Pregnancy complicated by malignant melanoma.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
C Kainz
Publications and source records attributed to C Kainz.
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↗
[Bilateral primary leiomyoma of the ovary].
Primary leiomyoma of the ovary is rare. Most of these tumors are only a few millimeters in diameter and unilateral, generally occurring in women aged 45 to 65 years. We present the exceptional case of a 16 year-old girl with bilateral ovarian leiomyomas, proved by immunohistochemistry, and discuss the feature of the case in the light of the known literature.
Adolescent↗
Intravenous leiomyomatosis of the uterus.
A case of intravenous leiomyomatosis of the uterus and 4 subperitoneal, pelvic leiomyomas without any connection to the uterus is demonstrated. The intravascular position of the tumors is proved by immunohistochemistry with positive reaction of antibodies against von Willebrand Factor. This rare growth pattern of benign leiomyoma of the uterus often shows extrauterine extension by intravascular growth within venous channels, sometimes causing cardiovascular complications. This tumor should not be confused with malignant neoplasia.
Female↗
Treatment of skin ageing symptoms in perimenopausal females with estrogen compounds. A pilot study.
A wide range of somatic symptoms of the perimenopausal female is due to the decrease of estrogen at that age. Minor attention has been paid hitherto to the involvement of estrogens in female skin ageing symptoms. In our study, the ageing skin of the face of perimenopausal females was treated with a 0.3% estriol cream (8 patients) or with a 0.01% estradiol cream (10 patients) for 6 months. Dermatologic follow-up was performed monthly. At each follow-up venous blood for radioimmuno assay determination of prolactin (PRL), follicle stimulating hormone (FSH) and estradiol (E2) was sampled. In addition, prior to and after 3 and 6 months of treatment, gynecological examinations for climacteric symptoms, mammary and colposcopic investigations and vaginal smears for cytology were performed. Both treatment groups showed improvement of the various skin ageing symptoms at the end of treatment. The effects of the group treated with topical estriol were slightly superior with regard to their extent and onset. No hormonal side effects were noted either clinically or by hormone monitoring. According to these preliminary results, local estrogen treatment appears to be a promising new approach for the treatment of skin ageing in perimenopausal females. However, for minimizing the risk of systemic hormonal side effects, concentrations and size of application field should be limited.
Administration, Cutaneous↗
Proteolytic enzyme cathepsin D in follicular fluids and its possible role in ovulation.
Explore the source record for details and available documents.
Adult↗
[Hyperreactio luteinalis in pregnancy].
We report on the extremely rare case of ovarian overstimulation in a single pregnancy without prior hormonal stimulation therapy. During the 26th week of gestation ultrasound examination showed a 103 x 57 x 78 mm polycystic tumour with echogenic structures inside the cysts, located behind the uterus. Further management consisted of laparotomy with partial resection of a cystic part of the left ovary. Frozen section examination confirmed the diagnosis of hyperreactio luteinalis and excluded malignancy. To avoid torsion of the ovaries, cysts from both sides were aspirated. On day 8 and 18 after surgery, sonography revealed no pathological finding. In the 40th week of gestation, a healthy baby was delivered. The possibility of a hyperreactio luteinalis has to be kept in mind, when cystic solid tumours of the ovaries are diagnosed during pregnancy. A conservative management is appropriate, because a normal spontaneous remission occurs after delivery.
Adult↗
[Extensive intraductal components of invasive ductal breast carcinoma--value of mammography].
The presence of an extensive intraductal component (EIC) in patients with infiltrating ductal carcinoma is a major factor for predicting local recurrence after breast-conserving surgery and radiotherapy. A retrospective study including 67 consecutive cases of stage I and II infiltrating ductal carcinomas of the breast was conducted to determine the predictive values of mammographic features associated with the presence or absence of EIC. 43% of the lesions contained a pathologically verified EIC. 63% (25/40) of lesions showing mammographic evidence of calcifications with or without a mass were associated with an EIC. In contrast, only 17% (4/24) of carcinomas without calcifications demonstrated an EIC. This difference was statistically significant (p < 0.001). Lesions with calcifications greater than 3 cm in extent were significantly (p < 0.01) more likely to have an EIC (8/9; 89%) than those with calcifications less than 3 cm in extent (17/31; 55%). Furthermore, no patient with a palpable mass who had normal findings on mammograms was diagnosed to have an EIC.
Adult↗
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↗
[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↗
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↗
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↗
Peri-operative elastase-alpha-1 proteinase inhibitor in patients with postoperative intervertebral discitis.
In a prospective study of 251 patients operated upon for lumbar disc herniation it has been investigated whether the preoperative and early postoperative values of Elastase-alpha-1 Proteinase Inhibitor (EPI)-an indicator of inflammatory processes-and C-reactive Protein (CRP)-a well known predictor of some postoperative complications-were correlated to the later development of discitis. Postoperatively discitis developed in 14 patients. A randomly chosen group of 15 complication-free patients out of the total of 251 cases was used as control group. Elevated EPI plasma values, especially in the pre-operative and first postoperative days, turned out to be significantly related to the likelihood of later discitis development, but no such relation for the CRP plasma values could be established. Thus and early prediction of patients at risk for this complication seems to be possible by pre- and postoperative measurement of EPI. It could be justified-but its usefulness has yet to be proven-to give antibiotics prophylactically and other anti-inflammatory medication in patients with elevated pre- and postoperative EPI values.
Acute-Phase Reaction↗
An analysis of the prediction of cephalopelvic disproportion.
Since cephalopelvic disproportion inevitably leads to cesarean section it seems to be mandatory to identify patients with an absolute discrepancy between the size of the fetus and the birth canal in order to avoid unnecessary trials of labour. In a case control study, comparing a group of patients who delivered by cesarean section because of cephalopelvic disproportion with an age matched control group, routinely assessed pelvic measurements and measurements of the newborn were correlated to cephalopelvic disproportion. Multivariate linear regression was applied to each group to determine, which of the maternal and fetal factors had the strongest influence on the mode of delivery. In the study group external conjugate showed the strongest positive relation to maternal body height (P < 0.01), the biparietal diameter of the newborn was negatively correlated (P < 0.01). None of the analyzed variables reached statistical significance in the control group. Differences between the two groups were marginal, thus providing no safe basis for decision making even in a population at high risk for developing cephalopelvic disproportion.
Adult↗
When applied to facial skin, does estrogen ointment have systemic effects?
We examined cytological vaginal smears of 17 women before and after three months of dermal estrogen (1 g of 0.01% estradiol ointment or 0.3% estriol ointment once daily), applied to the face for dermatological indications. The mean age was 57.1 +/- 7.6 years (range from 46 to 66). Seven women had estrogenic smears (more than 10% superficial cells) before therapy. Nine women were treated with 0.01% estradiol ointment and 8 were treated with 0.3% estriol ointment. Both groups had gynecological examinations including cervical and vaginal smears before and after treatment and also monthly measurements of serum follicle-stimulating hormone, prolactin and estradiol levels. Serum hormone levels and the appearance of vaginal smears showed no significant change during treatment.
Aged↗
[15 years vaginal delivery in post-cesarean status].
In a retrospective study covering a period of 15 years (1976-1991), we investigated 673 births after previous caesarean section compared to a matched pair group. During the observation period, an increase of vaginal delivery after previous caesarean section occurred. This decrease in resection rate (first five years period: 59%, 60% in the period of 1981-1985 and 42% within the last five years) could be achieved mainly in births after only one previous caesarean section. In patients with more than one previous caesarean section, the resection rate remained almost stable at 95%. The rate of complication was low in our study group, especially, if compared to studies in the USA. Three uterine ruptures with one maternal death occurred during the entire observation period. No correlation of the complication rate with an increase of vaginal delivery was observed. The more conservative obstetrical management had no negative impact on foetal outcome.
Apgar Score↗
[Diagnostic value of magnetic resonance study in after care of ovarian cancer].
Explore the source record for details and available documents.
Adult↗
[The incidence of positive cervix cytology 1980-1989].
Explore the source record for details and available documents.
Adolescent↗