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Biomedical subjects

J Deutinger

Publications and source records attributed to J Deutinger.

At least 127 records · Page 7Linked to original sources
PubMed1988

Development and application of simple expert systems in obstetrics and gynecology.

Expert systems have become increasingly popular in medicine for the support of medical decisions, e.g. diagnosis or treatment. We describe the development and application of 2 simple rule-based expert systems, one used for cycle stimulation in our in vitro fertilization program and the other for preoperative assessment of urinary incontinence. The programs were written using a commercially available expert system shell, are run on a standard personal computer, and are in actual use in our department. Though it is doubtful that simple expert systems can be superior to a human expert we feel that expert systems are very useful in the standardization of protocols and are a valuable teaching instrument.

Decision Making, Computer-Assisted↗
PubMed1987

[Comparison of vaginosonographic, transabdominal sonographic and laparoscopic follicle puncture for the retrieval of oocytes within the scope of an in vitro fertilization program].

For follicular aspiration and oocyte retrieval for in-vitro-fertilization (IVF) laparoscopy, laparotomy and different ultrasound guided methods like transvesical and transvaginal puncture can be used. Sonographically guided follicular aspiration has become more important because this procedure is less invasive. In this study we compared the results of 28 laparoscopical, 35 transabdominal and 21 transvaginal follicle puncture after successful cycle stimulation. Performing transvaginal puncture 4.7, using laparoscopy 3.4 and performing transvesical puncture 2.0 oocytes per attempt were retrieved. The advantages of transvaginal follicle aspiration were a shorter operation time, a superficial anesthesia and compared to laparoscopy a less invasive and simple technique. Therefore this method is now commonly used for routine IVF procedures in our institution.

Female↗
PubMed1987

Comparison of the results of vaginal and abdominal follicle scans.

The hormonal profile and sonographical assessing of the number and size of the follicles are important in hyperstimulated cycles. Follicular imaging obtained by abdominal scanning may be distorted by echoes from the intestine or by unfavourable location of the ovaries and patients must have a full bladder. We compared the number and size of the follicles at abdominal sonography with the results obtained by vaginal sonography in 37 patients. Vaginal sonography showed more follicles than abdominal sonography because of improved imaging of small follicles on early days of cycle. This might help one to tailor the hyperstimulation to an individual's endocrine response.

Adult↗
PubMed1987

Relationship between the steroid and prolactin concentration in follicular fluid and the maturation and fertilization of human oocytes.

Seventy-eight follicles and their follicular fluid were aspirated from 46 women undergoing in vitro fertilization (IVF) procedures after stimulation of the ovaries with a low-dose human menopausal gonadotropin/human chorionic gonadotropin stimulation regimen. The concentrations of estradiol (E2), progesterone (P), testosterone (T), and prolactin (PRL) were measured in follicular fluid and related to the maturation of the oocyte-corona-cumulus complex (OCCC) and the fertilization of oocytes. Follicles containing mature oocytes had significantly higher follicular fluid E2 and P levels than follicles with intermediate and immature oocytes. A constant decrease in PRL and T values with advancing follicular maturation was observed. Similar results were obtained when the fertilizing ability of the oocytes was examined. The gradual decline in follicular fluid PRL and T levels during follicular development was connected with increasing E2 and P biosynthesis and therefore seems to be an important precondition for normal follicular and oocyte maturation.

Adult↗
PubMed1987

Prostaglandin metabolism in umbilical vessels of smoking and non-smoking mothers.

Arachidonic acid (AA) and its metabolites are responsible for the regulation of the umbilical blood flow. We investigated the prostaglandin (PG) synthesis in umbilical arteries and veins of 16 smoking and 17 non-smoking mothers. AA and PGs were analyzed after extraction of samples by means of thin layer chromatography (TLC). Of all the AA metabolites in umbilical arteries and veins, prostacyclin reached the highest concentration. In non-smoking mothers the conversion rate of AA in arteries and veins was similar. The only exception was PGE2 which showed a significantly lower concentration in umbilical veins of smoking mothers. However, the influence of PGE2 on the blood flow of umbilical arteries and veins seems to be of minor importance compared to other vessels.

Arachidonic Acid↗
PubMed1987

Hormonal parameters in follicular fluid and the fertilization rate of in vitro cultured oocytes.

Oocytes and matched samples of follicular fluid were obtained from 52 preovulatory follicles aspirated laparoscopically for in vitro fertilization (IVF). Follicular fluid concentrations of estradiol (E2), progesterone (P), testosterone (T), prolactin (HPRL), prostaglandin F2 alpha (PGF2 alpha), prostaglandin E (PGE), protein content, and collagenolytic activity were measured and related to the fertilization rate of oocytes cultured in vitro. High concentrations of P and low levels of T and HPRL were associated with mature, fertilizable oocytes. Levels of PGF2 alpha, PGE, and follicular fluid protein concentrations were similar in both groups. Mean collagenolytic activity was increased in the fertilized oocytes, although no significant difference could be observed. Our data demonstrate a close association between follicular fluid steroid and HPRL concentrations and successful fertilization of oocytes.

Dinoprost↗
PubMed1987

Vaginosonographical determination of the true conjugate and the transverse diameter of the pelvic inlet.

In suspected cases of cephalopelvic disproportion pelvic measurement and the estimation of the fetal weight can be essential for the management of labor. We measured the true conjugata and the widest transverse diameter of the pelvic inlet with a new vaginal scanner. The biparietal diameter (BPD) was measured with a real-time sector scanner. The results of vaginosonographical measurement were compared and showed good correlation with both conventional radiological measurement and measurements obtained by a compound scanner. Vaginosonographical measurement which causes no pain, is quick and also allows measurement of the transverse diameter of the pelvis, might become a routine method in all suspected cases of cephalopelvic disproportion.

Birth Weight↗
PubMed1987

Follicular aspiration for in vitro fertilization: sonographically guided transvaginal versus laparoscopic approach.

Laparoscopy is the most commonly used procedure for oocyte retrieval in an in-vitro fertilization (IVF) program. In this study we compared the results of 21 laparoscopic and 21 sonographically guided transvaginal oocyte retrievals using a vaginal probe. Laparoscopically 3.7 and transvaginally 4.8 oocytes per patient were recovered. Overall 6 pregnancies were achieved, giving a pregnancy rate of 14.1% per patient. Vaginal follicular aspiration resulted in a higher oocyte recovery rate. The advantages of the method were a shorter operation time, a superficial anesthesia and, compared to laparoscopy, a less invasive and simpler technique. Therefore this method is now commonly used for routine IVF procedures in our institution.

Adult↗
PubMed1987

[Effect of serum prolactin on cycle stimulation and fertilization of human oocytes].

During cycle stimulation for in-vitro fertilisation (IVF) some patients develop hyperprolactinaemia. Since prolactin (PRL), being an aromatase inhibitor, can interfere with follicular fluid steroid metabolism, we examined the influence of high serum PRL levels on the endocrine response and fertilisation rate of oocytes. 33 consecutive patients stimulated by hMG/hCG for IVF were included in this study. Two groups of patients were established: Group 1 consisting of 18 patients with serum PRL levels less than or equal to 25 ng/ml, and group 2 containing 15 patients, who developed PRL levels greater than 25 ng/ml during cycle stimulation. The serum oestradiol (E2), progesterone (P) and PRL levels 3, 2 and 1 day before and at the day of follicle puncture were evaluated. The decrease of E2 levels at the day of oocyte retrieval was significantly steeper in group 1. The P levels 2 days before oocyte retrieval were significantly higher in group 1 indicating the onset of preovulatory luteinization. Luteinization after the hCG injection was more effective in group 1 resulting in significantly higher P levels. Fertilisation and cleavage rates were significantly higher in patients with normal PRL levels. High serum PRL levels therefore might indicate an interference in follicular and oocyte development leading to oocytes of inferior quality.

Chorionic Gonadotropin↗
PubMed1987

[Computer-assisted documentation and recording of findings of obstetrical ultrasound findings].

Since 1976 on our department obstetrical reports are generated and stored by computer. This kind of documentation has been also introduced for obstetrical ultrasound investigations. One year ago the part of our database for storing and recording the results of obstetrical ultrasound examinations was changed according to new purposes. This system was designed to support diagnosis of pathological findings and to arrange the results more clearly. Immediately after the investigation the results are entered in a terminal (3278 IBM). Our database is a CICS (Customer Information Computer System) application of the WAMIS (Wiener Allgemeines Medizinisches Informationssystem) from the IMC (Institut für Medizinische Computerdokumentation). The results of the investigation are printed after storage in the data base. The screen and the obtained print-out are divided into several sections according to medical purposes. Since the results of fetal measurement are displayed graphically, fetal growth and the change of normal or abnormal findings can be judged immediately. The new layout of the hardcopy of the results of our ultrasound investigations improves diagnosis of pathological findings. Each examinator is forced to visualize fetal organs, signs of fetal vitality and to perform standardized measurement. Therefore, the possibility to find pathological alteration is improved especially if the investigator is less experienced.

Computers↗
PubMed1987

Fetal kidney volume and urine production in cases of fetal growth retardation.

The amount of amniotic fluid has a close correlation to the function of the fetal renal system. In many cases of fetal growth retardation oligohydramnios is obvious. The aim of this study is the investigation of the hourly fetal urine production rate (HFUPR) and the growth of fetal kidneys during pregnancy in cases of fetal growth retardation and to evaluate the renal participation in the origin of oligohydramnios in cases of growth retardation. In 52 healthy pregnancies and 27 cases with known fetal growth retardation, the volume of the fetal kidneys was measured sonographically and the hourly rate of fetal urine production was determined. Two third of the patients with fetal growth retardation had obvious oligohydramnios. In cases of fetal growth retardation the volume of the fetal kidneys was significantly smaller when compared to the control group, and the volume of fetal urine production was significantly lower. The reduced perfusion of the fetal kidneys in those cases with fetal growth retardation may be the reason for the reduction of the HFUPR. Due to the fact that HFUPR is a dynamical parameter and in close relationship to the perfusion of the fetal kidneys, the identification and measurement of this parameter may help to detect subacute and imminent fetal distress in cases of sonographically proven fetal growth retardation.

Adult↗
PubMed1986

[Intrauterine pregnancy following intratubal gamete transfer--a case report].

Since the beginning of 1986 gamete intrafallopian transfer (GIFT) has been used in the treatment of infertile couples. Only patients in whom tubal patency has been ascertained are included in the programme. After hormonal stimulation of the ovaries and laparoscopic follicular aspiration oocytes and semen are transferred by means of catheterisation into the fallopian tubes. The first pregnancy in our department established by gamete intrafallopian transfer--and the first in Austria to our knowledge--is reported.

Adult↗
PubMed1986

[Normal sizes of internal genitals in girls before and after the menarche].

Knowledge of the average size of the organs of the true pelvis is a prerequisite for the diagnosis and treatment of suspected disorders of the uterus and ovaries in children and adolescents. 76 girls in the premenarche (age = 1 to 14 years) and 31 girls in the postmenarche (age = 13 to 18 years) underwent ultrasound investigation of the inner genitals. Firstly, measurements of the uterus were taken in three dimensions. The volumes of the ovaries were calculated from 3-dimensional measurements of ovarian size. The results of measurements and calculations were used to establish median values and 10th and 90th percentile. Our results show nearly linear growth of the uterus and the ovaries between the 2nd and the 14th year of age. After the menarche accelerated growth of the organs of the true pelvis was detectable in all dimensions.

Adolescent↗
PubMed1986

Endosonographic staging of carcinoma of the uterine cervix.

The advantages of a new endosonic technique for staging carcinoma of the cervix are demonstrated. Using this method virtually all palpable findings can be objectified, and in most cases, assessing the size of the tumor inside the cervix seems to allow further differentiation in stage Ib. By imaging the parametrium, rectal sonography provides an important diagnostic aid for making the differentiation between stages Ib, IIb and IIIb. For assessment of the extent of vaginal infiltration, rectal ultrasound diagnosis and in particular vaginosonography can be used. Rectal and especially transurethral sonography are useful for detecting an infiltration of the bladder wall and for further evaluation of cystoscopically visible vesiculated oedema.

Female↗
PubMed1986

Pregnancy-specific parameters in early pregnancies after in vitro fertilization: prediction of the course of pregnancy.

The plasma concentrations of the beta subunit of human chorionic gonadotropin (beta-hCG), pregnancy-specific glycoprotein, and progesterone were measured in 37 pregnancies after in vitro fertilization. Twenty-one pregnancies ended with delivery, 9 as clinical abortions, and 7 as biochemical abortions. To predict the pregnancy outcome as early as possible, we designed a prediction graph by calculating a "cutoff line" using discriminant analysis and prediction bands up to 95% probability. This prediction graph can help in the estimation of the probability of pregnancy outcome with satisfactory reliability by determination of beta-hCG only.

Abortion, Spontaneous↗
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

[Length of the uterine cervix toward the end of pregnancy--a sonographic study].

In the last weeks of gestation a progressive effacement of the uterine cervix can be observed. 28 patients underwent sonographical investigation weekly between 30th and 40th week of gestation for measuring the cervical length. We found a significant shortening of the uterine cervix in primiparae by about 34.4%, in multiparae by about 41.9%. Sonographic measurement enables objective determination of the length of the uterine cervix and can be helpful in observing the course in cases of imminent preterm delivery.

Cervix Uteri↗