Biomedical subjects

B Hinney

Publications and source records attributed to B Hinney.

50 records · Page 3Linked to original sources

PubMed1989

[Diagnostic in-vitro fertilization].

Unexplained sterility is one of the major problems in the treatment of childless couples. The reason for sterility can be the result of different factors such as andrological or anatomic-physiological dysfunctions. The therapeutic approach to treat patients with unexplained sterility at the Department of Obstetrics and Gynecology, University of Goettingen, is, to exclude those patients from further therapies who obviously have no chance to become pregnant by any technique of reproductive medicine. A so called "diagnostical IVF" gives information about the fertilization capacity of male and female gametes in vitro. The results of a one year study with 85 couples (tubal sterility = 57; idiopathic sterility = 28) indicated, that even with no differences in the number of oocytes retrieved, the fertilization and cleavage rates were significantly higher in the group of patients with tubal sterility (fertilization rate: 63.1% vs 46.1%; cleavage rate: 57.5% vs 40.6%). Thus the transfer rate in patients with unexplained sterility was about 15% lower (68.9%) than in patients with tubal sterility (85.6%). On the other hand, after embryo transfer the pregnancy rate was double in those patients with unexplained sterility (38.7 vs 15.7%). If there is no fertilization of the oocytes in at least two IVF cycles all attempts to fulfill the patients desire for a child seem useless. In contrast successful in vitro fertilization provide the bases for further intrauterine insemination cycles which can be assisted by psychotherapy. This regimen seems helpful to classify patients with unexplained sterility and avoids long lasting frustrating therapies.

Embryo Transfer↗

PubMed1988

Angiotensin II/III and substance P in human follicular fluid obtained during IVF: relation of the peptide content with follicular size.

Ovarian follicular fluid (FF) of a number of species contain regulatory peptides secreted by granulosa cells or by autonomic nerve terminals. In this report we demonstrate the presence of authentic (HPLC-verification) angiotensin II and III as well as of substance P (SP) in human FF obtained from hMG stimulated infertile patients undergoing in vitro fertilization. Angiotensin II/III (AII/III), estradiol (E2) and progesterone concentrations increase with the size of the follicles. SP concentrations did not vary significantly in FF of various sizes. These peptide concentrations in FF are about 10-fold higher than those measured in the serum of the same patients. Attempts to correlate SP, AII/III, E2 and progesterone concentrations in the individual FF with the ability of an oocyte to be fertilized, failed. Neither AII/III, SP, E2 nor progesterone concentrations were different in these subclasses of FF. Follicles of patients punctured under general anesthesia contained significantly more SP than follicles of patients which had lumbar analgesia. AII/III concentrations were the same in FF of both treatment groups. The presence of angiotensin II and III in FF in increasing concentrations depending on the maturity of the follicle and the inability of general anesthesia to affect the AII/III concentrations suggests that this peptide is produced within the ovary.

Anesthesia, General↗

PubMed1986

[Postoperative therapy of epithelial ovarian cancer at the Göttingen University Gynecologic Clinic. A retrospective analysis of 82 patients 1981-1984].

An epithelial ovarial carcinoma was diagnosed and treated during 1981 to 1984 in 82 patients of the Department of Gynaecology of the University of Göttingen. The diagnostic approach and therapy are described in the paper by Grospietsch et al. [Geburtsh. u. Frauenheilk. 46 (1986), 588]. The present paper deals with the results of postoperative treatment, with particular emphasis on those factors presently considered to be prognostically relevant, such as postoperative tumour residue, age of the patient and stage of tumour spread. The results are classified according to rate of response, progression-free interval and survival time or survival rate. Analysis of the results shows that on the one hand an improvement of long-term results (survival time) has been very unsatisfactory with present-day methods--and moreover, that partly such long-term results are obtained only on the basis of an accurate diagnosis--whereas on the other hand the short-term results (tumour-free interval) together with a clear improvement of the quantity and quality of life do justify the considerable effort required by the treatment concept. Improvement of the overall result is more likely to be achieved by clinical and preclinical research towards consolidation of the primary therapy effect than by employing "trial-and-error" methods within the framework of primary therapy.

Adult↗

PubMed1985

Effects of medrogestone and conjugated oestrogens on serum lipid and lipoprotein concentrations.

Twenty patients, aged 30-60 yr, who had undergone bilateral ovariectomy, were treated orally with 5 mg medrogestone (6,17-dimethylpregna-4,6-diene-3,20-dione) and 1.25 mg conjugated oestrogens per day, according to a constant dosage pattern during the cycle (22 + 6 days). The lipids and lipoproteins were determined twice before the start of therapy and 3, 6 and 12 mth thereafter. The lipids were quantified enzymatically and the lipoproteins by quantitative lipoprotein electrophoresis. Whilst cholesterol and triglyceride concentrations showed no detectable change, a slight but significant increase was seen in the high-density alphalipoprotein (HDL) cholesterol concentrations. The low-density beta-lipoprotein (LDL) cholesterol level showed a moderate fall. There was a resultant reduction in the beta/alpha-lipoprotein ratio. Accordingly, the apoprotein A1 concentrations were found to be elevated, while apoprotein B tended to fall to lower levels during therapy. When these changes are measured by the lipid metabolism risk criterion for the occurrence of coronary heart disease applicable to post-menopausal patients, the effects of the above-mentioned combination may be regarded as entirely favourable.

Adult↗

PubMed1983

Cytogenic investigation of 103 patients with primary or secondary amenorrhea.

Cytogenetic investigations were carried out on 103 women presenting with either primary (n = 88) or secondary (n = 15) amenorrhea. A sex chromosome anomaly was found in 26% and 33% of these patients, respectively. Other studies on women with primary amenorrhea have found a similar or even higher percentage of patients with an abnormal karyotype. It is therefore suggested that all women with absence of menstruation after the age of 16 years should be investigated cytogenetically. The surprisingly high percentage of pathological karyotypes among the secondary amenorrhea group does indicate that sex chromosome anomalies cannot be ruled out in women who have had apparently normal ovarian function for at least some time, and therefore more patients from this group should be selected for chromosome analysis.

Adolescent↗

PubMed1981

[The parotid gland as target organ of regional and distant metastases (authors' transl)].

The lymph nodes of the parotid gland get their tributary lymph vessels from the skin of the face, the scalp and the anterior face of the concha. Therefore malignant skin tumours--the majority of them are melanomas and squamous cell carcinomas--may lead to parotid metastases. In comparison to these regional metastases, parotid metastases of distant tumors are extremely rare. The paper describes for the first time a parotid metastases of an uterus sarcoma.

Aged↗

PubMed1977

Quinoxalinol derivatives of aliphatic 2-oxocarboxylic acids. Infrared and mass spectra of the O-trimethylsilylated compounds.

In acidic media o-phenylenediamine and 2-oxoacids react to yield quinoxaline derivatives. On derivatization in pyridine with silylating reagents quinoxalinol-O-TMS ethers or O-TMS-ether-TMS-esters are formed exclusively as shown by gas chromatography infrared spectrometry and gas chromatography mass spectrometry. These derivatives have very favourable properties for gas chromatographic detection and quantitation of the parent 2-oxoacids. The mass spectra have characteristic fragments which facilitate easy identification. In addition, 'single ion monitoring' of all aliphatic 2-oxoacids can be performed with only three fragments at m/e 217,232 and 245. In some aspects the mass spectra resemble those of other heterocyclic compounds which contain an O-alkyl sidechain. The fragmentation mechanisms were deduced by low resolution mass spectrometry with and without deuteration, high resolution mass spectrometry and metastable ion evidence. A new type of rearrangement alpha-beta-elimination of ethylene or propylene from the aliphatic sidechain, is proposed for some O-TMS quinoxalinols.

Chemical Phenomena↗

PubMed1976

On the origin of the supernumerary chromosome in autosomal trisomies--with special reference to Down's syndrome. A bias in tracing nondisjunction by chromosomal and biochemical polymorphisms.

The differential staining methods for chromosomes have led to the demonstration of more chromosomal polymorphisms. Not rarely, these polymorphisms allow in autosomal trisomies the detection of parental origin of the supernumerary chromosome. In addition, the malsegregation may be ascribed to 1st or 2nd meiotic division in informative families. This approach of analyzing possible causes of trisomies is subject to a considerable bias. Trisomic phenotypes are twice as frequent for 2nd meiotic errors than for 1st meiotic errors. Also, rare chromosome variants seldom occur in matings where malsegregation in 1st meiotic division can be detected. In the present paper this bias is analyzed mathematically on the family as well as on the population level. From this mathematical analysis and from the data in the literature we conclude that Down's syndrome as a whole is caused about 5-10 times more often by a malsegregation in 1st meiotic than by an error in 2nd meiotic division. Mainly from experimental studies in rodents, causes for errors in 1st and 2nd meiotic division are becoming apparent. They are summarized in the context of the results of the present paper.

Down Syndrome↗

PubMedDate not supplied

Evaluation of tubal patency by hysterocontrast sonography (HyCoSy, Echovist) and its correlation with laparoscopic findings.

In 20 patients with suspected infertility, fallopian tube patency was assessed using Doppler-supplemented hysterocontrast sonography (HyCoSy). All patients underwent transvaginal HyCoSy with the contrast agent SHU 454/Echovist prior to laparoscopy with chromopertubation (chromolaparoscopy). Following application of the Echovist contrast medium, the fallopian tubes were visualized with B-mode scanning and tubal flow was evaluated by means of Doppler sonography. None of the patients received anesthesia. We found corresponding results with regard to the tube patency between HyCoSy and conventional chromolaparoscopy in 82.5% of cases. These results make transvaginal HyCoSy a suitable first-line diagnostic procedure in patients with infertility disorders.

Adult↗

PubMedDate not supplied

Regulation of steroid production and its function within the corpus luteum.

During the second half of the luteal phase, the human corpus luteum becomes responsive to regular luteinizing hormone (LH) pulses. These LH pulses stimulate progesterone secretion tonically, and during this tonic stimulation, additional LH-independent progesterone pulses occur, which are particularly pronounced in women with human chorionic gonadotropin-stimulated luteal function. No progesterone pulses are seen in women suffering from corpus luteum deficiency due to absent LH pulses. The corpus luteum thus has a progesterone pulse generator turned on by gonadotropins but functioning for several hours without further gonadotropic support. This pulse generator appears to be regulated by intraluteal auto-/paracrine mechanisms, which we have investigated in a porcine model using molecular, cellular, and in vivo tools. Luteal oxytocin and progesterone release occurs in tightly coupled pulses. In vivo, oxytocin and prostaglandin F2 alpha(PGF2 alpha) stimulate estradiol and progesterone release and estradiol itself further stimulates progesterone release. Analysis of the different luteal cell compartments (large luteal cells, small luteal cells, fibroblasts) suggests an intraluteal circuit that involves paracrine effects of estradiol, oxytocin, and PGF2 alpha. At the time of luteolysis, the luteotropic effects of estradiol are inhibited by tumor necrosis factor derived from invading macrophages and the intraluteal circuit is thereby disrupted, leading to luteolysis.

Corpus Luteum↗

PubMedDate not supplied

Prognostic value of an automated sperm analysis in IVF or insemination therapy.

During the course of sterility treatment semenograms of 271 IVF and 316 insemination patients were carried out by two automated semen analysers. The parameters of these analyses were correlated to pregnancies resulting from the treatment. Semen samples were analysed in the ejaculate and after swim-up preparation. In addition, the swim-up suspension of IVF patients was measured again 18 h after sperm preparation. Patients were divided into three groups: (1) couples who achieved a pregnancy, (2) couples who did not achieve a pregnancy, and (3) IVF patients with no fertilization of the oocytes. Because of large standard deviations in the quality of ejaculates, the results in the IVF group show no significant differences in the semen parameters of husbands of pregnant and non-pregnant women. In contrast husbands of women with no fertilization have a significantly lower sperm motility. After swim-up preparation these differences no longer occur. A further measurement, taken 18 h later, reveals that there are no differences in the sperm parameters between the pregnant and non-pregnant group. However, the semen quality in the group with no fertilization is significantly reduced. The results of the insemination patients are similar to those of the IVF group. Thus, the results from automated sperm analysers cannot replace either the microscopic or biochemical analysis of an ejaculate and, moreover, cannot be used as prognosis for the fertilization capacity of sperms or a following pregnancy.

Autoanalysis↗

PubMedDate not supplied

[Changes in the basic immunologic parameters interleukin-2 receptor and CD8-antigen in pre-eclampsia].

The serum level of interleukin-2 receptor (sIl-2R) and CD-8 antigen were determined as basic parameter in terms of the stimulation of the t-cell mediated immune reaction in patients suffering from pre-eclampsia (n = 21), HELLP syndrome (n = 12) and pre-existing hypertension (n = 10). The data were compared with those of healthy nonpregnant female volunteers (n = 10) and normotensive pregnant women in the course of pregnancy. Hypertension in pregnancy was associated with an increase of sIl-2R and sCD-8 levels depending on the severity of the hypertensive disorder. In the group of patients with severe pre-eclampsia the median of sIl-2R serum level increased from 370 U/ml (normotensive patients) to 730 U/ml and that of sCD-8 from 640 U/ml to 1100 U/ml. In patients with pre-existing hypertension there was a smaller increase of sIl-2R (median 520 U/ml) and decrease of sCD-8 (median 520 U/ml). 6 to 8 weeks after delivery in the group of hypertensive patients the sIl-2R levels were normalized and the levels of sCD-8 were elevated (median 1030 U/ml). The results support the hypothesis of T-cell mediated immunological reactions as pathogenetic factors of the genesis of the hypertensive disorders in pregnancy.

Adult↗

PubMedDate not supplied

[Prevention of habitual abortion by buffycoat transfusions].

From an immunological point of view the product of pregnancy may be regarded as a haplo-different allotransplant. A system possibly closely linked to the HLA-region is postulated to lead to the immunological recognition of the fetus by the mother and, paradoxically, to a take of the "transplant". The postulated system apparently codes for antigens present on both trophoblast and adult lymphocytes (TLX = trophoblast-lymphocyte-crossreacting). The prevention of rejection is thought to be effected by blocking factors (BF) present in the serum or plasma of the mother. There may be different kinds of BF: a specific BF (detectable only in an autologous assay system), appearing late in pregnancy, which inhibits several lymphocyte-dependent reactions (e.g. production of MIF, MLC). This BF has been identified as an IgG-class antibody. a nonspecific BF, appearing early in pregnancy which inhibits the MLC in vitro. c) may be a third BF, also specific, which is found only in plasma but not in serum. All described BF-activities were absent in women with habitual abortions. HLA-identity or partial identity could imply TLX-identity. The consequence of such an identity could be: non-detection of the trophoblast by the immune system of the mother, no production of BF, abortion. However several investigators could not find any HLA-identity of the partners with habitual abortions. A protective effect on the fetus has been seen when pregnant women were immunised with adult leukocytes, using either buffycoats from various HLA-different but bloodgroup-compatible donors or isolated leukocytes from the spouse.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Habitual↗

PubMedDate not supplied

[Immunization with partner lymphocytes: improvement of pregnancy rate in sterility patients].

In a two-centre prospective study 20 patients with a history of unsuccessful sterility treatment underwent immunization with paternal lymphocytes to improve the pregnancy rate in the subsequent therapeutic AIH or IVF/ET cycle. Unsuccessful sterility treatment was defined as no pregnancy after 8 properly monitored AIH cycles and at least one diagnostic IVF/ET or more than 3 IVF with transfer of 3 embryos. After successful immunization expressed by the induction of Fc-receptor blocking antibodies 10/20 patients became pregnant. Nine of these patients delivered healthy children, one patient experienced a first trimester abortion. A successful second pregnancy occurred in 6 of these patients. No significant correlation between the previous history and pregnancy success could be found, except a slight advantage for patients with a history other than tubal sterility. There were no differences in the anamnestic data as well as in the success rate between the two independent centres Göttingen and Leuven (10 patients each). These data suggest, that adjuvant immunotherapy might improve markedly the pregnancy rates in selected cases of sterility.

Abortion, Habitual↗