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Biomedical subjects

H Janisch

Publications and source records attributed to H Janisch.

At least 55 records · Page 3Linked to original sources
PubMed1986

Factors influencing successful in vitro fertilization and embryo transfer: a matched pair study.

In the present matched-pair study successful and unsuccessful IVF-ET trials in patients with similar preconditions were compared. Sixteen consecutive cases of clinical pregnancies after IVF and ET were included. For each pregnant patient the subsequent patient who fulfilled the matching criteria and who did not conceive was chosen as a control subject. The matching criteria were the stimulation regimen and the number of embryos transferred. Pregnant and nonpregnant patients were compared with regard to their age, the total dosage of hMG, the cycle day at oocyte retrieval, the E2 levels 48 and 24 hours before laparoscopy, the E2 rise, the number of retrieved oocytes, and the cleavage rate. In both groups the investigated variables showed no significant difference between pregnant and nonpregnant patients. In patients with the same cycle stimulation and the same number of embryos transferred, successful implantation was not predictable by the evaluated parameters.

Adult↗
PubMed1986

[Morphologic changes in anterior levatorplasty].

In a follow-up study 3-12 months after a modified anterior repair we examined 36 patients clinically, urodynamically and by means of plastic moulds of the vagina. Though 30/36 patients said they were improved by the operation problems at intercourse were frequent: more than a third of the patients complained about stenosis of the vagina. On the vaginal moulds the diameter of the impression of the levator muscle was 0.5 cm smaller after modified anterior repair as compared to colporrhaphy. 33/36 patients developed a descent of the posterior vaginal wall. We conclude that a satisfactory correction of a descent of the vagina can be achieved by the modified anterior repair; however a large number of patients develop rectocele and stenosis of the vagina with subsequent difficulty at sexual intercourse.

Adult↗
PubMed1986

[Anterior levatorplasty in prolapse and incontinence: a clinical and urodynamic study].

In this follow-up study we demonstrate the clinical and urodynamic results in 46 patients who underwent modified anterior repair because of vaginal prolapse or incontinence. Besides frequent inflammations of the lower urinary tract (70%), dehiscence of the anterior vaginal wall was quite common (30%). Considering the patient pre- and postoperative anamnestic data, we found a significant increase in continent patients (4 preoperative-18 postoperative). The urodynamic parameters showed a change in the first urge to void at significant higher bladder volumes, and a significant increase of the functional length of the urethra. After surgery a negative stress profile and a positive clinical stress test were seen less often.

Adult↗
PubMed1986

[Rheography in pregnancy--a noninvasive method of early detection of placental insufficiency].

UNLABELLED: Intrauterine growth retardation (IUGR) is a major obstetrical problem. About 20% of stillbirths are growth retarded. Increased vascular resistance is suspected to cause preeclampsia and IUGR. Our study used rheography 1. to show the change of vascular resistance during pregnancy, 2. to scrutinize any connections between maternal peripheral perfusion and the development of IUGR. For the first part of the study 168 healthy pregnant women of different gestational age were studied to examine the physiological conditions of peripheral haemoperfusion. In the second part we employed rheography in 177 cases of last trimester pregnancies. The parameter used was the rheographic quotient (RQ), defined as the volume of the pulse wave. To compare RQ values of patients with different heart frequencies these values were multiplied by the pulse rate per second (relative pulse volume, Pr). RESULTS: 1. RQ values remained nearly constant during the first trimester (0.7%). During the second trimester a noticeable increase in RQ was found, leading to RQ values of about 1.3% in the third trimester. From the 28th week until delivery no further significant changes occurred. Using Pr, our data showed increased values from the 16th gestational week onwards. Early-stage values (0.8%/sec) increased more than twofold (1.7%/sec) until delivery. 2. Out of 177 pregnancies, 26 led to newborn below the 10th percentile (mean = 2230 g). Rheographic data showed highly significant differences between the AGA and SGA groups: the mean RQ values of the AGA sample was 1.2 +/- 0.4%, of the SGA sample 0.6 +/- 0.35% (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Volume↗
PubMed1986

Detection of antibodies in pregnancy serum reacting with isolated placental basement membrane collagen.

Adsorption of human IgG from pregnancy sera to placental basement membrane collagen could be demonstrated by an in-vitro assay. Polystyrene tubes were coated with purified type IV collagen and incubated with serum samples. Bound human IgG was detected using 125I labelled antihuman IgG. Median adsorption levels were 4000 (interquartile range 2500-9500) cpm/ml serum in 25 uncomplicated pregnancies and 21 000 (interquartile range 14 500-44 500) cpm/ml serum in 14 pre-eclamptic women. Specifity of the adsorption reaction could be demonstrated using uncoated tubes and collagenase treated coated tubes, which all showed low binding. In competition experiments with dissolved collagen fractions (type I, III, IV) most effective displacement of binding was observed with type IV collagen. This indicates collagen selectively of the adsorption reaction of human IgG to basement membrane collagen. Our in-vitro studies support immunohistological findings of IgG binding to trophoblastic basement membranes and their ultrastructural abnormalities detected in pre-eclamptic placenta.

Basement Membrane↗
PubMed1985

[Fertility following function-preserving surgery in tubal pregnancy].

In the last few years an obvious trend toward conservative technique in tubal surgery is observed. Likewise, at our institution, emphasis was placed on preservation of function, too. 59 patients received conservative surgery of tubal pregnancies between 1979 to 1982. 7 women were lost for follow-up. 28 patients showed further desire for child-bearing. 20 of them have had a subsequent intrauterine conception (71.4%), 11 women have had term pregnancies (39.3%). 3 patients were pregnant at time of investigation. The abortion rate was 17.8%. Recurrent ectopic pregnancies were found in 5 cases (9.5%). However, the operated fallopian tube was involved only in 3 cases (5.7%). In 26 cases the patency of the tubal lumen was examined by means of hysterosalpingography. 50% of those women had remained childless. The results of HSG showed a patent passage of the operated tube in 11 cases. Our results show a high rate of subsequent pregnancies and a rather low incidence of repeat ectopic pregnancies in cases of conservative surgery and justify our decision to save the involved tube whenever fertility is desired.

Abortion, Spontaneous↗
PubMed1985

[Effect of late motility on the fertilization of ova in the IVF program].

In the course of the IVF programme at our department we made the observation that even with primarily normal sperm counts late motility often varies widely. The impression that late sperm motility might be related to successful fertilisation caused us to study the influence of late sperm motility on fertilisation rates in a series of 80 patients. Sperm was capacitated with B2 medium (Menezo INRA). Even in the presence of an originally normal sperm count, reduced late motility was associated with lower fertilisation and embryo transfer rates. It seems that late sperm motility will have to be considered as an important parameter in evaluating the prognosis for successful IVF and ET.

Adult↗
PubMed1984

[Initial results of echographic staging in cervical cancer].

Twenty women with invasive carcinoma of the cervix were investigated by means of rectal sonography. A radical Wertheim's operation was performed in all cases. Ultrasound investigation was more accurate than rectovaginal palpation. Comparison between ultrasound or rectovaginal palpation with the pathohistological findings confirm that ultrasound is factual while palpation still includes bias. However, it is not yet possible to differentiate between inflammatory and carcinomatous infiltration of the parametria. The size of carcinomas restricted to the cervix can be estimated by means of ultrasound.

Female↗
PubMed1984

[Vecchietti's operation for the formation of a neovagina: technic and results].

We performed Vecchietti's operation in 10 patients with absence of the vagina (8 Rokitansky-Küster-syndrome, 1 testicular feminization, 1 occlusion of the vagina after radiotherapy). There were no intra- or postoperative complications; on discharge the neovagina was patent for 2 fingers in all cases. On follow-up examinations 2 to 20 months postoperatively the neovagina was no longer patent in the patient after radiotherapy, all other patients had neovaginas with a length ranging from 5 to 9 cm and reported satisfactory coitus without dyspareunia. According to our experience the conditions for successful surgical formation of a neovagina are: good psychosocial adjustment, some preoperative sexual experience, higher age, preoperative counselling, and longterm follow-up.

Adolescent↗
PubMed1984

[Rectal sonography--an expansion of the diagnosis of recurrent cervical neoplasms].

Rectal sonography--especially with the use of modern rotating scanners--provides major progress in the diagnosis of recurrent malignant tumours in the lower pelvis. Due to the high resolution and the possibility of exact localisation this method is less biassed, and hence rectal scanning can be used as a routine method in future in cases suspected of recurrences located at the pelvic wall. Sonography in general and its advantages are discussed in comparison to other techniques for the diagnosis of recurring cervical malignancies.

Diagnosis, Differential↗
PubMed1983

[Prostacyclin therapy in EPH gestosis (preliminary report)].

EPH-gestosis is still today one of the most dangerous complications of pregnancy, threatening both, maternal and fetal life. Until now only symptomatic treatment was possible. A new mode of treatment of EPH-gestosis may evolve from the use of prostacyclin, a potent vasodilator and inhibitor of platelet aggregation. We tried prostacyclin therapy in three patients with severe gestosis. The results of prostacyclin infusion on this condition, the pregnancy, the fetus, the placenta and the morphology of the umbilical artery are discussed.

Adult↗
PubMed1983

Heat flux from the fetal scalp during labor and fetal outcome.

In 40 deliveries a new variable, heat flux from the fetal scalp, was recorded and correlated with fetal outcome. The heat flux from the fetus, which reflects the temperature gradient between the warmer fetus and the mother was measured by a transducer attached to the fetal scalp after rupture of the membranes. In the last 20 min before delivery we found a statistically significant correlation (p less than 0.05) between heat flux from the fetus and pH of umbilical artery blood. Heat flux in the group with higher pH differed significantly from those with lower pH. We conclude that heat flux measurements could be developed and used for fetal monitoring.

Body Temperature↗
PubMed1983

[Method for recording the parametrical situation in cases of carcinoma of the cervix uteri].

The degree of parametrical infiltration in cases of carcinoma of the cervix uteri could until now be judged by palpation only. Special ultrasound examinations with rectal scanners should be beneficial in future for the recording of the parametrical situation. Although it is not possible to differentiate between inflammatory and cancerous infiltration with this new method, additional punctures under echographic control could be of great value.

Adnexa Uteri↗
PubMed1982

[In vitro fertilization--a therapeutic procedure?].

In vitro fertilization and subsequent implantation of the embryo is one way of treating infertility in women not only with extensive damage of the Fallopian tubes of inflammatory or post-surgical aetiology, but also with idiopathic sterility. However at our present state of knowledge in vitro fertilization should not be seen as a final answer, separated from other methods of treatment (e.g. microsurgery of the tubes). From the ethical point of view, specific treatment for disorders of the reproductive organs, to which in vitro fertilization belongs, must be permitted.

Embryo Transfer↗