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Biomedical subjects

J Eberhard

Publications and source records attributed to J Eberhard.

54 records · Page 3Linked to original sources
PubMed1979

[Stress incontinence in women--the evaluation and interpretation of intra-urethral pressure profiles obtained by microtransducers (author's transl)].

In 100 women urethrocystometric investigations were carried out with the microtransducer method. The women were of different height and the examinations were done at different states of bladder filling. The interpretation of the resting and stress pressure profiles of the urethra were done according to well defined parameters. The profiles were studied in continent and in continent women regarding their diagnostic value. From the results guidelines for the quantitative and qualitative evaluation of stress incontinence were derived, discussed and conclusions for treatment are outlined.

Female↗
PubMed1978

[Urethro-cystometry: a comparison between open-end catheters with flow and microtransducer catheters (author's transl)].

In 40 women a comparative urethrocystometric study between microtransducer catheters and open-end catheters was performed. Analysis of resting and cough urethrapressure profile concerned clinical and practical value as well as reproducibility. All of these aspects can better be achieved by microtransducer catheters compared to the open-end catheter system. Best results were obtained when measuring with microtransducers in standing position.

Female↗
PubMed1978

[The diagnosis of urinary incontinence in gynaecology. Indications for urodynamic diagnosis and description of urodynamic diagnostic apparatus (author's transl)].

Our experience with comparative measurements using various methods of diagnosis of urinary incontinence resulted in the development of a urodynamic measurement station within the department. This station is equiped for urethrocystotonometry with microtransducers for urethrocystograms and for lateral urethrocystograms. The technological details of the apparatus are described. The greatest diagnostic value give measurements in the standing patient. The methods of measurement, the interpretation of the results and the pre-operative records of urethral pressure profiles are described. The urethrocystotonometry is especially valuable for functional diagnosis. For the morphologic evaluation and especially in view of the choice of the operative procedure a modified method of the lateral urethrocystogram is used.

Female↗
PubMed1977

[Possibilities and limitations of obstetric intensive medicine: a cost-savings analysis (author's transl)].

With the increasing use of obstetrics intensive supervision methods, perinatal mortality could be decreased from greater than 2.5% to less than 1.0% between 1965-1975. Cases of clinically relevant acidosis in the umbilical artery (pH less than 7.10) declined from 2.41% to 0.51% between 1973-1975. On the basis of these results and the statistical data from Hagberg (14), it can be concluded that 1 child out of every 1.000 births can be preserved from a severe infantile cerebral paresis and 1 child from severe mental retardation via obstetric intensive supervision. The cost for obstetric intensive medicine per 1.000 births was 370.000 Swiss francs in 1975. As a result of the decline in cerebrally damaged and mentally retarded children, expenditures of between 1.3 to 1.9 million Swiss francs were avoided. This means a savings of 1 to 1.5 million Swiss francs.

Blood Chemical Analysis↗
PubMed1976

The effect of modern intensive monitoring in obstetrics on infant mortality and the incidence of hypoxia and acidosis.

UNLABELLED: We consider intensive monitoring to be fetal monitoring during labor and in the newborn period of all births using the most efficient methods. During the last ten years we have sequentially used the following techniques: Amnioscopy, blood analysis, estrogen determinations in urine, external and internal cardiotokography and internal pressure determinations, gas analyses of umbilical blood. amniotic fluid analyses (phospholipids), ultrasound (B-apparatus) and HCS determinations. All clinics dealing with risk pregnancies should have these techniques available. Total perinatal mortality decreased to below 2% after introduction of cardiotokography. During the last year it decreased to 0.89%. Premature mortality shows the same decrease and is 50% of total mortality. The frequency of premature deliveries remained unchanged at 6.2%. Both improved intensive monitoring and neonatal reanimation and intensive care contributed to the reduction of perinatal mortality. Continuous heart rate recordings make it possible to uncover hypoxic and acidotic states in time and this is of particular value for the premature infant. The incidence of acidosis (pH less than 7.10) was 2.03% before monitoring was introduced and fell to 0.45% this year when intensive monitoring became the rule. No pH lower than 7.0 was found this year. It is thus not sufficient to monitor only cases at risk, since in about 50% of infants born with acidosis no alarming symptoms were found that would have indicated the need for intensive monitoring. CONCLUSION: Infant mortality should be reduced to less than 1% if the diagnostic tools available are applied. Below this nonviable infants limit further improvement. Perinatal hypoxia and acidosis (below pH 7.10) should also be lower than 0.5% but at least lower than 1%.

Acidosis↗
PubMedDate not supplied

Digital subtraction radiography for monitoring dental demineralization. An in vitro study.

The aim of the present study was to evaluate the assessment of progression of demineralization by digital subtraction radiography. In each of 14 extracted human teeth, 2 approximal enamel demineralization lesions were induced in vitro to simulate dental caries. A modified tunnel preparation with glass ionomer fillings was performed on one lesion of every tooth as a model of caries inhibition. Every week, radiographs were obtained under standardized conditions over a period of 42 days. The radiographs were digitized and calibrated for grayscales. Reference landmarks were chosen and aligned for the different pictures by computer-assisted imaging to adjust the images for projective distortions. The images of the 7th, 14th, 21st, 28th, 35th and 42nd day were subtracted from the baseline radiograph. The mean value of gray values of the subtraction images was calculated and ANOVA tests for repeated measurements and paired t tests were used for statistical analysis. The results of the present study indicate that statistically significant gray level changes due to progression of demineralization could be detected in the radiographic images by subtraction analysis. Differences between glass ionomer-filled and nonfilled lesions failed to reach significance. The introduced method may have the potential to detect and document minute caries progression.

Analysis of Variance↗
PubMedDate not supplied

Influence of alternative birth methods on traditional birth management.

BACKGROUND: Because of popular demand for more natural childbirth, a new concept was introduced in 1991 in our clinic. It consisted of careful monitoring and birth management, restrictive use of invasive methods, and free choice of different birth methods including waterbirths and other alternative birth methods. Our aim was to determine the influence of our new birth concept on the way women give birth and on the birth management in our clinic. METHODS: In a total of 9,418 births between 1991 and 1997 [new birth concept KSF (KSF = Kantonsspital Frauenfeld)], the changing pattern of birth methods and birth management in our clinic under the influence of the new birth concept were analysed. The results were compared to a historical group in our clinic, a total of 5,602 births from 1986 to 1990, and to data from a contemporary group from Swiss clinics, a total of 344,328 births from 1986 to 1997. FINDINGS: Our study shows that alternative birth methods are very popular. The waterbirth rates have risen steadily and stabilized at around 40-50% of the spontaneous births. The Maia-birthing stool births rates reached a peak of popularity in 1993 (23%) 5 years after their introduction, dropping again to 10% of the spontaneous births. The bedbirth rates have stabilized at around 40% of the spontaneous births. Other birth methods such as standing, supported by a rope, on the mat or on all fours are much less popular. The impact of our new birth concept on different aspects of birth management differs greatly from one to another. The episiotomy rate has dropped from a previous rate higher than 80% to a rate lower than 15%. The caesarean section rate in our clinic (around 10%) has remained substantially below the Swiss average (around 15%). The rate of the spinal and epidural analgesia was maintained at a constant level, around 13%, while the Swiss average rates doubled and reached 23% in 1997. The induction and amniotomy rates as well as the use of oxytocin were not influenced by the new birth concept and are comparable to the Swiss average. CONCLUSION: Alternative birth methods and in particular waterbirths are very sought after. This popular pressure insisting upon less invasive, more natural birth management can be well integrated into the security-oriented way of thinking of classical medicine. In our clinic the general trend towards more invasive measures in birth management could be countered by the introduction of a new birth concept with alternative birth methods.

Analgesia, Epidural↗
PubMedDate not supplied

Waterbirths: a comparative study. A prospective study on more than 2,000 waterbirths.

BACKGROUND: Waterbirths were introduced in 1991 as part of a new birth concept which consisted of careful monitoring and birth management, restrictive use of invasive methods and free choice of different birth methods. METHODS: After the introduction of this new birth concept a prospective observational study was initiated. All parturients of the region give birth in our clinic without preselection, ours being the only birth clinic of the region. 2% of the parturients will be referred to a larger birth clinic (university clinic) mainly because of preterm births before the end of the 33rd week of pregnancy. Every one of the 7,508 births between November 1991, and May 21, 1997, was analyzed. In this article the birth parameters of mother and child in the most often chosen spontaneous birth methods will be compared to assess the safety of alternative birth methods in general and of waterbirths in particular. 2,014 of these 5,953 spontaneous births were waterbirths, 1,108 were Maia-birthing stool births and 2,362 bedbirths (vacuum extractions not included). RESULTS: The parity and age of the mother as well as the newborn's birth weight are comparable in all 3 groups: waterbirth, Maia-birthing stool, and bedbirths. An episiotomy was performed in only 12.8% of the births in water, in 27. 7% of the births on the Maia-birthing stool and in 35.4% of the bedbirths. These differences are statistically significant. In spite of the highest episiotomy rates, the bedbirths also show the highest 3rd- and 4th-degree laceration rates (4.1%), thus the difference between the rates for bedbirths and alternative births methods for severe lacerations is significant. The mothers' blood loss is the lowest in waterbirths. Fewer painkillers are used in waterbirths and the experience of birth itself is more satisfying after a birth in water. The average arterial blood pH of the umbilical cord as well as the Apgar scoring at 5 and 10 min are significantly higher after waterbirths. Infections of the neonate do not occur more often after waterbirths. No case of water aspiration or any other perinatal complication of the mother or child which might be water-related was reported. CONCLUSION: Waterbirths and other alternative forms of birthing such as Maia-birthing stool do not demonstrate higher birth risks for the mother or the child than bedbirths if the same medical criteria are used in the monitoring as well as in the management of birth.

Analgesia, Epidural↗
PubMedDate not supplied

Evaluation of selective caries removal by a fluorescence feedback-controlled Er:YAG laser in vitro.

AIM: To establish a fluorescence threshold level that could guide a therapeutic Er:YAG laser through a caries lesion to determine a therapeutic endpoint of caries removal. MATERIALS AND METHODS: A total of 65 extracted human teeth, 35 with dentine caries and 30 healthy, were used for this study. An Er:YAG laser system that emitted at a wavelength of 2.94 microm was used. The laser was equipped with a laser fluorescence feedback system, excitation wavelength 655 nm, to control the irradiation by the Er:YAG laser. The evaluated threshold levels of the fluorescence feedback system were 3, 7, 8, 10, 12, 15 and 20. After treatment the teeth were prepared for histological staining according to the method of Brown and Brenn for the identification of bacteria. The specimens were subjected to a quantitative evaluation of residual bacteria on the treated dentine surface. In addition, the internal fluorescence of dentine and potential fluorescence changes of dentine after laser irradiation were evaluated. RESULTS: About 80% of the irradiated dentine surface showed residual bacteria with threshold levels of 20, 15, 12, and 10. Residual bacteria were not found with threshold levels of 7 and 3. The study revealed a significant increase in dentine fluorescence after laser irradiation. CONCLUSION: The results of the present in vitro study indicate that a fluorescence threshold level of 7 or 8 units can guide an Er:YAG laser to a complete removal of carious dentine.

Aluminum↗