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Biomedical subjects

U Ulrich

Publications and source records attributed to U Ulrich.

At least 55 records · Page 3Linked to original sources
PubMed1992

Naloxone stimulation test in women with hypothalamic amenorrhea: a preliminary report.

We researched the possibility of the induction of ovulation by means of chronic opioid receptor blockade in 4 women with hypothalamic amenorrhea. Daily 4 mg naloxone were given as a bolus injection intravenously. By means of continuous determination of LH, FSH, 17-beta-estradiol (E2) and progesterone as well as of sonographic folliculometry follicular growth and subsequent ovulation should have been proved. Neither we found alterations of the basal values of LH, FSH, E2 and progesterone, nor we observed a follicular growth. These results lead us to the conclusion to put a naloxone stimulation test before further therapy. In this way opioid mediated hypothalamic ovarian insufficiencies can be registered and a therapy optimum can be reached early.

Adult↗
PubMed1992

[Carl Credé: in memory of the 100th anniversary of his death (14 March 1892)].

Major advances taught by the German gynaecologist and obstetrician Carl Siegmund Franz Credé were the manual expression of the placenta and the prophylaxis of the gonoblennorrhoea. Under his supervision, as head of the obstetrical department of the Berlin Charité, the first exclusively gynaecological unit was founded in Europe. In 1856, he was elected head of the Department of Obstetrics of the University of Leipzig. Credé was the editor of the first 42 volumes of "Archiv für Gynäkologie". He died on March 14th, 1892, from prostatic carcinoma.

Germany↗
PubMed1992

[Christian Gerhard Leopold (1846-1911)].

Christian Gerhard Leopold was one of the outstanding German gynaecologists at the turn of this century. Although interested in the entire discipline of obstetrics and gynaecology including related areas, he is merely known today for his obstetrical manoeuvres. Under his chairmanship, the Dresden Royal Gynaecological Infirmary developed into a leading hospital in Germany. Leopold died on September 12, 1911, following a heart attack.

Germany↗
PubMed1990

[Dopamine antagonists in anovulation?].

Increased hypothalamic dopamine turnover may prevent the ovulatory LH peak by different mechanisms and may in this way result in anovulation. Ten patients with anovulatory menstrual cycles who had been treated with clomiphene citrate without success were given the dopaminolytic drug pimozide (Antalon) at a dose of 5 mg/day orally either from day 7 to day 11 (7 women; group 1) or from day 11 to day 15 of the menstrual cycle (4 women; group 2). One patient from group 2 ovulated during the treatment cycle. A further woman from this group exhibited an LH peak, but did not ovulate, whereas a slow increase of the circulating LH level was recorded in the remaining two patients. Systematic investigations should clarify whether introduction of dopaminolytic therapy in the treatment of hypothalamic anovulation may be justified.

Anovulation↗
PubMed1990

[Ovulation induction using clomiphene conversion].

20 anovulatory and clomiphene resistant patients had been treated by the so called clomiphene conversion. Pregnancies could be achieved in 6 women. 7 further patients reacted by ovulation. In selected cases the clomiphene conversion may be an alternative of therapy with gonadotrophins and GnRH pulsatile.

Adolescent↗
PubMed1989

Pituitary response in the doubled GnRH-TRH test on the 5th day post partum or post abortum after ablactation by oral means of ethinylestradiol sulfonate.

The function and reactivity of the hypothalamo - anterior pituitary axis had been tested after primary ablactation with ethinylestradiol sulfonate (EES) by means of the doubled GnRH-TRH-test. The reaction of the hypothalamo-pituitary axis is, in early puerperium, drastically reduced by GnRH stimulation. The physiological hyperprolactinemia of puerperium leads to a non-responsiveness by means of exogenous GnRH. Simultaneously there exists a greater sensitivity of the hypothalamo-pituitary system for the negative and a relatively lesser sensitivity for the positive feedback of estrogens in puerperium.

Abortion, Spontaneous↗
PubMed1989

[The influence of endogenous opioids in hypothalamic amenorrhea. Diagnostic and therapeutic aspects].

We investigated the possibility of induction of ovulation by means of chronic opioid receptor blockade with naloxone. Daily 4 mg were given as an intravenous bolus injection in 4 women suffering from hypothalamic amenorrhea till the 30th day of therapy. A possible maturation of ovarian follicles and a subsequent ovulation should be proved by means of daily determination of LH, FSH, estradiol and progesterone as well as of a sonographic folliculometry. The day prior to and the first day of naloxone treatment we took blood samples every 10 minutes during 4 hours for determination of LH pulse frequency and amplitude. Neither we found any alteration of the basal values of LH, FSH and estradiol, nor we observed a follicular growth. These results lead us to the conclusion to introduce a naloxone stimulation test as a further diagnostic step. In this way opioid mediated hypothalamic ovarian insufficiencies could be registered and a sufficient therapy could be reached.

Amenorrhea↗
PubMedDate not supplied

[Fetomaternal macrotransfusion after attempted external version].

BACKGROUND: External cephalic version is an alternative to both vaginal breech delivery and to caesarean section. The objective of this study was to summarize potential complications of external cephalic version. Which means are available for early detection and treatment of these complications? CASE REPORT: A 28-year-old 1/0 with breech presentation was considered for external cephalic version at the 38th week of gestation. As three version attempts failed, the patient was discharged after normal fetal heart tone (FHT) registration and normal ultrasonographic findings on the next day. Caesarean section was planned six days later. On the day of admission, FHT registration revealed a decreased beat-to-beat variability and a sinusoidal baseline. Doppler-flow indices of the A. umbilicalis and A. cerebri media were normal, although middle cerebral artery peak systolic velocity was increased. Rapid caesarean section was performed, and an anemic baby (hemoglobin 3.4 g/dl) was born. After transfusion of 100 ml red blood cells, further development of the newborn was normal. DISCUSSION AND CONCLUSION: Fetomaternal macrotransfusion may be a rare complication of external cephalic version, occurring even several days after the mechanical manipulation. FHT registrations and ultrasonographic doppler flow measurements performed periodically unit birth are necessary to detect such complications early. The Kleihauer-Betke test is the method of choice to diagnose fetomaternal macrotransfusion.

Adult↗
PubMedDate not supplied

[Endometriosis and malignoma].

Malignant tumors arising from endometriosis are rare. A frequency of about 1% has been reported with in 80% the ovary, and in 20% extragonadal sites being affected. The most common extragonadal manifestations are the rectosigmoid and the rectovaginal septum. For extragonadal malignant tumors arising from endometriosis, complete resection followed by post-operative radiotherapy, possibly plus adjuvant progestin therapy, is the treatment of choice. Endometriosis-associated ovarian carcinomas are likely to present with lower stage disease and predominantly lower grade tumors. While their treatment follows that of common ovarian cancer, a poorer response to chemotherapy must be considered. As unopposed estrogen replacement therapy has been identified as a risk factor for the development of endometriosis-associated cancer, it is not recommended for hormone replacement therapy in women with a history of endometriosis. Loss of heterozygosity and mutations of the PTEN tumor suppressor gene may be early events of tumorigenesis. Endometriosis and its malignant transformation, perhaps, may serve as a suitable model in this regard. According to recent studies, endometriosis is associated with an increased relative risk of non-Hodgkin lymphoma.

Endometriosis↗
PubMedDate not supplied

[Possibilities of surgery and their differentiated use in the individual treatment of endometriosis].

Numerous medical, surgical, and combined therapies have been proposed in the management of endometriosis. This range of treatment options contrasts remarkably with the evidence regarding their respective proven success rates. An exact preoperative differential diagnosis as well as adherence to operative recommendations that have been established meanwhile are essential for optimal results of surgery.

Endometriosis↗
PubMedDate not supplied

[Laparoscopic therapy of intestinal endometriosis and the ranking of drug treatment].

UNLABELLED: Patients with severe endometriosis involving the rectovaginal septum and bowel makes surgery necessary. The laparoscopic approach offers the possibility to perform the complete resection with minimal invasive techniques. Small lesions can be removed by full-thickness-resection. Large nodules make a segmental resection necessary. Deep lesions are resected with stapling devices. Nodules in the sigmoid ore removed by laparoscopic assisted hand-sewn anastomosis. RESULTS: Between 3/96 and 7/03 142 patients with severe endometriosis involving the bowel have been treated laparoscopically. The pre-operative complains have been reduced as following: dyschezio: 88%, dyspareunia 87%, chronic pelvic pain 96%, disturbance of sexuality 75%. The complication rate was minimal: leakage of the anastomosis n=4 (2.8%), paraproctial abscess 2 (1.4%), blood transfusion 1 (0,7 %), severe stenosis of the anastomosis 6 (4.2%). CONCLUSION: Laparoscopic approach is a safe and effective technique to treat deep infiltrating endometriosis with bowel involvement. The hormonal treatment of bowel endometriosis is used in patients with minimal symptoms. The postoperative treatment becomes necessary in incomplete operations or in patients with severe adenomyosis and infertility.

Endometriosis↗
PubMedDate not supplied

Parametrial and rectovaginal adenocarcinoma arising from endometriosis.

Malignant extragonadal tumors arising from endometriosis are rare. We report on two cases. A 41-year-old gravida 1, para 1 (G1P1), with adenocarcinoma of the right parametrium arising from endometriosis and a 51-year-old G1P1 with endometriosis-associated rectovaginal adenocarcinoma were treated. Treatment included radical surgery plus radiation therapy. While the former patient was doing well 2 years after the primary diagnosis, the latter suffered a local pelvic recurrence 2 years later. Although there are no randomized controlled studies, radical surgery followed by radiation therapy seems generally to be the treatment of choice. The analysis of PTEN in various forms of endometriosis and its malignant transformation may help in understanding the early steps of tumorigenesis.

Adenocarcinoma↗