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Biomedical subjects

G Sliutz

Publications and source records attributed to G Sliutz.

57 records · Page 4Linked to original sources

[Obstetric management of patients with HELLP syndrome].

The syndrome of haemolysis, elevated liver enzymes and low platelet count (HELLP-Syndrome) is a severe form of preeclampsia and eclampsia. The clinical course is characterized by right upper quadrant and epigastric pain, hypertension, proteinuria and edema. Maternal and neonatal morbidity are high. The underlying cause for this pregnancy-related syndrome is still unclear. As soon as a reliable diagnosis is established handling of patients suffering from HELLP-Syndrome is ambivalent: Immediate termination of pregnancy, however, poses a problem at early gestational age. Therefore some authors have advocated a conservative management. At our department active management and delivery by Caesarean section as soon as possible has gained acceptance in the past 5 years. We report our experience with 23 patients over a 12 year period, and with 4 patients from the intensive care unit (N = 27). Mean gestational age was 33.5 weeks (+/- 4.8) and the mean birthweight was 1922.5 g (+/- 971.5). 19 patients were delivered by Caesarean section. Most complications were based on a delayed delivery and subsequent deterioration of maternal condition. Reduction of the time interval between establishment of diagnosis and termination of pregnancy (1980-1985-3 days; 1986-1992-12 hours) resulted in a better outcome. We recommend intensive laboratory screening and exact clinical examination since missed or delayed diagnosis as well as delayed delivery are life threatening for mother and child. Only prompt delivery yields an improvement of prognosis.

Adult↗

Serum evaluation of basic FGF in breast cancer patients.

Basic fibroblast growth factor (bFGF) is a potent endothelial cell mitogen found in a variety of normal and tumour tissues and is of prognostic relevance in human malignancies such as renal cell carcinoma and leukaemia. This study presents the data of 104 serum samples of 20 patients suffering from breast cancer. Mean serum levels of bFGF in these patients were 13.9 +/- 17. 1 (min 0, max 56.4) pg/ml and 2.4 +/- 5.9 (min 0, max 24.7) pg/ml, respectively (p = 0.01). Basic FGF reached a sensitivity of 61% at a specificity of 87% when applying a cut-off level of 5 pg/ml. A continuous increase of bFGF serum levels before the clinical detection of relapse (lead time) was seen in 3 out of 8 cases with a mean lead time of 4 months. Preoperative serum levels were not of prognostic value and showed no correlation with axillary lymph node metastasis. These preliminary results indicate that, in breast cancer patients, soluble bFGF may be useful in early detection of primary tumours, recurrences and monitoring of therapy.

Adult↗

Prostate specific antigen (PSA) in breast and ovarian cancer.

Prostatic specific antigen (PSA) is commonly used for the diagnosis and monitoring of prostatic adenocarcinoma, and has recently been detected in breast cancer and it is also thought to be produced by ovarian cancer. To examine the prognostic value of PSA tumor expression, we investigated the tumor cytosols of 26 patients with breast cancer and of 16 women with ovarian cancer. We used a chemiluminescence immunoassay for the quantitative determination of PSA (detection limit 0.003 ng/ml). The median PSA level in breast cancer patients was 0.31 ng/mg (minimum 0.003, maximum 4.4). PSA expression was significantly lower in poorly differentiated breast cancers compared to moderately and highly differentiated tumors. Advanced lymph node metastases were also correlated with lower PSA expression. We found no correlation with relapse free or overall survival. Median PSA level in our ovarian cancer patient collective was 0.014 ng/mg (minimum 0.003, maximum 0.046). We found a significant correlation between PSA expression and the estrogen receptor content of the tumor. PSA expression showed no correlation with histological grading, tumor size or other tumor characteristics in ovarian cancer. There was no correlation with relapse free or overall survival in ovarian cancer patients. Our study demonstrates that PSA is expressed in ovarian malignancies but at a lower level compared to breast cancer tissue. PSA was not able to identify a subset of patients with good prognosis in breast and in ovarian cancer patients.

Adenocarcinoma↗