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Biomedical subjects

B Hinney

Publications and source records attributed to B Hinney.

At least 37 records · Page 2Linked to original sources
PubMed1996

The corpus luteum insufficiency: a multifactorial disease.

The pulsatile release pattern of LH during the entire menstrual cycle is well defined; however, the response of corpora lutea to these LH pulses in patients suffering from corpus luteum insufficiencies (CLI) is largely unknown. Patients suffering from CLI were selected from infertile patients on the basis of low progesterone (P < 25 nmol/L) in a blood sample withdrawn during a monitoring cycle. During the next cycle, nine blood samples were collected during the follicular and luteal phase and follicular development was assessed by vaginal sonography. Of 109 patients who had a CLI in the monitoring cycle, 55 had a CLI again, and 38 women agreed to undergo assessment of pulsatile hormone secretion. These women again had P < 25 nmol/L at days 6 and 7 of the luteal phase and blood samples were withdrawn through antecubital vein catheters from 0900-1700 h at 10-min intervals on days 7, 8, or 9 following ovulation. From 38 patients with such defined CLI, 16 (42%) had no LH episode and significantly lower basal LH levels in comparison with 14 control subjects. Thirteen (34%) of the patients had normal appearing LH episodes despite too low P and E2 concentrations, but their CL did not react to the LH episodes. The remaining 9 patients (24%) had normal LH episodes; their CL reacted to these episodes, but their basal P levels were too low. In all blood samples LH was not only determined using an immunoassay but also by the mouse Leydig cell testosterone production bioassay. It could be established that no CLI exists, which is due to the release of bioinactive LH. It is anticipated that the differentiation of three different types of CLI, one of hypothalamic and two of ovarian origin, may allow the development of differential diagnostic and therapeutic tools in the future.

Adult↗
PubMed1995

Diagnosis of early ectopic pregnancy by measurement of the maternal serum to cul-de-sac fluid beta-hCG ratio.

In patients suspected of having an ectopic pregnancy, because of a positive beta-human chorionic gonadotropin (beta-hCG) test and a sonographically undetectable gestational sac, even laparoscopy cannot always achieve a precise diagnosis, when the gestational age is very early. This means that the patient has to be followed by repeated beta-hCG measurements and repeated laparoscopy, which are expensive and inconvenient for the patient. This paper reports on a method that is simple to perform and that will provide the clinician with valuable information about the strong likelihood of a tubal pregnancy when ultrasound and beta-hCG measurements raise the suspicion but are not diagnostic. A prerequisite for this approach is the availability of a minimal volume (1-2 ml) of peritoneal fluid in the pouch of Douglas. A total of 131 patients who had a positive beta-hCG test and an undetectable gestational sac within the uterine cavity and who had a small volume of cul-de-sac fluid were studied. The fluid was obtained transvaginally by means of an ultrasound-guided automatic puncture system. The beta-hCG level was determined in the cul-de-sac fluid and in the maternal serum, for comparison. In two cases with tubal pregnancy, concentrated viscous blood samples were aspirated and beta-hCG concentrations could not be measured for technical reasons. In 129 cases, the ratio of levels of beta-hCG between serum and cul-de-sac fluid could be measured. In 42 out of 44 patients with intrauterine pregnancy, the ratio was greater than unity; in 82 out of 85 patients with a tubal pregnancy, the ratio was less than unity. With this ratio used for detection of tubal pregnancy, the diagnostic sensitivity of the test was 95.4% and the specificity was 95.2%. The positive predictive value was 97.6% and the negative predictive value 91.3%. We conclude from these findings that the measurement of the maternal serum to cul-de-sac fluid beta-hCG ratio facilitated the early diagnosis of an ectopic pregnancy in the Fallopian tube.

Ascitic Fluid↗
PubMed1995

Micromorphometry and spermatozoa binding patterns of fertilized and unfertilized human oocytes after in-vitro fertilization.

Human oocytes (n = 380) from 71 in-vitro fertilization patients were measured 18 h after insemination to find out if certain parameters of oocyte morphology could be related to fertilization. In addition, the number and distribution patterns of spermatozoa bound to or within the zona pellucida of 534 oocytes were analysed. The mean diameter of the human oocyte was 167.7 +/- 9.5 microns and its mean volume was 2.5 x 10(6) micron 3. There were no significant differences in diameter between 112 fertilized and 168 unfertilized oocytes, although they displayed differences in the size of the perivitelline space and the zona pellucida. The age of the patients had no significant effect on the morphometry of the oocytes. Sperm binding patterns did not correlate with fertilization. The number and distribution of the spermatozoa on the surface of the zona pellucida was extremely heterogeneous and was not related to the occurrence of fertilization. All possible binding and distribution patterns were in the same range in both fertilized and unfertilized oocytes. In conclusion, the micromorphometry of human oocytes and their sperm binding patterns were not related to the occurrence of fertilization.

Adult↗
PubMed1995

Regulation of luteal function by luteinizing hormone and prolactin at different times of the luteal phase.

In 54 healthy women luteal function was assessed by sequential withdrawals of blood samples at 10-min intervals for 8-10 h. Subgroups of the women were studied during the early and late ovulatory period and during the early, mid- and late luteal phase. Bio- and immunoreactive luteinizing hormone (LH), prolactin, testosterone, estradiol and progesterone levels were determined in each sample. While the bio- and immunoreactivity of LH pulses correlated fairly well, a number of bio- or immunoreactive LH pulses were observed that were not detected by the respective other method. Responsivity of the corpus luteum to LH episodes developed during the second half of the luteal phase and was most marked in cases where LH episodes were accompanied by prolactin episodes. In the absence of prolactin episodes. LH episodes did not stimulate progesterone or estradiol secretion. The highest incidence of coincident LH and prolactin pulses was observed during the mid- and late luteal phase. Serum testosterone levels showed also some fluctuations but these were independent of immuno- or bioactive LH episodes and therefore most likely not of luteal origin. Prior to menstruation LH episodes were not any more stimulatory to progesterone secretion, indicating that it is not the withdrawal of LH but, rather, another possibly intraovarian mechanism that results in luteolysis. In a number of women, increased estradiol and progesterone secretion was strictly related to the prior occurrence of LH and prolactin pulses. In other subjects, both gonadal steroids fluctuated largely with no discernible correlation to LH fluctuations. This may indicate that in these subjects the corpora lutea have some degree of autonomous regulation.

Adolescent↗
PubMed1994

Overexpression of the oncogene c-erb B2 in primary ovarian cancer: evaluation of the prognostic value in a Cox proportional hazards multiple regression.

To date, there are no prognostic factors in ovarian cancer that adequately account for tumor biology and disease behavior. In recent years, some reports have described the prognostic significance of the amplification and overexpression of the oncogene c-erb B2 in various human cancers. Concerning ovarian cancer, this is still a matter of discussion. In the present study, tumor tissue of 275 patients treated for ovarian cancer at the Department of Obstetrics and Gynecology of the University of Göttingen between 1982 and 1992 was immunohistochemically analyzed for overexpression of c-erb B2-encoded transmembrane protein p185. In 19% (51 of 275 cases), p185 overexpression was detected. The percentage of p185-positive cases varied from 7 to 46% according to histological subtype. Correlation with tumor stage and the degree of histological differentiation was not observed. Patients with p185-positive tumors had a significantly worse prognosis (p = 0.001); median survival was 20 months compared with 33 months for p185-negative tumors. In the Cox proportional hazards regression, p185 overexpression was identified as an independent prognostically relevant factor. These results suggest that overexpression of oncogene c-erb B2 in ovarian cancer characterizes a group with unfavorable tumor biology and a significantly worse prognosis.

ErbB Receptors↗
PubMed1993

Factor XII (Hageman) deficiency in women with habitual abortion: new subpopulation of recurrent aborters?

OBJECTIVE: To examine the possible association between factor XII (FXII) deficiency and an elevated number of abortions. DESIGN: Factor XII activity, FXII antigen concentration, other blood clotting parameters, and phospholipid antibodies were examined in venous blood from 43 women with repeated (3 to 7) abortions before the 28th week of gestation but without gynecological and chromosomal abnormalities. The data were compared with those obtained from 49 age-matched women without fetal loss. RESULTS: Eight cases with moderately reduced FXII activity (35% to 68% of normal) could be identified in the abortion group, whereas among controls no abnormalities in FXII activity and antigen concentration were found. The relative occurrence of reduced FXII level was higher among patients with more than three abortions as compared with those with three abortions. CONCLUSION: Repeated abortions may be associated with reduced level of FXII activity of unknown origin.

Abortion, Habitual↗
PubMed1992

[Overexpression of c-erbB-2 oncogene in primary ovarian cancers: incidence and prognostic significance in 243 patients].

In ovarian cancers, no valuable prognostic factors are available so far for predicting biological behaviour and clinical outcome. During the last years, overexpression of c-erbB-2-oncogene has been reported to be a prognostic factor in various human carcinomas. Its prognostic value in ovarian cancer is still a matter of controversy. The records and histological specimens of 243 patients with primary ovarian cancer were reviewed. Overexpression of c-erbB-2-oncogene encoded transmembrane protein p185 was determined immunohistochemically using polyclonal and monoclonal antibodies. Of 243 investigated tumours, 45 (19%) were positive. We examined the relationship between p185 and clinical stage, histological type, grading and prognosis. p185 overexpression differs within the histological subtypes of tumours. No correlation was found between p185 overexpression and stage or histological grade. The follow-up data demonstrate that patients with positive staining for p185 have a significantly worse prognosis (p = 0.001) than those with negative staining. These results suggest that overexpression of c-erbB-2 oncogene is associated with higher biological aggressiveness and unfavourable course of disease.

Adenocarcinoma↗
PubMed1992

Comparison of luteinizing hormone pulsatility in the serum of women suffering from polycystic ovarian disease using a bioassay and five different immunoassays.

Bioassays and immunoassays of protein hormones often read different parts of the molecule and give conflicting results. Therefore, we studied the LH bioactivity (bLH; mouse Leydig cell testosterone production assay) and immunoreactive LH (irLH) using five immunoassays [one conventional polyclonal RIA and four immunometric sandwich assays using monoclonal antibodies (mAB)] in five women suffering from polycystic ovarian disease (PCOD). Blood samples were taken from these patients at 10-min intervals for 24 h. Data were analyzed by the PC Pulsar pulse detection program. As described by others, bLH is increased in PCOD patients, and LH pulse frequency is largely accelerated (18-28 pulses/24 h). Almost every LH pulse was detected by the polyclonal RIA, whereas all mAB immunoassays detected significantly fewer pulses than the bioassay or the RIA. Occasionally, irLH pulses were detected by some assay systems when bLH activity did not increase, and there was a great difference in the temporal occurrence of bLH and irLH pulses. It is concluded that the type of immunoassay used for the detection of LH levels is also of importance for the number of detected LH pulses. Furthermore, each mAB immunoassay appears to detect different epitopes on the LH molecule, such that different conformational and/or glycosilated states are identified. Often, irLH pulses occur with no concurrent bLH pulses, which may indicate that the pituitary in PCOD patients releases pulses of biologically inactive LH in response to hypothalamic GnRH release. Hence, the pituitary gonadotrophs must be in some degree of synchrony in producing such biologically inactive material.

Biological Assay↗
PubMed1991

[Diagnosis of early extrauterine pregnancy by serum and Douglas pouch fluid hCG level].

In 44 patients with assumed ectopic pregnancy culdocentesis were carried out under transvaginosonographic control. In 23 cases, the clinical diagnosis ectopic pregnancy and in 16 cases, an early intact intrauterine pregnancy could be verified. Five patients had an early abortion. In all patients with an intact intrauterine pregnancy, the cul-de-sac liquid was serious. In 16 of the 23 cases of ectopic pregnancies, the fluid was bloody, 6 aspirates were bloody/serous and one serous. The findings in patients with an early abortion were as follows: three serous, one bloody/serous, one bloody. Further information could be gathered from the comparison of hCG-levels in simultaneously obtained serum samples and cul-de-sac liquid. All intact intrauterine pregnancies were associated with lower hCG-levels in the cul-de-sac liquid than in the serum (ratio: serum/cul-de-sac liquid greater than 1.3). In all ectopic pregnancies but one, we found an inverse constellation (ratio: serum/cul-de-sac liquid less than 0.7). In the described exceptional case the ratio was nearly 1 and when culdocentesis was repeated 5 days later, a ratio of 0.17 proved the clinically suspected ectopic pregnancy. In 3 cases of histologically confirmed intrauterine abortions, the hCG-level in the cul-de-sac liquid was lower than in the serum, in 2 cases of early abortions without histologically proved localisation the hCG-level was slightly above the level in the serum.

Abortion, Spontaneous↗
PubMed1991

[Immunotherapy for the prevention of abortion].

It is now commonly assumed that a normal, successful pregnancy requires the specific recognition of the trophoblast by the immune system of the mother, resulting in production of protective or blocking factors (BF). In habitually aborting women, this recognition and/or BF production does not seem to occur. Immunisation of patients with leukocytes from the partner or from donors is postulated to induce these BF and to prevent fetal loss. After the exclusion of nonimmunological causes, 31 patients with at least three previous abortions and no pregnancies lasting longer than 16 weeks, were immunised with leukocytes from their partners. Eight women were already pregnant when treated, 15 became subsequently pregnant. Seventeen (= 74%) had uncomplicated pregnancies, six suffered again from early pregnancy loss. All 15 children, born so far had average birth weights and developed normally. The EAI-test (Power 1983) was of prognostic value: an increase of more than 50% in rosette inhibition activity in the serum of treated patients, correlated well with the successful outcome of their pregnancies; whereby the lack of this increase was associated with another early pregnancy loss. We could not confirm the reported of higher HLA-identity of couples with habitually aborting women, compared to fertile couples. HLA-typing (A, B, C, DR, and DQ) showed a higher proportion of identical allo-types in a group of 33 fertile couples than in a group of 44 couples with habitual abortions. This finding was significant (p less than 0.05).

Abortion, Habitual↗
PubMed1990

[Clinical management of cystic ovarian tumors].

In a prospective study at the University of Göttingen 206 cystic ovarian tumours were examined vaginosonographically. Basing on a graduated schedule, the individual therapy of each ovarian tumour was determined. By use of this clinical management, all blastomas could be detected correctly and in 6.8% of all cases a follicle or corpus luteum cyst was operated per laparotomiam. Basing on the created data, the authors suggest a simple and effective clinical management of cystic ovarian tumours.

Adolescent↗
PubMed1990

[CA-125 serum level in early pregnancy follow hMG/hCG stimulated and unstimulated cycles].

The CA-125-antigen could not only be identified in the epithelium of serous ovarian carcinoma, but also in the regular surface epithelium of the endometrium, the decidua and the peritoneum. The aim of this study was, to examine the pattern of CA-125 in the serum of women at early stages of pregnancy, after hMG/hCG-stimulation and subsequent insemination, IVF or GIFT. In particular, it was differentiated between simple or twin pregnancies, ovarian hyperstimulation syndrome and mole pregnancies. 16 patients, who spontaneously became pregnant after cyclus-monitoring, served as a control group. Among the total of 77 patients, 16 women with single pregnancies without stimulation showed an increase of CA-125 values to maximum amounts of 42.9 +/- 18.8 U/ml in the 8th week. 21 patients with single pregnancies after hMG/hCG-treatment and IVF, exhibited maximums of 97.5 +/- 66.8 U/ml in the 6th week, in cases of twins (n = 10) of 216.8 +/- 85.1 U/ml in the 7th week. Considering the group with the hMG/hCG-stimulation and following insemination (n = 20), maximum values of 91.4 +/- 57.3 U/ml were found in the 6th week, just as in the IVF-group. In cases of ovarian hyperstimulation syndrome (n = 5) as well as in such of a mole pregnancy (n = 5), drastically elevated values of 9519 and 1496 U/ml respectively, have been demonstrated. The decidua is regarded as a presumable source of high antigen levels in normal pregnancy, while the peritoneum is assumed to be such as for the ovarian hyperstimulation syndrome. Concerning mole pregnancy, the antigen levels could possibly emerge from the amniotic fluid.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomarkers, Tumor↗
PubMed1989

[Immunotherapy of couples with habitual abortion].

After habitual abortions and the exclusion of nonimmunological causes of miscarriage, 26 patients were treated with lymphocytes of their partners of prophylaxis of abortion. The first treatment was done during early pregnancy in eight patients. Of the remaining 18, 12 have become pregnant up to now. Five pregnancies have gone to term, one is in the 13th week at the moment, and five are in the 20th week. Two patients lost their baby after the 20th week due to nonimmunological causes. Again seven patients had an early spontaneous abortion. Thus, the success rate of the immunological therapy is 63.2% at the moment.

Abortion, Habitual↗
PubMed1989

[Documentation of surgical data with dBASE-III].

By the development of microelectronic it is nowadays possible to manage even large amounts of data by personal computers (PC). Quality control and a prescribed operationstatistics compels to use a computer. In most cases, however, the employment of a computer fails because of the lack of adequate soft-ware. As a basis of such a use the relational data bank system dBASE-III offers it's services. The introduced system OPSTAT serves to fill in and to control the operation manual and makes it possible to register and to analyse all operations, diagnoses, complications and special risk factors.

Documentation↗