[GnRH analogs versus gestagens in therapy of endometriosis].
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Adult↗
Biomedical subjects
R Wenzl
Publications and source records attributed to R Wenzl.
[Tuboscopy. Initial experiences with microendoscopic tubal diagnosis].
To date, investigators have relied on hysterosalpingography, hysterosalpingoscintigraphy, and laparoscopic chromopertubation for the diagnosis of tubal disease causing infertility. With the development of the "linear everting catheter" system it may now be possible to evaluate the tubal lumen and to diagnose changes in the tubal wall or the tubal mucosa by direct visualization. This paper describes our initial clinical experience with 14 women who underwent evaluation for infertility. The new catheter system allowed both inspection of the tubal ostium without cervical dilation or concomitant hysteroscopy and virtually atraumatic access to the tube by means of an endoscope measuring half a millimeter in diameter and a magnification of 40. Given adequate experience with this technique it may also be performed in an outpatient setting. Ultimately, tuboscopy may come to play a major part in the diagnosis of sterility. Other potential applications of this new technology are the tubal transfer of embryos, intratubal insemination and the conservative treatment of tubal pregnancy.
Adult↗
Beta-endorphin, steroids, and prolactin. Immunoassay in breast cysts and blood.
Circulating levels and cyst fluid concentrations of beta-endorphin (beta-EP), estradiol, progesterone, and prolactin were measured by radioimmunoassays in 10 premenopausal women with gross breast cysts. In addition, aspirates and frozen tissue sections from cystic lesions were investigated immunocytochemically for a possible beta-EP production. Epithelia of dilated ducts, smaller cysts, and hyperplastic lesions without atypia showed a strong positive reaction in the cytoplasm. In apocrine metaplasia, this staining was concentrated in the apical region. The staining intensity in atypical hyperplasia was diminished. Occasionally, normal duct and lobular epithelia exhibited positive beta-EP immunostaining. Levels of beta-EP, estradiol, and progesterone in the cyst fluid were significantly higher than in blood, but no significant differences were observed for prolactin. The ratios of progesterone to estradiol, estradiol to prolactin, and progesterone to prolactin in the cyst fluid were considerably higher than in blood. This suggests that beta-EP and steroid hormones are secreted from the lining epithelia into the breast cysts.
Estradiol↗
[Diagnosis of cephalothoracopagus--a case report].
Cephalothoracopagus twins were diagnosed at 22 weeks' gestation, hence this case was diagnosed early enough antenatally to allow vaginal pregnancy termination. This case underlines the need for exact ultrasound screening during early pregnancy.
Adult↗
Breast cyst fluid concentrations of beta-endorphin, steroids and gonadotrophins in premenopausal women with gross cystic disease.
Breast cyst fluid (BCF) and plasma levels of beta-endorphin (beta-EP), oestradiol (E2), progesterone (P), luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), prolactin (PRL) and cortisol were assayed radiochemically in a group of 10 premenopausal women aged 45-50 years suffering from gross cystic breast disease. The concentration of beta-EP (fmol/ml) in BCF (17.6 +/- 4.6 S.E.) was over four times higher than that in plasma (4.2 +/- 0.5 S.E.). The level of E2 was 41 times higher (1738.2 +/- 350.5 S.E. pg/ml) and that of P was 47 times higher (65.47 +/- 8.25 S.E. ng/ml) in BCF than in plasma. The significantly increased values of beta-EP, E2 and P in BCF and the identification of beta-EP in the cyst-lining epithelium indicated that local synthesis occurs. Growth factor-like properties of beta-EP and E2 are responsible for the propagation of cystic changes. The autonomous formation and activity of beta-EP, E2 and P in cystic formations were not correlated with LH, FSH, TSH and cortisol levels, which were significantly higher in plasma than in BCF. The concentration of PRL in BCF was not significantly higher than that in plasma. Moreover, the plasma concentrations of testosterone, androstenedione, thyroxine, triiodothyronine, thyroxine-binding globulin and sex-hormone-binding globulin were within the normal ranges. In this study we demonstrated synergism between beta-EP and steroid hormones which encourages the development of gross cystic disease in premenopausal women.
Estradiol↗
Early detection of ectopic pregnancy by transvaginal ultrasound.
Transvaginal (TVU; 19 patients) and transabdominal ultrasound (TAU; 24 patients) were compared in their ability to visualize an ectopic pregnancy. The direct visualization of ectopic pregnancy (EUP) was 25% with TAU and 94.7% with TVU. All women had a proven EUP in laparoscopy. TAU approach showed a significant inferiority (P less than 0.02) and TVU a superiority (P less than 0.08) in comparison to clinical examination. 83% of 43 women had spotting. Nonspecific signs for EUP like fluid in the pouch of Douglas was seen in 20.9%. Thin endometrium was seen in 6.9%, in 37.2% the thickness of endometrium was under 10 mm, in 55.8% more than 10 mm. An intrauterine pseudogestation sac was detected in 6.9%, corpus luteum formation in 37.2%.
Adult↗
[Gynecologic Doppler ultrasonography].
The resistance of the vessel of the ovarian artery changes during the cycle. At the time of ovulation the resistance of the vessel of the ovarian artery decreases under the influence of steroid production in the ovary. The resistance decreases and the blood flow increases. In our study we could show that women with a normal cycle have low pulsatility indices in the ovarian arteries when oestradiol is rising. In women with PCO-Syndrome the blood flow in the ovarian artery is very low in spite of the fact that the patients got hormonal treatment. On the day of follicular puncture in our IVF-group and also on the day before, the pulsatility-index of the ovarian artery was very high in patients with PCO-Syndrome and it was significantly lower in patients with normal cycle. The women with PCO-Syndrome had also low oestradiol levels in the plasma. In the group with PCO-Syndrome no woman became pregnant, women with high oestradiol levels and low PI of the ovarian artery at the time of follicular puncture became pregnant in 19%.
Adult↗
[The value of vaginal ultrasonography in early pregnancy].
Heart action was detected in our first group of 150 pregnant women during the early period of pregnancy (5th to 8th week post menstruationem) in 25% at the end of the 5th week of pregnancy, in 85% at the end of the 6th and, in 100% in the 7th week. In our second group of 59 women with tubal pregnancy, confirmed by laparoscopy, it was possible to detect the extrauterine pregnancy transabdominally in 25% and transvaginally in 94.7% via sonography (p = 0.03). Extrauterine pregnancy was easier detectable by vaginosonography due to the proximity of the organ and the better power of resolution, as a direct sign of extrauterine ring formation surrounded by a circular wall-like structure.
Adult↗
[Vaginosonography in gynecology].
Vaginosonography is a new method for gynaecological diagnosis. Its special advantage is to reach the uterus and the ovaries at close range. A structural refinement of the surrounding tissue allows to better coordinate individual structures to the different organs. A further advantage is, that a filled bladder is not required. At the first time diagnostic ultrasound can be used in corpulent patients as well. Vaginosonography is of special importance in the diagnosis of the endometrium according to the event of cycle identifying different types of amenorrhea, and also informative during the climacteric period. Besides the demonstration of the endometrium the time of ovulation can be determined by folliculometry, and an exceeding follicular growth can be stopped at the right time. Transvaginal puncture of follicles is a quicker and easier technique than the usual laparoscopic approach. Early diagnosis of pregnancy is of great importance as well. Using vaginosonography, a missed abortion and an extrauterine pregnancy can be varified in a simple way. A cervical insufficiency can be evaluated in a better way by the determination of the opening of the internal orificium of the cervix. There is further use of the method in other fields of gynaecology.
Abortion, Missed↗
[Comparison of transabdominal and transvaginal sonography in extrauterine pregnancy].
In 19 patients the transvaginal (TVU) and in 24 patients the transabdominal (TAU) ultrasound approaches were compared in their ability to identify by visualisation the adnexal mass of ectopic pregnancy. The direct visualisation of ectopic pregnancy (EUP) was 25% in TAU and 94.7% in TVU approach (p less than 0.03). All women had a proven EUP in laparoscopy. TAU approach showed a significant inferiority (p less than 0.02) and TVU a significant superiority (p less than 0.08) in comparison to palpation. 83% out of 43 women had spotting. Unspecific signs for EUP like retrouterine fluid was seen in 20.9%. Line formed endometrium was seen in 6.9%, in 37.2% the thickness of endometrium was under 10 mm, in 55.8% more than 10 mm. An intrauterine pseudo-gestation sac was detected in 6.9%, corpus luteum formation in 37.2%. With vaginosonography organs can be seen at close range, therefore it is easier to recognise the specific signs of EUP - an extrauterine ring - formation surrounded by a dam-like structure of the tube.
Adult↗
[Early diagnosis of tubal pregnancy with vaginal sonography].
In 19 patients, the transvaginal (TVU) and in 24 patients, the transabdominal (TAU) ultrasound approaches were compared in their ability to identify by visualization the adnexal mass of ectopic pregnancy. The direct visualization of ectopic pregnancy (EUP) was 25% in TAU and 94.7% in TVU approach (p 0.03). All women had a proven EUP in laparoscopy. TAU approach showed a significant inferiority (p 0.02) and TVU a significant superiority (p 0.08) in comparison to palpation. 83% out of 43 women had spotting. Unspecific signs for EUP, like retrouterine fluid, was seen in 20.9%. Striated endometrium was seen in 6.9%, in 37.2% the thickness of endometrium was less than 10 mm, in 55.8% more than 10 mm. A pseudogestationsac was detected in 6.9%, corpus luteum formation in 27.2%. With vaginosonography, organs can be seen at close range, and the specific signs of EUP, an extrauterine ring-formation surrounded by a dam-like structure of the tube, was identified in 94.7%.
Chorionic Gonadotropin↗
[Early diagnosis of tubal pregnancy using vaginal sonography].
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Chorionic Gonadotropin↗
[The value of hyperprolactinemia determination within the scope of galactorrhea].
Of 210 women with galactorrhea 66.2% had normal prolactin serum levels. Only in 33.4% elevated prolactin levels could be found, 0.4% were hypoprolactinemic. The TRH-stimulation test detected latent hyperprolactinemia in 13.5% of the cases, showed a normal thyroid function in 81.5%, hypothyroidism in 13.9% and hyperthyroidism in 4.6% and this is considered to be a more valuable diagnostic tool than the MCP-test. Galactorrhea was associated with the following conditions: hyperprolactinemia (34.8%), menstrual disturbances (67.4%), post-pill amenorrhea (30.2%), mastalgia (30.2%), prolactinoma (18.6%), fibrocystic disease (11.6%), hirsutism (4.6%), diabetes mellitus (2.3%).
Adult↗
[Detection of asymptomatic bacteriuria in the puerperium using a test strip].
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Bacteriological Techniques↗
[Imaging of premature uterine contraction in vaginal sonography].
A collective of 60 patients with clinical diagnosed contractions was vaginosonographically examined. During the ultrasound examination preterm labour was seen in 42 patients. In a control group (n = 50) preterm contractions were not detectable. The average time of the contractions was 88 seconds in the primipara group and 90 seconds in the multipara group and showed no statistical significance. In the group of the primipara a shortening of the cervical length of 17 (+/- 6) mm, in the multipara group 15 (+/- 5) mm was seen under contractions, furthermore a thickening of 8 +/- 4 mm respectively 10 +/- 5 mm. The internal os of the primipara opened 11 +/- 6 mm, of the multipara group 13 +/- 6 mm. The highest incidence of uterine contractions was found in the 32nd week. The paired students t-test showed a significance of p less than 0.001 for the cervical length, thickness and internal os and for the thinning of the dorsal uterine wall, subdividing the parity did not show statistical significance. The vaginosonography is able to help detecting preterm labour.
Adult↗