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A Reinthaller

Publications and source records attributed to A Reinthaller.

At least 55 records · Page 3Linked to original sources
PubMed1995

Splice variants of CD44 in human cervical cancer stage IB to IIB.

Aberrant expression of the cell adhesion molecule CD44 has been detected in human tumors and the expression of specific CD44 isoforms (splice variants) has been shown to be associated with metastasis and poor prognosis in human malignancies. We used three different variant exon sequence-specific murine monoclonal antibodies to epitopes encoded by exon v5, exon v6, or exon v7-v8 of human variant CD44 to study the expression of CD44 splice variants by immunohistochemistry in human cervical cancer. One-hundred five patients with surgically treated squamous cell carcinomas of the cervix stages IB to IIB were included in the study. CD44 splice variants CD44v5, CD44v6, and CD44v7-8 were detected in 70, 67, and 26%, respectively. Tumors expressing exon v6 had significantly more often metastasized to the pelvic nodes (58 vs 79%, P = 0.04). Expression of exon v6 was significantly correlated with a greater probability of vascular space invasion (73 vs 50%, P = 0.04) and a significantly lower rate of inflammatory stromal reaction (48 vs 78%, P = 0.004). Patients suffering from tumors expressing splice variant CD44v6 showed poorer overall survival (P = 0.03). In cases with negative pelvic lymph nodes we found a poorer prognosis when tumors expressed CD44v6 (P = 0.01) or CD44v7-8 (P = 0.02). Among the investigated CD44 splice variants expression of exon v6 is the most promising prognostic marker in surgically treated cervical cancer.

Adult↗
PubMed1995

Influence of age and human papillomavirus-infection on reliability of cervical cytopathology.

The aim of the present study was to evaluate the effect of age and human papillomavirus (HPV) infection associated cellular changes on the predictive value of cervical cytology. In a group of 671 women with Papanicolaou smears suggesting low grade squamous intraepithelial lesion (LSIL), a high grade squamous intraepithelial lesion (HSIL) or invasive cervical cancer, cervical cytology was correlated with the histological finding. Predictive values were calculated and related to severity of the lesion, age and HPV associated changes. The predictive values of Papanicolaou (cervical) smears suggesting LSIL, HSIL and invasive carcinoma were 40%, 86%, and 78%, respectively. A poor predictive value of smears suggesting LSIL was found among older women. HPV associated changes were diagnosed in 80% of women < or = 25 years of age, 66% in the age group 26 to 35 years, 51% in the age group 36 to 45 years and 38% in women aged > or = 46 years (P = 0.03). The presence of HPV associated cellular changes led to a significantly higher number of overdiagnoses (9% with HPV infection compared to 4% without HPV infection) and HPV negative cases were more frequently associated with underdiagnosis (15% without HPV infection compared to 8% with HPV infection, P = 0.0011). This result remained significant after adjustment for age (P = 0.004). Cellular changes associated with HPV infection most frequently occurred in young women. HPV infection should therefore be acknowledged as source of overdiagnosis in the cytological evaluation of SIL especially in young women.

Adult↗
PubMed1995

[Sarcoma botryoides (embryonal rhabdomyosarcoma) as an unusual diagnosis of cervix polyps].

Embryonal rhabdomyosarcomas of the female genital tract usually occur during infancy in the vagina. Only in rare cases can they be found in the cervix, where they are most commonly seen in adolescence. Their prognosis seems to be good since the introduction of a combination of surgery and chemotherapy. We report a case of cervical embryonal rhabdomysarcoma in IRS stage Ia in a 32-year-old female. After surgical resection and chemotherapy there has been no evidence of disease for 7 months. The case is compared with the published literature and prognostically relevant features, and possible problems in the differential diagnosis in biopsies are discussed.

Adult↗
PubMed1995

Prognostic value of CD44 splice variants in human stage III cervical cancer.

The expression of specific cell adhesion molecule CD44 isoforms (splice variants) has been shown to be associated with poor prognosis in human malignancies, such as breast cancer. We used three different variant exon sequence-specific murine monoclonal antibodies to epitopes encoded by exons v5, v6 or v7-v8 of human variant CD44, to study the expression of CD44 splice variants by immunohistochemistry in human stage III cervical cancer. We investigated 40 pretreatment punch biopsies of cervical cancer FIGO stage III. CD44 splice variants CD44v5, CD44v6 and CD44v7-8 were detected by means of immunohistochemistry in 90%, 55% and 25%, respectively. CD44 epitopes encoded by exon v5 were not correlated with prognosis. Expression of CD44 splice variants containing epitopes encoded by exon v6 were correlated with significantly poorer prognosis (Mantel test, P = 0.008). Five-year survival rates with or without CD44v6 expression were 20% versus 71%, respectively. Expression of CD44v7-8 was also correlated with significantly poorer overall survival (Mantel test, P = 0.02). Expression of CD44 splice variants containing epitopes encoded by exons v7-v8 and especially exon v6 is associated with significantly poorer prognosis in stage III cervical cancer patients.

Aged↗
PubMed1995

Immunohistochemical and serological evaluation of CD44 splice variants in human ovarian cancer.

The surface glycoprotein CD44 is widely distributed in different tissues. In contrast to healthy tissue, tumour samples show a more complex pattern of CD44 expression, indicating a loss of splice control. Beside cell-surface expression, the measurement of soluble CD44 in serum of cancer patients could be useful in early diagnosis and assessment of disease status. We evaluated the surface expression of CD44 isoforms in 22 ovarian cancer patients by means of immunohistochemistry. Additionally, we investigated 134 serological samples of these patients for the occurrence of CD44 isoform expression. For CD44 standard, CD44v5 and CF44v6 mean serum levels in patients with clinically detectable or non-detectable ovarian cancer were 422.4 +/- 143.8 ng ml-1 and 547.4 +/- 148.2 ng ml-1, 12.3 +/- 7.9 ng ml-1 and 21.9 +/- 12.2 ng ml-1 and 105.5 +/- 37.9 ng ml-1 and 144.9 +/- 50.9 ng ml-1 respectively (P-values not significant). CD44 surface proteins containing epitopes encoded by splice variants CD44v5, CD44v6 and CD44v7-8 were immunohistochemically detected in 9% (n = 2), 13% (n = 3) and 4% (n = 1) of the 22 tumour samples respectively. In the present study we showed that in ovarian cancer CD44 isoforms CD44v5 and CD44v6 are expressed in very low amounts by the tumours. In accordance with this, we found that the presence of tumour is not associated with higher serum levels of CD44standard, CD44v5 and CD44v6 in preoperative serum samples in ovarian cancer patients.

Adult↗
PubMed1995

[The Bethesda system--an improvement in classification of cervix cytology?].

Cervical cytology screening programmes have significantly reduced cervical cancer mortality. In 1988 the National Cancer Institute developed a new classification for reporting cervical cytology--"The Bethesda System". The aim of our study was to compare the clinical usefulness of this new classification with the classification used in German-speaking countries (which discriminates cytologically between moderate and severe dysplasia) including a verbal classification predicting the histological grade of cervical intraepithelial neoplasia (CIN I, II, III). 671 patients with abnormal cervical cytology results and subsequent conisation or hysterectomy were included. We correlated cytological and histological diagnosis (gold standard). In cases of cytologically suggested moderate dysplasia we found histologically CIN I, CIN II and CIN III in 11%, 41% and 42%, respectively. Our results show that discrimination of CIN II and CIN III by means of cytology is limited. Using our therapy schedules we found that adequate therapy is possible by each of the cytological classification systems. The cervical smear is used as a screening test to determine which women require further examination using colposcopy. Under these circumstances an adequate therapy is possible with both classifications. The results underline the importance of colposcopy in the management of cervical dysplasia. As long as conisation is commonly used in German-speaking countries as the only diagnostic tool after an abnormal cervical smear the Bethesda System increases the risk of overtreatment.

Adult↗
PubMed1995

[CD44 splice variants as prognostic factors in invasive cervix carcinoma].

OBJECTIVE: Aberrant expression of specific isoforms of the cell adhesion molecule CD44 has been detected in various malignant human tumors. We wanted to verify whether the expression of these splice variants was associated with a higher incidence of metastasis and poor prognosis. METHODS: We studied the expression of CD44 splice variants v5, v6 and v7-8 by immunohistochemistry in human cervical cancer. 105 surgically treated patients with cervical cancer of stages IB-IIB were included in the study. RESULTS: Tumors expressing exon v6 had significantly more often metastasized to the pelvic nodes (p = 0.04), and patients suffering from tumors expressing CD44v6 showed poorer overall survival. Even in cases with negative pelvic lymph nodes, we found a significantly poorer prognosis when tumors expressed CD44v6. CONCLUSIONS: Among the investigated CD44 splice variants, expression of exons v6 and v7-8 is the most promising prognostic marker in cervical cancer. They can possibly identify patients with an increased risk earlier than morphologic prognostic parameters.

Carcinoma, Squamous Cell↗
PubMed1995

Concentrations of various arachidonic acid metabolites in menstrual fluid are associated with menstrual pain and are influenced by hormonal contraceptives.

In a pilot study we investigated the association between concentrations of various eicosanoids in menstrual blood with pain and oral contraceptive use. Menstrual fluid was collected on tampons by 12 women who did not use an oral contraceptive but suffered from slight primary dysmenorrhea and by three pain-free women who used an oral contraceptive. Eicosanoids (cyclooxygenase products: 6-ketoprostaglandin F1 alpha, thromboxane B2, prostaglandin E2, prostaglandin F2 alpha, 13,14-dihydro-15-ketoprostaglandin F2 alpha, 12-hydroxy-heptadecatrienoic acid; lipoxygenase products: 5-, 12-, 15-hydroxy-eicosatetraenoic acid (HETE), leukotriene B4, leukotriene C4, leukotriene D4, leukotriene E4) and female sex steroids (17 beta-estradiol and progesterone) were analyzed by the combined use of high-performance liquid chromatography and radioimmunoassay. 12-HETE was the main arachidonic acid metabolite. An increased metabolism of arachidonic acid was associated with pain, especially when synthesis of 12-HETE was elevated. Oral contraceptive use decreased the synthesis of prostaglandins as well as leukotrienes. The concordant changes of cyclooxygenase and lipoxygenase products in dysmenorrhea or in oral contraceptive use may be explained by an increased or decreased phospholipid metabolism, respectively.

12-Hydroxy-5,8,10,14-eicosatetraenoic Acid↗
PubMed1995

[Electro- versus laser surgery for conservative laparoscopic revision of tubal pregnancies].

The objective of this study was to determine possible benefits of carbon dioxide laser over electrosurgical usage in conservative laparoscopic treatment of ectopic pregnancies (EP). 41 ectopic pregnancies managed by laparoscopic surgery were analysed retrospectively in regard to operation time, intraoperative blood loss and postoperative complications. No significant differences between both groups were observed. According to our data no advantage of the CO2 laser over electrosurgery in the conservative laparoscopic management of EP's could be demonstrated.

Adolescent↗
PubMed1994

Microsurgical treatment of tubal sterility using the CO2 laser: a reasonable alternative to IVF in cases of tubal sterility.

A retrospective analysis of women treated microsurgically using the CO2 laser in sterility treatment was performed. The aim of the study was to determine women's personal feeling about the procedure, prognostic factors, success rates, and complications. Included were 192 patients with tubal occlusions or pelvic adhesions treated by means of CO2 laser microsurgery between February 1984 and July 1992. A standardized questionnaire was used to evaluate women's procedure-related stress, extrauterine and intrauterine pregnancy rates, pregnancy complications, and postoperative complaints. In 75 cases, records and questionnaires contained sufficient data and were included for further analysis. Adhesiolysis alone, unilateral neosalpingostomy, bilateral neosalpingostomy, or new implantation was done in 7%, 52%, 33%, and 8%, respectively. In the range of 1-10, a medium degree procedure-related stress (mean 4.3, range 1-10) was expressed by the treated women. No surgery-related complications were observed. The overall pregnancy rate was 37.3%, and 10.7% were tubal pregnancies. In 26.7%, fertility surgery resulted in intrauterine pregnancies, and 21.3% of the treated women delivered living children. Three women had two consecutive pregnancies after surgery. Women with intrauterine pregnancy, extrauterine pregnancy, and no pregnancy had a mean age of 29.5 +/- 3.8, 27.3 +/- 5.3, and 32.3 +/- 4.2 years, respectively (p = NS). Mean duration of infertility before start of surgical treatment was 42.4 +/- 34.6, 41.6 +/- 25.8, and 48.8 +/- 33.2 months, respectively (p = NS). Intraabdominal instillation of streptokinase to prevent reformation of adhesions had no significant impact on tubal patency results or pregnancy rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Fallopian Tube Diseases↗
PubMed1994

Immunohistochemical study of in vivo and in vitro IgA coating of candida species in vulvovaginal candidiasis.

OBJECTIVE: To evaluate whether quantitative or qualitative IgA deficiencies in cervicovaginal secretions can be identified in patients with recurrent vulvovaginal candidiasis. DESIGN: Prospective and controlled study. SETTING: Department of Dermatology, University of Vienna. SUBJECTS: 30 patients with symptomatic and recurrent vulvovaginal candidiasis at the time of their presentation. 30 healthy women as a control group. INTERVENTION: Blood samples were drawn for measurement of serum IgA levels. Smears of the cervix and vagina were taken for direct microscopy and microbiological culture. Lavage of the vagina and ectocervix was performed with sterile saline solution for measurement of cervicovaginal IgA levels. MAIN OUTCOME MEASURES: IgA levels of serum and cervicovaginal secretion evaluated by Single Radial Immunodiffusion. IgA labelling was demonstrated on fungal elements in vaginal smears and subcultured blastospores after incubation with vaginal secretions by immunohistochemistry. RESULTS: We could not find any significant difference of IgA levels in serum and cervicovaginal secretions between the symptomatic group and healthy controls (p value for serum = 0.5796, p value for secretion = 0.2381). In vaginal smears yeasts revealed IgA coating on their surfaces, whereas three of the 61 subcultures were negative. Negative subcultures were assigned to three patients with recurrent candidiasis. No correlation was found between IgA levels of cervicovaginal secretions and staining intensity of subcultured blastospores after incubation with vaginal secretions (r = -0.0578). IgA levels of serum and vaginal secretion showed no correlation (r = -0.00012). CONCLUSION: Recurrent vulvovaginal candidiasis cannot be attributed to IgA deficiency. In some cases an IgA coating defect of yeasts might be involved. In addition inactivation of the IgA molecule by candida proteases might be of pathogenetic importance.

Adolescent↗
PubMed1994

Zinc levels of serum and cervicovaginal secretion in recurrent vulvovaginal candidiasis.

OBJECTIVE: To determine whether zinc deficiency in serum or vulvovaginal secretion is a risk factor for recurrent vulvovaginal candidiasis. DESIGN: Prospective and controlled study. SETTING: Department of Dermatology, University of Vienna. SUBJECTS: 21 women who had experienced at least three documented episodes of acute vulvovaginal candidiasis within the previous 12 months. Fifteen women without anamnesis of vulvovaginal candidiasis as a control group. INTERVENTIONS: Blood samples were drawn for measurement of plasma zinc levels. Lavage of the vagina and ectocervix was performed with sterile saline solution for measurement of cervicovaginal zinc levels. MAIN OUTCOME MEASURES: Zinc levels of serum and cervicovaginal secretions were determined by flame atomic absorption spectrophotometry. RESULTS: We found no significant difference in the mean zinc concentration of plasma and cervicovaginal secretions between the recurrent vulvovaginal candidiasis and the control group. (p value for serum = 0.71, p value for secretion = 0.80). Zinc levels of plasma and cervicovaginal secretions showed no correlation (patient group: r = -0.05, control group: r = -0.07). CONCLUSION: It is well known that zinc not only exerts a major impact on different immune functions, but also participates in growth and morphogenesis of Candida albicans. Our results could not confirm the previous hypothesis that zinc deficiency of serum is a risk factor in recurrent vulvovaginal candidiasis. It is possible that the local zinc level of cervicovaginal secretions essentially influences antifungal activity of third generation azole antimycotics.

Adult↗
PubMed1994

[Radiosurgical treatment of cervical intraepithelial neoplasia].

In the present study we present our experience and data with loop electrosurgical excision procedures for the treatment of human papilloma virus (HPV)-associated lesions and intraepithelial neoplasia of the cervix. 58 patients underwent loop excision because of colposcopically suspect cervical lesions. In 78 cases cone biopsy (large loop excision of the transformation zone, LLETZ + partial resection of the cervical canal) was performed. In 80% of the loop excisions the lesions were removed with clear resection margins. Patients undergoing LLETZ conization were compared to patients who had a cold knife conization previously. The two groups were matched with regard to age, parity and histology. The cone specimen of patients with LLETZ conization revealed lesion-free margins in 93% compared to 87% in the group with cold knife conization. Operation time and duration of hospital stay were significantly shorter in the group of LLETZ conization. Loop electrosurgical excision procedures therefore represent an adequate method for the treatment of HPV-associated lesions and intraepithelial neoplasia of the cervix.

Biopsy↗
PubMed1994

Development and influence of an endogenous serum luteinizing hormone surge after ovulation induction in stimulated cycles.

The aim of this study was to investigate whether the endogenous serum luteinizing hormone (LH) discharge in stimulated cycles--either simultaneously with or shortly after exogenous human chorionic gonadotropin (hCG) administration--is influenced by serum steroid hormones and follicle stimulating hormone (FSH). We also tested whether the LH discharge affects intrafollicular hormone metabolism and oocyte fertilization. In a group of 46 women with tubal pathology who were undergoing in vitro fertilization (IVF), follicular fluids were collected during oocyte retrieval. In addition blood samples were drawn daily, starting at cycle day 7 until the day of oocyte retrieval. LH, FSH, estradiol, progesterone, testosterone and prolactin were determined in all samples of serum and follicular fluid. Oocyte maturation was classified according to the morphology of the oocyte corona-cumulus complex. Of the 46 women studied, 15 showed no LH surge (group A) and 31 developed an endogenous LH surge (group B). Serum samples showed no significant differences between the two groups in follicular phase estradiol, progesterone, testosterone and prolactin. Only levels of serum FSH showed a significant difference between groups A and B (p < 0.0005). In follicular fluid samples LH (p < 0.05) and FSH levels (p < 0.005) were significantly different. Fertilization rate and cleavage rate, however, did not differ significantly. The late endogenous LH surge occurring simultaneously with or shortly after hCG application for ovulation induction did not affect intrafollicular steroid metabolism, oocyte maturation, fertilization rate or cleavage rate.

Adult↗
PubMed1994

The diagnostic value of magnetic resonance imaging for the detection of tumor recurrence in patients with carcinoma of the ovaries.

Disease status during follow-up evaluation of patients with carcinoma of the ovaries is the main criterion for the selection of appropriate management. A cohort analysis was performed to investigate if magnetic resonance imaging (MRI) could improve noninvasive assessment of disease status in patients with carcinoma of the ovaries during follow-up examination. Twenty-four women with carcinoma of the ovaries after primary surgical treatment with subsequent platinum containing chemotherapy were entered into the study. MRI was performed in addition to sonography and computed tomography (CT). Patients without evidence of disease underwent restaging laparotomy. Sensitivity of sonography, CT and MRI was 50, 63 and 75 percent, respectively. Combination of CT and MRI revealed a 75 percent sensitivity rate. Specificity for sonography, CT and MRI was 100, 94 and 94 percent, respectively, and for the combination of CT and MRI, 88 percent. Positive and negative predictive value and accuracy of these methods were 100, 80 and 83 percent for sonography; 83, 83 and 83 percent for CT; 86, 88 and 88 percent for MRI, and 75, 88 and 83 percent for the combination of CT and MRI. In one instance of false-negative sonographic and CT results, MRI detected recurrence located in postoperative scar tissue. In one instance, MRI did not add essential information to the other imaging methods. Therefore, MRI as a time- and cost-intensive procedure should be reserved for instances in which there are doubtful findings arising with other diagnostic tools, rather than as an indispensable routine procedure in the follow-up evaluation of patients with carcinoma of the ovaries.

Adult↗