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W Klosa

Publications and source records attributed to W Klosa.

12 recordsLinked to original sources
PubMed1989

[Assessing the extent of gynecologic tumors by a sonographic tumor score with special reference to ovarian cancer].

Ultrasonic findings in 1317 operatively confirmed gynecological tumors were classified according to five degrees of homogeneity: I, clearly outlined solitary cysts; II, clearly outlined homogeneous tumors; III, poorly defined or slightly heterogeneous tumors; IV, marked heterogeneous tumors; V, completely heterogeneous tumors. In the different groups, the rates of malignancy were: I, 0.9%, II, 1.9%; III, 17%; IV, 58%; and V, 75%. In a further study 1082 patients with a negative or doubtful result of the physical examination were investigated using ultrasound. Abnormal findings in 126 cases were able to detect 8 carcinomas, 25 kystomas, and 63 other tumors.

Female↗
PubMed1989

[Computer-assisted urodynamics].

Advantages of computer assisted urodynamics with the "Urosoft" program (Wiest KG, Munich) are: Better Display with colormonitor and enhanced graphic adapter, a more rapid quantitative data evaluation, especially with larger data volumes, a better data storage and management, the possibility of program extension for scientific purposes, and the providing of a medical report. Disadvantages are additional costs for hard- and software, an individual time for familiarizing and adjustment and an additional expenditure in cases where only a qualitative evaluation is done. Important is a data analysis in a second step, not done automatically with the measurements, to eliminate artifacts.

Female↗
PubMed1988

[Prenatal sonographic diagnosis of abdominal wall defects and stenoses of the intestinal tract].

Today prenatal sonographic diagnosis of abdominal defects and stenoses of the intestine is possible without few exceptions during general screening in the 20th week of gestation. In a retrospective study, 56 malformations in this area were investigated, which had been diagnosed at the University Hospital Freiburg during 1973 and 1985. Besides the criteria of sonographic diagnosis the etiology, incidence, prognostic factors, the course of pregnancy and delivery and the postpartal management are described. The rate of direct sonographic diagnosis in this area has increased from 26% up to 91%. The worst prognosis was found in infants with diaphragmatic hernias and exomphalos, whereas infants with stenosis of duodenum and small intestine had the best prognosis.

Abdominal Muscles↗
PubMed1988

[Detection of liver metastases in gynecologic neoplasms by sonography, scintigraphy, computerized tomography and liver enzymes].

In a retrospective study the diagnostic validity of sonography (US), computer-tomography (CT), scintigraphy (SC) and serum alkaline phosphatase (AP) in the detection of liver metastases was evaluated in 929 patients with malignant tumors: ovary (n = 367), mamma (n = 189), endometrium (n = 181), cervix (n = 162), fallopian tube (n = 10), vulva (n = 20). Definitive diagnosis was confirmed by autopsy (n = 51), surgical intervention (n = 297) or follow-up (n = 581). Specificity, sensitivity and overall accuracy of the different methods in the indication of liver metastasis were as follows: CT (n = 58) 81%, 98%, 93%, US (n = 929) 70%, 94%, 90%, SC (n = 512) 66%, 85%, 81%, AP (n = 325) 68%, 93%, 87%. In the last examination period, US and CT reached comparable results. In view of efficiency, AP and US would appear suitable for routine control in gynecological malignancies.

Alanine Transaminase↗
PubMed1987

Urinary protein patterns and EPH-gestosis.

In pregnancy a glomerular or mixed glomerular/tubular proteinuria in excess of 0.5 g/day was found in EPH-gestosis or preceding glomerular disease. A pure tubular proteinuria was not found in EPH-gestosis. The severity of the clinical picture was positively correlated with the daily protein loss.

Diagnosis, Differential↗
PubMed1986

[Monitoring of pregnancy in diabetes mellitus].

From 1970-1984 116 diabetic pregnant patients were monitored and delivered at the University Hospital of Freiburg, Department of Obstetrics and Gynaecology. The pregnant diabetics were managed and controlled by an interdisciplinary team of internists and obstetricians. For better control of the maternal metabolic status, the diabetic patients were admitted to the hospital three times during their pregnancy. Foetal monitoring was done by ultrasonography, hormone analyses and cardiotocography. In most cases foetal growth retardation and macrosomia were detected early via sonography. Decreased urinary excretion of total oestrogen was measured during late pregnancy in 13% of the diabetic patients. In cardiotocography a loss of foetal reactivity was observed in 11% of all non-stress tests (NST). In more than 50% of these cases, the total oestrogen excretion also decreased. In patients with normal oestrogen values, an abnormal NST was rarely observed. Abnormal oxytocin challenge tests (OCT) were recorded in 19% of the patients. Among these cases most of the patients with a non-reactive NST were found. In 85% of the patients with pathological changes in the OCT a Caesarean section had to be performed, and among these in all patients with a loss of foetal reactivity in the cardiotocogram. In correlation with the foetal outcome, loss of reactivity in the cardiotocogram has greater pathological relevance than deceleration with maintenance of reactivity. For an early recognition of imminent placental insufficiency, OCT proved to be the most sensitive parameter. The increased incidence of acute placental insufficiency in diabetics during delivery underlines the need for repeated stress tests during late pregnancy.

Birth Weight↗
PubMed1986

Simultaneous investigations of maternal cardiac output and fetal blood flow during hypervolemic hemodilution in preeclampsia--preliminary observations.

In pre-eclampsia hemodynamic alterations are characterized by a lack of plasma volume expansion and a raised peripheral vascular resistance. For the compensation of plasma volume deficit and to restitute blood fluidity the therapeutic use of plasma volume expanders (f.e. low molecular dextran) is recommended. Several groups (Goodlin et al., Cloeren et al., Heilmann et al., Seghal et al., Schröck) have demonstrated benefitial effects on fetal status and development in the course of hypervolemic hemodilution in preeclampsia. This therapeutic procedure presumes the continuous surveillance of maternal hemodynamics to early recognize heart insufficiency or fluid overload in the lungs. We use the noninvasive thoracic impedance cardiography for continuous monitoring of maternal heart performance. The effect of hypervolemic hemodilution on fetal circulation has not been quantitatively investigated yet. Meanwhile pulsed doppler ultrasonography offers the possibility of estimating quantitative changes on fetal blood flow. We used both noninvasive techniques--thoracic impedance cardiography and pulsed doppler imaging system--for the simultaneous evaluation of maternal and fetal hemodynamic parameters during hypervolemic hemodilution. This preliminary report summarizes the investigations in 5 patients with pre-eclampsia (mean arterial blood pressure greater than or equal to 103.3 mm Hg, hemoconcentration with elevated hematocrit levels greater than or equal to 38%). The patients received an infusion of 500 ml dextran 40 over a period of exactly 60 minutes. The simultaneous measurements of maternal and fetal cardiovascular parameters were performed in 15-minutes intervals during dextran application and 15 minutes (p 15), 30 minutes (p 30) and 60 minutes (p 60) after the end of infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Ultrasonic Doppler method for noninvasive determination of fetal blood flow volumes].

Fetal blood flow volume and unteroplacental flow profiles can be measured with a linear real time scanner in conjunction with a pulsed Doppler system. It was the aim of this study to simulate the blood flow volume under varying experimental conditions by using an in-vitro model, and to examine and compare pulsed Doppler equipments. Defined flow rates between 200 and 1200 ml/min were pumped via a tygon tube placed in a liquid bath. The sample volume was kept constant, the depths of the tube were varied. Processing of the Doppler signals was done by spectrum analysis. There was a good correlation between true and ultrasonically measured flow rates (r = 0.96-1). However, particularly low flow rates resulted in an overestimation of blood flow when using high-pass filtering for avoiding Doppler signals arising from the vessel wall. These errors probably not only depend on the flow profiles, but also on the measuring techniques involved with the individual instruments. The effect of high-pass filtering must be taken into account when interpreting the results, particularly in the case of low-flow rates.

Blood Flow Velocity↗
PubMed1985

[Influence of the "aliasing" effect and the filter on the quantitative determination of the mean flow rate and flow volume per unit of time using the pulsed Doppler ultrasound method].

By the pulsed doppler ultra sound the blood flow volume will be measured by a discrete time signal. The consequences which are obtained for fourier's transformation are deduced and specially the problem "aliasing" for the quantitative measurement of the flow volume per time is discussed. The influence of the different filters on the quantification of the blood flow volume per time can be demonstrated by in-vitro measurements compared with the pulsed doppler combination of Kranzbühler (pulsed Doppler combination 8105, linear 8130) and the pulsed Doppler combination of Toshiba (pulsed Doppler combination SAL 50).

Blood Flow Velocity↗
PubMed1978

[Amniotic fluid tests for fetal lung maturity (author's transl)].

Amniotic fluid specimens of 30 pregnant women were examined for the evaluation of the fetal lung maturity. Three assays were used in parallel: the determination of the lecithin concentration, the estimation of the lecithin/sphingomyelin ratio and the shake test. The results were compared together and with the fetal outcome. The shake test has proved to be sufficient for the exclusion of an immature lung. To avoid failure from false-negative results of the shake test an additional determination of the lecithin/sphingomyelin ratio is recommended, whenever clinical dates give rise to expect a mature lung. The determination of the lecithin concentration has no advantage compared to the lecithin/sphingomyelin ratio. Pathology as candida infection or anecephaly falsifies.

Amniocentesis↗
PubMedDate not supplied

[Therapy of hypotension in pregnancy using norfenefrine hydrochloride with special reference to the effects on fetal circulation--initial observations].

Hypotension in pregnancy represents an often underestimated danger for mother and fetus. Several investigators have described an increased incidence of miscarriages, premature delivery and small for date babies. In a first study 10 pregnant women with hypotension and severe orthostatic dysregulation were treated with norfenefrine hydrochloride (3 x 45 mg p. os/day). To investigate the effects of this therapy we monitored maternal blood pressure, subjective well being, CTG and furthermore fetal circulation by using pulsed doppler sonography. An average 4.2 days of treatment were required for complete alleviation of symptoms. Blood flow volume and resistance-index were determined for the fetal aorta descendens, and were found to be the same as in normal pregnancies. In addition no difference in fetal outcome was seen and there was no occurrence of premature contractions.

Blood Circulation↗