Biomedical subjects
Publications and source records attributed to P Husslein.
The injection of different substances into early, unruptured tubal pregnancies is increasingly advocated. In this study, fertility was evaluated after treatment of tubal pregnancy by means of prostaglandins. The overall tubal patency rate was 86.4% and 14 of 20 patients (70%) could subsequently achieve pregnancy.
Explore the source record for details and available documents.
The incidence of tubal pregnancy has been increasing in recent years. The improvement in diagnostic procedures leads to an early detection of tubal pregnancies. As a result, conservative treatment modalities are more feasible today. In this study, we compared the treatment of tubal pregnancy by means of locally applied prostaglandin with pelviscopic surgery. 75 patients with an early tubal pregnancy were included in each group. The comparison between the two groups showed, that prostaglandin treatment has a higher failure rate, than treatment by pelviscopic surgery. However, postoperative fertility indicated better results in the prostaglandin treated patients.
In the present study, plasma oxytocin and prostaglandin F2 alpha metabolite (PGFM) concentrations were measured in 46 patients admitted for preterm labour. Gestational age ranged from 20-34 weeks. Samples were collected 12 hours before and after initiation of tocolysis. Patients with a premature rupture of the membranes and/or intra-amniotic infection were excluded in this study. There was a significant difference in the oxytocin (p = 0.05) and PGFM levels (p = 0.007, after 12 hours: p = 0.004) between a control group without preterm labour and women with preterm labour. No differences were seen between the successfully treated (delivery more than 5 days after start of tocolysis) and the failure group. There was no significantly different increase or decrease in PGFM and Oxytocin plasma levels between treatment failures and successfully treated patients.
In recent years, the requirements of society towards the quality of research have increased. Especially in the perspective of European integration, ethical and conceptual problems have to be revisited. Clinical research is alimented by technical development and the results of fundamental and pharmacological research. The obligation of converting the most recent knowledge into conventional treatment is the driving force of development. Clinical research is fraught with multiple risks, mainly the risks incurred by patients enrolled in clinical studies, and the risks of drawing erroneous conclusions from badly designed studies. This is the reason why the organization of clinical studies must satisfy the highest quality standards. Prospective randomized double-blind studies are doubtless the best design although they usually involve the difficult problem of patient information. As concerns publications, the picture may be distorted. Thus all the studies should be published exhaustively. Clinical research is thus a great challenge from both the intellectual and the ethical points of view.
Explore the source record for details and available documents.
The results are presented of amniocentesis for diagnostic genetic purposes in 180 patients. A diagnosis was obtainable in 170 cases (94%). Genetic abnormalities were detected in 11 cases; one patient miscarried 3 days after amniocentesis. Antenatal diagnosis of certain genetic disorders can be considered a routine method nowadays and should be offered to any woman at risk. It therefore seems necessary to supply the practitioners with the relevant information on this topic.
A de novo reciprocal translocation 46,XX,t(3;7)(q21;q11), detected at amniocentesis performed because of advanced maternal age, is presented. Both parents showed a normal karyotype. The girl was delivered and has shown no phenotypic abnormality in the first year after birth. Problems encountered with the prediction of the fetal outcome in balanced structural rearrangements are discussed.
10 patients with missed abortion, intrauterine fetal death or hydatifidiform mole were given 15-(S)-15-methyl prostaglandin F2 alpha intramuscularly for the induction of labour or, in 2 cases, to obtain softening of the cervix prior to curettage. The mean time interval between induction and abortion was 6 h 9 min, with a mean dosage of 890 mcg prostaglandin per patient. Vomiting or diarrhoea occurred in 7 patients. Apart from a drop in haemoglobin concentration in 1 patient and a temporary increase in white cell count in 6 patients, no other pathological laboratory findings were detected. We conclude from these results and the relevant literature that the intramuscular administration of 15-(S)-15-methyl prostaglandin is an effective and safe means of inducing labour in missed abortion, intrauterine fetal death and hydratidiform mole.
Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (HPRL), 17 beta-estradiol (E2) and progesterone (P) were estimated in 46 subjects with normal menstrual cycles in whom hysterectomies were performed. Estrogen (ER) and progesterone receptor (PgR) levels in endometrial samples of these patients were estimated, and histological dating of the cycle day was carried out. Similarly, hormone serum levels and ER as well as PgR were estimated in 17 patients with endometrial carcinoma. No correlation between LH, FSH, HPRL and ER as well as PgR was noted in the normal subjects. Correlation between P and ER was observed in this group. Parallel variations between E2 and PgR were recorded in the normal females. In the carcinoma group no correlations between hormone serum levels and receptor contents were found, but ER and PgR correlated with each other. Receptor levels was highest in the well-differentiated group of endometrial carcinoma. The present experiments provide a rationale for progestagen therapy of carcinoma of the endometrium.
A retrospective cost benefit analysis is initiated for the program to improve the perinatal mortality and morbidity in Austria which was started by the Federal Ministry for Health and Environment in 1974. Based on the official registry of birth in Austria the expenses for the intensive maternity care and delivery are calculated. From 1974-1978 the perinatal mortality of 2,514 children was prevented. It is assumed that for each prevented case of perinatal mortality two cases of cerebral damage were prevented. The benefit is calculated as alternative cost. The comparison of cost and benefit showed an approximate balance.
A case of carcinoma of the cervix in a patient with Turner-Syndrome is reported. The possible causes of the rare coincidence of these two diseases are discussed.
In 40 pregnant women who had exceeded term and presented "immature" portio uteri a priming with prostaglandin F2 alpha was carried out. A new procedure of local application using a portioadapter was tried. This synthetic adapter was inserted over the uterine cervix by means of vacuum suction, filled with a mixture of 15 mg PG F2 alpha and methyl-cellulose ether, left in place for 6 hours and then removed. The control examination after the removal of the adapter showed a highly significant improvement of the cervical score in the nulliparae as well as in the multiparae group. In 7 cases the PG-filled adapter was inserted twice. Two cases (5%) had to be considered therapeutic failures because of insufficient cervical maturation. The method described should not be interpreted as birth induction but should be understood to be a preparation for the start of planned artificial birth.
The results are presented of amniocentesis for diagnostic genetic purposes in 180 patients. A diagnosis was obtainable in 170 cases (94%). Genetic abnormalities were detected in 11 cases; one patient miscarried 3 days after amniocentesis. Antenatal diagnosis of certain genetic disorders can be considered a routine method nowadays and should be offered to any woman at risk. It therefore seems necessary to supply the practitioners with the relevant information on this topic.
A case of acute postoperative cholecystitis following subtotal gastrectomy for carcinoma has been observed. The combination of temporary intraoperative shock and probably vagal denervation of the gallbladder initiated secondary acute cholecystitis. After an emergency type cholecystectomy the patient recovered.
Explore the source record for details and available documents.
The effect of 0.5 mg Ouabain (O) i.v. on sinus node function and on intracardiac conduction was studied by His bundle electrography and atrial stimulation. 7 patients with normal sinus node function and av conduction (group I), 5 patients with sick sinus syndrome (group II), and 5 patients with av block of changing degree (group III) were examined. 2 additional patients had simultaneous sinus node dysfunction and av block (group II/III). The sinus node recovery time was prolonged in 6 patients, the av block was located proximal to the His bundle in 4 patients and distal to the His bundle in 3 patients. The spontaneous sinus rate decreased in group I and remained unchanged in group II and III after O. The PA interval increased slightly after O in groups II and III, the AH interval during sinus rhythm was prolonged after O in groups II and III and in the whole group together. During atrial pacing, the stimulus-His-time was increased in each group when compared at identical stimulation rates. In 4 of 7 patients av block type Wenckebach appeared at a lower stilmulation rate after O. The HV interval remained unaltered after O, the sinus node recovery time varied after O. Phenytoin had no positive effect on the changes observed after O. Unwanted actions of O such as increased bradycardia or increased av conduction disturbances were not observed. O appears to be reasonably safe in most patients with sick-sinus syndrome and changing av block.