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Biomedical subjects

J Legarth

Publications and source records attributed to J Legarth.

At least 37 records · Page 2Linked to original sources
PubMed1989

Characteristics of Doppler blood-velocity waveforms in a cardiovascular in vitro model. I. The model and the influence of pulse rate.

In order to study the indices describing the flow-velocity curves a cardiovascular in vitro model has been constructed. The model consists of two parts: (i) A heart simulator producing controllable cardiac output, pulse rate and pressure variations, (ii) a circulatory system made of elastic butyl rubber tubes with adjustable peripheral resistance bed. The flow-velocity curves were obtained by a Doppler velocity meter as a function of the pulse rate (PR) when pressure, volumetric flow, and peripheral resistances were constant. The four evaluated indices, pulsatility index (PI), peak velocity (Vpeak), rising slope (RS) and A/B ratio (A/B i.e. maximum/minimum velocity ratio) all showed significant correlation with pulse rate. PI, A/B and Vpeak showed a marked increased at low pulse rate and the inverse relation between these indices and pulse rate were best described by power functions, whereas RS was found to be inversely proportional to pulse rate. The results are in good agreement with the few existing clinical observations, and we suggest that the relations described are taken into consideration in the clinical interpretation of blood velocity indices.

Blood Circulation↗
PubMed1989

Albumin transfusion in non-immune fetal hydrops: Doppler ultrasound evaluation of the acute effects on blood circulation in the fetal aorta and the umbilical arteries.

A case of non-immune fetal hydrops, diagnosed as mucopolysaccharidosis VII with hypoalbuminemia, was treated in utero with albumin transfusions via cordocentesis on five occasions. Blood samples were taken for analysis of full blood count and blood gases before and after the transfusions. Pulsed Doppler ultrasound examinations of the arterial waveform were performed in the umbilical arteries and the descending fetal aorta and analyzed for the pulsatility index (PI). The hemoglobin concentration and the hematocrit decreased from 111 +/- 5 g/l and 0.335 +/- 0.008 to 95 +/- 5 g/l and 0.282 +/- 0.023 (mean +/- SD), respectively, after the transfusions. The calculated blood volume increased more than the given volume, indicating an autotransfusion causing additional plasma volume expansion. The blood gases were not significantly changed by transfusion. The PI decreased both in the umbilical arteries (p less than 0.05) and the descending fetal aorta, indicating peripheral vasodilatation. A positive correlation was found between the umbilical artery PI and the hematocrit before and after the albumin transfusion (r = 0.59; p less than 0.05). This relation could be due to covariation with other factors, e.g. peripheral vasodilatation secondary to the increased blood volume and the puncture of the umbilical vein itself. No improvement of the hydrops was seen after the albumin transfusions. The fetus died in utero during spontaneous labor after 30 gestational weeks.

Albumins↗
PubMed1989

Characteristics of Doppler blood-velocity waveforms in a cardiovascular in vitro model. II. The influence of peripheral resistance, perfusion pressure and blood flow.

A cardiovascular in vitro model was used to examine the influence of peripheral resistance on the Doppler blood-velocity waveforms. In the study the velocity indices were determined as a function of peripheral resistance either with the flow kept constant (the perfusion pressure varied) or with the pressure constant (the flow varied). The peak velocity (Vpeak) is normally accepted as a simple expression of the stroke volume. However, in this study Vpeak did increase with resistance when the stroke volume was constant. Rising slope (RS) is said to correlate with heart contractility, but in this study such a relation was not found. Pulsatility index (PI) and A/B ratio (A/B) are normally considered to reflect peripheral resistance. PI was found to be a flow- and pressure-independent proportional expression of peripheral resistance. A/B also increased with resistance but this relationship is more uncertain. The results of this in vitro study support the clinical use of PI as a flow- and pressure-independent estimate of peripheral resistance. The relation of RS and Vpeak to heart contractility and stroke volume, respectively, is found to be dependent also on resistance, blood flow, and pressure.

Blood Flow Velocity↗
PubMed1988

The efficiency of prostaglandin E2 vaginal suppositories versus intracervical prostaglandin gel for induction of labor in patients with unfavorable inducibility prospects.

Two different applications of prostaglandin E2 for induction of labor were randomly used in 113 women with an unripe cervix; 57 women were given prostaglandin suppositories each containing 2.5 mg PGE2 in a basis of Witepsol S55 (Dynamit Nobel), another 56 women were treated with intracervical gel containing 1 mg PGE2 in 5 g hydroxypropylmethyl cellulose. The treatment was repeated after 4 h if the cervix was still unripe, and the procedure was repeated the following day if the cervix was still unfavorable. Cesarean sections was performed within 48 h after the start of induction and before the second stage of labor in 8 women in the suppository group and 7 women in the intracervical gel group. Of the remaining 98 women, 73% (34/48 women) in the suppository group and 36% (18/50 women) in the cervical gel group had delivered within 24 h (p less than 0.01). After 48 h, 88% (42/48 women) in the suppository group and 74% of the women (37/50 women) in the cervical gel group had delivered (p greater than 0.05). The induction-delivery interval in the suppository group was half that found in the cervical gel group. There was no significant difference between the two groups in the use of instrumental vaginal deliveries and cesarean sections nor was there any difference with regard to fetal distress. The post-delivery condition of the newborn was similar in the two groups. No side-effects were reported in either of the two groups.

Administration, Intravaginal↗
PubMed1987

Prostaglandin E2 vaginal suppository for induction of labour: an efficient, safe and popular method.

Two different methods for induction of labour were randomly used in 100 women with a favourable cervix. The patients were treated with either prostaglandin vaginal suppositories containing 2.5 mg PGE2 in a base of Witepsol S55 (Dynamit Nobel) or intravenous infusion of oxytocin. The PGE2 vaginal suppository was significantly more efficient than the intravenous infusion of oxytocin in relation to the time interval from the start of induction of labour to delivery. Also the percentage of women who delivered within 48 hours (success rate) was higher in the suppository group. Significantly more women in the suppository group found this induction method recommendable.

Dinoprostone↗
PubMed1986

Episiotomy repair--immediate and long-term sequelae. A prospective randomized study of three different methods of repair.

Three methods of episiotomy repair were randomly assigned after 900 consecutive deliveries. The three procedures were: (1) continuous No. 00-plain catgut in the vagina; No. 00-plain catgut interrupted stitches in the perineal muscles and fascia, and No. 00-nylon interrupted stitches in the skin. (2) The same technique as in (1), but with No. 0-polyglycolic acid (Dexon) in all layers. (3) The suture material as in (2), but used with a subcuticular technique. The women treated with method 3 reported statistically significant less pain and disabilities in the early puerperium. Three months after delivery 262 women (33%) still had perineal complaints which could be directly related to the episiotomy in 25% (8% of total number). The group treated with method 3 had the best long-term results and we conclude that the subcuticular technique using polyglycolic acid should be the method of choice.

Catgut↗
PubMed1982

Diagnostic value of ultrasound scanning and curettage in ectopic pregnancy. A prospective controlled trial.

The object of this study was to assess the diagnostic value of ultrasonic scanning alone and of ultrasonic scanning combined with histological examination of endometrial tissue on suspicion of subacute ectopic pregnancy. For the 93 patients comprising the study, ectopic pregnancy was diagnosed in 21 cases. The diagnostic sensitivity of ultrasound scanning alone proved high, there being 97% correct, negative diagnosis, while a correct positive diagnosis was made in 79%. Ultrasound scanning combined with histological examination of endometrial tissue did not improve the diagnostic accuracy. It is concluded that on suspicion of ectopic pregnancy, ultrasound scanning is a valuable screening method for the exclusion of this condition.

Adult↗
PubMed1982

Uterus didelphys. Report of a case with torsion of the uterus occurring during labor.

In a 30-year-old primigravida with uterus didelphys there occurred, during labor, mutual torsion of the inferior lower uterine segments, the cervix of the pregnant right uterus crossing in front of the lower segment of the non-pregnant left uterus. This blocked the birth canal, and the patient had to be delivered by cesarean section. The frequency of major uterine malformations, their diagnosis, and role in the obstetric prognosis are discussed.

Adult↗
PubMed1981

Termination of midtrimester pregnancies induced by hypertonic saline and prostaglandin F2 alpha 116 consecutive cases.

In 116 patients, abortion was induced in midtrimester by intra-amniotic administration of 20% hypertonic saline and 25 mg prostaglandin F2 alpha. Within 60 hours 113 aborted (success rate 97.4%). Of these 68.1% had aborted within 24 hours and 92.9% within 48 hours. Thirteen patients who had not aborted within 24 or 48 hours were treated with oxytocin drip. It is concluded that the combination studied is an effective abortifacient in midtrimester and that the injection-abortion time is reasonable, the great majority aborting within 48 hours. No live fetuses were delivered, and the complication rate was acceptable.

Abortion, Induced↗