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Biomedical subjects

F Melchert

Publications and source records attributed to F Melchert.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Angiogenesis of human breast cancers: neovascularization in xenotransplants and oxygenation in situ in patients].

OBJECTIVE: Recent reports have shown that vascularization of breast cancers is an independent prognostic parameter. Tumor growth and neovascularization were investigated in xenotransplants of breast cancers and tissue oxygenation was measured in patients with breast tumors. METHODS: Tumor cells of the breast cancer MX-1 were implanted intradermally in 40 nude mice. Tumor growth and neovascularization were quantified microscopically. Tissue oxygenation was determined in 66 patients with breast tumors using the pO2-histography technique. RESULTS AND CONCLUSION: The angiogenesis begins prior to tumor growth, is insufficient and leads to chaotic blood flow. This results in a heterogeneity of tissue oxygenation in breast cancers. Oxygenation at the tumor periphery appears to be of prognostic importance for clinical outcome of breast cancer.

Animals↗
PubMed1995

[Coping with illness/quality of life and immunologic parameters of patients with breast carcinoma and benign tumors].

OBJECTIVE: Maladaptive coping of the cancer illness leads to considerable psychosocial burden which can-as a chronic stress factor-impair various immune functions, e.g. cellular immunity. PATIENTS AND METHODS: In a collective of 118 patients suffering from mammary carcinoma and 48 patients suffering from benign mammary tumors Coping was measured with the EORTC-MAC-scale and Quality of life with three questionnaires. Out of the immunologic variables the lymphocyte subpopulations were determined with flow cytometry. Immunglobulines, neopterin, C-reactive protein, and herpes serology were determined using standard methods. RESULTS: At follow up a slight increase of the mean vales of sum-scores is observed for the adverse coping mechanisms, like helplessness/despair and fear. On the other hand, the values for the coping styles fatalism and denial decrease. Significant correlations are seen between anxious attitude and number of natural killer cells (CD16 and CD56). It must be pointed out that area of social contact show an inverse correlation in patients with mammary cancers: a strong improvement correlates with diminished natural killer cells as well as reduced activated killer cells. CONCLUSIONS: The aim of this study is to determine whether a high risk group can be defined using these parameters and if these parameter can be influenced by psychotherapeutic interventions such as establishing "Coping-support-groups".

Adaptation, Psychological↗
PubMed1995

[Changes in the vitamin A status in dysplastic epithelium of the cervix].

In 34 patients with HVP-infection of the cervix and in 40 patients with CIN III standardised biopsies were taken from the involved area and normal cervical epithelium for determination of the local concentration of retinylester. In all cases diagnosis was confirmed colposcopically, cytologically and by histology. HPV infection was confirmed by in situ hybridisation. Determination of retinylester was performed by HPLC. No significant difference of local retinyl-plamitate concentration was detectable in HPV infected versus normal tissue. Retinyl-palmitate concentration was extremely lower in CIN III compared with normal cervical epithelium and HPV-infected tissue. The determination of plasma level of retinol showed no significant difference between the two groups. So it can be presumed that the reduction of retinyl-palmitat in CIN III is a local process and a local supplementation of Vitamin A might contribute to the prevention of cervical neoplasia.

Anticarcinogenic Agents↗
PubMed1995

[Uterine rupture without predisposing factors after a single vaginal PgE2 administration in prolonged pregnancy].

The case of a 38-year old 3/1 gravida with prolonged pregnancy is discussed. Labour was induced with a prostaglandin (PgE2-) vaginal tablet 4 days after an oxytocin stress test had failed. After rapid labour development, imminent fetal asphyxia suddenly occurred, leading to an emergency cesarean section. A rupture of the left uterus wall rupture with laceration of uterine vessels was demonstrated. This is the first case report of a uterus rupture that happened in prolonged pregnancy without predisposing risk factors after a single PgE2 dose that was correctly placed into the posterior fornix.

Administration, Intravaginal↗
PubMed1994

Oxygenation of mammary tumors as evaluated by ultrasound-guided computerized-pO2-histography.

The average pO2 in breast carcinomas in situ is significantly lower than that in the normal breast tissue. The mean pO2 value for benign breast tumors is significantly higher than that of the breast cancers but lies significantly lower than the corresponding normal breast. No significant differences are found in the mean pO2 values when comparing cancers of different stages and histology. A decrease in the mean pO2 value is measured from the periphery to the center of the breast tumors investigated. The average pO2 values for pre- and postmenopausal patients differ significantly. The described method provides a reliable assessment of tissue pO2 in situ with a minimum of discomfort. Due to extensive inter tumor heterogeneity, prediction of pO2 values for tumors of same stage and same histology is not possible, so that measurement of individual tumor is mandatory for determining therapy response.

Adenofibroma↗
PubMed1994

[Ultrasound assessment of the postmenopausal endometrium. Is measuring thickness adequate?].

Sonographic assessment of the endometrium in postmenopausal women is generally based on total thickness as only criterion. The cut-off values recommended in literature, however, vary considerably. The purpose of this study was to examine the significance of sono-morphology besides biometry of the endometrium. If vaginosonography showed an endometrial thickness of 3 mm or less, all histological findings were inconspicuous; beginning at a thickness of 10 mm only hyperplasias, polyps and carcinomas were found. In the range between, including more than one-third of our patients, the structure can point out the type of histology: Homogeneity, low echogeneity and a median echo are not important findings, but inhomogeneity and high echogeneity point to pathological changes of the endometrium. Using combined, metric-structural criteria in vaginosonography of the endometrium, not only the predictivity, but above all the selectivity is improved.

Adenoma↗
PubMed1994

[Treatment of therapy refractory squamous epithelial hyperplasia of the vulva by CO2 laser vaporization].

Mostly, older women suffer from dystrophic disease of the vulva, which develops in a chronically progressive way. The main symptoms are substantial pruritus and secondary alteration of the skin. Good results could be obtained by a combination of different conservative treatments. Relapses occurred in about 10% of the cases. In 23 patients with unsuccessfully treated disease, we tested the indication for CO2-laser therapy. The hyperplastic lesions were vaporized under colposcopic control. By this procedure, we obtained in 2/3 of the cases very good results already after the first operation. Radical interventions can be avoided almost completely by laser vaporisation of therapy-resistant squamous cell hyperplasia of the vulva.

Aged↗
PubMed1994

[Quantitative determination of fetal fibronectin in cervical smears: a new marker for evaluating the risk of premature labor].

There is a well-known correlation between ascending infection and preterm labour. Nevertheless, up to now an exact method to identify patients which are at high risk for preterm labour does not exist. Fetal fibronectin is an extracellular matrix protein, which is produced by fetal membranes. High concentrations are present in amniotic fluid, but not in cervical secretions in uncomplicated pregnancies (only in 3-4%). If there is an inflammatory mediated damage to fetal membranes (amnion/chorion) or a mechanical disruption caused by preterm contractions, fetal fibronectin should be released into the cervix and vagina. A prospective clinical study measuring quantitatively the content of fFN in cervicovaginal secretions in patients with preterm labour (n = 43), preterm rupture of membranes (n = 15) and 20 controls was undertaken. In 16 patients frequent specimen could be obtained over a period of several weeks. 14 of the 34 patients with preterm labour, which could be observed until delivery, delivered before term (< 37. WOP). In 13 fFN was present in a concentration > 75 ng/ml (sensitivity: 92.4%). 13 patients were negative for fFN and only one of these patients delivered before term (92% chance of term delivery in absence of fFN in cervicovaginal fluids). In 8 patients with beta-adrenergic treatment fFN was present. All patients delivered before term. The 15 patients with PROM had very high concentrations of fFN with a medium concentration of 967.3 ng/ml. 18 of the 20 control patients were negative for fFN (< 75 ng/ml), 2 had a slightly elevated concentration of 84 and 85 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Chorioamnionitis↗
PubMed1994

[Tumor asepsis in organ saving pelviscopic ovarian surgery exemplified by dermoid cysts].

Three different surgical techniques were performed to remove ovarial tumors by pelviscopic organ-preserving surgery. Contamination of the peritoneal cavity with cystic and tumorous materia had to be prevented. Ovarian surgery was done in 112 pre-menopausal patients. Three techniques were compared: 1. complete extirpation of the cyst, 2. extirpation of the cystic wall after careful irrigation of the cyst, 3. the 'diaphragm technique': the affected ovary is operated inside a bag. Contamination of the peritoneal cavity was prevented only by the 'diaphragm technique'.

Asepsis↗
PubMed1994

[Varicella infection at birth].

At birth maternal infection with the Varizella-Zoster-Virus (VZV) is very rare but poses a truly life-threatening risk to the newborn. The neonatal mortality rate is up to 20-30%, if the maternal VZV-infection occurs between day 4 ante partum and day 2 post partum. The mortality can be decreased, if labour is successfully delayed by tocolytic agents until VZV-antibodies produced by maternal immune response have passed the placental barrier. There are indications that the mortality may also be lowered by passive immunisation of the newborn, but further research is needed. We recommend strongly to check VZV-IgG-antibodies-titres promptly, if VZV-infection is suspected. Labour then should be delayed by tocolytic agents as described in 2 case reports to allow maternal IgG-antibodies to cross the placental barrier to the foetus.

Adolescent↗
PubMed1993

[D-dimer and plasminogen activator of the urokinase type: personal experiences with breast cancer].

Plasma values of d-dimer, a stable end product of plasmin-induced fibrinolysis, were ascertained in 128 female patients with mammary carcinoma. These patients demonstrated significantly increased d-dimers in comparison with the control group with benign mammary disease (p < 0.01). The sensitivity and specificity of d-dimer were slightly higher than those of the established tumour marker CA 15-3 and CEA. There was no correlation between d-dimers in the plasma and increased expression of urokinase plasminogen activator (UPA) in the tissue. Increased d-dimers in the plasma of female patients with mammary carcinoma reflect multi-factoral interactions between carcinoma growth and the haemostatic-fibrinolytic system, and may be used as tumour markers.

Adult↗
PubMed1993

[Diagnosis of local panarteritis nodosa of the uterine cervix].

A 44-year old woman was referred because of metrorrhagia and asthenia. A diagnosis of uterine malignancy was suspected on the basis of the management of the Cervix uteri and an elevated erythrocyte sedimentation rate. Conisation and hysterectomy were performed, and histological examination revealed necrotising vasculitis affecting the Cervix uteri. Corpus uteri, muscle and fat biopsies showed no Periarteritis nodosa lesions. The incidental finding of necrotising arteritis in a surgical uterine specimen, involves further study to exclude systemic disease. The ability to involve any organ in the body makes it possible for specialists in every branch of medicine to be involved in the management and care of these patients.

Adult↗
PubMed1993

[Marshall-Marchetti-Krantz operation or fasciaplasty in therapy of recurrent urinary incontinence in women].

In this study, a follow-up examination was carried out, comprising 59 female patients who were operated between the years 1985 and 1991 because of recurrent urinary incontinence. We distinguished two different operating methods: 34 women were treated following the Marshall-Marchetti-Krantz operation technique, whereas a fasciaplasty-suspension was employed om 25 patients. At the urodynamic follow-up examination, the patients had experienced an average history of 2 years' recurrent urinary incontinence. The patients' subjective observation of anamnestic urinary incontinence was objectified by a clinical cough test, cystotonometry and sonography of the small pelvis. Making extensive use of the urodynamic examination possibilities showed a 79.4% improvement following the Marshall-Marchetti-Krantz operation in comparison to a 52% improvement after the fasciaplasty operation. The operations success is assessed by evaluation of the depression quotient. Here the Marshall-Marchetti-Krantz operation resulted in a significant improvement. After the fasciaplasty operation, however, this was not found to be the case.

Fasciotomy↗
PubMed1993

[Pelviscopic sacropexy in treatment of vaginal prolapse].

Although transabdominal sacropexy to correct vaginal prolapse is technically simple and yields good results, a minimal invasive procedure is desirable in the treatment of this benign condition. We therefore developed a laparoscopic sacropexy technique and were able to apply this operation successfully. Pelviscopic sacropexy does not differ greatly in principle from the intraabdominal approach; however, the techniques used in the individual steps must be adapted to pelviscopic methods.

Female↗
PubMed1993

[Prevention of human birth trauma I. Computer-assisted simulation of delivery using magnetic resonance tomography and finite element analysis].

Imaging procedures suitable for diagnosis of cephalopelvic disproportion, such as radiological pelvimetry, computer- or magnetic resonance imaging (MRI) fail to reflect the dynamics of delivery, including deformations of the birth channel as well as of foetal structures. In order to validate findings of imaging procedures in this respect, a method has been developed to perform dynamic, biomechanical postprocessing of the static information obtained from MRI. Using a specially developed software MRI pixel, matrices of the maternal pelvis and the foetal head were colour-coded and--according to the principle of equal density--line data were created. After sectional attribution of the resulting polygones, a three-dimensional mesh of so called Finite Elements (FE) was created, which can then be used for deformation analysis. The foetal head was then moved through the birth channel by means of computed simulation. This allows not only ongoing deformations to be visualised, but also resulting forces can be calculated at any time of the delivery process for any point of the anatomical model. Furthermore, these calculations can be performed assuming various conditions such as different cephalopelvic dimensions and various labour forces or biomechanical properties of the tissues involved. This paper aims at presenting the method and its mode of working by means of one example of a computed birth simulation.

Adult↗