponding to the diameter of the duct, either a semirigid 0.87 mm fiberendoscope can be successfully introduced via a 1.2 mm catheter, or a flexible 0.50 mm fiberendoscope via a 1.0 mm catheter. A controlled distension using few milliliters of ringer's lactate is the prerequisite for clear visualization of the intraductal space and protection against iatrogenic wall lesions. Metal microtocars are available as prototypes. They carry a somewhat higher risk to perforate, but are advantageous when pointing at an intraductal structure and using the microtrocar as a mark for microdochectomy.

Animals↗
PubMed1995

[Hysteroscopic endometrium ablation in "high-risk" situations and in hemorrhagic diathesis].

A hysteroscopic endometrial ablation (HEA) under maximal anesthesiologic surveillance was performed on 34 high-risk patients (group I: chronic anticoagulant therapy n = 26; group II: endogenous coagulopathy n = 8) with therapy resistant meno-metrorrhagia to avoid a hysterectomy (HE). Total amenorrhea, or a least hypomenorrhea respectively cyclic spotting could be attained primarily in 22 patients (group I: 19; group II: 3), after a repeat procedure in further 6 patients (4 in group I, 2 in group II). Subjective evaluation of surgical results (overall 22 patients primarily satisfied, 6 secondarily) also differed between the two subgroups (group I: p < 0.01 primarily satisfied; p < 0.05 secondarily satisfied vs. p < 0.05 and p < 0.01 in group II). A HE had to be performed on two patients due to extensive adenomyosis uteri interna (group II). The significantly better results in the anticoagulation group were probably due to the basic illness. Larger groups will, however, be necessary before any conclusions from this difference can be drawn. No surgical or anesthesiological complications occurred. There also were no major postoperative complications (1 endomyometritis, 2 cervical stenoses). Endometrial ablation was found to be a valuable treatment alternative for this specific group of patients with severe coagulopathy, thrombo-embolic or thrombotic disease.

Adult↗
PubMed1995

[Tissue glue in endoscopic surgery].

Tissue-glue stands out by virtue of its ability to ensure non-traumatic tissue apposition and hemostasis, leading to a reduction in operative time. This explains the use of this technique in a wide range of indications in gynecological endoscopy. These include ovarian reconstruction after the extraction of cysts, tubal anastomoses and even closure of iatrogenic perforations of the uterus. In these indications, the application of tissue-glue can be considered as the method of choice because of its excellent long term results. In contrast, its effect in the sealing of peritoneal or serosal defects with the aim of avoiding adhesions has not yet been clearly demonstrated. Analysis of a sufficient number of cases with long follow-up is essential before any final assessment can be made. Among 75 instances of endoscopic use of tissue-glue up to now, we have never encountered any post-operative complications, nor during subsequent follow-up. In addition to its ability to stimulate tissue healing, tissue-glue offers a simple and non-traumatic alternative to the lengthy technique of endoscopic sutures, with a hemostatic action in parallel.

Dissection↗
PubMed1995

CD80-transfected human breast and ovarian tumor cell lines: improved immunogenicity and induction of cytolytic CD8+ T lymphocytes.

Human tumor cell lines derived from breast and ovarian carcinomas have been found to be ineffective in stimulating the induction phase of an immune response such as T cell proliferation in allogeneic mixed tumor cell lymphocyte cultures. Since representative tumor cell lines are effectively lysed by activated T lymphocytes, the induction of an effector phase is not impaired. In order to reconstitute the potential to induce primary T cell activation, we transfected CD80 into a breast (KS) and an ovarian carcinoma (GG) cell line. CD80 expression in KS cells resulted in improved primary T cell activation, whereas it was ineffective in the case of GG cells. However, treatment of CD80-transfected GG cells with INF-gamma rendered them immunogenic, and resulted in T cell proliferation. Likewise, TNF-alpha and/or INF-gamma augmented T cell proliferation induced by CD80-transfected KS cells. Furthermore, T lymphocytes stimulated with cytokine-treated CD80+ KS cells gave rise to a long term proliferating CD8+ CTL line with class I MHC restricted cytolytic antitumor activity. These studies emphasize the requirement for costimulation in generating tumor-specific immunity, and demonstrate the efficacy of CD80 in generating CD8+ cytolytic T lymphocytes.

Antigens, CD↗
PubMed1994

Immunoscintigraphy of human mammary carcinoma xenografts using monoclonal antibodies 12H12 and BM-2 labeled with 99mTc and radioiodine.

For immunoscintigraphic localization of human breast cancer two monoclonal antibodies (mabs) 12H12 (immunoglobulin G1) and BM-2 (immunoglobulin G3) were developed. The mabs, directed against two different epitopes on the mucin glycoprotein TAG-12, showed reactivity with 96% of all primary mammary carcinomas. The antibodies were labeled with either 125I or 131I. In addition, 12H12 was directly labeled with 99mTc according to the method of Schwarz and Steinsträsser (A. Schwarz and A. Steinsträsser, J. Nucl. Med., 28:721, 1987). Biodistribution was measured in female nude mice bearing the human mammary carcinoma SF-15. Both radioiodinated mabs showed similar biodistribution with fast tumor uptake (8.5% injected dose/g at 6 h postinjection), which increased to 10-11% injected dose/g at 24 h and subsequently remained constant up to 120 h. 99mTc-Labeling of the mab 12H12 led to an enhanced tumor uptake of 10.5 and 14% injected dose/g at 6 and 24 h postinjection, respectively, and to significantly accelerated blood clearance of radioactivity. Similar results were obtained with a second mammary tumor (AR-1), while an endometrial tumor (EK-3) showed a 3-fold lower accumulation of radioactivity and no difference in uptake of radio-iodinated and 99mTc-labeled 12H12. Scintigraphic imaging of tumor-bearing nude mice with the 99mTc 12H12 at 24 h postinjection clearly demonstrated a diagnostic potential of the new mab for tumor localization and staging.

Animals↗
PubMed1994

The HysteroTrainer, a simulator for diagnostic and operative hysteroscopy.

Hysteroscopy has become an integral part of operative gynecology, with rates of major complications of 1%. To avoid serious, even lethal, complications, an intensive, well-structured training program for practicing surgeons is necessary. In response to these educational requirements. The HysteroTrainer was developed to provide in vitro simulation training for diagnostic and operative hysteroscopy, including laser and high-frequency electrosurgery.

Cervix Uteri↗
PubMed1994

Operative Hysteroscopy: Results, Security Aspects, In Vitro Simulation Training (Hysterotrainer)

To date, hysteroscopy has become an integral part of the overall gynecologic surgical concept. In 156 women results of intrauterine hysteroscopic surgery are demonstrated to be at least comparable to those of conventional procedures. Moreover, a meta analysis of the literature (n = 10,000) as well as our own experience (n = 200) supports the view that complication rates may be minimized by a well-structured training program which includes the recently developed in vitro simulation trainer, the HysteroTrainer.

Journal Article↗