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Biomedical subjects

W Lichtenegger

Publications and source records attributed to W Lichtenegger.

At least 91 records · Page 5Linked to original sources
PubMed1984

Fetal insulin balance: gestational diabetes and postpartal screening.

It must be determined whether high neonatal birth weight (greater than or equal to 4000 g) is due to genetic factors or to a disorder of maternal carbohydrate metabolism. Oral glucose tolerance tests are known to be unreliable during the puerperium. If the mother's carbohydrate metabolism was disturbed during pregnancy, neonatal overweight may result from fetal hyperinsulinism. This can be diagnosed by determining the insulin in the umbilical cord blood. Mature neonates of metabolically healthy women show an insulin level of 9.2 +/- 4.4 microU/ml (N = 180) in the umbilical cord blood. The third, tenth, 50th, 90th, and 97th percentiles were calculated as 1.4, 4.3, 8.8, 15.4, and 17.7 microU/ml, respectively. With insulin values over 20 microU/ml in the umbilical cord blood, a disturbance of maternal carbohydrate metabolism during pregnancy is likely. Among 4560 births in one year, 335 neonates weighed 4000 g and more, corresponding to a proportion of 7.35%. In one quarter of the infants over 4000 g, high birth weight was associated with fetal hyperinsulinism. This corresponds to a frequency of 1.8% of all births.

Birth Weight↗
PubMed1982

[Prostaglandins for the induction of labor].

PGE2 has been used for labor induction for more than 10 years. Oral PGE2 appears to be the prostaglandin favoured in recent years rather than intravenous PGE2. There are fewer side effects of the drug when administered in this manner. It is concluded from the present investigation that oral and intravenous PGE2 have certain advantages as compared with other preparations for induction of labor at term, although it cannot entirely replace intravenous oxytocin. PGE2 tablets intravaginally are very effective for the priming of an unripe cervix.

Administration, Oral↗
PubMed1981

Comparison of oral prostaglandin E2 and intravenous oxytocin for induction of labour.

153 oral prostaglandin E2 (PGE2) inductions of labour were compared with 172 inductions with oxytocin. Details of these inductions are presented. After review of the data we assumed that induction of labour with oral PGE2 is less hazardous to mother or infant than with oxytocin. The similarity between the contractions of spontaneous labour and those labours produced by PGE2 is represented by the caesarean section rate in cases of effective induction. The operative delivery rate in the oxytocin-treated group was significantly higher. The need for close observation of the progress of labour during PGE2 inductions is emphasized.

Administration, Oral↗
PubMed1978

Clinical experience in the application of the tissue pH electrode.

Only after placing the pH electrode through an incision could its point enter deep enough into the tissue. The storage of the pH electrode in a reference buffer considerably improved the stability of the electrode. The ECG electrode is at present the weakest link in the realization of continuous pH measurements. Improvements should be effected mainly with the ECG electrode, the electrode cable and the application instruments.

Electrocardiography↗
PubMed1978

Practical experience in the usage of a pH electrode.

A total of 57 continuous pH measurements have been carried out at the University Clinic of Gynecology in Graz since September 1976. In 41 cases diagrams were suitable for evaluation. In fetal distress the pH curves showed increasing waves synchronous with labor activity. A linear pH curve seems to preclude imminent danger to the fetus. A decline in the pH curve prior to delivery may be caused either mechanically or by fetal distress.

Electrodes↗
PubMed1978

Insulin levels in amniotic fluid. Management of pregnancy in diabetes.

A correlation between high insulin levels in amniotic fluid and the appearance of diabetogenic fetal morbidity was found in radioimmunoassays of 487 samples of the fluid. The mean insulin level in metabolically normal pregnancies rose from 9 muU/ml (Week 27) to 15 muU/ml (Week 40). The insulin level in amniotic fluid of diabetic patients was elevated up to 27 times the mean. Insulin levels in the umbilical cord and urine of newborns of diabetic mothers were also elevated, to 29 and 21 times the mean, respectively. Elevation of insulin levels in amniotic fluid portends diabetogenic fetal morbidity. High and rising insulin levels at an early stage (26-28 weeks) may indicate a high risk of preterm onset of labor. Regular adjustment of metabolic compensation on the basis of amniotic fluid insulin made it possible to reduce the level in 12 of 17 pregnant diabetic women by increasing insulin dosage. The 12 women were thereby enabled to carry their pregnancies to term and to await the onset of spontaneous labor without diabetogenic fetal morbidity. Beta-stimulating agents affect glucose management and may cause elevated insulin levels in amniotic fluid.

Amniotic Fluid↗
PubMed1978

Alpha-fetoprotein content of amniotic fluid in normal and abnormal pregnancies.

Elevation above the normal range of alpha-fetoprotein (AFP) concentration in amniotic fluid occurs in the presence of certain fetal anomalies. The value of a new method for radioimmunoassay of APF in amniotic fluid was tested by an analysis of 486 samples taken by amniocentesis at various stages of pregnancy. The normal range of concentrations during pregnancy was established by 348 samples from healthy women with normal pregnancies. This was compared with the levels found in the presence of various fetal malformations--Rh-isoimmunization, maternal diabetes, chromosomal anomalies, and fetal death in utero. The findings and their implications are discussed.

Amniotic Fluid↗
PubMed1978

[Determination of the gestation period by means of ultrasound. Cephalometry in twins (author's transl)].

In 147 twin pregnancies, the biparietal diameter of the skull was determined by means of an ultrasound B-scan method. 574 individual measurements were evaluated. It was found that a marked flattening of the growth curve sets in from the 30th week of pregnancy, compared with single births. The difference amounted to 6 mm in the 40th week of pregnancy. The wavy shape of the mean value curve in twins up to the 30th week of pregnancy, appears particularly remarkable. The reason for this phenomenon could be seen in high-grade placental insufficiency causing spontaneous abortion or premature delivery. Accordingly, an increased incidence of abortion was recorded in the 21st and 25th week, as well as a peak in premature births in the 29th and 30th week of pregnancy. The heads of the twins were not equal in size. The average difference of the diameters of the skull was 6 mm.

Abortion, Spontaneous↗
PubMed1977

[The excretion of chorionic gonadetropin in 55 cases of hydatidiform mole (author's transl)].

In 55 cases of hydatidiform mole, 323 quantitative assays of chorionic gonadotropin were evaluated. In cases of molar degeneration the mean HCG excretion was 20% below normal. In cases of hydatidiform mole and invasive mole the mean HCG excretion was significantly above normal. Many cases of hydatidiform mole and all cases of invasive mole showed a repeat rise of the HCG titres after curettage. The pattern of HCG excretion in hydatidiform mole is shown in diagrams.

Chorionic Gonadotropin↗
PubMed1975

[The comparative value of ultrasound examinations and quantitative determinations of chorionic gonadotropin in the differential diagnosis of the disturbed early pregnancy (author's transl)].

The diagnostic value of ultrasound examinations is compared to the diagnostic value of determinations of the chorionic gonadotropin (HCG) excretion in normal and abnormal early pregnancy. 330 pregnancies between 5 and 16 weeks gestation were examined. there were 78 cases of normal early pregnancy, 131 cases of threatened abortion, 29 cases of missed abortion and 92 cases of incomplete abortion. the diagnostic accuracy of ultrasound examination was 95,5% in 582 determinations, the HCG excretions showed a diagnostic accuracy of 87,1%. The combined accuracy of both methods reduced the diagnostic error to 0,58%. The results in the different groups of patients were compared. Errors in ultrasound diagnosis decrease with increasing gestational age. Diagnostic errors were especially observed in cases of uterine retroversion, obesity or unknown menstrual history. The diagnostic accuracy of the HCG excretion is improved by serial determinations.

Abortion, Incomplete↗
PubMedDate not supplied

["IMO"--intraoperative mapping of ovarian cancer].

INTRODUCTION: The majority of patients diagnosed with ovarian cancer are in an advanced stage of the disease at the time of first diagnosis. The standard clinical staging (FIGO) occurs intraoperatively. The FIGO classification hides ambiguities and is useful as a means of orientation. However, an exact assessment of stage at first diagnosis, can form the basis for the evaluation of diagnostic and prognostic factors and furthermore has influence on adjuvant treatment. METHOD: We developed a systematic surgical and histopathological tumor documentation instrument, further we investigated its clinical and scientific application. RESULTS: Between September 2000 and July 2002, 128 patients with primary and recurrent ovarian cancer were operated and prospectively documented. The median age of the patients at the time of first diagnosis was 55 years. The majority of patients diagnosed with primary ovarian cancer had a diffuse tumor spread pattern (localised: 18 [32 %]; central: 14 [25 %]; diffuse: 24 [43 %]). In patients diagnosed with recurrent ovarian cancer the three defined tumor spread patterns showed a comparable distribution (localised 19 [28 %]; central: 19 [28 % ]; diffused: 29 [43 %]). While in most of the patients with primary ovarian cancer the highest tumor mass was concentrated in the lower abdomen/ pelvis, in comparison, in patients with recurrent ovarian cancer it was located mostly in the upper abdomen ("change of level", p=0,027). CONCLUSIONS: The IMO (Interoperative Mapping of Ovarian Cancer) represents a new instrument for a detailed and objective documentation of surgical and pathological results of patients with ovarian cancer and helps provide a more precise staging. Potentially this prospective documentation support the development of SOP's (Standard Operating Procedures) and could be an efficacious instrument of quality management.

Adult↗