Palliative radiotherapy of mucocutaneous lesions in malignant acanthosis nigricans.
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Acanthosis Nigricans↗
Biomedical subjects
E Weiss
Publications and source records attributed to E Weiss.
Male-female inequalities result in submission to high-risk sex in many societies. Special report: women and HIV.
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Acquired Immunodeficiency Syndrome↗
[Primary radiotherapy of endometrial carcinoma].
From 1987 to 1993 21 patients with inoperable endometrial carcinoma of all stages received primary radiation therapy. Patients were treated either with combined external beam radiation (EBRT) and afterloading therapy (AL) or AL alone. AL was delivered in high dose rate (HDR) mode. According to tumor stage 3 to 6 times 7 or 10 Gy were applied to line A, one session per week. Due to changing dose prescriptions total doses for EBRT ranged from 45 to 50.4 Gy. 65% of patients died until the end of follow-up (range 6 to 66 months). 23% died due to progressing tumor or therapeutic sequelae (hemorrhagic colitis), 42% died from intercurrent disease. Only 6 patients are alive, one of them with tumor. After a complete course of radiation therapy there was no in-field relapse. One patient irradiated with curative intention developed paraaortal lymph node metastases. During the observation time of our study most patients died of no tumor related reasons. Primary radiation therapy does effectively control endometrial carcinoma. However, old age, reduced general condition and concomitant disease compromise survival rates after radiation therapy alone.
Adenocarcinoma↗
Laparoscopic-assisted perineal rectosigmoidectomy for rectal prolapse.
One of the important surgical principles in perineal rectosigmoidectomy (Altemeier's procedure) for full-thickness rectal prolapse is to ensure the complete resection of the redundant rectosigmoid colon to avoid recurrence of the prolapse. We present a new technique of laparoscopic assistance during this procedure, which helps achieve maximal mobilization and resection of the prolapsed portion.
Anastomosis, Surgical↗
Ulcerative keratitis from overnight contact lens wear compared with other life risks.
Wearers of extended wear contact lenses are at increased risk for ulcerative keratitis compared with daily wear contact lens users. Using incidence rates, we compared ulcerative keratitis in contact lens wear with other diseases and serious life risks. "Comparative risk," a theoretical construct for this paper, is a framework through which the incidence rates are compared. Although the risks of ulcerative keratitis in extended wear are greater than with daily wear contact lenses, the risks of extended soft contact lens wear are 2-10 times less than the risks for non-fatal, serious and disruptive occurrences in a general population. Contact lens associated ulcerative keratitis is in the range of 10-20 times greater than the incidence of common causes of death in a low risk, middle-age population.
Adult↗
[Post-unification changes in inpatient psychiatric treatment in a Berlin treatment clinic].
In the present report the authors reach the conclusion that concerning the pathological picture no essential alterations can be observed. Patients, however, presently often enter therapy in a worse condition than before. Thus the tendency to arrive at a chronic stadium increases. In our opinion this development is partly owing to the fact, that the continuity of treatment is interrupted and partly to changes concerning the framework of conditions of live in society. We regard it as our task, also with the modified conditions of life, to render possible the dialogue between all participating in the treatment. Our purpose and wish remain to put all our available abilities to the disposition of the patients.
Berlin↗
Virilizing stromal Leydig cell tumor (Leydig cell-containing thecoma) of the ovary in pregnancy. A case report with extensive immunohistochemical investigation of the tumor cells.
The rare case of a stromal Leydig cell tumor of the ovary occurring in a 21-year-old woman who developed signs of virilization during pregnancy is reported. Serum androgen levels were markedly elevated. At cesarean section, a slightly hypotrophic, but otherwise normal, female infant was delivered and a tumor of the right ovary measuring 12 cm in maximum diameter was resected. Histologic examination revealed a sex cord-stromal tumor consisting of spindle-shaped, thecomatous cells and a large number of loosely scattered clusters of large polygonal cells with abundant eosinophilic cytoplasm. Both types of tumor cells were strongly immunoreactive for vimentin, but exhibited no proliferative activity and no overexpression of p53 protein. A few of the polygonal cells contained typical crystalloids of Reinke. Cellular atypia was not a prominent feature, and a diagnosis of benign stromal Leydig cell tumor was established. As expected, 20 months after diagnosis the patient exhibits no signs of recurrence or dissemination. To the best of our knowledge this is only the second case of a stromal Leydig cell tumor occurring in pregnancy to be described.
Adult↗
Laparoscopic vs open colon surgery. Costs and outcome.
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Activities of Daily Living↗
Application of an alkaline phosphatase fusion protein system suitable for efficient screening and production of Fab-enzyme conjugates in Escherichia coli.
We report a novel vector system suitable for the efficient preparation of alkaline phosphatase (PhoA)-labelled antibody Fab fragments in Escherichia coli. The previously described pGE20 vector used for the functional expression of truncated heavy (Fd) and light (L) chains of Fab into the bacterial culture medium was modified by inserting the E. coli PhoA coding region 3' to the Fd cloning sites. The secreted Fd-PhoA fusions and L proteins were found to be disulfide linked and Fab-PhoA complexes, prepared with IgG1 antibodies recognizing specifically human tumor necrosis factor alpha, were shown to be useful for the rapid detection of antigen. When an additional short peptide was interposed between the Fd and PhoA domains, nearly all of the recombinant Fab-PhoA conjugates present in the culture supernatant retained both antigen binding and enzymatic activity. A method for the detection and selection of bacterial colonies expressing bifunctional hybrid molecules of desired antigen specificity was also developed. Taken together, the systems described permit the generation and production of Fab-PhoA conjugates in E. coli, which can replace conventionally prepared PhoA-labelled antibodies in appropriate immunoassays.
Alkaline Phosphatase↗
Purification and analytical characterization of an anti-CD4 monoclonal antibody for human therapy.
A purification process for the monoclonal anti-CD4 antibody MAX.16H5 was developed on an analytical scale using (NH4)2SO4 precipitation, anion-exchange chromatography on MonoQ or Q-Sepharose, hydrophobic interaction chromatography on phenyl-Sepharose and gel filtration chromatography on Superdex 200. The purification schedule was scaled up and gram amounts of MAX.16H5 were produced on corresponding BioPilot columns. Studies of the identity, purity and possible contamination by a broad range of methods showed that the product was highly purified and free from contaminants such as mouse DNA, viruses, pyrogens and irritants. Overall, the analytical data confirm that the monoclonal antibody MAX.16H5 prepared by this protocol is suitable for human therapy.
Animals↗
In vivo biotinylated recombinant antibodies: construction, characterization, and application of a bifunctional Fab-BCCP fusion protein produced in Escherichia coli.
We describe a novel vector system suitable for the efficient preparation of in vivo biotinylated antibody Fab fragments in Escherichia coli. The previously described pGE20 vector used for the functional expression of truncated heavy (Fd) and light (L) chains of Fab into the bacterial culture medium was modified by inserting the C-terminal 101-amino-acid polypeptide of the biotin carboxyl carrier protein subunit of E. coli acetyl-CoA carboxylase (BCCP*). The secreted Fd-BCCP* fusion and L chain proteins were found to be disulfide linked and Fab-BCCP* complexes of an IgG1 antibody (Mab4) to human tumor necrosis factor alpha (TNF) were shown to retain both antigen and streptavidin-binding activities. The capacity of the Fab4 linked to BCCP* to bind TNF was identical to that observed with unmodified Fab4. Up to 15% of the expressed hybrids were able to interact with streptavidin when exogeneous d-biotin was added into the bacterial culture medium. The Fab4-BCCP* molecules were found to be more efficient than Fab4 linked to an engineered streptavidin-affinity tag for the detection of antigen on solid phase. In addition, we show here that the bacterially expressed Fab4-BCCP* complexes, adsorbed to streptavidin-agarose beads, can be used for the one-step purification of recombinant TNF by immunoaffinity chromatography.
Acetyl-CoA Carboxylase↗
Presence of an expressed beta-tubulin gene (TUBB) in the HLA class I region may provide the genetic basis for HLA-linked microtubule dysfunction.
An expressed beta-tubulin gene (TUBB) has previously been localized to chromosome region 6pter-p21 in man. By using a panel of deletion mutant cell lines and radiation-reduced hybrids containing fragments of chromosome 6, the TUBB locus could be mapped to the HLA class I region at 6p21.3. A long range restriction map including TUBB and several HLA class I genes was then generated by rotating field gel electrophoresis. The results show that TUBB maps to a segment 170-370 kb telomeric of HLA-C. This location suggests that a mutation at the TUBB locus could be the cause for certain forms of HLA-linked microtubule dysfunction, including immotile cilia syndrome.
Animals↗
Treatment of primary insomnia with trimipramine: an alternative to benzodiazepine hypnotics?
A group of 19 middle aged patients suffering from primary insomnia according to the DSM-III-R were treated in a single-blind study with trimipramine, a sedating antidepressant. A total of 15 patients completed the study protocol and were evaluated. The present pilot study aimed at investigating the sleep-inducing properties of trimipramine, and at clarifying the question of whether short- or long-term rebound insomnia occurs after discontinuation of this drug. At four measurement points, i.e. under baseline conditions, under treatment and 4 and 14 days after drug discontinuation, sleep was recorded with an ambulatory-electroencephalogram (EEG) monitoring device in the patient's home environment. Simultaneously, psychometric tests were applied to measure withdrawal symptoms, subjective sleep quality and well-being during daytime. Trimipramine at a mean dose of 166 +/- 48 mg led to a significant increase in sleep efficiency, total sleep time, and stage 2% sleep-period time (SPT), whereas a significant decrease in wake time and stage 1% SPT was noted. Insomniac patients reported an improvement in subjectively perceived sleep quality following trimipramine. Additionally, an improvement in well-being during the daytime occurred. Negative side effects were limited to dry mouth due to the anticholinergic properties of the drug. Discontinuation of trimipramine did not provoke either short- or long-term rebound insomnia in objective and subjective sleep measurements considering mean values of the whole sample, although a subgroup of patients did display total sleep times below baseline values during short- and long-term withdrawal, but generally without a concomitant worsening of sleep quality according to the sleep questionnaire.
Adult↗
The significance of plasma progesterone levels during early pregnancies achieved after in vitro fertilization (IVF) treatment.
OBJECTIVE: Corpus luteum steroidogenesis is lower for in vivo ectopic pregnancy than for intrauterine pregnancy. There is a progesterone hallmark level distinguishing between viable intrauterine pregnancy and nonviable or ectopic pregnancy. This study attempts to answer whether this is also true for in vitro fertilization-treated patients. STUDY DESIGN: Using information retrieved from a computerized database, we compared the plasma 17 beta-estradiol (E2) and progesterone during the luteal phase and for every 2 to 3 days for several weeks during early pregnancy between those patients with proven ectopic pregnancies and those with singleton and multiple intrauterine pregnancies. Vaginal ultrasonography to detect an intrauterine gestational sac was performed from day 19. A total of 73 pregnancies resulted from the replacement of fresh embryos in our in vitro fertilization-embryo transfer program. RESULTS: Only at day 10 post embryo transfer did those patients with ectopic pregnancy show statistically lower mean (SD) serum levels of E2 [2257 (SD, 2351) pmol/L] and plasma progesterone [PP; 221 (SD, 283) nmol/L] compared with patients with intrauterine pregnancy, whose mean E2 was 8846 (SD, 5871) pmol/L and mean PP was 805 (SD, 582) nmol/L (P = 0.008). For the rest of the follow-up until surgery was performed in ectopic pregnancy, there were no differences of statistical significance between extrauterine pregnancy and the intrauterine pregnancy groups. Furthermore, only on day 10 post embryo transfer, did we find a discriminatory zone (confidence interval, 95%) for E2 levels (903 to 3502 pmol/L for EP vs 6116 to 9493 pmol/L for a singleton and 4875 to 9493 pmol/L for multiple pregnancies). PP levels were 26 to 283 nmol/L for ectopic pregnancy versus 496 to 1096 nmol/L for both singleton and multiple pregnancies. An intrauterine gestational sac was visualized at a mean of 23.2 (SD, 4) days after embryo transfer. On this day, the mean P levels were 982.6 (SD, 286.2) nmol/L for intrauterine and 804.5 (SD, 502.4) nmol/L for ectopic pregnancies (P = NS). CONCLUSIONS: Except for day 10 post embryo transfer, the steroidogenesis in ectopic pregnancy after in vitro fertilization treatment does not differ from successful intrauterine pregnancy. This observation negates an impaired steroidogenesis for ectopic pregnancy after in vitro fertilization and makes the PP level irrelevant in the diagnosis of pregnancy implantation.
Chorionic Gonadotropin↗
CK-BB as indicator of prenatal brain-cell injury in fetuses with absent or reverse end-diastolic flow velocities of the umbilical arteries.
The purpose of this study is to determine the levels of brain type isoenzyme of creatine kinase (CK-BB) as a possible indicator of a pre-existing intrauterine brain-cell damage in cord blood sera of fetuses with preceding absent or reverse end-diastolic flow velocities of the umbilical arteries (AREDFV). CK-BB isoenzyme activities were determined in umbilical cord sera of 13 newborn infants with preceding AREDFV and in 14 fetuses with low end-diastolic flow velocities (LEDFV) of the umbilical arteries. 50 newborn infants with elective cesarean section and normal umbilical artery blood flow velocity waveforms were used as controls. Two-tailed Student's t-test and Fischer's exact test were used for statistical evaluation of the results. CK-BB isoenzyme activity did not depend on gestational age. Fetuses with AREDFV showed a significant increase in CK-BB values, whereas fetuses with LEDFV had CK-BB activities within the normal range of the controls. The elevated CK-BB values of the AREDFV group were not correlated with fetal acidosis at birth. Brain-cell injury with leakage of CK-BB isoenzyme might be present in fetuses with AREDFV even before (preterm) delivery.
Blood Flow Velocity↗
[Fetal heart rate and Doppler ultrasound].
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Blood Flow Velocity↗
Women's lives and sex: implications for AIDS prevention.
Preliminary findings from the Women and AIDS program, a research grants program of the International Center for Research on Women in Washington, D.C. that supports 17 studies in developing countries worldwide, provide a glimpse into the complex interaction between women's social and economic status and risk of HIV infection. In many settings, the cultural norms that demand sexual fidelity and docile and acquiescent sexual behavior among women permit--and sometimes even encourage--early sexual experimentation, multiple partnerships, and aggressive and dominating sexual behavior among men. Drawing upon the finding from the program, the paper analyzes how such cultural norms, together with women's social and economic dependency, can limit a woman's ability to negotiate safer sex with her partner; restrict her access to information and knowledge about her body; force her to sometimes barter sex for survival; increase her vulnerability to physical violence in sexual interaction; and compromise her self-esteem. The findings highlight the limitations of the current HIV/AIDS prevention strategy for reducing women's risk of HIV, and underline the urgency for an approach to prevention that is grounded in the realities of women's lives and sexual experiences--an approach that recognizes the relationship between the dynamics of gender relations, sexual behavior, and HIV risk.
Acquired Immunodeficiency Syndrome↗
Low target birth weight or growth retardation? Umbilical Doppler flow velocity waveforms and histometric analysis of fetoplacental vascular tree.
OBJECTIVE: The placental vascular architecture of small-for-gestational-age fetuses seems to have an impact on the flow patterns in the umbilical arteries. STUDY DESIGN: Blood flow velocity waveforms of the umbilical arteries were measured by Doppler ultrasonography in nine small-for-gestational-age fetuses with elevated systolic/diastolic ratios of the umbilical arteries, seven small-for-gestational-age fetuses with normal flow patterns, and 14 appropriate-for-gestational-age fetuses with normal flow patterns. After delivery histomorphometric placental investigations were performed. RESULTS: Reduced end-diastolic flow velocities were significantly associated with both a reduction of vascularization within the terminal villi and adverse diffusion conditions, indicating insufficient functional maturity. The perfusion and diffusion capacity of small-for-gestational-age placentas with normal umbilical artery flow velocity waveforms was similar or even slightly better compared with the appropriate-for-gestational-age control values. CONCLUSION: These data suggest that Doppler flow velocimetry in the umbilical arteries is predictive of a vascular lesion within the placentas of small-for-gestational-age fetuses.
Blood Flow Velocity↗