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Biomedical subjects

G Holtz

Publications and source records attributed to G Holtz.

At least 19 recordsLinked to original sources
PubMed1987

Isthmic ectopic pregnancy and salpingitis isthmica nodosa.

Two hundred eighty-five charts were reviewed from patients who underwent surgery for ectopic pregnancy. Excluded were patients with previous tubal reparative surgery, linear salpingotomy, or failed sterilization. The incidence of isthmic ectopic pregnancy in the remaining 255 cases was 15.3%. The association of salpingitis isthmica nodosa (SIN) and isthmic ectopic pregnancy was determined by review of resected tubal segments. SIN was noted in 17 of 37 cases (45.9%) of isthmic ectopic pregnancy. SIN places the patient at risk for recurrent ectopic pregnancy or infertility. Recommended conservative management of isthmic ectopic pregnancy is segmental resection with postoperative emphasis on documentation of SIN when present. Postoperative hysterosalpingography is recommended with an abnormal contralateral tube or when SIN is noted in the resected tubal segment. Management options after an isthmic ectopic pregnancy when future fertility is desired are presented.

Fallopian Tubes↗
PubMed1987

Laparoscopy in the massively obese female.

Fifteen women weighing more than 250 pounds (113.6 kg) underwent laparoscopy. The open technique was used in two patients electively because of repeated pelvic laparotomies through periumbilical incisions. Of the remainder, four had used the closed technique and in nine it was necessary to adopt an open technique. Use of the latter effectively "lengthened" the instruments. Visualization was excellent in all but one subject, and the only complication was a single case of wound cellulitis.

Female↗
PubMed1987

Interleukin-1: a possible role in the infertility associated with endometriosis.

Increased numbers of activated macrophages are associated with mild endometriosis. Interleukin-1 (IL-1) is a protein produced by macrophages and is believed to be a primary mediator of host responses. IL-1 induces prostaglandin and fibrinogen synthesis and stimulates fibroblast proliferation. This study was undertaken to evaluate the role of IL-1 in the infertility associated with mild endometriosis. Peritoneal fluid (PF) was obtained at laparoscopy from 11 patients with minimal or mild endometriosis and from 7 women undergoing tubal ligation. Peritoneal macrophages were isolated and cultured for 24 hours. Peritoneal and macrophage culture fluids were studied for IL-1 activity, which was measured with the EL-4 assay. IL-1 activity was present in the PF of 10 of the 11 patients with endometriosis and 11 of the 11 macrophage culture fluids and was absent in the PF and macrophage culture fluid of the tubal ligation patients. The effect of recombinant alpha-IL-1 on the in vitro growth of 2-cell mouse embryos was also studied. IL-1 in concentrations similar to those present in the PF (greater than 1 U/ml) was toxic to mouse embryo development. We conclude that the IL-1 may play a role in the infertility associated with endometriosis.

Animals↗
PubMed1986

Adhesion prevention in the rabbit with sodium carboxymethylcellulose solutions.

With the use of a rabbit surgical model, the ability of 1%, 2%, and 3% solutions of sodium carboxymethylcellulose to reduce postoperative uterine adhesions was determined. At all concentrations sodium carboxymethylcellulose was more effective than either 32% dextran 70 or heparinized lactated Ringer's solution. Neither the dextran nor Ringer's solution had a significant (p less than or equal to 0.05) effect. The beneficial effects of sodium carboxymethylcellulose were closely dose-dependent (correlation coefficient 0.97). Sodium carboxymethylcellulose is highly effective in reducing postoperative adhesions in laboratory animals, and additional studies are warranted to further define its efficacy and safety.

Animals↗
PubMed1985

Luteinized unruptured follicle syndrome in mild endometriosis. Assessment with biochemical parameters.

Failure to extrude an ovum, with subsequent luteinization of the unruptured follicle (LUF), has been proposed as a cause of infertility in women with mild endometriosis. To assess the incidence of this process we performed laparoscopies in the early luteal phase on 16 women with mild endometriosis and 8 control subjects. Peritoneal fluid was aspirated and a plasma sample obtained concurrently. Estradiol (E2) and progesterone (P) concentrations were determined. A review of the literature suggested that the following hormonal criteria correlated with follicular rupture: fluid E2 greater than or equal to 500 pg/ml, E2 fluid/plasma ratio greater than or equal to 3.1, fluid P greater than or equal to 3,000 ng/dl and P fluid/plasma ratio greater than or equal to 5:1. All control subjects met at least one E2 and one P criterion: 75% met all. In contrast, less than one-third with mild endometriosis met all, and three (19%) met none. Five met only E2 criteria. These findings suggest that LUF occurs occasionally in association with mild endometriosis. Additionally, ovarian steroidogenesis, particularly P secretion, was impaired frequently in the absence of LUF in women with endometriosis.

Ascitic Fluid↗
PubMed1982

Adhesion induction by suture of varying tissue reactivity and caliber.

The importance of suture size and chronic reactivity in adhesion induction was evaluated in two experiments. In experiment I interrupted sutures (4/0 chromic, 4/0 polyglactin, and 6/0 polyglactin) were placed in the dorsal surfaces of rabbit uterine horns. Adhesions were infrequently induced by all suture materials. In experiment II 4-cm-long incisions were made in the distal antimesenteric uterine horns. These were then reapproximated with running sutures (4/0 chromic, 4/0 polyglactin, 6/0 polyglactin, and 8/0 nylon). Adhesion formation occurred to 16 of 18 incisions closed with 4/0 or 6/0 suture, whereas none of five incisions closed with 8/0 suture formed adhesions. These observations suggest that suture size rather than tissue reactivity is paramount in adhesion induction.

Animals↗
PubMed1980

Effect of thirty-two per cent dextran 70 on peritoneal adhesion formation and re-formation after lysis.

Thirty-two per cent dextran 70 in dextrose (Hyskon) has been reported effective in limiting adhesion formation following a peritoneal injury when employed in doses larger than that known to be safe for intraperitoneal use in humans. The effectiveness of a lower dosage believed to be safe for human use was investigated. Female rabbits received a standardized injury to their uterine horns and proximal fallopian tubes. Following the injury, Hyskon (2.5 ml/kg of body weight) was dripped over the sites of injury in the treatment group. Animals were reoperated upon 2 weeks later, and adhesions were scored. Hyskon significantly reduced adhesion formation. In a second experiment the effect of Hyskon on adhesion re-formation was evaluated. Adhesions were induced in the same manner. Two weeks later, the animals were reoperated upon, and adhesions were scored and lysed. Hyskon was instilled in the treatment group as in the first experiment. No significant difference was noted between adhesion scores in control and treatment groups after adhesion induction or when re-evaluated 2 weeks after lysis.

Animals↗
PubMed1979

The oncogenic effect of immunosuppressive (cytotoxic) agents in (NZB X NZW) mice. I. Long-term treatment with azathioprine and ifosfamide.

The increased incidence of neoplasia in the chronic use of immunosuppressive agents has been linked to a variety of factors including age, dose, agent, and frequency of administration. In this study azathioprine (az) and ifosfamide (ifo) were given both daily and weekly to female (NZB X NZW) mice over a period of 14 or 16 months in various dose regimens. Daily treatment with both agents prolonged survival time significantly but induced an apparently dose-related increase in tumor frequency. Intermittent ifo therapy produced neoplasia and survival results comparable to daily treatment, whereas intermittent az failed to extend longevity or produce malignancies. Varying the age of the mice (180 vs. 120 days) at the outset of treatment did not materially affect results in any respect. Ifo is less toxic than az in doses prolonging survival.

Animals↗
PubMed1979

Primary pure insular ovarian carcinoids.

Ovarian carcinoids are generally found in association with teratomatous elements. Reported are the 23rd and 24th primary pure insular ovarian carcinoids. One of the cases presented initially with carcinoid heart disease.

Aged↗
PubMed1979

Paraneoplastic hypercalcemia in ovarian tumors.

Two cases of paraneoplastic hypercalcemia secondary to ovarian tumors are presented. Both cases were secondary to ectopic parathormone (PTH) production. Other mediators postulated to cause this syndrome are prostaglandins, vitamin D-like sterols, non-vitamin D sterols, vitamin A, cortisol, and "osteoclast-activating factor.' The key treatment modalities for acute hypercalcemia are hydration and diuresis with furosemide; phosphates, steroids, antiprostaglandins, and hemodialysis may also be of value. Calcitonin is theoretically the most attractive treatment modality, but the rapid development of resistance limits its use to acute management. Mithramycin is most effective for long-term palliation of hypercalcemia if tumor-directed therapy is unsuccessful. Review of the literature confirms the previously made observation that mesonephromas are disproportionaately represented in association with this syndrome.

Adolescent↗
PubMed1976

Characterisation of autoantibodies to erythrocytes in autoimmune haemolytic anaemia by chloroquine.

Chloroquine splits autoantibodies from erythrocytes of patients with autoimmune haemolytic anaemia in vitro. After the removal of chloroquine from the samples the autoantibodies can be identified in the eluates. With one exception the autoantibodies of patients with idiopathic autoimmune haemolytic anaemia (AIHA) and severe haemolysis were completely split from the cells, whereas the autoantibodies of patients with symptomatic AIHA and moderate anaemia, of patients with diseases unrelated to haemolysis, and of healthy persons, were not completely split from the erythrocytes. In general, autoantibodies, which are associated with severe haemolysis, were more easily split from the red cells by chloroquine. The eluted IgG incomplete warm autoantibodies were only in part specific to Rh antigens. The Rh specificity does not correlate with the absence of presence of increased haemolysis. The inhibition of the autoantibodies and the splitting or 'loosening' of the antigen-antibody linkage with the immunocomplex by chloroquine could be responsible of a longer survival of autoantibody-coated red cells in patients with AIHA.

Anemia, Hemolytic, Autoimmune↗
PubMed1976

[Relation between RNA-synthesis and electrophoretic mobility of peripheral lymphocytes (author's transl)].

PHA and pokeweed mitogen increase the RNA-synthesis and decrease the electrophoretic mobility (e.m.) of normal peripheral lymphocytes. The increase in RNA-synthesis is not observed culturing lymphocytes from some patients with chronic lymphocytic leukemia. In these cases the electrophoretic mobility remains unchanged. In some patients with CLL an increase in RNA-synthesis develops later than in normal controls. Correspondingly the decrease of the e.m. can be observed with delay. Erythrocytes and thrombocytes are not influenced by the mitogens. Since an increase in RNA-synthesis and decrease of the e.m. is also observed in mixed lymphocyte cultures without the presence of mitogens it is followed that the increase in RNA-synthesis is responsible for the decrease of the e.m.

Cell Membrane↗