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Biomedical subjects

J Deutinger

Publications and source records attributed to J Deutinger.

At least 109 records · Page 6Linked to original sources
PubMed1989

Placental biopsy for rapid fetal karyotyping in the second and third trimesters of pregnancy.

Rapid chromosomal analysis in the 2nd and 3rd trimester of gestation is desirable in cases of suspected or proven fetal malformation. The presence of any chromosomal aberration of the fetus influences the further prenatal and perinatal management of the pregnancy. Placental biopsy and preparation of trophoblast tissue after short term culture offers the possibility of getting satisfactory results within 2 to 3 days of biopsy. Fifty-seven patients underwent placental biopsy between the 16th and 36th weeks of gestation because of sonographically suspected or proven fetal malformation. In 51 of 57 cases fetal karyotyping was successful and no severe complications after biopsy were seen. Eight pathologic karyotypes were found. In 3 cases the chromosomal analysis yielded unsatisfactory results because of the inadequate quality of metaphases. In another 3 cases not enough chorionic tissue was aspirated in 2 biopsy attempts. In all other cases normal fetal karyotypes were found. Sonographically guided placental biopsy represents a simple method for fetal karyotyping and is a useful tool for the management of pregnancies with suspected or proven fetal malformation in the 2nd and 3rd trimester.

Chorionic Villi Sampling↗
PubMed1989

Transvaginal pulsed Doppler velocimetry in fetal arteries.

Transabdominal pulsed Doppler velocimetry in fetal arteries might be difficult with extreme obesity, anhydramnios, cord presentation and an unfavourable position of the fetal head. A vaginal transducer gets closer to the presenting part of the fetus and therefore has advantages for Doppler velocimetry in fetal arteries.

Adult↗
PubMed1989

Transvaginal pulsed Doppler measurement of blood flow velocity in the ovarian arteries during cycle stimulation and after follicle puncture.

In experimental studies, an increase of the ovarian blood flow was found during cycle stimulation. In this study, the authors performed transvaginal pulsed Doppler measurements of the ovarian arteries in stimulated cycles before and after follicle puncture. Four days before follicle puncture, high flow velocities in systolis were found compared with diastolis. Toward the day of embryo transfer, a marked increase of the diastolic blood flow velocity was observed. In patients with high endocrine response, the pulsatility index (PI) was significantly lower compared with that of patients with low endocrine response. The technique of transvaginal pulsed Doppler measurements offers the possibility to study the alterations of the ovarian blood flow under physiologic and pathophysiologic conditions.

Adult↗
PubMed1989

[Comparison of transvaginal and transabdominal Doppler flow measurements in uterine vessels in the normal course of pregnancy].

Despite physiological and methodical drawbacks Doppler velocimetry in the arcuate arteries has become a standard for examination during pregnancy. Arcuate arteries are terminal branches of the uterine vaculature and supply only a circumscript area. Local vasoconstriction (due to contractions) and placental infarction may give erroneus results. Measurements in arcuate arteries at the site of placental insertion showed flow patterns different from those in the rest of the uterus. Since continuous wave Doppler systems were mostly applied, the received echoes could have originated from any part along the sound beam. Signals from arteries of the anterior abdominal wall may lead to "false pathological" waveforms. All these drawbacks have been overcome by Doppler velocimetry of the main stem uterine artery on its course through the parametrium by a transvaginal inserted probe that combines a 240 degrees "panorama" sector scanner with a pulsed Doppler system. Both main vessels supplying the uterus, i.e. left and right uterine artery, could be visually identified and pulsed Doppler velocimetry could be applied. This provided us with information about perfusion of the whole organ and showed us also the physiological range of left to right discrepancy in the flow patterns. In 63 pregnant women with a single foetus and an uneventful course of pregnancy we compared transabdominal measurements of the arcuate arteries with transvaginal measurements in both main uterine arteries. In 56 women we found pathological wave forms in the arcuate arteries (A/B ratio greater than 2) despite lack of clinical or transvaginal measured evidence of malnutrition.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteries↗
PubMed1989

[Transvaginal pulsed Doppler measurement of flow velocities in pelvic vessels following cycle stimulation].

The availability of pulsed Doppler probes has made it possible to sample signals at a chosen depth and thus to detect the flow in any selected deep vessel. Pulsed Doppler signal processing combined with real-time imaging, the so-called "duplex" method, is now also available for transvaginal transducers. The advantage of endosonographic ultrasound investigation is the possibility of using higher frequencies leading to a better resolution of anatomical structures of the small pelvis. Therefore this method allows the precise localisation of a deep vessel and the positioning of the Doppler sample volume within it. The transvaginal approach enables one to position the transducer close to the artery for better measurements. For our study we used a vaginal probe with 7.5 MHz with a pulsed Doppler equipment linked to a Combison 320 (Kretztechnik, Zipf, Austria). The integrated pulsed Doppler is not attached at a fixed angle but can be moved in the whole sector of 240 degrees. We investigated, if during follicle phase of the cycle changes of the pelvic blood flow velocity could be observed. 14 patients undergoing in vitro fertilization for sterility reasons participated in our study. We performed daily measurements of the blood-flow velocity of the ovarian artery and the internal iliac artery from cycle day 8 until the day of induction of ovulation. During cycle stimulation the observed decrease of the A/B ratio was dependent on cycle day and number of follicles. We found a decrease of the A/B ratio in the ovarian artery from 3.85 in cases with 2 follicles to 2.71 in cases with 5 follicles.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
PubMed1989

[Hypophyseal suppression and subsequent cycle stimulation: experiences in an in vitro fertilization program].

Gonadotropin releasing hormone (GnRH) agonists can induce a hypogonadotropic state. We studied the effect of a long acting GnRH agonist on pituitary gonadotropin levels, the pattern of serum steroid levels in subsequent cycle stimulation, and whether such a protocol can improve the results of an in-vitro fertilization (IVF) program. 29 patients with tubal factor from our IVF program received 4 mg Decapeptyl CR intramuscularly and were subsequently stimulated with FSH/HMG/HCG (Group I). 35 patients were stimulated according to our standard protocol with HMG/HCG (Group II). After a single injection of Decapeptyl CR, serum levels of LH, FSH and E2 fell to more than half of pretreatment levels. In the subsequent cycle stimulation the gonadotropin dosage was increased threefold compared with the control group. In group I, progesterone levels were significantly higher. Though more oocytes were retrieved in group I, fertilization rates were significantly lower. After Decapeptyl and the subsequent stimulation, we observed short rises in urinary LH in 22/29 patients. In our experience, a single intramuscular injection of Decapeptyl resulted in sufficient pituitary suppression, however, we could not see an improvement in the results after IVF.

Estradiol↗
PubMed1989

[Particular aspects of creation and assessment of an obstetrical data bank].

The use of computers improves data storage capacity and leads to a homogeneous documentation of data obtained. After extensive preparations documentation was started using in 1975 the 2nd Department of Obstetrics and Gynecology computer. The obstetrical-gynecological data base is used for organisational, epidemiological, scientific and mixed purposes. The main purpose is periodical evaluation of routine procedures. The evaluation of obstetrical data is often combined with specific problems. To compare the data obtained, clinical findings have to be entered in standardized form and to be related to the week of pregnancy. The expected date of birth has to be corrected often as a result of several investigations. Furthermore, it has to be differentiated between single and multiple pregnancy. Good cooperation between physician and medical computer expert is necessary for good quality of evaluation. The evaluated data enable one to find new aspects and connections, which may offer the impetus to perform new prospective research.

Expert Systems↗
PubMed1989

[Color-coded Doppler sonography in pregnancy].

Recently the advantages of angiodynography have been reported for different purposes. The goal of this study was to find out the validity of colour flow mapping for obstetric patients. Additionally, we compared the obtained results with those obtained by conventional pulsed Doppler measurement. 30 women with an uneventful pregnancy were investigated. Angiodynography enabled us to depict a selected vessel quicker and to visualise the course of the investigated vessel. Furthermore, the new method of colour flow mapping and subsequent pulsed Doppler measurement results in visual vessel recognition of fetal and maternal vasculature and therefore subsequent Doppler measurement is also possible in small vessels. This method could be valuable for the diagnosis of high-risk pregnancies.

Adult↗
PubMed1989

Endosonography in obstetrics and gynecology: the importance of standardized image display.

The use of endosonographic methods (transvaginal sonography, transrectal sonography, cystosonography, hysterosonography) is increasing for diagnostic and therapeutic procedures in obstetrics and gynecology. Because different means of description lead to confusion, endosonography needs a defined method of orientation. The topography used for transabdominal sonography should also be employed for endosonography. When performing transabdominal sonography, the scanner surface is always projected to the top of the screen, regardless of whether the patient is investigated from a ventral or dorsal position. With endosonography, the contact surface of all linear arrays, curved arrays, and sector scanners should be projected to the bottom of the screen. Using a frontally radiating sector scanner or curved array for a sagittal section, the left side of the screen should correspond with dorsal and the right side with ventral; for all other sections, left and right must be defined. A standardized way of displaying images obtained by endosonography should project the scanner surface to the bottom of the image and can be used on all available technical equipment without major difficulty. The advantage of displaying endosonographic images in this standardized manner is the simple differentiation of pictures obtained by an endosonographic or transabdominal technique.

Female↗
PubMed1988

Development of mouse embryos following conventional and ultra rapid cryopreservation.

A conventional computer-controlled program for cryopreservation of mouse embryos at the 4 to 8 cell stage was compared with various methods of ultra rapid cooling. 104 embryos were frozen by using the conventional cooling program. 79% of the embryos developed to blastocysts after thawing. Sixty-three embryos were vitrified and 81% reached the blastocyst stage within 2 days of culture. Using the ultra rapid cooling program A (4-step equilibration of embryos in cryoprotectant) 62% of embryos survived after freezing and thawing. Only 12% survival rate could be achieved by employing the ultra rapid program B (2-step equilibration of embryos in cryoprotectant). The significantly higher survival rate of program A compared to program B was due to the longer equilibration time and therefore presumably higher intracellular concentration of cryoprotectant. In program B the short equilibration time with the cryoprotectant seemed to result in an inadequate dehydration of blastomeres leading to intracellular ice formation and cell destruction.

Animals↗
PubMed1988

Vaginosonographic velocimetry of both main uterine arteries by visual vessel recognition and pulsed Doppler method during pregnancy.

In 88 pregnant women (7 to 40 weeks' gestation) we performed Doppler velocimetric studies of the uterine artery on its course through the parametrium by means of the newly developed, frontally radiating duplex sector scanner. This device enabled us to visually recognize the vessel and apply the more refined pulsed wave system. In 71 of 88 women, we were able to obtain measurements from both uterine arteries. We found significant differences in the maximum systolic to minimum diastolic frequency shift (A/B ratio) up to 4 between the right and left vessels in the first and second trimester. In the third trimester, the differences almost disappeared (mean +/- SD A/B ratio difference 0.4 +/- 0.3) in these uncomplicated pregnancies. We also report our mean values (first, second, and third trimesters) of the A/B ratio and the pulsatility index as an average from the right and left side measurements. Both values declined during the course of pregnancy (A/B ratio, 5.5, 2.9, and 2.1; pulsatility index, 2.5, 1.7, and 1.3). We conclude that, with some experience, this scanner has the advantage of visually recognizing the vessel under study and allows measurements in both main uterine arteries. The average of the right and left measurements provides a better summary of uterine perfusion. Due to the significant right/left difference in the A/B ratio, unilateral measurements of the uterine artery may give erroneous results during the first and second trimesters. Theoretically, the pulsed system provides a "cleaner" signal, but the values are comparable to those of devices that apply a continuous wave system.

Arteries↗
PubMed1988

Transient hyperprolactinemia during cycle stimulation: influence on the endocrine response and fertilization rate of human oocytes and effects of bromocriptine treatment.

The effect of transient hyperprolactinemia and its treatment during cycle stimulation on the endocrine response and fertilization rate of human oocytes was studied. Fifty stimulated cycles were included in the study and divided into three groups: group I consisted of 18 cycles with serum prolactin (PRL) levels less than or equal to 25 ng/ml; group II contained 15 cycles, where patients developed PRL levels greater than 25 ng/ml; group III consisted of 17 cycles, where patients, who already developed hyperprolactinemia in a previous cycle, were treated by 3.75 mg bromocriptine daily. The serum estradiol (E2), progesterone (P) and PRL levels 1, 2, and 3 days before and at oocyte retrieval were evaluated. The E2 decrease at oocyte retrieval was significantly steeper in groups I and III. Follicular luteinization was more effective in groups I and III. The fertilization rate in groups I and III was significantly higher than in group II. High serum PRL levels seem to interfere in follicular and oocyte development. The treatment of transient hyperprolactinemia improved the patients' endocrine response and the fertilization rate of oocytes.

Adult↗
PubMed1988

[Pulsed Doppler flow measurements using a vaginal ultrasound probe--integration into fetomaternal hemodynamics].

A recently developed "Panorama" sector scanner emitting in frontal direction (KretzTechnik, Zipf, Austria), combined with pulsed Doppler signal processing, makes it possible to visualize the main branch of the uterine artery already during its passage through the parametrium, and to adjust the Doppler beam under visual control. This makes it possible for the first time to receive flow signals that are free from superimpositions and are reliable, from both vessels supplying the pregnant uterus. It was the aim of our study to describe the haemodynamic changes at the uterine arteries in the course of pregnancy and to collect first experiences on the blood flow of the entire uterus. 42 women with an uneventful course of pregnancy were examined between the 8th and the 40th week of pregnancy. Angle-independent parameters such as the A/B ratio and pulsatility index dropped significantly during the course of pregnancy. The A/B ratio dropped from 5.4 during the first trimenon to 2.2 during the third trimenon, and the pulsatility from 2.6 to 1.3. This new method makes it possible to receive at more reliable and in respect of the total blood flow of the uterus more representative values for insertion into the second part of the haemodynamic equation for the pregnant uterus.

Arteries↗
PubMed1988

[Comparison of Doppler flow measurements of the arcuate artery and uterine artery in fetal growth retardation].

Transabdominal Doppler velocimetry in the arcuate arteries has been the widest used technique for the assessment of uterine perfusion despite theoretical and physiological drawbacks. The size of arcuate arteries is beyond the resolution of modern scanners. They represent terminal branches of the uterine vasculature and do not provide information regarding total uterine blood supply. Transvaginal Doppler velocimetry of the main uterine arteries on its course through the parametrium by means of a newly developed frontally radiating 240-degree "panorama" sector scanner promised a solution. The aim of the study was to compare the A/B ratios in both arteries (i.e. arcuate vs. main uterine) in pregnancies with a growth retarded fetus below the 10th percentile, as defined by ultrasound biometry. We wondered firstly which vessel better demonstrates velocity waveforms leading to growth retarded newborns defined by a birth weight beyond the 10th percentile (Hohenauer) and secondly, how frequently pathological A/B ratios in the uterine vessels are associated with pathological A/B ratios in the umbilical arteries. In 25 growth retarded fetuses (ultrasound biometry), we found more often pathological waveforms in the arcuate arteries (n = 20) than in the main uterine arteries (n = 18). Pathological waveforms in all three vessels (arcuate, main uterine, umbilical) were found in 12, in the arcuate and umbilical vessels in 13, and in the main uterine and in umbilical artery in 17 cases. Six fetuses were within the normal weight range at delivery indicating normal fetal growth. Pathological A/B ratios in the main uterine artery were more often associated with a growth retarded newborn.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Elevated tissue type plasminogen activator in human granulosa cells correlates with fertilizing capacity.

An increased production of plasminogen activators, able to convert plasminogen into plasmin, has been found in experiments in vivo on rat ovarian granulosa cells at the time of ovulation, indicating an involvement in follicular rupture. The granulosa cells of 49 follicles from 20 patients undergoing in-vitro fertilization were obtained by laparoscopy and tested for the content of urokinase-type plasminogen activator (u-PA), tissue-type plasminogen activator (t-PA) and inhibitor of plasminogen activator (PAI). In the respective follicular fluids the concentrations of oestradiol (E2), progesterone (P) and testosterone (T) were determined and the levels of these enzymes and of the follicular steroid content were related to the fertilizing behaviour of the respective oocytes. Follicles containing oocytes which could be fertilized, revealed significantly higher follicular fluid E2 and P levels and significantly lower T levels than follicles with unfertilized oocytes. The respective granulosa cells of fertilized oocytes exhibited higher levels of t-PA compared to their unfertilized counterparts, whereas no significant difference occurred in the levels of u-PA and PAI. These data suggest that successful fertilization of human oocytes is associated with a high content of t-PA in granulosa cells and high E2 and P levels in the follicular fluid.

Adult↗