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Biomedical subjects

H Janisch

Publications and source records attributed to H Janisch.

At least 73 records · Page 4Linked to original sources
PubMed1982

Could aspiration of the Graafian follicle cause luteal phase deficiency?

Luteal phase quality was evaluated in 32 patients wih nonstimulated cycles after laparoscopic oocyte recovery for in vitro fertilization. A luteal phase deficiency occurred in two cases (6.2%), the mean duration of the luteal phase was 13.5 +/- 1.3 days in 30 patients, and two patients developed amenorrhea of 23 and 43 days respectively after laparoscopy in spite of normal progesterone values 7 and 9 days after oocyte recovery. Six embryo transfers were performed after fertilization and regular cleavage of the obtained oocytes. No pregnancy resulted from the embryo transfers, although the patients had apparently normal luteal phases. In one patient there was a transient beta-subunit human chorionic gonadotropin (beta-hCG) elevation in serum. Luteal phase deficiency should not be main cause of a nonsuccessful embryo transfer. However, a prophylactic luteal phase support after oocyte recovery and embryo transfer in nonstimulated cycles is proposed.

Chorionic Gonadotropin↗
PubMed1982

Influence of laparoscopic follicular aspiration under general anaesthesia on corpus luteum progesterone secretion in normal and clomiphene-stimulated cycles.

In 32 patients with unstimulated normal cycles and 24 with cycles stimulated with clomiphene and human chorionic gonadotrophin (hCG) all visible follicles were punctured laparoscopically under general anaesthesia for the purpose of in vitro fertilization. In unstimulated cycles the time of surgery was between 24 and 32 h after the first luteinizing hormone (LH) increase in the urine; in the cycles stimulated with hCG (5000 i.u.) laparoscopy was between 35 and 37 h after injection. Blood samples for progesterone determination were taken about 7 days later. Progesterone levels were compared with those in a control group not subjected to surgery, in which the progesterone levels were determined 7 days after the LH increase. There was no statistically significant difference in the progesterone levels in the unstimulated subjects after laparoscopy compared with those in the control subjects but progesterone levels in the stimulated subjects were significantly higher (p less than 0.01). Durations of the luteal phases showed no significant differences thus laparoscopy under general anaesthesia does not impair luteal function.

Adult↗
PubMed1982

[New trends in treatment of ovarian carcinoma (author's transl)].

Poor survival rates of ovarian carcinoma have continued to be a cause of grave concern over decades and led to growing attention and alert in recent years. Promising results have already been recorded. More knowledge of important factors with relevance to prognosis has been helpful in unitising large-scale therapeutic studies for better comparability, a desire which had been unfulfilled in the past. Close interdisciplinary cooperation between gynaecologists, radiotherapists, and chemotherapists proved to be essential to optimum programmes of therapy. Persistent basic research for better understanding of biological behaviours of ovarian carcinomas and of so far unknown factors of prognosis and persistent efforts for earlier diagnosis of ovarian carcinoma are just as important. This is the only way to more effective control of the disease which still is, diagnostically and therapeutically, one of the major problems in gynaecology.

Carcinoma↗
PubMed1982

[Optimum surgical staging and rational use of radiodiagnostic methods in case of ovarian carcinomas (stages III and IV)].

Pretherapeutic informations furnished by surgery and histopathology are of special importance for the local high voltage therapy of the operated ovarial carcinoma. The intraoperative state does not only confirm the diagnosis, but also reveals the full biologic extension of the tumor and, thus, the correct staging. Extensive supplementary radiodiagnostic examinations are necessary if the informations furnished by the surgeon are not complete. Between February 1977 and February 1981, we treated 55 patients suffering from ovarial carcinomas with a combined simultaneous radio-chemotherapy (45 patients with stage III and 10 with stage IV). The first operations had been performed at gynecologic departments of other hospitals in 60% of all cases, at surgical departments of other hospitals in 20% of all cases and at the II. Gynecologic Clinic of the University of Vienna in only 20% of all cases. The definitive staging was established by postoperative analyses of X-ray views of the chest, liver-spleen scintigrams, ultrasonic examination, computed tomography, lymphoscintigraphy and lymphography. 36 women were submitted to an early therapeutic second operation. It turned out that in most of all cases the retroperitoneal manifestations were correctly recognized by the different radiodiagnostic methods; histopathology was superior in only 8% of all cases. The rate of retroperitoneal metastases is 45% out of the total collective and 40% out of patients in stage III. With the therapy method applied, the survival time does not depend upon the retroperitoneal state as long as there are no tumor manifestations with a maximum diameter of more than 2 cm. The liver metastases described after the first operation do not necessarily correspond to such manifestations; often they are rather tumorous peritoneal layers. More attention should be given to the state of the subdiaphragmatic region, because manifestations in this region are an unfavorable diagnostic factor. Patients in stage III have possibly still curative chances. A careful surgical exploration and a close co-operation between surgery, histopathology, radiodiagnosis and clinical examination are not only a basis for a rational treatment but will also exempt patients from unnecessary or cumbersome examinations.

Adult↗
PubMed1982

[Interdependence of response rates, survival rates, stage and histology after radio-/chemotherapy in patients with advanced ovarian carcinoma].

Between February 1977 and February 1981, 55 patients with ovarian cancer (45 at stage III and 10 at stage IV) underwent simultaneous radio-/chemotherapy and early therapeutic second-look operation. The overall response rate amounts to 94%, 63% of which are complete and 31% are partial remissions. Stage III comprises 74% complete and 26% partial remissions. Patients with complete remission at stage III have a significantly longer tumor-free survival time than patients with partial remission (median 16 vs. 8 months). A longer overall survival time (median 30 vs. 16 months) is also significant. At stage III there have been 74% successful therapeutic second operations. In all patients with residual tumors above 2 cm in diameter after primary operation a response rate of 92% could be achieved, 52% showed complete remissions. The survival time proved to be independent of both histological parameter and age. The remaining residual tumor above or under 2 cm in diameter in any single location is, however, a significant prognostic factor for long-time survival. Possible curative chances for patients with stage III disease are only to be expected through interdisciplinary oncological cooperation.

Adult↗
PubMed1981

[Simultaneous radio-chemotherapy of advanced epithelial ovarian cancer--results after three years (author's transl)].

An interdisciplinary prospective, non-randomized study was performed at the University Clinic for Radiotherapy and Radiobiology of Vienna in 26 patients with advanced epithelial ovarian cancers (FIGO stage III and IV) from February 1977 until February 1980. All patients underwent a combined radiotherapy-chemotherapy programme. In those 12 patients in whom at the time of the first operation only a biopsy was possible, the aim was to achieve early operability for a second-look operation (with removal of the internal reproductive organs, the omentum and remaining tumour masses). In 8 of theses 12 patients it was technically possible to perform radical surgery or to reduce tumour masses to under 2 cm. Of 20 evaluable patients 14 had stage III and 6 had stage IV cancer. In patients with stage III the response rate was 100% and the complete remission rate (with or without second-look operation) was above 70%. The duration of complete remission exceeded 10 months, median survival is at present 17 months. Patients with stage IV had a response rate of 66% (but mainly partial remissions), with significantly shorter survival times. Bowel complications occurred in one quarter of the patients and led to a revision of our therapeutic concept and the time sequence of the combined modality treatment. The importance of significant prognostic factors is stressed. The study indicated the superiority of the combined treatment approach in patients with stage III cancer. Patients with stage IV cancer, are, on the other hand, best managed primarily by chemotherapy; palliative irradiation and a second-look operation should be reserved only for selected patients.

Adult↗
PubMed1981

[Current concepts of the surgical management of gynaecological tumours (author's transl)].

The ultimate goal of the surgical management of gynaecological carcinoma certainly is the complete removal of the main tumour or at least a diminution in tumour size, so that the remaining tumour cells can be destroyed by the body's own defensive mechanisms, by an additional course of systematic irradiation or chemotherapy or by a combination of all these measures. Primary removal of the tumour influences a series of useful body functions (cell-linked and humoral antibody reactions, etc.), while the subsequent heightened growth rate of the remaining tumour cells following surgery renders them more sensitive to the additional therapy.

Antibodies, Neoplasm↗
PubMed1981

Results of laparoscopic recovery of preovulatory human oocytes from nonstimulated ovaries in an ongoing in vitro fertilization program.

The technique and results of 50 laparoscopies performed on sterility patients to obtain mature oocytes from Graafian follicles with a view to carrying out in vitro fertilization are described. In 32% of all laparoscopies and in 52% of all punctured follicles it proved possible to obtain a mature oocyte. Different diameters of puncture needles as well as different suction intensities are compared. As a result of increasing experience and improved technique, the exact time for the intervention was correctly determined in 92% of cases. The recovery rate for oocytes was also increased to 58% with respect to laparoscopies carried out.

Cell Separation↗
PubMed1981

[Technique of obtaining mature oocytes via laparoscopy for in-vitro fertilisation (author's transl)].

Technique and results of 50 laparoscopies performed on sterility patients to obtain mature oocytes from Graafian follicles to carry out in vitro fertilisation, are reported. In 32% of all laparoscopies and in 52% of all punctured follicles a mature oocyte could be obtained. Different diameters of puncture needles as well as different suction intensities are compared. It is mentioned that through increasing experience and improved technique the exact time for the intervention has been correctly determined in 92%. The recovery-rate for oocytes also could be increased to 58%. A further improvement in this important initial step to a successful in vitro fertilisation program is feasible.

Female↗
PubMed1981

[Human in vitro fertilisation and embryotransfer: first results at the 2nd department of obstetrics and gynaecology, university of vienna (author's transl)].

Methods and Results of human in vitro fertilisation at the 2nd Department of Obstetrics and Gynaecology, University of Vienna are reported. Applying preparations of media and culture techniques according to Edwards et al. no satisfactory results could be achieved: only 3 out of 11 preovulatory oocytes were fertilised, no cleavages occurred. Using modified Ham's F 10 medium according to Lopata et al. fertilisation could be observed in 60% as well as regular cleavages in 40%. 5 Embryotransfers have been performed in the 8 cell or in the 16 cell stage respectively. No implantation occurred in 4 of these, in one case evidence for a transient implantation could be proved by an increased activity of SP1 and HCG beta. In this case obviously postimplantation death occurred resulting in a bleeding 16 days after oocyte recovery. Possible reasons for failures in fertilisation and cleavage as well as possibilities for improving the rate of reimplantation are discussed.

Adult↗
PubMed1981

Heatflux from the fetus during delivery.

A new thermodynamic model for the fetus in utero is introduced. As the fetus is warmer than the mother, heat flows from the fetus to the maternal organism (i. e. uterine muscle, vagina). This heatflux was measured during delivery. The heatflux from the fetal head was 11 +/- 1.6 Watt/m2 (mean +/- SD). It was influenced by the maternal temperature (correlations statistically significant) in two births with pathological heart rate patterns in the cardiotocogram we observed a heatflux which deviated markedly from the norm. In conclusion, heatflux measurements could yield valuable information about the fetal metabolism and circulation of the fetomaternal unit, and could be applied as a additional method for fetal monitoring.

Body Temperature↗
PubMed1980

[Study of the utero-placental perfusion by means of a circulation model (author's transl)].

The radioactivity time curves recorded over the utero-placental unit after application of 250 microCi 113mIn-transferrin may be regarded as the sum of various functional factors and morphological components. In order to be able to evaluate the influence of one single factor on the course of the curve in-vitro experiments were performed using a circulation model and an artificial placenta designed by the authors. The experiments confirmed that a gradual rise of flow resistance - equal to that present in cases of EPH-gestosis - results in a gradual reduction of the flow. By simultaneously raising the systolic pressure the values recorded got normal lowering the systolic pressure to values equal to those observed in hypotension a gradual drop of the flow was evoked. The results show that a rise of flow resistance or a drop of the mean arterial pressure results in curves as seen in case of reduced maternal blood supply to the placenta.

Blood Circulation↗