Biomedical subjects

R Bollmann

Publications and source records attributed to R Bollmann.

194 records · Page 11Linked to original sources

PubMedDate not supplied

Amniotic fluid pressure in both cavities of twin-to-twin transfusion syndrome: a vote against septostomy.

OBJECTIVE: To report our results of the measurement of the amniotic fluid pressure in twin-to-twin transfusion syndrome before and after amniodrainage and the separate measurement in the cavity of the stuck twin and the recipient, respectively, in 2 cases. METHOD: Six patients with severe TTS underwent therapeutic amniodrainage. Amniotic fluid pressure was obtained before and after reduction of the fluid volume. In 2 of these cases we were able to calculate the pressure separately in both amniotic cavities, the donors (stuck twin) and the recipients. RESULTS: In all cases of TTS, amniotic pressure was high before and reduced after amniodrainage. The pressure was equal in the donors and in the recipients cavity. CONCLUSION: Amniotic pressure seems to be high in TTS, but equal in both cavities. Therefore, amniotic septostomy is probably of low value, especially if a high-risk monoamniotic situation is artificially created.

Amnion↗

PubMedDate not supplied

Fetal cardiomegaly: echocardiographic findings and outcome in 19 cases.

The echocardiographic findings and clinical courses in 19 fetuses with marked cardiomegaly [heart length, width, area, cardiothoracic ratio, heart/thoracic area (CTA) ratio > 2 SD] were reviewed. An abnormal heart was the reason for referral in 16 cases of 19 (84.2%). The mean gestational age was 31.5 weeks at detection. Intracardiac hemodynamics were studied using pulsed, color, and M-Mode color Doppler. Despite the heterogeneous etiology of marked cardiomegaly (5 Ebstein's anomalies, 5 tricuspid valve dysplasias, 3 dilatative cardiomyopathies and 6 miscellaneous) a holosystolic tricuspid regurgitation with right atrial enlargement was found in 17 of the 19 cases (89.4%) as a common pathogenetic feature. A hydrops was found in 10 cases (52.6%). Besides 1 elective legal abortion, a high mortality rate of 83.3% was observed in the group followed up (6 intrauterine and 9 neonatal deaths). Among the cardiac measurements the CTA ratio seemed to correlate with fetal outcome, since all three survivors had the lowest values and all fetuses with CTA ratio > 0.6 showed a lung hypoplasia as a sequel of compression by cardiac enlargement. The presence or the development of hydrops, an obstruction of the right ventricular outflow tract, and the lung hypoplasia could be considered as signs of poor prognosis. A reliable differentiation between a patent pulmonary valve, pulmonary stenosis and pulmonary atresia in severe tricuspid regurgitation using modern Doppler means is difficult as seen in our studied group and in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiomegaly↗

PubMedDate not supplied

Beckwith-Wiedemann syndrome: difficulties with prenatal diagnosis.

Beckwith-Wiedemann syndrome (BWS), though a well-delineated clinical and morphological entity, can be difficult to diagnose by prenatal ultrasound examination when incomplete forms occur. We present a case with sonographic results including hydronephrosis, cardiomegalia, hepatomegalia, macroglossia, and prominent forehead. No abdominal wall defect was detected. Karyotype was normal. In spite of intensive prenatal diagnostics, BWS could not be diagnosed definitely until birth.

Adult↗

PubMedDate not supplied

Associated malformations and chromosomal defects in congenital diaphragmatic hernia.

In order to determine the frequency of associated malformations and chromosomal defects in patients with congenital diaphragmatic hernia (CDH) our experiences with CDH during the last 8 years (1985-1993) were reviewed. During the study period, 33 fetuses (prenatal group) with CDH were examined at our level III ultrasound department. In the same period 11 neonates (postnatal group) were admitted to our pediatric surgical unit after postnatal diagnosis of a CDH. Those cases had not been suspicious for CDH during prenatal level I scan. In 24 (72.7%) of the cases with CDH seen prenatally, at least one or more extradiaphragmatic malformations could be detected. Most of them affected the cardiovascular, skeletal, genitourinary and nervous system. Six (18.1%) fetuses had chromosomal abnormalities, especially trisomy 18. In contrast to these findings just 4 of the 11 babies (36.3%) seen postnatally had associated malformations and all of them had a normal chromosome set. Survival rate of fetuses with CDH and associated anomalies (7.1%) was poor, in contrast to those with an isolated CDH (43.7%). Prenatal ultrasound investigations being suspect for CDH should encourage the clinician to make further diagnostical efforts. This includes detailed ultrasound examination and cytogenetic analysis. Associated malformations as well as chromosomal defects are often present in affected patients.

Abnormalities, Multiple↗

PubMedDate not supplied

Prenatal diagnosis of right lung agenesis using color Doppler and magnetic resonance imaging.

Unilateral lung agenesis should be suspected in fetuses presenting mediastinal shifting and absence of evidence of diaphragmatic hernia. Confirmation of diagnosis is not possible until birth as other more common lung anomalies may have a similar appearance. We present a case with right lung agenesis diagnosed at 34 weeks of gestation. Important for precise diagnosis was the color Doppler procedure, which revealed the absence of right pulmonary vessels. This is the first case in which unilateral lung agenesis has been recognized prenatally by nonvisualization of the corresponding lung vessels. The prenatally performed magnetic resonance sonography did not offer any advantages over sonography. Postnatally, the diagnosis was confirmed, and sinus venosus defect was also found. To prevent recurrent cardiopulmonary crisis, which could be caused by mediastinal shift, a tissue expander was implanted successfully at 3 months of age.

Adult↗

PubMedDate not supplied

[Maternal hepatitis B infection as the cause of nonimmunologic hydrops fetalis].

A 16-year-old primigravida was referred to our department at 22 weeks gestation because of a nonimmune hydrops fetalis. Sonography revealed an isolated fetal ascites. Cordocentesis was performed to rule out anaemia, infection and chromosomale abnormalities, followed subsequently by intrauterine transfusion because of fetal anaemia (hemoglobin-concentration of 8.4 g/dl). It was found that the pregnant suffered from an acute hepatitis-B-virus-infection with positive HBsAg, positive HBeAg and HBc-IgM antibodies, confirmed by serological tests. In a second cordocentesis the cordblood specimen was found to be HBsAg positive as well. The fetus was intramusculary given hyperimmune-globulin under ultrasound guidance. In the further course of pregnancy signs of meconium-peritonitis were observed. Postnatally a distal ileal perforation was detected and the newborn underwent laparotomy for distal ileal perforation. In this case report we discuss the connection with nonimmune hydrops fetalis and the maternal and fetal hepatitis-B-virus-infection.

Adolescent↗

PubMedDate not supplied

[Uses of vaginal pH measurement for prevention of premature labor. Results of a prospective study].

UNLABELLED: The influence of the microflora of the vagina and cervix has been undervalued for the induction of premature birth. Examination of the microbiological problem by determination of the vaginal pH in combination with the microflora (Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum). Report of the outcome of 161 prospective, ad the beginning normal pregnancies in comparison of 200 primary hospitalized pregnancies with symptoms of imminent premature birth. CONCLUSION: The vaginal pH is a very useful parameter of screening for identification of disturbances of the microflora in practice. In cases of pathologic pH (> 4.5) it is possible by therapy to reduce the premature birth rate.

Acid-Base Equilibrium↗

PubMedDate not supplied

[Prenatal rubella diagnosis].

Primary rubella infections during the first trimester of pregnancy are an indication for the termination, although not all of fetuses will be infected. Concerning this situation a prenatal rubella diagnostic in 55 pregnant women was carried out to demonstrate a fetal infection. Simultaneously or separately, as methods the determination of rubella IgM antibodies in fetal blood, the demonstration of viral RNA by DNA-RNA-hybridization and the cultivation of rubella virus from amniotic fluid samples were used. In 7 of 40 women the investigation of amniotic fluids showed a positive reaction of the hybridization, in 2 cases a rubella virus could be isolated. IgM rubella antibodies were found in 5 fetuses. Because of its insufficient effectivity at present the prenatal rubella diagnostic should be applied only in special situations, e.g. in cases of a wanted child.

Amniotic Fluid↗

PubMedDate not supplied

Ureaplasma urealyticum and male infertility: an animal model: II. Morphologic changes of testicular tissue at light microscopic level and electron microscopic findings.

Testicular biopsies were obtained from Wistar rats that had been infected artificially with Ureaplasma urealyticum, serotype 3. Approximately 50% of the biopsy specimens obtained 3 and 6 months after infection showed degeneration of the germinal epithelium, giant cell formation and Leydig cell hyperplasia. Electron microscopic studies revealed striking alterations of Sertoli cells, germ cells, and Leydig cells as well as ureaplasma organisms inside the seminiferous tubules. The changes noted in the ertoli cells were apparent as early as one week after infection.

Animals↗

PubMedDate not supplied

Ureaplasma urealyticum and male infertility: an animal model. I. Artificial infection, breeding experiments and histological preparation of organs.

Male Wistar rats were infected with Ureaplasma urealyticum, serotype 3 or 7, by injecting broth containing organisms into the urinary bladder following laparatomy. Animals were sacrificed 3, 7 and 21 days after infection. Ureaplasmas were detected in the organs of the genital tract by culture in 43% (serotype 3) and in 60% (serotype 7) of the animals. Type-specific ureaplasma antigen was detected in the genital organs in 44% (serotype 3) and 45% (serotype 7) of the animals. Control animals injected with sterile bouillon were negative for organisms and antigen. Male Wistar rats artificially infected with Ureaplasma urealyticum, serotype 3, were mated 3 and 6 months after infection with ureaplasma free female rats. The mating experiment revealed a smaller mean litter size and a lower birth weight in the offspring of infected males compared with the control animals, but no general influence on the fertility of infected animals.

Animals↗

PubMedDate not supplied

[Prenatal diagnosis and management of fetal arrhythmias].

Reported in this paper are 25 cases of fetal arrhythmia handled at the Gynaecological Department of the Berlin School of Medicine (Charité) over a period of two years. They were subdivided by tachycardiac, bradycardiac, and simple forms, following ultrasound-assisted diagnosis (realtime, M-Mode, Doppler). This proved to be useful for better prenatal management and prognosis. The first and second forms were linked to higher rates of malformations or contributory and recordable causes, whereas the third form could be considered harmless, the more as spontaneous postnatal regression was to be expected. Successful experience is reported, as obtained from prenatal therapy either via the mother or by direct invasive treatment to the child (thigh, umbilical vein). Early referral to an adequately staffed and equipped centre and exclusion of cardiac defects are conditions for good success. Intrauterine deaths occurred in two cases due to cardiac malformations, and non-immunological fetal hydrops was established in four cases. Optimal management of the inhomogenous group of fetal arrhythmias should be undertaken in interdisciplinary teamwork at centres with experience in perinatal medicine.

Adult↗

PubMedDate not supplied

[Change in sodium and potassium concentration in human seminal plasma infected experimentally with Ureaplasma urealyticum].

The concentration of sodium and potassium ions was measured by flame photometry in human seminal plasma and human sperm cells as well as in a sperm cell suspension infected experimentally with Ureaplasma urealyticum during incubation as long as 22 hours. The sodium concentration is 86.2 +/- 21.97 mmol/l cells in sperm cells and 120.8 +/- 15.87 mM in seminal plasma. The potassium concentration is 33.2 +/- 16.35 mmol/l cells in sperm cells and 26.7 +/- 4.92 mM in seminal plasma. The sodium concentration decreased considerably in the suspension medium of sperm cells during the first hour of incubation and increased again subsequently. The potassium concentration in the suspension medium changed only little. The sodium concentration in the infected sperm cell suspension was insignificantly increased compared with the mycoplasma-free controls. The potassium concentration was slightly higher in the infected specimens than in the controls. There was no mycoplasma-induced effect on the concentration of sodium and potassium in the sperm suspension after experimental infection.

Humans↗

PubMedDate not supplied

[Pregnancy in Takayasu arteritis].

We report the course of pregnancy in a patient with Takayasu's arteritis type I and describe the diagnostical and therapeutical management with repeated Doppler-sonography. Immunosuppressive therapy was reduced in pregnancy and could be maintained on a low level even after delivery. In the third trimester arterial blood pressure raised up to 190/60 mm Hg and was sufficiently lowered by prescription of verapamil. Repeated Doppler-sonographic investigation beginning with 20 weeks of gestation revealed indices in the normal range during the whole pregnancy. After 37 weeks of gestation a healthy infant was delivered vaginally. The post partum course was uneventful.

Adult↗

PubMedDate not supplied

[Fetal atrioventricular blood flow velocity in the 2nd half of pregnancy: a Doppler echocardiographic study].

Pulsed Doppler velocimetry of both fetal atrioventricular valves derived in the four-chamber-view were performed in 94 uncomplicated pregnancies between the 20th and the 40th week of gestation. The maximal velocities in early (E-peak) and late diastole (A-Peak) as well as the E/A Ratio were calculated for both tricuspid (TV) and mitral valves (MV). Normal ranges for the six measured parameters were constructed and correlated with gestational age. In the second half of pregnancy an increase of the E-wave for both valves was found (TV r = 0,59; MV r = 0,48) with higher values through the TV compared with the MV. In comparison the A-velocities showed a flat increase during the observation time (TV r = 0,32, MV r = 0,24). The E/A Ratio for both valves which is < 1 in the fetus showed an increase throughout pregnancy, mainly due to the increase of the E-wave in the observed period of time. These intracardiac Doppler flow measurements enable an insight into the physiology of fetal circulation. They give a basis for the analysis of blood flow under pathological conditions, like in congenital heart defects or in intrauterine growth retardation.

Blood Flow Velocity↗