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Biomedical subjects

H Graeff

Publications and source records attributed to H Graeff.

At least 145 records · Page 8Linked to original sources
PubMed1985

[Bacterial colonization of the cervix and complications later in the course of pregnancy following cerclage].

In 107 patients undergoing cerclage operation, cervical bacterial flora was documented in a prospective study. Complications due to bacterial contamination were recorded. Postoperatively there was an increase in cervical bacteria, both in number and variety. The results were highly significant. The incidence of premature labor, premature rupture of membranes, puerperal and neonatal infections is higher than the level in our own institution and the overall level in Bavaria. Our results suggest that cerclage involves an increased risk of cervical contamination with subsequent complications during pregnancy, puerperium and newborn period.

Bacteria↗
PubMed1985

[Simultaneous determination of Ca 125 and D-dimer in plasma and ascites in ovarian cancer].

In 37 patients with ovarian carcinoma stages Ic to IV the values of preoperatively determined tumour markers and the values of the follow-ups were examined in a trial to observe the course of the disease. The following sensitivity was recorded: Ca 125 92%, D-dimer 100%, TPA 76%, CEA 29%, CA 19-9 15%. Ca 125, D-dimer and TPA are unsuitable as follow-ups. They are also detectable in ascites.

Adenocarcinoma, Mucinous↗
PubMed1985

Measurement of crosslinked fibrin derivatives in plasma and ascitic fluid with monoclonal antibodies against D dimer using EIA and latex test.

D dimer and related crosslinked fibrin derivatives were measured in plasma of normal subjects and in patients with various disorders. In 23 healthy, young females low plasma levels were found (mean 47 ng/ml). In 12 patients with deep vein thrombosis, moderately elevated levels (mean 593 ng/ml) were seen. Higher levels were found in 6 patients with pulmonary embolism (mean 3,337 ng/ml). The highest values occurred in 4 patients with severe intravascular coagulation (31,000 to 390,000 ng/ml). In 22 patients with ovarian cancer and in 21 patients with other gynecologic carcinoma, normal to highly elevated levels of D dimer like material were found. These values corresponded well to concentrations of tumor marker CA 125, measured in the same samples, and to tumor activities staged in these patients based on clinical examinations. Very high values of crosslinked fibrin derivatives (75,000-525,000 ng/ml) were determined in ascitic fluid of patients with ovarian cancer.

Adult↗
PubMed1984

Crosslinked fibrin derivatives and fibronectin in ascitic fluid from patients with ovarian cancer compared to ascitic fluid in liver cirrhosis.

Ascitic fluid from patients with ovarian cancer and from patients with alcohol induced liver cirrhosis were compared in respect to hematological and related parameters (content of fibrinogen and fibrin (ogen) degradation products, fibrinopeptide A, F-CB3 related antigen, ratio of crosslinked fibrin to non crosslinked fibrin (ogen), fibronectin and total protein). In tumor ascites all parameters except FPA were significantly elevated compared with cirrhosis ascites. Tumor ascites contains a six-fold higher level of fibrin (ogen) degradation products. A considerable portion of it constitute crosslinked (factor XIII induced) high molecular weight fibrin derivatives. Their content is approx. 10 times higher in tumor ascites than in cirrhosis ascites. Characterization of the crosslinked fibrin derivatives revealed the presence of fragments DD, DY, and some other fragments compatible with XY, DXD, DXY, YXY and DXX. The fibronectin content is also significantly higher in tumor ascites compared with cirrhosis ascites. The value ranges showed no overlap. The findings suggest a turnover of fibrinogen in both ascitic fluids via coagulation and fibrinolysis. In tumor ascites however, fibrinogen seems to be catabolized to a higher degree via the degradation of crosslinked fibrin.

Ascitic Fluid↗
PubMed1984

Recent aspects of hemostasis, hematology and hemorheology in preeclampsia-eclampsia.

Because intravascular fibrin deposition is found in the glomerular capillaries of patients who have died of eclampsia, it was long assumed that a chronic form of intravascular clotting represents the decisive cause of the condition. Fibrin deposition is also typically observed in the uteroplacental bloodstream. The occurrence of high levels of soluble fibrin and fibrin(ogen) degradation products, which in severe cases can also include fibrin oligomers, in combination with thrombocytopenia and factor VIII consumption were interpreted as additional evidence for the significance of intravascular clotting in the pathogenesis of EPH gestosis. The hemolysis of the microangiopathologic type, which occurs in severe cases, was attributed to the resulting impairment in microcirculation. Doubts regarding this theory arose when it was noted that the course of EPH gestosis is not altered by the use of heparin, and that even in severe cases of eclampsia with hemolysis and thrombocytopenia the plasmatic clotting system is involved only to a small extent and probably only secondarily. More recent investigations have yielded the first evidence of reduced prostacyclin synthesis in maternal and fetal vessels in patients with EPH gestosis. Since prostacyclins lower arterial resistance yet at the same time are strong inhibitors of thrombocyte aggregation, this prostacyclin deficiency could account for the hypertension and the occurrence of platelet thrombi in the placental bloodstream associated with EPH gestosis. The observation of a reduction in the number of thrombocytes as a consequence of increased platelet breakdown, which precedes a rise in the level of fibrin(ogen) degradation products, also points to the significance of an abnormal interrelation between platelets and endothelium. In addition to the plasmatic and thrombocytic hypercoagulability and impaired prostacyclin synthesis, hemoconcentration with increased microvascular permeability is also observed. Early detection of disturbances of the vessel wall and vessel contents may provide a means of prophylaxis.

Adult↗
PubMed1983

[Thrombocytopenia and disseminated intravascular coagulation in low-dose heparin prophylaxis].

During postoperative prophylaxis of thrombosis using subcutaneous low-dose heparin thrombocytopenia and consumption coagulopathy without manifest haemorrhage were observed in a female patient with gynaecologic problems on the tenth postoperative day. Using gel-electrophoresis, demonstration of cross-linked fibrin derivatives, which occur only after contact with thrombin, was proof that disseminated intravascular coagulation must have been present. Cancellation of heparin prophylaxis was sufficient for regression of the haemostatic disorder. Platelet function tests performed two months later showed as the only reproducible abnormality that the patient's plasma caused inhibition of desaggregation of normal platelets only when heparin was present. The remarkably close chronologic connection of heparin prophylaxis with thrombocytopenia and consumption coagulopathy suggests a possible causal connection. However, at present the possibly heterogeneous aetiology cannot be explained satisfactorily.

Adult↗
PubMed1983

[Postpartum streptococcal gangrene].

A case of acute hemolytic streptococcal gangrene is presented. Typical signs of this disease are local pain, erythema, edema, formation of blisters, and gangrene. Malaise and fever are more unspecific. The special clinical feature of this postpartum case is discussed and compared with the literature. The therapy comprised extended incision of the vulva, application of antimicrobial agents, and exchange transfusion.

Acute Disease↗
PubMed1983

Immunohistochemical studies on opioid peptides in the human placenta.

The demonstration of the immunoreactive proopiomelanocortin (POMC) peptides beta-endorphin (beta-E), beta-lipotropin (beta-LPH), alpha-melanotropin (alpha-MSH), and corticotropin (ACTH) in the human placenta or in tissue cultures of placental origin using radioimmuno-, bio-, or radioreceptor assay suggested that opioid peptide hormones or their precursors are synthesized in the placenta. In order to test this hypothesis, we tried to localize opioid peptides immunohistochemically. On neighbouring sections of the placenta which were incubated with antisera against beta-E, beta-LPH, alpha-MSH, ACTH, BAM-12 P, BAM-22 P, Heptapeptide, alpha-Neoendorphin and Dynorphin 1-17, the immunoperoxidase method was used. The placenta and the pituitary of perfusion-fixed rats were used for controls. The negative immunohistochemical findings in the human and rat placenta do not support the view that beta-E, beta-LPH, alpha-MSH and ACTH are synthesized in the syncytiotrophoblast of this organ. The site of origin of proopiomelanocortin peptides which are present in the maternal and the fetal plasma most likely is the maternal and fetal pituitary.

Animals↗
PubMed1983

[Markerfunction of crosslinked fibrin derivatives in ascitic fluid from patients with ovarian cancer: a comparison with ascitic fluid in liver cirrhosis].

Ascitic fluid from patients with ovarian cancer contains high levels of fibrin(ogen) degradation products (FDP). Crosslinked fibrin derivatives were isolated by precipitation and separated by PAA-gel-electrophoresis. In order to evaluate the submolecular structure the total precipitate and single derivatives were investigated after cleavage of the disulfide bonds. The findings are related to the radioimmunological measurements of certain fibrinopeptides. Tumor ascites contains approximately ten times higher levels of crosslinked fibrin derivatives than cirrhosis ascites. The fibrinopeptide A content is similar, whereas the levels of plasmin-induced alpha-chain fragment are significantly higher in tumor ascites. The findings suggest a catabolism of fibrinogen in ascitic fluid via coagulation and fibrinolysis. In tumor ascites fibrinogen is catabolized to a significantly higher degree via the degradation of crosslinked fibrin. Crosslinked fibrin derivatives may therefore be usable as non-carcinoembryogenic tumor markers.

Ascites↗
PubMed1983

[Hysterectomy for septicemia following caesarean section].

From 1971 to 1980 20 patients at the first department of women of the university of Munich required a puerperal hysterectomy because of septicemia following caesarean section. During the same time a total of 2,726 caesarean sections were performed. 14 of the 20 women requiring hysterectomy had the caesarean section in the first department for women. Six women were referred with septicemia following caesarean section in another hospital. The causative relationship between caesarean section and septicemia was reviewed leading to the indication for hysterectomy. The indications for the caesarean section, risk factors for increased puerperal infection, the postoperative course, the indication for hysterectomy, the findings at operation the findings in the operative specimen and the course following hysterectomy were reviewed. Risk factors promoting an ascending infection postpartum were the type of labor, frequent vaginal examinations, previous attempts at vaginal delivery, and internal fetal monitoring by a scalp electrode. The recognition of incipient septicemia include severe pain in the abdomen and a subjective feeling of severe illness in the patient. The white blood count is increased, the body temperature is high and beginning respiratory insufficiency points to the severity of the illness. In these cases a repeat laparotomy with hysterectomy to eliminate the focus of infection is the treatment of choice for the septicemia. 19 of the patients who required hysterectomy for septicemia following caesarean section were discharged home after a mean hospital stay of 36 days. One of the patients died 41 days following caesarean section and 20 days following hysterectomy because of septicemia resistant to treatment.

Adnexa Uteri↗
PubMed1982

[Peripartal infections].

Infections are still the most frequent peripartal complications. Very often they are nosocomial (hospital acquired) infections. Diagnosis and therapy of severe conditions may pose considerable problems. The most significant clinical factors in patient survival are the attentive surveillance and early recognition of the patient's disorder. The choice of antibiotics has to be done in consideration of the bacteriology of the vagina (endogenous infection). Removal of the infection site (uterus with or without adnexae) is the therapeutic procedure with the highest success rate in cases with sepsis or bacterial shock. Prophylaxis of infectious morbidity following caesarean section seems to be possible and advisable in patients with certain risk factors (labour, rupture of membranes, repeated vaginal examinations).

Cesarean Section↗