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Biomedical subjects

W Künzel

Publications and source records attributed to W Künzel.

At least 55 records · Page 3Linked to original sources
PubMed1997

[Caries decline in Germany--causes and consequences].

The reunification of the two German states has resulted in social transformations in Eastern Germany after 1990, in the wake of which disadvantageous effects on oral health were to be expected. Contrary to the predicted caries increase, a caries decline in the juvenile population could be proven by epidemiological comparative studies (n = 50612) (decrease between 1983-1989 and 1993-1995 by 34.2%). The caries decline is probably caused by a broader availability of fluorides, a high level of individual dental curative and preventive care (fissure sealings) and by changed oral health behaviour and nutritional habits. Reference is made to a possible tangent between a high level of antibiotics consumption and the virulence of oral pathogenic streptococci.

Adolescent↗
PubMed1996

Kinetics of humoral antibody response to trivalent inactivated split influenza vaccine in subjects previously vaccinated or vaccinated for the first time.

We studied differences in immune responses after first time immunization with a trivalent inactivated split influenza vaccine, or after vaccination in the preceding year, in 42 healthy volunteers (40 +/- 13 years). Sequential serum samples were collected over 40 weeks. Previously vaccinated volunteers exhibited 40-92% protective antibody levels in their prevaccination sera. Subjects vaccinated for the first time had higher response rates and meanfold antibody increases than those vaccinated previously. Both groups had protective antibody titres 59% 7 days after vaccination and 70% of vaccinees maintained protective antibody titres after 280 days. The results corroborate earlier findings on the rapid immune response and may have a bearing on future vaccination policy.

Adult↗
PubMed1996

Blood pH in the umbilical artery at birth: an analysis of data from patients delivered in Hesse between 1986 and 1989.

OBJECTIVE: Measuring blood pH in the umbilical artery at birth is an important means of maintaining obstetrical quality. Consideration of the interrelations between low umbilical blood pH and perinatal risk factors may enable obstetricians to provide better care of the mother and child during pregnancy and delivery. We therefore studied the incidence of measuring blood pH at birth, the distribution and normal range of umbilical blood pH at birth, and the correlation between umbilical blood pH and pre-, sub-, and postnatal risk factors in patients delivered in Hesse between 1986 and 1989. SUBJECTS: Over this period 2053 women were delivered between 30 and 32 weeks and 128,654 between 39 and 41 weeks of gestation. Each of these two groups was further subdivided according to the mode of delivery (spontaneous vaginal delivery; operative vaginal delivery; Cesarean section). Of the patients delivered between 39 and 41 weeks of gestation, 24,315 had exhibited no risk factors during pregnancy or delivery. RESULTS: The overall incidence of measuring umbilical blood pH at birth was about 70%, whereas pH measurements were taken in only 60% of preterm babies delivered vaginally. The percentage of preterm neonates with an umbilical blood pH < 7.10 was considerably higher than that of term fetuses (5.0% vs. 1.3%). Of the neonates born of women displaying no risk factors during pregnancy and delivery, 22.4% had an umbilical blood pH < or = 7.25. In patients delivered at term hardly any correlation was found between prenatal risk factors and umbilical blood pH. This contrasted to the situation in patients delivered between 30 and 32 weeks of gestation. In most subgroups a close correlation could be demonstrated between umbilical blood pH and both sub- and postnatal risk factors. No correlation was detected between umbilical blood pH and perinatal mortality. CONCLUSION: In view of the aim of maintaining and improving obstetrical quality in Hesse, the incidence of measuring umbilical blood pH at birth should be increased, especially in preterm fetuses. Since 22.4% of all babies from patients exhibiting no risk factors during pregnancy and delivery had an umbilical blood pH < or = 7.25, we have to reflect once again on the range of 'normal' umbilical blood pH at birth. Consideration of the various interrelations between umbilical blood pH and pre-, sub-, and postnatal risk factors demonstrated in this study may enable obstetricians to reduce the incidence of severely compromised fetuses at birth.

Delivery, Obstetric↗
PubMed1996

Maternal and perinatal health in Mali, Togo and Nigeria.

OBJECTIVE: The health care system in many developing countries is less efficient compared with that in the industrialized world. The aim of the present study was to investigate the differences of the efficiency of the health care in obstetrics in Nigeria, Mali and Togo. STUDY DESIGN: The data were collected in African district hospitals from Lomé/Togo (n = 1002), Bamako/Mali (n = 1462) and Kaduna/Nigeria (n = 1055) with a routinely applied questionnaire analyzed at the University Giessen and compared with the data from the Department of Obstetrics and Gynaecology Giessen (Germany) (referral hospital) (n = 1313) and the total data pool of the perinatal survey 1993 in Hesse (n = 58430). RESULTS: The medical history indicates important differences: the incidence of young mothers below 18 is highest in Mali (9.8%) compared with Nigeria (2.7%) and Togo (2.6%) (Hesse 0.6%). In general there is an increased rate of previous pregnancies of more than five: 13-28% (Hesse 2.1%). The rate of prenatal visits is also reduced: more than ten visits have 2% in Togo, 10.6% in Mali and 15.5% in Nigeria (Hesse 72%). Ultrasound examinations are very rare (1-12%) and tocolysis is nearly unknown. As a result the incidence of dead infants in the medical history is high: Mali 28%, Togo 18%, Nigeria 10.8% (Hesse 1.7%), as well as the rate of low birth weight infants. This is also reflected in the perinatal mortality which ranged from 115/1000 in Mali, 77/1000 in Togo and 68/1000 in Nigeria (Hesse 5.3/1000, Ob/Gyn Giessen 16.4/1000). CONCLUSION: The improvement of perinatal and maternal health in the developing world can only be achieved if family planning, prenatal care, selection of high risk pregnancies goes in parallel with a sound organization implemented and supported by the government.

Birth Weight↗
PubMed1996

Age and reproductive status affect basal venous tone in the rat.

OBJECTIVE: Changes in venous tone alter vessel diameter and capacitance of veins. These alterations may be induced by the steroid hormonal milieu. Therefore, our question was whether venous tone differs between estrous cycle, pregnancy and old rats. STUDY DESIGN: Mesenteric veins from young, pregnant and old Sprague-Dawley rats were dissected and cannulated in a venograph system with a continous readout of pressure-dependent lumen diameter. RESULTS: During estrous cycle venous tone was increased in metestrous (P < 0.05), whereas it was decreased in all old rats (P < 0.05). There was higher venous tone in pregnant animals compared to controls (P < 0.05). CONCLUSIONS: Venous tone exhibits marked differences during rat estrous cycle. It is increased during pregnancy and decreased in old rats.

Aging↗
PubMed1996

Trends in caries experience of 12-year-old children in east European countries.

This paper reviews published data on the caries experience of 12-year-old children in east European countries, including the 14 states of the former Soviet Union. With the exception of the Czech Republic (2.7) all DMFT indices in the east European countries were within the range of 3.1 (Bulgaria) to 5.1 (Poland). For the states of the former Soviet Union the DMFT indices were higher in the northern regions (range 3.3 in Belorussia to 7.7 in Latvia) than in the southern regions (1.2 in Tadzikistan to 3.1 in Kirgizia). Other than in southern states of the former Soviet Union, 'low' or 'moderate' caries experience (by WHO criteria) were found only in countries with developed oral health care systems. In most of the other countries implementation of oral health promotion and prevention at the community level is needed.

Child↗
PubMed1996

Fluoride concentrations and distribution in premolars of children from low and optimal fluoride areas.

We have compared the fluoride (F) concentrations from the enamel surface to the dentino-enamel junction (DEJ), and through dentine to the dentino-pulpal junction (DPJ) in premolars extracted from school children in Chemnitz (former Karl-Marx-Stadt), Germany (F: 1.0 ppm in the water supply), Erfurt, Germany (F: 0.2 ppm in the water supply) and Nagoya, Japan (F: 0.1 ppm in the water supply). In teeth from children in Cheminitz, Erfurt and Nagoya, the profiles of F distribution using an abrasive microsampling technique revealed high F concentrations in the enamel surface, with a substantial decrease towards a plateau in the interior. In dentine the F concentrations were higher than in enamel, and also decreased to a plateau from the DEJ, thereafter increasing considerably towards the DPJ. F concentrations at any depth in the enamel and dentine of teeth from Chemnitz were 2-3 times higher than those in Erfurt and Nagoya. There was no significant difference in F concentrations or distributions between Erfurt and Nagoya. Close to the DEJ in both enamel and dentine as well as the enamel surface and the DPJ side of dentine, higher F concentrations were observed in Chemnitz compared with Erfurt and Nagoya.

Adolescent↗
PubMed1996

Skin blood flow influences the transcutaneous PCO2 (tc PCO2) during stress in the guinea pig.

The transcutaneously measured carbon dioxide tension (tc PCO2) allows fetal monitoring in a continuous and non-invasive way. Though tc PCO2 is correlated well with the fetal acid-base balance, rather large variations in tc PCO2 exist. A decreased skin blood flow is known to influence the transcutaneous oxygen tension (tc PO2), and tc PCO2 might be affected in an equal way. During fetal asphyxia skin blood flow is extremely reduced. Thus, tc PCO2 might be affected by fetal asphyxia, which it is supposed to detect. To elucidate the role of reduced skin perfusion on tc PCO2, experiments on acutely instrumented guinea pigs were performed and skin perfusion was changed by injection of catecholamines. During control tc PCO2 was twice as high as the arterial PCO2 due to a reduced skin perfusion. After injection of catecholamines skin blood flow rose, tc PCO2 fell and the arterio-transcutaneous difference in PCO2 decreased. Then skin perfusion decreased and tc PCO2 increased. We conclude, that during stress situations with a low skin perfusion, as the acutely instrumented guinea pig, tc PCO2 is higher than the arterial PCO2 and can be influenced by changes in skin blood flow. These findings are relevant for the interpretation of tc PCO2 recordings during fetal asphyxia, where an extreme vasoconstriction exists.

Animals↗
PubMed1996

Andrological work-up of patients undergoing microsurgical epididymal sperm aspiration or testicular sperm extraction.

Microsurgical epididymal sperm aspiration (MESA) and testicular sperm extraction (TESE) require close cooperation between andrologists, urologists and gynaecologists. Intracytoplasmic sperm injections were established in Giessen in March 1994 and embryo transfer (ET) was performed in 342 of 375 patients (91.2%). The percentage of pregnancies and ongoing pregnancies are 35.4% per ET (32.3% per cycle) and 25.1% per ET (22.9% per cycle), respectively. Microsurgical procedures such as epididymovasostomy or vasovasostomy and cryopreservation of human semen are also established methods. The purpose of the present study was to describe the andrological work-up for patients before MESA and TESE. Experiments demonstrate that incubation of testicular tissue samples in IVF medium and treatment with 1 mg ml-1 pentoxifylline increase the number of extracted motile spermatozoa. Centrifugation of the medium results in a further concentration of sperm cells. If no motile spermatozoa can be found in the supernatant medium, they may be extracted directly from the testicular tissue samples by means of a micromanipulator.

Cell Separation↗
PubMed1995

[Laparoscopic ante-fixation of the uterus--modification of the Menge operation].

Surgical antefixation of the retroflected uterus is today for several reasons a rare event. We report on a forty-year old patient with dyspareunia, dysmenorrhoea and lumbalgia. Elevation of the uterus by means of a Hodge pessary relieved her symptoms. This prompted laparoscopical suspension of the diagnosed retroflexio uteri mobilis. We used a modification of Menge's technique stitching the rotund ligament to the anterior surface of the uterus. This modified technique is especially useful because it can be performed easily by laparoscopy. In addition shortening of the round ligaments achieves a physiological position of the uterus in the pelvis without major changes in the pelvic anatomy.

Adult↗
PubMed1995

[Dental status and treatment requirements of the elderly population of Györ, a major Hungarian city (I)].

We performed a 'random sampling' oral health survey in a Hungarian city among the elderly population. This examination was a part of an International Standard Research. The most important result of this survey is, the high number of toothless and edentulous persons. Therefore, the demand for periodontal and restorative treatment is unimportant from the point of view of epidemiology. We emphasize, that it is very important to save the remains of dentition by improvement of personal ral hygiene, regular scaling and crown or bridgework in addition to prosthetic rehabilitation.

Aged↗
PubMed1995

[Prosthetic status, conditions of the oral mucosa and temporomandibular joint, as well as treatment needs in the elderly population of a Hungarian city (Györ) II].

In a Hungarian city a special oral health survey concerning prosthetic status, oral mucosa and temporo-mandibular joint condition of the elderly population has been performed by standardized methods. The most frequent prosthetic finding was the removable prosthetic appliance (denture). It is suggested, that the number of dentures should be decreased with higher priority for the preservation of natural dentition and it should be achieved to change the dentures at proper intervals among denture-wearing patients. The prevalence of temporo-mandibular joint function-disturbances was low. In order to diagnose earlier the praecancerous lesions and conditions a regular oral health survey at least once a year among the people above 55 years of age should be organized.

Aged↗
PubMed1994

The prognostic value of magnetic resonance imaging for the management of breech delivery.

In patients with breech presentation secondary cesarean section is often caused by a failure to progress in labor due to a disproportion between fetal breech and maternal pelvis. The aim of the present study was to select such patients for primary cesarean section by prenatal use of magnetic resonance imaging. In 39 patients with breech presentation at term, maternal obstetric conjugate, transversal inlet diameter, sagittal mid-pelvis diameter, and interspinal distance, as well as fetal transversal and sagittal breech diameters, were measured by magnetic resonance imaging 1-7 days before delivery. All obstetricians that were involved in this study were blind to the measured values. For statistical evaluation the Mann-Whitney U-test was used. In 13 of these patients a secondary cesarean section was performed due to failure to progress in labor and in 9 due to other indications (intrauterine asphyxia, etc.). Seventeen women were delivered vaginally. The proportion between maternal pelvic inlet and fetal breech diameters was significantly less favourable in patients with failure to progress in labor (n = 13) than that in patients who were delivered vaginally (n = 17) (0.97 +/- 0.06 vs. 0.86 +/- 0.05, P < 0.001). Furthermore, by comparing the maternal pelvic inlet diameters with the corresponding fetal breech diameters, three groups of patients could be selected: one group (A; n = 8), in which the patients could be delivered only by cesarean section, a second group (B; n = 10), in which delivery by both cesarean section and vaginally was possible, and a third group of patients (C; n = 12), in which vaginal delivery was exclusively successful.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

The birth survey in Germany--education and quality control in perinatology.

Perinatal mortality in Germany fell during the past four decades from 5% in 1955 to 0.5-0.6% in 1992. This decrease was achieved by organisational health improvements: movement from home to hospital deliveries, mother protection law, guiding principles for prenatal care, pregnancy passport, regionalisation of high risk cases; and medical achievements: fetal monitoring before and during labor, ultrasound technics and neonatal intensive care units with neonatal monitoring, PEEP ventilation and surfactant application. This movement has been supported in the last decade by the implementation of a perinatal survey, starting in Munich, Bavaria in 1975 and distributed, since 1980, over all the states of Germany. The perinatal review is a birth data assessment on a voluntary basis, which provides the opportunity to compare the data with the mean of the participating hospitals. It is therefore an instrument for selfeducation and selfcontrol. It is also used for analysing long-term trends (i.e. caesarean section rate) and for estimating implemented obstetrical managements (i.e. corticosteroid treatment) on a large data pool. Perinatal reviews support the goal to keep the perinatal mortality low or even to achieve a further decrease.

Female↗