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Biomedical subjects

G Martens

Publications and source records attributed to G Martens.

At least 19 recordsLinked to original sources

The FlexiGard 330 ICC, an ultrasound evaluation.

The FlexiGard 330 intrauterine copper contraceptive (ICC) was studied by ultrasound in 405 patients immediately following insertion and at each follow-up visit, for up to 5 years. The present study confirms the validity of the anchoring concept for the suspension of bioactive substances in the uterine cavity. The major conclusion from the study is that the anchor is non-migrating even when observed over a long period of time. Ultrasound examination is the method of choice to evaluate proper insertion technique as well as proper positioning of the device at follow-up.

Evaluation Studies as Topic

Is early repopulation of macrophage-depleted lymph node independent of blood monocyte immigration?

Popliteal lymph nodes (LN) of mice were depleted of their macrophage (M phi) populations in the subcapsular sinus and medulla by subcutaneous injection of dichloromethylene diphosphonate (Cl2MDP)-containing liposomes into the footpads. Complete restoration of both M phi populations could be observed as late as 5 months after liposome administration. This relatively long repopulation time could be due to a depot of liposomes, directly killing all M phi precursors after extravasation into the interstitial tissue of the footpad. On the other hand, local interstitial precursors with very low turnover rates may have been depleted in the interstitial tissue of the hind leg. Therefore, two different types of experiments were performed; one in which M phi-depleted LN were replaced by control LN at various time points after liposome treatment, and another whereby M phi-depleted LN were transplanted into control animals. When liposome-treated, M phi-depleted LN were transplanted into control animals, a complete restoration of both populations in the subcapsular sinus and medulla could be observed within 5 weeks. Control LN transplanted into a Cl2MDP-liposome-treated leg showed a rapid disappearance of M phi from the subcapsular sinus and medulla and these cell populations remained absent for at least 7-8 weeks after liposome treatment, when the first cells started to reappear. Complete repopulation of these areas by M phi took as long as 15 weeks. Using labeled liposomes the presence of a continuous liposome depot was found to be very unlikely. These results suggest that the population of precursor cells that will give rise to M phi in the subcapsular sinus and medulla of a LN is probably contained within the interstitial tissue and is almost independent of precursor supply from the blood compartment.

Animals

[Semiautomatic preparation of anesthesia records using the DATATRAC].

In this paper we report on our experience with clinical use of the electronic clipboard DATATRAC, which is designed for semiautomatic recording during anesthesia, i.e., for automated recording of cardiocirculatory parameters during anesthesia. In a period of 3 years, about 50 and 800 DATATRAC anesthesia records have been produced during vascular surgery and ophthalmic surgery, respectively. We discuss the advantages and short-comings of this type of anesthesia recording and the objections raised to it, and we analyze the malfunctions that can occur and their significance.

Anesthesiology

[Decision support].

Explore the source record for details and available documents.

Decision Making, Computer-Assisted

[ISA--Information System Anesthesia. Decision support by a computer-based information system].

"ISA"-Information System Anesthesia-will support the anesthesiologist by presenting information concerning the anesthesia approach. In addition to computing patient data (monitoring), there are three special fields where computers are used in anesthesia: (1) simulation systems for anesthesia training (preventing critical incidents); (2) critiquing systems to comment on the planned anesthesia decisions; and (3) reference systems for rapid information gathering. Simulation and critiquing systems are mainly useful for personal training. Reference systems present information concerning the anesthesia problems to aid in decision-making. ISA is a reference system designed to support the decision process for neurosurgical operations; a new method of presenting information by personal computer in the surgical working area. For each neurosurgical operation there is a graduation of condensed and detailed information with the option of also obtaining general anesthesia knowledge.

Anesthesiology

[Direct transfer of obstetrical data by magnetic means in a randomized multicenter trial of the subjective count of fetal movements by the mother-to-be].

Ten Belgian maternity hospitals have collaborated in an international clinical multicenter trial: Multicenter Fetal Movement Trial. Nine maternity hospitals were already managing a computerized data bank before their participation in the trial. In seven of these centers the local team was able to write a program for direct transmission of data, using standard sequential ASCII files. This procedure presents many advantages: there is a gain in time and money, since it is no longer necessary to fill out data collecting forms, or coding at a central level. Transcription errors are avoided, adhesion to strict and standard definitions is guaranteed, the micro-systems are performing in a suitable fashion in each center, modifications of parameters (and corrections) are done very quickly and, automatically carried out, on the basis of clinical data as well as "research" data, transmission by telecommunication is immediately and easily feasible.

Belgium

[Perspectives of an electronic data processing-controlled anesthesia protocol].

There are two ways to introduce electronic data processing in anesthesia recording, which should be combined in the future: (1) computer-aided data collection (during anesthesia) and (2) data analysis. Both procedures have their own advantages and disadvantages. The first step in data collection is a system whereby the on-line registered data are automatically plotted and the discrete data are noted by hand (semi-automatic recording). The second step is to keep the minutes on a display screen instead of on paper, thus producing a protocol in digital form (automatic recording). We discuss the problems of these computer-aided recording systems and future trends, in particular the problems caused by the "human-computer interface" and by uncertainty with respect to the validity of the stored data. For computer-aided data analysis of anesthesia records, one has to select appropriate data in order to build up data bases. This selection is necessary whether the protocol is in analogical or in digital form, and we attempt to develop some general rules, the concrete selection depends, of course, on the aim of the evaluation. As an example we discuss evaluations for administrative purposes. Evaluations for scientific questions are even more affected by the quality of data definitions, and the efforts involved in data management are considerably higher. At the end of this paper we sketch a hybrid information system for computer-aided anesthesia recording that combines data collection and data analysis.

Anesthesiology

The effect of locally administered estrogens on the human cervix.

A randomized study to evaluate the effect of natural estrogens on the unripe uterine term cervix was conducted. One hundred and five term gravidas were studied, of whom 70 were treated with 180 mg 17 beta-estradiol or 250 mg estriol (treated women) and 35 were treated with gel only (control group). In all subjects the distented Foley catheter used for the instillation was left in situ. Twelve hours after the instillation there was no apparent difference in mean cervical progress between treated women and controls and the rather unexpected degree of cervical ripening is atributed to the intra-uterine balloon catheter. The procedure could not be shown to have any untoward effect on the mother or the fetus.

Acid-Base Equilibrium

Gray scale ultrasound for the investigation of early pregnancy.

73 early gestations (6-14 wk) were investigated with gray scale ultrasound. 7 of them ended in spontaneous first-trimester abortion, and in all of these the findings were characteristic for spontaneous interruption of pregnancy. The remaining 66 continued to term. Regression analysis was performed with respect to the diameter of the gestation sac, the fetal crown-rump length, and the placental surface and thickness. The method is considered appropriate for the diagnosis of early abortion and the study of placental morphology and morphometry. On the basis of the results obtained with gray scale techniques, various concepts derived from B-scan observations (e.g. implantation locus and early twin observation) will have to be corrected.

Abortion, Spontaneous

Ultrasound assessment of puerperal uterine involution.

Echographic measurement of the early postpartum uterus was performed, mainly to investigate whether involution patterns correlate with parity, the administration of oxytocin during labor, and lactation. Our findings suggest that these factors do not have a marked effect on uterine involution.

Female

Fetal effects of cervical ripening with extra-amniotic prostaglandin E2 in gel.

A gel containing 0.5 mg prostaglandin E2 (PGE2) was extra-amniotically instilled 90 clinically normal gravidae at term, for ripening of the cervix before elective induction of labor by amniotomy and intravenous PGE2. An acceptable increase in the Bishop score was noted to have occurred in 87/90 women, when assessed eight hours after administration of the gel; 14 of these women were then in established labor, which progressed uneventfully. Four of the 90 subjects required cesarean section for cephalopelvic disproportion. No adverse maternal or fetal effects of the procedure were detected under careful clinical, electronic and biochemical monitoring. However, epidural anesthesia adversely influenced the acid-base equilibrium of the fetus.

Acid-Base Imbalance

Extra-amniotic prostaglandin F2alpha in gel for prelabor cervical ripening.

In 22 normal term gravidas with unfavorable cervix, 5 mg PGF2alpha in Tylose gel was instilled into the extra-amniotic space. The treatment improved the cervical state so much that the women could be successfully induced by conventional methods. The procedure was well tolerated by the mother and it appeared to be perinatally safe.

Cervix Uteri