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G Bastert

Publications and source records attributed to G Bastert.

At least 163 records · Page 9Linked to original sources
PubMed1993

Family planning and desire for additional children after cesarean section.

OBJECTIVE: To determine the acceptance of contraceptives among cesarean section patients in a West African traditional environment. METHOD: Eighty-three cesarean section patients of a regional hospital in Burkina Faso were interviewed at their homes as to their attitudes towards family planning. RESULT: In collaboration with local midwives, contraception for 2 years had been recommended to the patients. Only one woman had been using contraceptives before. After cesarean, 46 women used contraceptives and 13 had undergone tubal ligature. Contraceptive users had their next pregnancy on average 10 months later than women not practicing contraception. Patients showed a strong interest to limit their family size. None of the women desired more than 5 children. CONCLUSION: Correct promotion provided, cesarean section patients in a traditional environment accept contraceptives and are interested in family planning.

Burkina Faso↗
PubMed1993

Hypertension in pregnancy.

Pregnancy-induced hypertension (PIH) is a frequent cause of maternal and neonatal morbidity and mortality. In the present study we focused on the pathophysiology of PIH, mainly on the role of mineralocorticoids, reversed blood pressure patterns, and the resulting necessity of continuous monitoring of the preeclamptic mother. Problems of antihypertensive therapy are discussed and the first results of a pilot study with Urapidil are presented. To examine the role of mineralocorticoids in the pathophysiology of PIH, we studied plasma aldosterone and 18-hydroxy-corticosterone (18-OH-B) levels in 25 women with PIH and in 25 healthy pregnant women. Furthermore, we evaluated the mineralocorticoid receptor (MR) count in mononuclear leukocytes in the 2 groups. The MR-count was significantly decreased in the PIH-group. The values of plasma aldosterone and 18-OH-B were also low. These results cannot be explained by receptor down-regulation due to higher level of mineralocorticoids of the zona glomerulosa. Perhaps deoxycorticosterone or a hitherto unknown mineralocorticoid is responsible for the hypertension and altered MR-status. The first results of continuous blood pressure measurements with a noninvasive, real-time blood pressure monitor (Finapres) are presented. The comparison of the obtained values with intraarterial measurements demonstrates a good correlation between the two methods. We also report on the first experiences with Urapidil in the treatment of hypertension in severe preeclampsia. The data show that hypertension in preeclamptic women can be treated by Urapidil without side effects or reflex-tachycardia. Further studies will have to prove if Urapidil is suited for prepartal treatment of PIH as well.

Antihypertensive Agents↗
PubMed1993

[Blood supply of malignant and benign tumors of the internal genitals].

Malignant tumours differ mostly from benign lesions in their blood supply. This fact can be used in the sonographic diagnosis of the tumour status. This, however, depends on the availability of ultrasound equipment, capable of demonstrating this difference, which can only be detected in smallest blood vessels, in which the blood flow is extremely slow. We employed the Sonolayer SSH 140A (Toshiba, Japan) and the Quantum 2000 (Siemens, Germany) for diagnosis of lesions of the female inner genital tract. Both instruments could visualize the slow blood flow velocities in the tissues examined. Diagnosis of blood circulation in tumours of the inner genital tract thus seems less dependent on the technology employed as is the case in examining the breasts. 41 patients with ovarian tumours, 31 with endometrial pathology, and 33 with cervical lesions were examined preoperatively. Findings were correlated to histology. The lowest resistance index (RI) measured was evaluated. The following RI values were found: Ovarian tumours: malignant 46%, benign 78% (49%). Tumours of the corpus uteri: malignant 54%, benign 65% (55%). Cervical lesions: malignant 55%, benign 79% (58%). Results in premenopausal women with non-malignant lesions are specified in brackets. Pre- and postmenopausal status proved essential. When compared to breast findings, the difference between benign and malignant tumours of the inner genital tract is less pronounced due to the fact, that, physiologically, these tissues are characterised by a higher blood supply. Differentiation was thus almost impossible in premenopausal women. However, in menopausal patients, a highly significant difference between benign and malignant tumours was found, which could serve as basis for tumour status prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
PubMed1993

[Prevention of adhesions with dextrans].

The effect of doses and molecular weight of dextrans on intraperitoneal adhesion formation were studied in an animal model. With increasing molecular weight the maximum effect is achieved with smaller quantities of the solutions. Because of the adhesion preventing properties, in cases of single and also multiple applications, dextran 60 should be preferred to other high molecular solutions.

Animals↗
PubMed1993

[The value of Doppler imaging of the aorta, carotid artery and middle cerebral artery in obstetric diagnostics].

The relation of blood blow in the fetal aorta and carotis is a marker for the well being of the unborn child. Increase of cerebral vascularity associated with decrease of blood flow in the aorta is a sign for a fetal risk situation. It is, however, of disadvantage that the fetal carotis is often difficult to image with an wedge-shaped angle between doppler beam and vessel. We therefore included screening of an intracerebral vessel (a. cerebri media) in order to find out whether examination of this vessel, much more easier to perform, may have a similar diagnostic value or be an even more sensitive prognosticator of fetal risk than the carotis. In two hundred and forty patients in the 29th to 40th week of gestation all these three vessels were scanned with the duplex system AI 3200, Dornier company, Germany. The result was correlated to sonographic biometry, birth weight, and mode of delivery. It could be proven that when analyzing individual findings, pathology in the risk groups is much higher, whereas mean values showed less marked differences between risk and control groups. Our results suggest that the a. cerebri media is a slightly more sensitive indicator of fetal risk, since in this vessel retrograde resistance can be detected earlier and is more evident. A combination between assessment of the aorta and a cerebral vessel, is however, the method of choice in cases of pathological findings in diagnosis of fetal well being, since only examination of a peripheral and a central vessel results in an exact diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗
PubMed1993

[Chlamydia trachomatis: screening within the scope of prenatal care and rapid diagnosis in threatened premature labor].

Cervical infection with Chlamydia trachomatis during pregnancy is related to the incidence of preterm labour and preterm rupture of membranes, causing elevated neonatal morbidity and mortality. The present study reports our two-years-experiences with a general screening on Chlamydia infection in prenatal care as well as diagnostic possibilities in case of imminent preterm delivery. In the examined population of totally n = 263 pregnant women attended in our prenatal care unit, the prevalence of cervical Chlamydia infection was 3.4%. Among the screened asymptomatic women (n1 = 179) 2.8% had positive findings. Among n2 = 84 patients with preterm labour and/or preterm rupture of membranes 4.8% revealed cervical infection. Specially in the acute situation of imminent preterm delivery, an immunological bedside assay (Clearview Chlamydia, R) tested in 203 cases versus the tissue culture as reference method proved helpful. Its sensitivity was 0.8, specificity 0.99. The test allowed to prove or exclude chlamydial infection within only 30 minutes.

Adult↗
PubMed1993

[Microsurgical heterotopic ovary transplantation. A preclinical study].

Free heterotopic autologous ovary transplantation might be a method to prevent iatrogenic radiocastration in case of Hodgkin's disease. Though first promising clinical case reports have been published, almost no experimental basic data are available. It was the aim of this study to develop a transplantation model in order to evaluate and improve operative technique and perioperative management preclinically. Whereas results in pilot transplantations on minipigs were impaired by the disposition to wound infections on the implantation site, transplantation on Beagle dogs proved to be a suitable model. Eleven transplantations have been performed (five in minipigs, six in Beagle dogs). The success rate of intact preserved transplants was 45% with an observation time of three months for the minipigs and 9 +/- 3.7 months for the dogs.

Anastomosis, Surgical↗
PubMed1993

[Breast cancer screening. State of the art and introduction to preventive measures].

Carcinoma of the breast is the most frequent cause of death in women aged between approximately 38 and 50 years. At present, 1 out of 14 women in Germany and 1 out of 9 in America suffer from breast cancer within a life time. To date, modern methods of treatment and hormone therapy have only been able to increase long-term survival by about 12%. Trials have shown that early diagnosis alone has been able to increase survival from 20% to 50%. Early diagnosis proved to be most effective when clinical examination plus mammography in two planes was carried out annually. An increase in survival has been achieved in post-menopausal women as a result of screening. 22 percent of breast cancers were detected at a curable in situ stage by means of screening. Even after a limited screening program of 4 examination cycles the increase in survival rate over 15-20 years was significant.

Breast Neoplasms↗
PubMed1993

[Effect of intracavitary irradiation on the venous system of the pelvis and leg].

A late complication of combined radiotherapy for malignoma of the inner genital tract is leg edema, whether of venous or lymphatic origin, which is not always clear. To analyse the influence of radiotherapy upon the pelvic and leg venous system, we performed sonographic caliber, occlusion plethysmographic and light reflexion rheographic measurements of veins in 32 patients prior and subsequent to irradiation. No statistically significant difference was found between mean values measured with the different methods. A clear deterioration of venous function was detected after treatment. Sonographic examinations of pelvic vessels after radiotherapy showed veins much less clearly outlined and with thicker walls, thus pointing to a direct connection between irradiation and edema of the vein wall. Whereas deterioration of the other parameters may also be explained by, for example, long periods of lying. Since according to our own observations, an insufficiency of the leg venous valves occurs relatively often, sometimes even years later, there is a clear correlation between irradiation and edema of the venous wall, with a slight deterioration of venous function detectable directly after irradiation. In order to prevent vein damage, prophylaxis of thrombosis and vessel topography should therefore always be considered when planning radiotherapy.

Adult↗
PubMed1992

An endoscopically assisted technique for construction of a neovagina.

The specific disadvantage of the commonly used Vecchietti method for reconstruction of the vagina in cases of vaginal agenesis is the need for laparotomy. We now describe a successful endoscopically assisted construction of a neovagina by a variation of the Vecchietti method. The method causes relatively little stress to the patient.

Cystoscopes↗
PubMed1992

Analysis of cytotoxicity of 131I-labelled OC125 F(ab')2 on human epithelial ovarian cancer cell lines.

Monoclonal antibody (mAb) OC125 detects the cell surface-antigen CA125, which is expressed in more than 80% of epithelial ovarian cancers but not in normal adult ovaries. Its high specificity and binding affinity makes OC125 a potential candidate for use in radioimmunotherapy (RIT) in patients with recurrent ovarian cancer. Initial biodistribution studies using radiolabelled specific mAbs have demonstrated significant increase in tumor uptake of dose as compared to radiolabelled irrelevant antibody. We report here an isodose comparison of the cytotoxicity of 131I-labelled OC125 F(ab')2, 131I-labelled nonspecific protein and external beam irradiation using a cesium-137 gamma source. Enhancement of cytotoxity due to the specific binding of the mAb could only be observed when a critical activity of 131I localized at the cell membrane. At a specific activity labelling of less than 4.1 mCi/mg, the antigen specificity of OC125 does not contribute to cell kill. Using a specific activity of 10.2 mCi/mg, the relative biological effectiveness of 131I-labelled OC125 (F(ab')2 was increased by a factor of 5 compared with external-beam X-ray therapy, and the specificity of mAb OC125 was found to enhance the cytotoxicity of the radioimmunoconjugate (RIC) by a factor of 2.7. This low value is in accordance with previously reported theoretical calculations for long range, low-LET isotopes and may be one of the reasons why RIT using 131I has severe limitations. In conclusion, it is necessary to maximize the specific activity of RICs with low-LET isotopes such as iodine-131 in order to maximize the ratio of the dose delivered specifically by membrane-bound mAb versus free-floating nonspecific protein.

Adenocarcinoma↗
PubMed1992

[Initial results of a new method of sonographic diagnosis of lung maturity].

The immaturity of the foetal lung is one of the central problems in obstetrics. In this paper first results are presented to determine the maturity of the foetal lung by sonography. Using the foetal liver as a reference organ we are avoiding the known pitfalls which made it impossible in the past to standardise the foetal lung changes depending upon the age of gestation. We examined 121 patients between week 27 and week 41. In one ultrasound section cut we depicted lung and liver as well. According to the known A-mode we registered frequencies in both organs. The registered frequencies were entered digitally into a computer and checked for f mean, f max and f min. Subsequently we calculated quotients of frequencies of the foetal lung and liver. For all weeks of gestation the mean value and standard deviation were calculated. We found that the liver is an adequate reference organ, since there is no change in the reflection pattern between the different weeks of gestation. We registered significant differences in the quotients of lung and liver between the different weeks of gestation, a cutting line being week 35. A quotient of Q mean lower than 1.1 hints to lung maturity while values over 1.1 point to immaturity.

Female↗
PubMed1992

[Three-dimensional ultrasound imaging of benign and malignant breast tumors--initial clinical experiences].

Previous experimental and clinical studies showed, that three-dimensional (3-D), i.e. dynamic spatial reconstruction of 2-D ultrasound images is feasible. A rotating acoustic plane helps to visualise the cross-sections serially and in a coordinated manner. When reconstructing the 2-D ultrasound images, surface reconstruction from planar contours of each cross-section is performed (so that the organ limits are defined) and the cross-sectional pictures are reconstructed into 3-D organ images. This approach had been described by the authors on a previous occasion. Another step forward is "transparent" spatial imaging eliminates the source of error involved in contouring. It is important to emphasise, that the 3-D system now described by the authors, yields a spatial image of the organ in question, and does not just present 3 planes of the organ (some authors have been claiming, that such an imaging method is also three-dimensional). Our system enables the imaging of several cross-sectional planes cut through the spatially calculated organ. This results in cross-sections, which cannot be performed by conventional sonography, thus disclosing new perspectives and possibilities. In the present article, the authors describe a clinical pilot study in the diagnosis of carcinomas of the breast. In our opinion, 3-D imaging of the tumours enables the physician to diagnose the status of the tumours; this is demonstrated by the examples of 35 malignant and benign tumours of the breast. In 95% of the cases of malignant tumours and 80% of the benign tumours, the diagnosis proved correct. This paper describes the fundamental possibilities and limitations of the new method.

Breast Neoplasms↗
PubMed1992

[B-streptococci in obstetrics--risks and consequences of maternal colonization and neonatal contamination].

2,373 mothers and their newborn were studied during two years with respect to B streptococci colonisation or contamination. Bacteriological, vaginal and anal smears were taken from mothers at the beginning of parturition, as well as the amnion and the aspirated stomach contents of the newborn, employing, in each case, conventional culture methods and a latex agglutination test as a rapid testing method. Smears from the ears were also taken from the newborn for bacteriological examination. The vertical transmission and its possible influencing variables were examined in 1,328 mother/child pairs of the first observation year. Surface contamination of the newborn was confirmed in 10% in at least one smear. In the group of mothers with B streptococci colonisation, the amnion showed the highest rate of contamination (43%), followed by the aspirated stomach contents (26%) and the ear smears (taken from each side separately) with 28% and 30% respectively. Vertical transmission was decisively influenced by vaginal maternal colonisation (50% of the cases resulting in contamination of newborn), whereas anal colonisation, if it was the only site of colonisation, resulted in contamination of newborn in only 32% of the cases. The rate of contamination of newborn dropped significantly from 50% to 20% after intrapartal antibiotic prophylaxis, the latter appearing to be meaningful only after at least 6 hours of exposure. In this group, the surface contamination could be reduced from 61% to 8%. A group of newborn suffering from early onset of sepsis (0.4%), was compared with a group of 13 newborn at risk of infection (0.9%) with established surface contamination and clinical or laboratory chemistry confirmation of infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Ampicillin↗
PubMed1992

[Ultrasound diagnosis of blood flow in benign and malignant breast tumors].

Malignant tumours can be differentiated from the benign ones by their vascular blood supply. We employed three methods to analyse the blood flow: the angiodynograph, the duplex system, and the continuous-wave Doppler method, and measured the blood flow in 151 patients on the preoperative day. Histology revealed a malignoma in 92 cases and a benign tumour in 59 cases. It was found, that in more than 90% of the malignomas, a high blood flow was identified in or around the tumour by means of the colour method (angiodynography), which could be quantified by the pulsed-wave Doppler. A significantly lower blood flow was evident in the benign tumours with a markedly increased resistance index (by 80%) established by means of the pulsed-wave Doppler. Continuous-wave (CW) Doppler showed a significantly higher blood flow with almost all malignomas in the entire breast, than was the case with benign changes. Our studies showed, that the enhanced blood flow in and around malignant tumours can be visualised by means of update technology, angiodynography being particularly suitable for demonstrating the flow by the B-mode. Quantification, however, is, at present, only possible by employing the duplex method with pulsed-wave Doppler. CW Doppler is suitable only for blood flow diagnosis of the entire organ, but it requires great precision of working method and is time consuming; tumour blood flow cannot be visualised on-target by this method.

Blood Flow Velocity↗
PubMed1992

[Palliative laser therapy in gynecologic oncology].

Local recurrences of carcinomas of the breast and genitals are a severe psychic and physical strain on the patients. Continuous confrontation with an often visible and generally painful tumour manifestation is an indication for palliative treatment, if other oncological therapies can no longer be employed. In these cases, the possibility of laser use represents a new therapeutic approach. In a pilot study at the University of Heidelberg, Department of Obstetrics and Gynaecology, a palliative laser therapy was performed on 45 patients with locally recurrent carcinomas of the breast (n = 29) and genitals (n = 16). Carbon dioxide and Nd:YAG lasers were utilized for tumour resection, vaporisation and coagulation. This new concept, the combined application of both wavelengths has been proved to be most efficient.

Adult↗