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Biomedical subjects

H Beck

Publications and source records attributed to H Beck.

At least 145 records · Page 8Linked to original sources
PubMed1990

Influence of the duration of the oestradiol rise on the success rate in GnRH analogue/HMG-stimulated IVF cycles.

The influence of the duration of the serum oestradiol (E2) rise before human chorionic gonadotrophin (HCG) injection on the outcome of in-vitro fertilization (IVF) cycles was investigated. Two different stimulation protocols were compared. In 218 cycles, the Norfolk protocol for stimulation with human menopausal gonadotrophin (HMG) was used (protocol A). In 235 cycles, pituitary function was suppressed by a single injection of a long-acting GnRH analogue ('Decapeptyl microcapsules') before HMG stimulation was started (protocol B). The overall pregnancy rates were significantly higher with protocol B (22% per puncture, 21% per started cycle) than with protocol A (14% per puncture, 9% per started cycle). For each interval of E2 rise duration (5-11 days), the fertilization rates (per oocyte) and the pregnancy rates (per puncture) were evaluated. There was a clear-cut maximum of the pregnancy rates for 6 and 7 days of E2 rise (21 and 16% respectively) for protocol A. For protocol B, pregnancy rates were generally higher than for protocol A. There was also a maximum of the pregnancy rates for 6 (32%) and 7 (29%) days of E2 rise but this maximum was not as clear-cut as for protocol A. The fertilization rates showed no significant differences for each interval of E2 rise in both groups (between 63 and 89%). Therefore, it is concluded that endometrial maturity, and not the oocyte's ability for fertilization, is the most critical factor for success in IVF cycles.(ABSTRACT TRUNCATED AT 250 WORDS)

Chorionic Gonadotropin↗
PubMed1990

[Performance of a rescue breathing device with glossopalatinal tube].

The "Lifeway" is a device for rescue breathing consisting of a mouthpiece for the rescuer, a non-rebreathing valve, a mouth-sealing cap and a glosso-palatinal tube (GPT) reaching into the patient's mouth. 54 patients--22 toothless and 32 with firm teeth--were ventilated mechanically via the original "Lifeway", via a variant with additional side-holes in the GPT, and, for comparison, via anaesthesia mask plus oropharyngeal airway and via endotracheal tube. Ventilation was sufficient: The arterial oxygen saturations, measured by pulse oximetry, and the end-tidal CO2 partial pressures were equal to those during ventilation via mask. Placing the modified "Lifeway" in toothless patients was significantly easier than placing the original and as easy as placing the mask; with the patients having firm teeth there were no significant differences. The incidence of obstructions, as registered by impediments to exhalation and by increases in peak inspiratory pressure, was significantly less frequent with the modified device, since the tongue could be "scooped" to a ventro-caudal direction if necessary. The modified "Lifeway" was as effective as the combination of anaesthesia mask and pharyngeal airway. The problems of the latter are, however, avoided; the use of the device by laymen thus seems feasible.

Adult↗
PubMed1990

[The effect of the Tuohy cannula on the positioning of an epidural catheter. A radiologic analysis of the location of 175 peridural catheters].

UNLABELLED: The aim of this study was to determine at which lumbar spinal level the tips of different epidural catheters may be located following insertion through cranially directed Tuohy needles. Previous studies varied with respect to materials and methods and may have left the false impression that different types of catheters are necessary or actually more advantageous for particular needs. MATERIALS AND METHODS: One hundred seventy-five trauma patients scheduled for surgery on their lower extremities received continuous epidural anesthesia. With the patient in a sitting position, a midline lumbar puncture was made and one of six different plastic catheters advanced 5 cm beyond the tip of the Tuohy needle. Postoperatively the catheters were filled with Iopamidol and ap X-rays taken of the lumbar spine. The catheter tips were declared to be "cranial" if they were more than 2 cm above, "caudal" if they were more than 2 cm below, and "equal to" if they were within 2 cm of the puncture site. RESULTS: Of the 175 documented catheter tips 47.7% assumed a cranial position, 9.2% were in a caudal position, and 43.4% remained within the level of insertion. A statistical analysis comparing catheter tip location among the six epidural catheter models tested did not reveal any significant differences. DISCUSSION: In a clinically controlled study based on the Tuohy principle of inserting catheters through a needle with a Huber point, different epidural catheter models were inserted into the lumbar epidural space and their locating radiologically documented. It was shown that 52% of the epidural catheters that had been advanced 5 cm into the lumbar epidural space through a cephaled-directed Tuohy needle did not reach the intended spinal level cranial to the puncture site. The results are similar to those of earlier studies, which were not systematic and involved a variety of methods and materials. One reason for the unreliable ascension of the catheter tips may be the many structures within the epidural space which may dislodge and divert the catheters during advancement. In addition, it has sometimes been observed that a change in the patient's position may cause a spinous process cranial to the puncture site to exert pressure and traction on the catheter, partially dislodging it. It must thus be concluded that the use of a Tuohy needle cannot guarantee cranial ascension of an epidural catheter in the lumbar epidural region.

Aged↗
PubMed1989

Two daily doses of sucralfate or cimetidine in the healing of gastric ulcer. A comparative randomized study.

A double-blind, randomized study compared the healing of gastric ulcer during a twice-daily regimen of 2 g sucralfate or 400 mg cimetidine. The patients received the tablets one-half hour before breakfast and one-half hour before bedtime. The study included 76 patients with endoscopically proven gastric ulcer. Patients with ulcers less than 3 cm from the pyloric ring and patients with ulcers less than 3 mm in diameter were excluded from the study. Sixty-four patients completed the study. Healing was endoscopically assessed at four-week intervals for 12 weeks. After four, eight, and 12 weeks, the healing rates for cimetidine were 55, 81, and 94 percent, respectively; the healing rates for sucralfate were 52, 79, and 91 percent, respectively. No statistically significant difference was found between the two regimens. At 12 weeks, the risk of overlooking a difference in favor of one of the two dosage regimens was less than 20 percent. The results suggest that 2 g sucralfate twice daily is as effective in the healing of gastric ulcer as 400 mg cimetidine twice daily.

Adult↗
PubMed1989

Circadian and seasonal variations of electrolytes in aging humans.

The circadian and seasonal variations of a set of routinely determined variables (chloride, sodium, potassium, calcium, inorganic phosphorus, magnesium, creatinine, urea and urate) were documented in young men (mean age +/- SD: 24.0 +/- 3.9 yr) and in healthy elderly men (75.3 +/- 6.6) and women (78.2 +/- 9.1). The same urinary variables, except magnesium, were studied in young men. The circadian variability of serum variables was between 2 and 11% except for serum inorganic phosphorus (12-22% according to the group). By contrast, urinary chloride, sodium and potassium revealed large peak-trough differences (55-75%) and the variability of urinary creatinine, urate and urea was also not negligible (20-30%). ANOVA validated seasonal variations for most of the plasma variables and for urinary calcium, phosphorus and uric acid. No age or sex difference in either 24 h means or amplitudes could be observed. These data are of interest for the concept of reference values, for the diagnosis of certain bone and renal disease as well as for chronooptimization in treatment of potential electrolytes deficiency states.

Aged↗
PubMed1989

Resection arthroplasty: middle- and long-term results.

Conclusions on results after resection arthroplasty were made by analyzing patient records with regard to completed questionnaires. Sixty-four patients were followed up for 2.1-15.9 years postoperatively. The indications for explanation were septic or aseptic loosening with extensive bony destruction. The average age of the patients was 69.7 years. A specially prepared questionnaire summarized each patient's condition at that time. Twenty-five patients had no discomfort in the operated hip: 25 others reported occassional mild pain during increased strain, and six patients complained of constant pain. All patients were able to walk with aids. In six cases the infection recurred. In summary, we can say that the goal of maintaining an infection- and pain-free hip was achieved in over 90% of cases, but the functional weight-bearing capacity was limited. Resection arthroplasty appears to be a successful treatment; it relieves the patients from pain and infection and can often end a long series of surgical operations.

Arthroplasty↗
PubMed1989

Distribution of monoaminergic, cholinergic, and GABAergic markers in the human cerebral cortex.

Mapping of a number of biochemical markers for noradrenergic, dopaminergic, serotoninergic, cholinergic and GABAergic systems was undertaken in 93 samples removed from the human cerebral cortex. The right hemisphere of brains from two subjects with no known history of neurological and psychiatric diseases was examined. Neurotransmitter markers were present in all cortical samples analysed, suggesting a widespread distribution of the corresponding neurons throughout the cerebral cortex. Each marker distributed heterogeneously in a distinct pattern. Noradrenaline concentrations were highest in the frontoparietal region and lowest in prefrontal and occipital areas. Markers for dopaminergic neurons (dopamine levels, dopamine/noradrenaline ratio and homovanillic acid levels) seemed denser in the prefrontal and temporal regions. 5-Hydroxyindolacetic acid levels were particularly high in the occipital area and decreased along the caudorostral axis. Choline acetyltransferase activity was highest in temporal and frontal lobes, at variance with muscarinic receptor distribution, which was highest in occipital cortex. Glutamate decarboxylase activity, an index of GABAergic innervation, did not vary markedly among the different areas of the cerebral cortex. The different biochemical markers investigated were detected in all cerebral cortical regions; their distribution was not homogeneous. A mismatch was observed between the distribution of cholinergic neuronal systems and receptors.

Aged↗
PubMed1989

[Noninvasive monitoring of gas exchange: methodologic prerequisites and clinical use].

The noninvasive determination of the respiratory gas exchange (measurement of oxygen uptake and carbon dioxide delivery) permits the calculation of cardiac output by Fick principle and of the actual energy requirement of the patient (indirect calorimetry). A system is presented for the continuous measurement of oxygen uptake and carbon dioxide delivery, that bases on simple components, which are available on most intensive care units. The methodical problems are discussed and the improvement of the signal of the oxygen sensor by digital signal processing is described. Clinical measurements on 16 patients are presented, whose metabolic rate early after extracorporal circulation was measured. The results reveal, that 4.4 hours after ECC the metabolic rate is close to the calculated basic metabolic rate. They demonstrate the importance of indirect calorimetry as a future bedside monitoring routine.

Anesthesia, General↗
PubMed1989

[Dental care of HIV carriers].

As HIV infections continue to spread worldwide, the number of patients with known or unknown HIV positivity seen in dental practice is increasing. Some of the infected individuals need more frequent dental care than the general population, because HIV infections tend to be associated with specific oral manifestations. HIV-positive individuals have special psychosocial problems attributable both to their disease and to their frequent association with socially discriminated groups. These problems are also reflected in the dentist-patient relationships. Dental care of known HIV-positive individuals is much less hazardous than the treatment of undiagnosed HIV carriers. Building confidence between the dentist and the patient is essential. As HIV transmission is similar to that of hepatitis B, the full battery of hygienic precautions established for preventing hepatitis B should be observed in dental work to prevent HIV infections. Conditions of work in dental offices should meet the hygienic standards needed to preclude the risk of infections both for the dentists and their patients.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Diagnostic limitations of isolated axiography interpretation].

Axiographic images of eccentric condylar paths can be more reliably interpreted by considering the clinical function data, compression test results and the MPI. In the case presented the abnormal position of the right condyle would have gone unnoticed without such a combined approach to the problem.

Cephalometry↗
PubMed1989

[Attitude and sex behavior following hysterectomy].

488 women have been asked after abdominal or vaginal hysterectomy by way of retrospective questionnaires about preoperative anxieties, postoperative psychosomatic complaints as well as disturbances of their vita sexualis. 48.6% of the patients had anxieties before operation and anaesthesia. After hysterectomy 71.9% of the women reported about hot flushes and other psycho-vegetative complaints. Although hot flushes occurred significantly more frequent in patients with salpingooophorectomy they could be observed also in one third of the women without removal of the ovaries. However libido, cohabitation frequency and orgasm ability were reduced significantly more frequent in the group of women after hysterectomy with salpingooophorectomy. This is caused by the failing blood supply to the ovary via the branches of the uterine artery. The reduce postoperative psychosomatic complaints as well as sexual dysfunctions it is important to give qualited instructions before and after the operation. On no account should a prophylactic exstirpation of the adnexa be carried out before the age of 50 years. A hormonal substitution is recommended to be done in time even for patients whose ovaries have not been removed suffering from psycho-somatio discomforts.

Adult↗
PubMed1988

Isomer-specific determination of 2,3,7,8-tetrachlorodibenzo-p-dioxin and related compounds in human fat and food.

An analytical procedure for the isomer-specific quantification of polychlorinated dibenzo-p-dioxins and dibenzofurans in samples of human and animal origin is described. It consists of a large-scale clean-up including various kinds of column chromatography and high-resolution gas chromatographic/mass spectrometric quantification referring to internal 13C-labelled standards. By additional application of gel-permeation chromatography and the use of a retention gap, detection limits in the low ppq range (10(-15) were achieved.

Animals↗
PubMed1988

Incidence and pathology of peptic ulcer disease.

Peptic ulcer disease has undergone a significant change in incidence and modern medical and surgical therapeutical modalities seems to change the history and outcome of the disease. The knowledge of the basic morphological and functional background of the entity is based on studies of ulcer formation and healing and of the influence of the gastroduodenal mucosa. Chronic gastritis is closely associated with peptic ulcer, and type, grade and dispersion of gastric changes are correlated to the activity and nature of the ulcer and the subsequent treatment, i.e. antrectomy. Parietal cell subpopulation shows a nearly unsusceptible numerical density during different phases of ulcer disease, only correlated to acid secretion in duodenal ulcer patients. The changes of gastric endocrine cells and morphological and subcellular changes of the parietal cells after medical and surgical treatment indicates a complex cellular regulation in the gastric mucosa.

Cohort Studies↗
PubMed1987

Parietal cell density before and after parietal cell vagotomy in duodenal ulcer patients.

Parietal cell density, mucosal height, grade of gastritis and pentagastrin-stimulated acid production were assessed before and three months after parietal cell vagotomy (PCV) in 14 patients with duodenal ulcer. Parietal cell density was found to be unaltered after vagotomy and there was no difference in the parietal cell count in the neck and base of the glands. Both the basal acid production and the pentagastrin-stimulated acid secretion were significantly reduced after PCV. No correlation could be shown between the stimulated acid production and the parietal cell count, either pre- or postoperatively. (r = 0.14 and r = 0.19). Mucosal height and grade of gastritic changes remained unchanged. It is concluded that PCV in duodenal ulcer patients causes no change in parietal cell density assessed at three months post-operatively. Vagotomy causes no mucosal atrophy or gastritic changes within this period.

Adult↗
PubMed1987

Parietal cell density in duodenal ulcer patients after short-term treatment with cimetidine and antacids.

In a prospective study, 20 patients with endoscopically proven duodenal ulcers were randomised to be treated with cimetidine 1 g daily or with antacids 350 mmol daily. The duration of treatment was 30 days, but this was extended to three months in 3 patients in the cimetidine group and 4 patients in the antacid group. A morphological study of biopsies taken via a gastroscope from the corpus mucosa showed no change in mucosal height, parietal cell density per unit volume or changes in cellular infiltration after 30 and 90 days treatment in the two groups. Neither H-2 receptor blockers nor antacids alter mucosal height or parietal cell density. Treatment was not found to induce gastritic changes in the mucosa.

Adult↗