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Biomedical subjects

T Steck

Publications and source records attributed to T Steck.

71 records · Page 4Linked to original sources
PubMed1990

Prednisolone promotes the secretion of progesterone and oestradiol by luteinised granulosa cells independent of human chorionic gonadotropin.

An in vitro model based on luteinised granulosa cells gained during an in vitro fertilisation programme examines the question of whether prednisolone, and thus glucocorticoids in general, are capable of exerting an influence on the secretion of oestradiol and progesterone. It can be demonstrated that prednisolone leads to dosage-dependent increases in the concentration of both steroids, even independently of concurrent stimulation by human chorionic gonadotropin. A similar mechanism for aromatase activity of human adipose cells is suggested.

Chorionic Gonadotropin↗
PubMed1989

[Initial experiences with hysterosalpingoscintigraphy in normal and pathologic fallopian tube passage].

A prospective study in 38 patients was designed to evaluate the efficacy and reliability of radionuclide hysterosalpingoscintigraphy (HSS) using 99mTc labelled human albumin macroaggregates (HAMA). Following application in the posterior vaginal fornix at the time of ovulation, HAMA normally migrate spontaneously through the uterus and tubes and may be identified after 20 min (range 5-90 min) in the uterine cavity and after 2 hrs (range 40 min - 3 hrs) in the free pelvis, using a gamma camera. When correlated with the findings of conventional contrast hysterosalpingography (HSG), the radionuclide procedure yielded comparable results in females with patent or clearly obstructed tubes. Using 8-10 MBq 99mTc, radiation exposure was estimated to be 0.75 cGy per ovary, which is considerably less than the mean dose absorbed with HSG. As the HSS procedure imitates the migration of spermatozoa by the means of an inert tracer, it allows a direct insight in the mechanisms of passive transport taking place in the uterus and tubes at the period of ovulation. Thus, it reflects the physiological state of the female reproductive tract. On the basis of the scintigraphic findings, equivocal results on HSG have to be re-evaluated, as tubes, which are anatomically patent under high pressure, may be functionally deficient.

Adult↗
PubMed1988

Hysterosalpingoscintigraphy: a simple and accurate method of evaluating fallopian tube patency.

A prospective study was designed to evaluate the efficacy of radionuclide hysterosalpingoscintigraphy using 99mTc-labelled human serum albumin macroaggregates in 17 patients (34 tubes). In normal females the macroaggregates migrate spontaneously through the female reproductive tract following application into the posterior vaginal fornix. They can be seen in the uterine fornix 20 min p.i. (range: 5-90 min) and as free pelvic activity 120 min p.i. (range 40-180 min). Free pelvic activity could also be demonstrated by culdocentesis. In infertile patients with failure of tubal patency images after 180 min offered no additional information. For the routine diagnosis camera images 5, 60 and 180 min p.i. are recommended. Using 5-10 MBq 99mTc the radiation exposure to the ovaries is about 1/9th of the exposure from a normal radiologic hysterosalpingogram. The reported data show results comparable with those of hysterosalpingography (HSG) in females with patent or with nonpermeable tubes, but in cases of high-pressure by patency by HSG the results of scintigraphy are superior to those of HSG. Moreover, this method provides new insights into sperm motility under various physiological and pathological conditions.

Adult↗
PubMedDate not supplied

[Fetal complications after failed pregnancy termination in the first trimester].

BACKGROUND: Two different methods are in use for induction of abortion: either dilation and curettage (D & C) or medical termination with antigestagens and/or prostaglandins. The risk of continuing pregnancy after D & C ranges from 0.023 to 1% and is inversely correlated with gestational age. METHODS AND RESULTS: Several authors reported fetal anomalies (limb and oro-facial defects) in such cases. For the medical induction of abortion a combination of Mifepristone and Misoprostole is the treatment of choice in order to reduce the risk of ongoing pregnancy. Using single drug therapy carries an increased risk of failure and of subsequent fetal anomaly. There seems to be an increased incidence of limb defects and Möbius' syndrome in fetuses born after failed termination of pregnancy, but normal fetal development is entirely possible. CONCLUSION/DISCUSSION: The patients concerned must be informed in detail of the risks and probable consequences which must be included in the counselling concept of the treating gynaecologist.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

[Effects of prepartum infusion solutions on glucose and bilirubin metabolism of mother and child in the prepartum and postpartum period].

BACKGROUND: Administration of glucose 5% infusion is regularly used in obstetrics. The purpose of the study was to investigate the effects of glucose as compared to xylose and electrolyte solutions on parameters of maternal and fetal glucose and bilirubin metabolism during labour and after delivery. PATIENTS AND METHODS: 53 pregnant women (> or = 37 weeks of gestation, uncomplicated pregnancies) were randomised by entering the delivery ward. Under labour either glucose 5%, xylose 5% or electrolyte infusions were administered. Maternal serum glucose, serum osmolarity, insulin and glucagon were analysed before administration and 20 minutes after delivery. In the newborn blood osmolarity and serum glucose levels were analysed in the umbilical cord directly after birth and in capillary blood samplings 2 hours after birth. RESULTS: Maternal blood glucose levels 20 min. post partum were significantly different (p < 0.05). Maternal insulin and glucagon concentrations 20 min. pp showed similar trends with glucose levels but were not significantly different. Glucose levels in the umbilical cord were significantly higher in the glucose than in the electrolyte group, but not higher than in the Xylit group. In contrast, the glucose-levels in the newborns after 2 h were significantly higher in the glucose group compared with both other groups. No significant differences were observed in bilirubin levels. Osmolarity in the umbilical cord between groups differed significantly. CONCLUSIONS AND DISCUSSION: In conclusion, the administration of different solutions showed a distinct influence on the maternal and neonatal glucose metabolism. A significant impact on the bilirubin levels could not be shown in this study.

Adult↗
PubMedDate not supplied

Impact of three-dimensionally measured endometrial volume on the pregnancy rate after intrauterine insemination.

OBJECTIVE: The success of artificial reproductive techniques not only depends on the quality of oocytes and spermatozoa but also on the receptivity of the endometrium. The aim of this study was to assess the role of endometrial volume measurement by three-dimensional ultrasound in predicting the pregnancy rate (PR) in women receiving controlled ovarian hyperstimulation followed by intrauterine insemination. MATERIAL AND METHODS: 104 patients having intrauterine insemination (IUI) were included in this prospective trial. Ovarian hyperstimulation was performed with gonadotropins in 73 % of patients and with clomiphene citrate (CC) in 27 % of patients. Endometrial thickness, pattern and three-dimensional volume were measured immediately before insemination. RESULTS: In 104 IUI cycles a total of 14 clinical pregnancies were recorded (PR=13.5 %). The endometrial volume was 3.5 ml and was not significantly different in pregnant (4.0 +/- 1.5 ml) from non-pregnant women (3.4 +/- 1.9 ml). In the subgroup of women with an endometrial volume > or = 2 ml and trilaminar endometrium the pregnancy rate was 22 %, significantly higher than that in women without these two criteria (PR 6 %, p < 0.05). The negative predictive value of an endometrial volume < 2 ml for a clinical pregnancy after IUI was 96 %. Endometrial volume and thickness were significantly higher after ovarian hyperstimulation with gonadotropins (3.7 ml and 11.0 mm) than with CC (2.8 ml and 9.5 mm; p < 0.05). CONCLUSIONS: An endometrial volume < 2 ml at the day of insemination is associated with a poor likelihood of pregnancy. Endometrial volume measured by 3D ultrasound is a new objective parameter to predict endometrial receptivity.

Adult↗
PubMedDate not supplied

[Hyaluronan and CD44 in maternal serum in pre-eclampsia].

BACKGROUND: Pre-eclampsia is associated with serum factors which can activate blood vessel endothelial cells. Hyaluronan (HYA) and its specific receptor CD44 play a central role in cell activation processes. Our study focussed on the behavior of serum concentrations of HYA and the soluble standard form of CD44 (sCD44std) in the maternal serum from normotensive and pre-eclamptic pregnancies. PATIENTS AND METHODS: Serum was collected from normotensive pregnant women (n = 10) and from pregnant women with a severe pre-eclampsia (n = 10). HYA-serum concentrations were measured with a radioimmunoassay while sCD44std were measured with an ELISA. RESULTS: The pre-eclampsia group shows a significant (p < 0.001, Mann and Whitney u-test) increased HYA serum concentration (median 79 ng/ml, range 53-165 ng/ml) when compared to the normotensive group (n = 10, median 32 ng/ml, range 19-59 ng/ml). sCD44std-serumconcentration in the pre-eclampsia group (328.3 +/- 68.3 ng/ml) was weakly higher but not statistically significant (p > 0.05) when compared to the normotensive group (292.9 +/- 74.0 ng/ml). There exist no correlations between the HYA and sCD44std serum concentrations in both pre-eclamptic and normotensive groups. CONCLUSION: The increased HYA-serumconcentration may indicate a pathophysiological role of the HYA/CD44-signal transduction system in pre-eclampsia. The existing overlap of HYA serum levels in the pre-eclampsia group with HYA serum levels in the normotensive control group limits the diagnostic precision of HYA serum concentration as a diagnostic parameter in pre-eclampsia. According CD44 it is not excluded that serum concentration of other soluble CD44-isoforms is increased in pre-eclampsia.

Adult↗
PubMedDate not supplied

Hysteroscopy for gamete intrafallopian transfer (GIFT).

Gamete intrafallopian transfer (GIFT) is performed currently using laparoscopy. We report on a pilot-study from 1.1.1987 to 31.12.1987 and from 1.5.1988 to 30.4.1989, in which we used hysteroscopy instead of laparoscopy for the GIFT-procedure. The entering conditions were: unexplained (idiopathic) infertility, failure of previous treatments, proven fertilization capability of the gametes in at least one IVF attempt, and request of the married couple to dispense with laparoscopy during GIFT procedure. Hysteroscopic GIFT was initially performed on hysterectomy specimens, using the Chorionoskop. Continuous flow CO2 through the fallopian tubes did not result in loss of gametes. Twenty-four treatment cycles were performed in 16 patients. In 19 cycles, gametes were transferred into one tube, and in two cycles they were transferred into both tubes. Four of 16 women conceived: one patient delivered at term, three pregnancies ended in a first trimester abortion. These results demonstrate that the hysteroscopic approach to intrafallopian gamete transfer can be successful. However, the technique is demanding and requires extensive training. We conclude that further improvements of hysteroscopic GIFT are needed.

Female↗
PubMedDate not supplied

[Clinical aspects and therapy of amniotic fluid embolism. Illustration based on a case report].

A case of amniotic fluid embolism during the delivery of an at term pregnancy is reported. The 34-year old primipara with an unremarkable medical history suddenly suffered from a seizure in the second stage of labor. Shortly prior to this event, a prolonged fetal bradycardia was recorded. After forceps delivery a massive postpartum haemorrhage as the result of a consumption coagulopathy occurred. Immediate resuscitation with artificial ventilation improved the condition of mother and child. The substitution of packed red cells and platelets, fresh frozen plasma and other blood derivates was necessary. Mother and child survived without any physical damage or neurological deficit. Because of the clinical pattern we diagnosed an amniotic fluid embolism.

Adult↗