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Biomedical subjects

O Bauer

Publications and source records attributed to O Bauer.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Accidents of the elderly].

The topic of accidents in elderly population has been studied on 2055 injured older than 65 years. The severity of injuries indicates the importance of accidents in this age-group. The proportion of fractures in the elderly population is twice of the average-in females over 75 years of age they take the half of the total number of injuries. While the incidence rate of males in the whole material with all of the age groups is twice of that of females, in elderly population it turns into equal. The rate of home-accidents grows with ageing. The elderly people specially the males suffer a high number of road traffic accidents as pedestrians or riding their bicycles. The severity of injuries and the broken health status in elderly people is a major problem both for the health care and the whole society.

Accidental Falls↗
PubMed1996

Hormone profiles under ovarian stimulation with human menopausal gonadotropin (hMG) and concomitant administration of the gonadotropin releasing hormone (GnRH)-antagonist Cetrorelix at different dosages.

PURPOSE: The premature LH surge in ART programs seems to be avoided by daily administration of the GnRH-antagonist Cetrorelix during the midcycle phase in controlled ovarian hyperstimulation with hMG. The dosage necessary for sufficient suppression of the pituitary gland is not yet defined. METHODS: To elucidate this question three daily dosages (3, 1, 0.5 mg) were administered and the hormone profiles obtained as well as the number of oocytes retrieved, the fertilization rate, and the consumption of HMG were compared. RESULTS: No premature LH surge could be observed at any of the three dosages administered. Both gonadotropins were deeply suppressed. The fertilization rates of the oocytes obtained were 45.3% in the 3-mg group, 53.1% in the 1-mg group, and 67.7% in the 0.5-mg group. The average uses of hMG ampoules were 30 in the 3-mg group, 27 in the 1-mg group, and 26 in the 0.5-mg group. CONCLUSIONS: Cetrolix, 0.5 mg/day, administered during the midcycle phase of controlled ovarian hyperstimulation with hMG is enough to prevent completely the premature LH surge. Perhaps even lower dosages would be sufficient. Regarding fertilization rates and use of hMG, the lower dosage seems to be the most favorable.

Adolescent↗
PubMed1996

Small-diameter laparoscopy (SDL) using a microlaparoscope.

PURPOSE: To determine the ability of new sub-2.0-mm-diameter microlaparoscopes to be used for diagnostic laparoscopy, 28 small-diameter laparoscopies (SDL) were performed during a 4-month-period. METHODS: These cases were performed under general anesthesia, with immediate follow-up confirmation with conventional laparoscopic equipment. An additional 13 SDL procedures were performed under analgosedation plus local anesthesia and were well tolerated by the patients. RESULTS: For the cases performed with conventional laparoscopic control, the visualization results were comparable in 27 of 28 procedures. In the nongeneral anesthesia SDL group, patients were highly satisfied and reported less post-procedural discomfort and minimal scar formation due to the smaller access ports. In this study, two types of microlaparoscopes were used. CONCLUSIONS: While both were adequate, the newer high-resolution microlaparoscope delivered an image much more similar to that which conventional laparoscopy and required little or no change in technique in order to obtain images. With the advent of this new endoscope technology with optics performance comparable to that of conventional laparoscopes, SDL has demonstrated to be a useful procedure for certain clinical indications.

Evaluation Studies as Topic↗
PubMed1996

[Significance of tumor necrosis factor alpha (TNF-alpha) in endometriosis].

Macrophage-derived substances such as cytokines and growth promoting factors are known to be present in the peritoneal fluid of women with endometriosis. Active endometriosis of the peritoneum is characterised by hypervascularization and neoangiogenesis. TNF-alpha is a pleiotropic cytokine also involved in angiogenesis and immunoregulation. Our question was to determine whether there are differences in the peritoneal TNF-alpha concentrations in women with various degrees of active and inactive endometriosis. We found that TNF-alpha concentrations were higher in the peritoneal fluid of women with endometriosis than in the peritoneal fluid of those without. TNF-alpha concentrations were higher in cases of active endometriosis than in cases of inactive endometriosis. The highest concentrations could be detected in women with severe endometriosis (stage III and IV rAFS).

Adult↗
PubMed1996

Comparison of cryopreservation of supernumerary pronuclear human oocytes obtained after intracytoplasmic sperm injection (ICSI) and after conventional in-vitro fertilization.

A comparison was made of pronuclear stage human oocytes obtained either after classical in-vitro fertilization (IVF) or after intracytoplasmic sperm injection (ICSI). After ICSI or IVF, three fertilized oocytes from each patient were kept in culture for a further 24 h before embryo transfer. The surplus oocytes were cryopreserved using the 'open freezing system' and 1,2-propanediol and sucrose as cryoprotectants. A cohort of 817 and 1626 oocytes in pronuclear stage were frozen after IVF and ICSI respectively. Of these, 333 and 744 zygotes have been thawed, of which 78 and 76.5% were morphologically intact zygotes after IVF and ICSI respectively. From the 204 (ICSI) and 89 (IVF) zygote transfers performed, 34 (17%) and 18 (20%) pregnancies were established. Both groups showed a similar abortion rate of approximately 20%. It is concluded that pronuclear stage oocytes resulting from ICSI can be successfully frozen/thawed and the survival and pregnancy rates achieved are comparable to those for zygotes obtained after IVF.

Cryopreservation↗
PubMed1996

The combination of two semen preparation techniques (glass wool filtration and swim-up) and their effect on the morphology of recovered spermatozoa and outcome of IVF-ET.

The aim of this prospective study was to relate sperm quality, especially sperm morphology, to the outcome of IVF results, when glass wool filtration (GWF) and swim-up were used in combination for the preparation of spermatozoa. A total of 60 ejaculates were analysed. GWF was compared with glass wool filtration/swim-up (GWF-SU) by using aliquots from the same semen samples to increase the precision of the comparison and to establish the cumulative effect of these two semen preparation methods on the morphology of the recovered spermatozoa. Sperm parameters were examined in native semen, in semen preparation samples after GWF and GWF-SU. The mean percentages for motility, morphology and velocity were improved significantly over those in fresh semen only when GWF-SU was used. GWF alone resulted only in a significantly higher recovery of motile spermatozoa. In semen preparation, 10% of spermatozoa with normal morphology appeared to be the cut-off point as there was a significantly higher recovery in fresh semen samples containing > 10% morphologically normal spermatozoa after GWF-SU. Outcome of IVF-ET following preparation with GWF-SU showed better results in comparison to the swim-up procedure alone, though this difference was not statistically significant. The cut-off point was also > 10% morphologically normal spermatozoa. Improvement in all aspects of IVF-ET occurred when native semen contained > 10% morphologically normal spermatozoa. It is concluded that GWF alone did not produce significantly better results but, in combination with swim-up, it resulted in significantly better sperm morphology and in an improved outcome of IVF-ET for fresh semen samples with > 10% morphologically normal spermatozoa.

Adult↗
PubMed1996

[Use of fibrin glue in vesico-vaginal fistulas after gynecologic treatment].

Vesicovaginal fistulas develop as an early complication following gynaecological operations or as a late complication following irradiation. The waiting period for the surgical closure of the fistula implies social and psychic problems for patients and attending physicians. Three cases report on the exclusive fibrin sealing for closing vesicovaginal fistulas after which continence was re-established.

Aged↗
PubMed1996

[Discrimination of small breast lesions with Doppler ultrasound].

We performed histological examinations on 75 patients in whom a breast lesion was identified by mammography or clinical examination. We found 35 malignant and 40 benign lesions with an average size of 16 mm. In 57 cases (76%) a lesion was identified preoperatively by the use of ultrasound. Blood flow of sufficient magnitude to be visualized by Colour Coded Doppler was only detectable in 22 cases of which 20 turned out to have a malignant lesion. Thus the detection of blood flow by Colour Coded Doppler in a small breast lesion may be considered as a sign of malignancy. However the absence of such blood flow should not be considered as an indicator of a benign lesion. At the same time we would like to point out that the detection of blood flow is also dependent on technical factors of the equipment used.

Blood Flow Velocity↗
PubMed1996

[Pregnancy and extreme myomatous uterus--conservative management].

The management of a pregnancy complicated by uterus myomatosus remains being controversially discussed. Myomectomy early in pregnancy is opposed by exspectative management with myomectomy subsequent to the post partum period. Therapeutic abortion and exstirpation of the gravid uterus represent only hypothetical but not reasonable alternatives. Complications like ureteral obstruction, sepsis, and torsion of the uterus with subperimetrial bleeding as a cause of fever of unknown origin may occur. Rapid growth of a fibromatous uterus in pregnancy may call for a biopsy. Two cases are presented to demonstrate that with intensive pregnancy surveillance exspectative management is justified and may lead to successful confinement of the pregnancy.

Adult↗
PubMed1996

[Risks of expectant management of extrauterine pregnancies with low HCG titers and absent clinical symptoms].

We report on 4 cases of ectopic pregnancy with low HCG-levels and lack of clinical symptoms, in which expectant management was performed. Advantages and disadvantages of the procedure are discussed. While one can find a variety of therapeutical concepts in the literature such as conservative medical treatment alone or in combination with laparoscopy or expectant management, we dispose to prefer a fertilization providing gentle operative laparoscopic assessment as the treatment of choice in all cases of ectopic pregnancy. In all 4 cases operative laparoscopy had to be performed after an interval of expectance when the patients displayed sudden severe clinical symptoms.

Adult↗
PubMed1995

Mini-swim-up: a new technique of sperm preparation for intracytoplasmic sperm injection.

PURPOSE: The male factor is nowadays one of the major problems in the treatment of infertility. New methods of assisted fertilization such as the intracytoplasmic sperm injection (ICSI) show better fertilization and pregnancy rates than classical IVF. METHOD: In this study, we present a new technique of sperm preparation: the "mini-swim-up." CONCLUSION: This technique, used in conjunction with the ICSI procedure, improves pregnancy and fertility rates in cases of severe oligoasthenoteratozoospermia.

Cell Separation↗
PubMed1995

Preserved pituitary response under ovarian stimulation with HMG and GnRH antagonists (Cetrorelix) in women with tubal infertility.

OBJECTIVE: To examine the pituitary response in patients undergoing short-term application of the GnRH antagonist Cetrorelix in the mid-cycle phase for hypophysial suppression of premature LH surges within an IVF-program. DESIGN: Twenty patients suffering from primary or secondary tubal infertility were stimulated with hMG from cycle day 2. From day 7 till ovulation induction Cetrorelix was administered in two different dose regimens (15 patients 3 mg s.c. daily; 5 patients 1 mg s.c. daily). Three hours before ovulation induction a GnRH test was performed using 25 micrograms of native GnRH and the pituitary response examined by measurement of the serum LH concentration after 30 min. RESULTS: Premature LH surges could be avoided in the 3-mg group and in the 1-mg group, respectively. Due to this, none of the cycles had to be cancelled. Oestradiol profiles and ultrasound demonstrated a satisfactory follicular maturation. All patients showed pronounced suppression of the serum LH levels before ovulation induction. The mean increase of serum LH due to the performed GnRH test was 10 mIU/ml for the 3-mg group, while the average maximum in the 1-mg group was about 32.5 mIU/ml. CONCLUSIONS: The pituitary response is preserved by the treatment with the GnRH antagonist Cetrorelix. The extent of suppression of the adenohypophysis, as expressed by the different reactions on GnRH test, can be modulated by the dosage administered. This should allow ovulation induction by GnRH or one of its agonists instead of hCG, which could be beneficial in patients at high risk of Ovarian Hyperstimulation Syndrome (OHSS) and those suffering from Polycystic Ovary Disease (PCOD).

Adult↗
PubMed1995

[Cryopreservation of human oocytes in the pronuclear stage with an automated "open system"].

In the period from June 1990 to February 1993, 718 excess pronucleated oocytes from 185 cycles were cryopreserved by using the "open freezing system" in our IVF-programme at the Department of Gynaecology and Hospital of the University of Bonn. 1.5 mol propanediol and 0.1 mol sucrose were used as a cryoprotectant. During this time 287, pronuclear oocytes were thawed; of these 245 survived the freezing process and were classified as intact. The survival rate in this study was 85.4%, though if only one intact pronuclear oocyte was transferred, no pregnancy could be achieved, whereas if two or three pronuclear oocytes were transferred, seven to ten pregnancies resulted, respectively (23.3% and 23.8% pregnancy rates). Eight healthy children have been born to date from four other ongoing pregnancies, one of them is a twin pregnancy.

Cell Survival↗
PubMed1995

[Diagnostic microlaparoscopies with 2 mm optics].

Within a period of 5 months a serious of 42 small diameter laparoscopies (2 mm) (SDL) were performed with a modified technical approach. 28 (SDL). Procedures were done under general anaesthesia and the findings were controlled by concurrent conventional laparoscopy. In 26 out of 28 patients we could confirm the SDL diagnosis. 14 patients had SDL in analgosedation. Optical information gained by SDL was sufficient and, as experience in handling the system increased, also competitive. The procedures performed in analgosedation were tolerated and highly appreciated (reduced incisional pains, reduced complaints due to pneumoperitoneum). SDL procedures seem to have possible indications in gynaecology.

Adult↗
PubMed1995

[Triplet pregnancy after intracytoplasmic sperm injections].

Morphology of the spermatozoa is one of the major criteria in severe male subfertility. We report on a case of severe Oligoasthenoteratozoospermia in which a triplet pregnancy could be achieved after intracytoplasmic sperm injection (ICSI). After treatment with GnRH-analogues/HMG/HCG seven oocytes of metaphase II could be retrieved and injected. Three of them fertilised and were transferred as four-cell stage embryos after two days. Seven weeks later an intact triplet pregnancy could be detected by ultrasonography. The severe sperm defects in this case were evaluated with the technique of electron microscopy. Ultramorphology of spermatozoa appears to have an important predictive value for fertilisation and pregnancy in classical IVF. Its value for the assisted procreation techniques such as ICSI remains to be investigated.

Adult↗
PubMed1995

Small diameter laparoscopy using a microlaparoscope.

In order to determine the suitability of new microlaparoscopes of < 2.0 mm diameter for diagnostic laparoscopy, 28 small diameter laparoscopies (SDL) were performed during a 4 month period. These cases were performed under general anaesthesia with immediate follow-up confirmation with conventional laparoscopic equipment (group I). An additional 13 SDL procedures were performed under analgesic sedation plus local anaesthesia and were well tolerated by the patients (group II). For group I, the visualization results were comparable in 27 out of 28 procedures. In group II, patients were highly satisfied and reported less post-procedural discomfort and minimal scar formation due to the smaller access ports. In this study, two different types of microlaparoscopes were used; while both were adequate, the newer high-resolution microlaparoscope delivered an image much more similar to conventional laparoscopy and required little or no change in technique in order to obtain images. This new endoscopic technology, with optical performance comparable to that of conventional laparoscopy, has been demonstrated to be a useful procedure for certain clinical indications.

Abdominal Pain↗
PubMed1995

Toxoplasma gondii antibodies in pregnant women and their newborns in Dar es Salaam, Tanzania.

The sera of 849 Tanzanian pregnant women were tested at delivery for Toxoplasma gondii antibodies with the Sabin-Feldman dye test (DT) and an immunosorbent agglutination assay. A total of 296 (35%) of these women had DT titers greater than 1:4. The percentage of women with dye test titers greater than 1:4 was 34-37% regardless of the individual ages. The rate of positivity for human immunodeficiency virus 1/2 (HIV-1/2) using Western blotting was 11.5%. There was no relationship between prevalence of a positive DT result and HIV infection nor between the intensity of the DT result and HIV infection. Sixty-four parturients had a DT titer of 1:1,000 or more. From 57 newborns of these mothers, cord sera were available and were screened by the DT and the immunosorbent agglutination assay. Seven of these were found to be positive for IgM and/or IgA antibodies. It was concluded that the rate of serologic evidence for prenatal Toxoplasma infection in cord blood samples in the present study of Tanzanian pregnant women was approximately 0.8%.

Adolescent↗