[Education and graduate education in the European Community].
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Biomedical subjects
Publications and source records attributed to E Reinold.
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Women with a normal menstrual cycle (n = 21, controls), polycystic ovary syndrome (n = 10) and hypogonadotropic amenorrhea (n = 3) were stimulated with clomiphen-citrate (4th day to 8th day of the cycle) and with human menopausal gonadotropin (8th day to 11th day). The vascular impedance of the ovary carrying the dominant follicles was monitored by endovaginal pulsed Doppler flow measurement. Simultaneously, serum levels of LH, E2 and 17-OHP were assayed. Contrary to controls, women with polycystic ovary syndrome or hypogonadotropic amenorrhea showed decreased hormone levels and no lowering of the vascular impedance. In controls, the lower pulsatility index is caused by neovascularization around the dominant follicle and by E2-induced vasodilatation in the ovarian artery.
In a study comprising a total of 700 pregnant women, umbilical resistance was examined. Measurements were taken at both sides of the cord. A decline in resistance was registered from the fetal abdominal wall to the placental insertion of the vessels. According to a collective of 500 patients with a normal development and outcome of their pregnancies a physiological constellation of the resistance indices could be confirmed. It was taken as a basis for the definition of pathological cases. Different pathologies were related quite clearly to a special (unphysiological) constellation of the indices.
In a retrospective study the results of vagino- and colour flow Doppler sonography of 23 tubal pregnancies verified by surgery were documented. Due to the neovascularisation in the trophoblast tissue the vascular impedance was elevated in all cases. The mean value of all pulsatility indices was 0.85 +/- 0.2. The direct signs of tubal pregnancy were seen in only 20 cases with vaginosonography alone. The combination of vagino- and colour flow Doppler sonography offers the chance of an earlier detection (5th week of pregnancy) of a tubal pregnancy.
An invasive mole in an ectopic pregnancy was diagnosed in the 16th week post amenorrhoea by transvaginal colour flow mapping. Colour flow mapping was the only noninvasive method used to verify the diagnosis. In this case the serum level of human chorionic gonadotropin (HCG) was very low (0.196 IU/ml) and subjective symptoms and uterine bleeding were absent.
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Based on a collective of 500 women with normal singleton pregnancies we examined the indices of flow resistance along the umbilical cord. Measurements were taken at the foetal abdominal side of the Aa. umbilicales on the one hand and at the placental insertion of the vessels on the other. According to our results we were able to establish a physiological constellation of the indices for each week of gestation, and - subsequently - for the whole duration of pregnancy. These constellations could be considered physiological. They may serve as a basis for the definition of pathological conditions.
Cephalothoracopagus twins were diagnosed at 22 weeks' gestation, hence this case was diagnosed early enough antenatally to allow vaginal pregnancy termination. This case underlines the need for exact ultrasound screening during early pregnancy.
A collective of 48 pregnant women, whose pregnancies showed signs of a pregnancy-induced hypertension or gestotic tendencies was examined by Doppler ultrasound. The subject of interest was the resistance along the umbilical cord. Measurements were taken both ends of the umbilical cords. Usually, a decline of the indices is seen, which makes the difference between the two ends (Delta F) turn out positive. Pregnancies with any sign of a gestotic development, showed elevated resistances at the placental end of the cord. The indices of the foetal abdominal insertion were just about the same. Delta F changed significantly in our group of patients. Here, the values of both sides either did not differ from one another or the placental indices even exceeded the foetal ones. We called this special constellation of umbilical indices a Doppler phenomenon characterising gestotic pregnancies.
411 women who had dysplasia, selected from an ambulatory group as well as 240 women from a random control group were examined, by using cervical smears, which were initially diagnosed as human papilloma viruses-DNA (HPV-DNA) of the type 6/11, or 16/18, or 31/33/35. This was achieved by the in-situ nucleic acid hybridisation technique. The results of the HPV-DNA typing were tabulated with the cytological diagnosis (Munich Papanicolaou (Pap.) group-classification). The control group corresponding to Pap.Gr. I, and was HPV-DNA positive in 6 (2.5%) of the 240 cases. The group of 180 patients with a Pap.Gr. II showed a HPV-DNA positive result for 75 cases (41.7%); 57 of 99 cases (57.6%) occurred in Pap.Gr. IIID; 42 of 54 cases 77.8% (L) were found in Pap.Gr. IV (a/b), and 72 of 78 cases (92.3%) appeared in Pap.Gr. V. The HPV-DNA mixed infections became evident as the cellular dysplasia increased. The results of the HPV-DNA positive diagnosis clearly indicate a close correlation with the Pap.Gr.-classification. The HPV-DNA type 16/18 was most frequent in cervical carcinomas (Pap.Gr. V). The cyto-histological control of the 57 HPV-DNA positive cases of the untreated Pap.Gr. IIID showed a regression in 31.6% of the 18 cases after a period of 3 to 6 months (post HPV-DNA typing). These were histologically normal. In 33 cases (57.9%), there was a persisting Pap.Gr. IIID (CIN I/II) and in 6 cases (10.5%) a progredient correlation in Pap.Gr. IV a/b. The Pap. group IV (a/b) was histologically a CIN grade III.
In this study, the cervical length, thickness, the width of the internal os, the cervical canal and the external os of 62 primipara and 77 multipara were measured vaginosonographically. Only patients with normal pelvic scores were examined. The measurements were carried out approx. every fortnight between the 16th and 34th gestational week. In the primipara group, the average cervical length was 36.8 mm +/- 12.0 mm, the thickness 27.8 mm +/- 4.4, the width of the internal os 6.3 +/- 2.1 mm, the cervical canal 4.2 +/- 2.0 mm and the external os 5.4 +/- 2.2 mm. In the multipara group, an average cervical length of 40.1 mm +/- 7.4 mm, a thickness of 29.3 +/- 3.9 mm, an internal os of 5.1 +/- 2.6 mm, a cervical canal of 4.3 +/- 1.3 mm and an external os of 5.8 +/- 1.8 mm were found. Contrary to our expectations, there was no statistically significant difference between the two groups. Furthermore we did not find any correlation between the internal and the external os.
Cervical smears of 50 women who had an abortion were examined by dot-blot hybridization for human papillomavirus (HPV), herpes simplex virus (HSV) types 1 and 2, and cytomegalovirus (CMV) DNA. HPV DNA type 16 or 18 positivity was shown in 17.6% of the cases; in the aborted material, however, it amounted to 30.8%. IgM-positive titres were present in a few cases. In cervical smears of intact pregnancies, positivity for HPV DNA types 6 and 11 was detected in 9.5% and for the HSV DNA types 1 and 2 and CMV DNA in 48.0% of the cases. In this group of patients mostly positive IgM and IgG titers were present.
Questionnaires were sent to all female members (n = 60) of the Austrian Funboard Association (funboard = the most athletic windsurfing class). They included questions about the menstrual cycle, physical capacity, libido and performance dependent on the particular cycle phase. There was no significant libido or capacity peak, neither for the windsurfers nor for a normal collective (n = 100); on the other hand there was an evident low during menstruation. A mean length of the menstrual cycle of 26.5 +/- 2.8 days and a bleeding time of 4.4 +/- 1.2 days were found, while metrorrhaghia and dysmenorrhea were less frequent than in the normal collective. One reason for these findings could be that physical activity reduces dysmenorrhea.
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The amplification grade of oncogene c-erbB-2 was examined by the polymerase-chain-reaction-method in DNA's of 56 primary mammary carcinomas. 26 (46.4%) of these showed the amplified oncogene c-erbB-2. In the strongly amplified cases, the expression of the c-erbB-2 oncoprotein was verifiable immunohistochemically. Between the progesterone receptor status (PR) and the amplified c-erbB-2 oncogene there was a statistically proven dependency. No correlation was observed between the amplified c-erbB-2 oncogene and the epidermal growth-factor receptor (EGFR).