Biomedical subjects

H Meden

Publications and source records attributed to H Meden.

At least 55 records · Page 3Linked to original sources

PubMed1990

[The value of preoperative diagnosis before second-look laparotomy in ovarian cancer].

In a retrospective analysis, the diagnostic validity of computed tomography (CT), sonography (US), CA 125 and CEA serum levels in the detection of tumor-masses were evaluated in 135 patients with primary ovarian cancer. A second-look-laparotomy followed in each patient and the surgical-pathological findings were correlated to preoperative results. Sensitivity, specificity, positive and negative predictive value of the different methods were as follows: CT (n = 102) 70%, 65%, 68%, 67%, US (n = 97) 52%, 94%, 94%, 49%, CA 125 serum levels (n = 76) 55%, 100%, 100%, 58%, CEA serum levels (n = 40) 15%, 86%, 67%, 35%. CT, US and CA 125-serum levels appear to be suitable for routine control in ovarian cancer, but cannot replace the diagnostic value of a second-look-laparotomy.

Antigens, Tumor-Associated, Carbohydrate↗

PubMed1989

[Congenital hyperthyroidism in maternal Basedow disease].

A case of congenital hyperthyroidism, after pregnancy complicated by Graves' disease is presented. Fetal tachycardia was the cardial symptom. Caesarean section was performed in the 29 years old patient with normal thyroid function in the 29th week of pregnancy. The neonate showed symptoms of a congenital hyperthyroidism with goitre. Antithyroid antibodies were found in the serum of both mother and child. At the age of ten weeks, after a short course of thyrostatic treatment, the infant was discharged with normal thyroid function following complicationfree progress.

Adult↗

PubMed1989

[Serum level of the tumor marker CA 125 before second-look laparatomy in primary epithelial ovarian cancer in relation to intraoperative findings].

Serum CA 125 levels were evaluated in 76 patients undergoing second-look laparatomy for primary epithelial ovarian cancer. The findings were related to the presence of intraabdominal tumor. CA 125 levels were greater than 35 U/ml in 26 cases in accordance to the intraoperative findings. CA 125 levels less than or equal to 35 U/ml were found in 50 cases out of which 29 were free of tumor, while 21 showed intraabdominal tumors. Thus a CA 125 level greater than 35 U/ml revealed to be a strong predictor of the presence of intraabdominal tumor. Due to low sensitivity monitoring serum CA 125 levels cannot replace second-look laparotomy.

Adult↗

PubMedDate not supplied

CA 125 in benign gynecological conditions.

The tumor marker CA 125 was initially thought to be specific for ovarian malignancies. Subsequently it was found to be raised in a variety of benign conditions, including pregnancy, pelvic inflammatory disease, tuberculosis and cirrhosis of the liver. With respect to gynecological tumors, CA 125 may be elevated in benign ovarian cysts, tubo-ovarian abscess, endometriosis, hyperstimulation syndrome, ectopic pregnancy and fibroids. These results demonstrate that CA 125 is a marker of non-specific peritoneal conditions.

Biomarkers, Tumor↗

PubMedDate not supplied

Immunohistochemical detection of HSP60-expression in human ovarian cancer. Correlation with survival in a series of 247 patients.

PURPOSE: In a previous pilot study, HSP60 expression at the transcriptional (mRNA) level was shown to be a negative prognostic factor in ovarian cancer. The aim of this study was to determine HSP60-expression by means of immunohistochemistry and to correlate the results with survival in a large series of ovarian carcinoma patients with a closed follow-up. MATERIALS AND METHODS: Slides from routinely processed, paraffin-embedded tumor blocks belonging to 247 patients with epithelial ovarian carcinoma were studied for the overexpression of HSP60 using the Lk2 monoclonal antibody and the strepatvidin-biotin-peroxidase technique. HSP60-expression was correlated with overall survival by means of life-table analysis and the Kaplan-Meier method. RESULTS: 47 tumors (19%) expressed HSP60. Of them, 12/29 (41.4% positivity) were stage I tumors, whereas only 35 out of the remaining 218 tumors in more advanced surgical stage (16.1%) showed HSP60 staining. This difference was statistically significant (Fisher s exact test; p = 0.004). Even when stratifying stage for stage, the difference between groups still remained statistically significant (Chi square test; p = 0.0095). The survival curve analysis showed a significant difference in favor of those tumors expressing HSP60 (median survival 28 vs. 37 months; log-rank test, p = 0.02). CONCLUSION: Immunohistochemical detection of HSP60-expression in human epithelial ovarian carcinoma is significantly more frequent in tumors from patients with initial stages of the disease. Therefore, HSP60-expression determined by this method is associated with a significantly better prognosis.

Antibodies, Monoclonal↗

PubMedDate not supplied

Docetaxel is effective in the treatment of metastatic endometrial cancer.

BACKGROUND: Systemic treatment of endometrial carcinoma with distant metastases is currently performed, inter alia, with anthracyclines, platinum, paclitaxel, if osfamid or progestins. This is the first report presenting experience in treatment of metastatic endometrial carcinoma with docetaxel. CASE REPORT: A 69-year-old women with adenocarcinoma of the endometrium was treated with primary combined radiotherapy. Two years later disseminated bilateral pulmonary metastases were detected and the patient was submitted to chemotherapy with epirubicin. After three cycles of chemotherapy with epirubicin examinations revealed metastatic progression. Thus, chemotherapy was changed to docetaxel. RESULTS: After three cycles of chemotherapy with docetaxel examinations revealed remission of the described pulmonary metastases more than 50%. A further three cycles of chemotherapy with docetaxel lead to continuing shrinkage of the detectable metastases to less than 25% of the original size. Because of various side effects, like increasing fatigue and asthenia, uncomfortable acral paresthesia and allergic skin reactions, the patient refused to continue chemotherapy. CONCLUSION: We conclude that docetaxel may be an active agent in patients with metastatic endometrial cancer, but care should be taken to minimize side-effects.

Adenocarcinoma↗

PubMedDate not supplied

Expression of the mismatch repair protein hMSH2 in carcinoma in situ and invasive cancer of the breast.

BACKGROUND: Dysregulations in the mechanism of DNA-repair are contributed to tumorgenesis and tumorprogression in human cancer. The mismatch repair gene hMSH2 encodes a protein, which recognizes and binds to mismatch-sequences of the DNA. METHODS: Using immunohistochemical techniques hMSH2 expression was analyzed in invasive cancer (n = 85) and in situ carcinoma (n = 34) of the breast. RESULTS: The percentage of hMSH2 positive cases was significantly (p = 0.0001) decreased in invasive cancer as compared to in situ carcinomas. There was an association of hMSH2 expression with parameters of unfavorable prognosis, such as lymph node involvement (p = 0.03), higher degree of malignancy (p = 0.05) and higher proliferative activity (p = 0.05). CONCLUSIONS: During development from in situ to invasive cancer of the breast, hMSH2 expression seems to be downregulated. However, in invasive cancer, hMSH2 expression seems to be associated with tumor progression. This could be explained by the fact that enhanced proliferation of tumor cells results in increased mistakes within DNA replication procedures.

Adenocarcinoma↗

PubMedDate not supplied

Weekly intravenous recombinant humanized anti-P185HER2 monoclonal antibody (herceptin) plus docetaxel in patients with metastatic breast cancer: a pilot study.

BACKGROUND: In patients with HER2-positive metastatic breast cancer (MBC), combined treatment of herceptin (H) and chemotherapy (CT) improves time to progression, response rates and survival compared with CT alone. MATERIALS AND METHODS: We evaluated the safety and efficacy of weekly Docetaxel combined with weekly H as treatment in HER2 overexpressing MBC. RESULTS: Preliminary toxicity data from 12 patients and 76 cycles of D and 80 cycles of H were analysed. No G3/4 toxicity was observed. The most frequent non-hematologic toxicities were fatigue (2 patients G2, 2 patients G1), dyspepsia (1 patients G2, 3 patients G1), diarrhea (1 patient G2, 3 patients G1), and nausea (1 patient G2, 3 patients G1). Six partial responses have been observed in 12 patients (ORR 50%). CONCLUSIONS: The combination of weekly Docetaxel and Herceptin is well tolerated with significant anti-tumor activity.

Adolescent↗

PubMedDate not supplied

Treosulfan in the treatment of advanced ovarian cancer: a randomised co-operative multicentre phase III-study.

BACKGROUND: In August 1988 a randomised phase III multicenter trial was started in order to compare cisplatinum/treosulfan (PT) with standard cisplatinum/cyclophosphamide (PC) in advanced ovarian carcinoma, aiming at lower toxicity and maintained efficiency. PATIENTS AND METHODS: Five hundred and nineteen patients were enrolled into the protocol. Final evaluation after a median observation time of more than five years was made in July 1996 and included 398 eligible patients, of whom 366 were evaluable regarding efficiency and 290 in respect of toxicity. The tumour stages were classified as FIGO II in 53, FIGO III in 244 and FIGO IV in 68 patients. The patients were stratified regarding post-operative tumour burden. RESULTS: Hematological and gastrointestinal toxicity WHO > = 3 were comparable between the two study arms though a significant difference could be demonstrated regarding alopecia (PT 8% vs. PC 47% after six cycles). The median time to progression as the main efficiency item was in favour of the study schedule (PT 20.6 vs. PC 15.1 months) while significant differences were neither observed in the whole study group nor in the analysed subgroups (R0, < 2 cm, > = 2 cm). The same held true for overall survival. CONCLUSION: PT may be recommended as a less toxic substitute for the former standard PC. After the acceptance of paclitaxel/cisplatin as a new standard, the role of treosulfan should be investigated regarding adjuvant therapy in patients without residual tumor, as a potential partner in triple or sequential treatment and in second-line treatment.

Adult↗

PubMedDate not supplied

[Transplacental cardioversion of fetal supraventricular tachycardia using sotalol].

Intrauterine fetal supraventricular tachycardia (FSVT) is a rare condition which is connected with organic heart disease in 4-10 per cent. Intrauterine pharmacologic cardioversion with digoxin and verapamil has been recommended previously. However, during pregnancy standard doses of digoxin result in suboptimal concentrations in the maternal serum and fetal therapeutic concentrations might demand doses inconvenient to the mother. Verapamil is not always effective. In this report we describe a case of FSVT. The arrhythmia was treated by administering sotalol to the mother after verapamil had failed to alter the fetal heart rate. This ist the first report of a fetal cardioversion with sotalol. We conclude that sotalol may be useful in the treatment of FSVT that is refractory to digoxin or verapamil.

Adult↗

PubMedDate not supplied

[Role of team work in preventing the birth of abnormal children].

In diagnosing and preventing the birth of abnormal children the authors stress the necessity of team work of different specialists and their centralisation at the University complex or hospitals. The results of such a team work organised at the Division of Medical Genetics, Department of Gynecology and Obstetrics in Ljubljana and their experience in detecting some of monogenic, chromosome, and etiologically unknown disorders are presented, as well as the results of the follow-up of certain cases. The value of team work in genetic counselling is also pointed out.

Abortion, Induced↗

PubMedDate not supplied

Prognostic significance of p105 (c-erbB-2 HER2/neu) serum levels in patients with ovarian cancer.

BACKGROUND: Elevated serum levels of the oncoprotein p105 (c-erbB-2, HER2/neu) have been found in patients with ovarian cancer, but its role in this disease has not been clearly established. MATERIALS AND METHODS: The authors studied the relationship between p105 serum levels, various tumor parameters, and survival in 57 patients with newly diagnosed, untreated ovarian cancer. Serum specimens were obtained at the time of initial surgery, and p105 levels were determined using the human neu quantitative ELISA assay. RESULTS: Elevated p105 serum levels were correlated with a poor prognosis since patients with low p105 levels had a better survival than patients with high p105 levels (P = 0.02). This result was confirmed in stage III patients (n = 29; P = 0.08). p105 serum levels were not related to tumor stage, grade, histologic findings or serum CA 125 levels. CONCLUSIONS: Our results suggest that ovarian cancer patients with elevated p105 serum levels may have a poor clinical outcome.

Adolescent↗

PubMedDate not supplied

Mib-1 evaluated proliferative activity in ovarian cancer with respect to prognostic significance.

In the present study, tumor tissue of 251 patients with ovarian cancer was immunohistochemically analysed for proliferative activity using the monoclonal antibody mib-1 and the analyse system CAS 200. The rate of the growth fraction varied from 0% to 71% mib-1 positive tumor cells with a median of 17%. There was a strongly significant association between proliferative activity and the degree of histological differentiation (p = 0.0005), whereas there was no significant correlation with tumor stage and histological subtypes. Using the median as the cut-off point, patients with higher proliferating tumors (> or = 17%) had a statistically significant worse prognosis (p = 0.0431). Especially in the group of patients with grade 1 and grade 2 tumors, measurement of the proliferative activity is of help for prediction of the postoperative survival time of patients (p = 0.0336), suggesting that measurement of the growth fraction estimated by mib-1 reflects more closely the degree of tumor differentiation. However, multivariate analyses cannot confirm these results.

Adolescent↗

PubMedDate not supplied

Serum levels of the c-erbB-2 (HER2/neu) encoded oncoprotein fragment p105 in normal pregnancies.

The c-erbB-2 encoded oncoprotein p185 is overexpressed in fetal epithelial cells, in the placenta, and in several human carcinomas. Elevated serum levels of the 105 kD extracellular part are found in cancer patients and in pregnancy. Our purpose was to examine whether there is a characteristic development of p105 serum levels in the course of normal pregnancy. Using ELISA, we measured the p105 serum concentrations in nonpregnant women, women with normal pregnancy in the 1st, 2nd, and 3rd trimester and pueperas. Compared to nonpregnant women, we found a significant decrease in p105 in the 1st and 2nd trimester, followed by a significant increase in the 3rd trimester. Post partum serum values returned to the levels found in nonpregnant women. The clinical judgment of female p105 serum values requires comparison with the normal range of random samples, and the consideration of pregnancy and the age of gestation as in vivo influencing factors.

Enzyme-Linked Immunosorbent Assay↗

PubMedDate not supplied

[Obstetric aspects of maternal hepatitis C infection].

The present study discusses problems of maternal infection with hepatitis C virus in pregnancy with respect to the recent publications on this subject. In particular, questions of vertical transmission during pregnancy and fetal infection sub partu are discussed using three cases as an example. It was shown that recently few informations on the risk of transmission of the hepatitis C virus from the mother to the infant in utero or sub partu are existing, but the actual studies provide some evidence for this risk to be relatively low. The actual knowledge concerning the mode of delivery of hepatitis C positive women as well as recommendations concerning the diagnostic and therapeutic procedures are comprehensively shown on the basis of the recent scientific results.

Adult↗

PubMedDate not supplied

Maintenance chemotherapy with oral treosulfan following first-line treatment in patients with advanced ovarian cancer: feasibility and toxicity.

PURPOSE: To evaluate the feasibility and toxicity of maintenance oral treosulfan chemotherapy for ovarian cancer patients after surgical treatment and response to first-line chemotherapy. PATIENTS AND METHODS: Thirty-nine patients were entered onto this trial. This was a pretreated patient population. The pretreatment consisted of radical surgery and chemotherapy. The treatment that immediately preceded oral treosulfan was standard-dose platin-based chemotherapy. Daily oral treosulfan was administered at a dose of 1250 mg for 5 consecutive days every five weeks for at least three cycles. All patients started daily oral treosulfan while in complete remission. RESULTS: A total of 322 cycles of oral treosulfan was administered, with a median of 6 cycles (range 3-24). Treosulfan in this schedule was generally well tolerated. The major toxic effects were leukopenia and thrombocytopenia, which, however, were manageable and rapidly reversible. There were no episodes of bleeding or leukopenic fever. No anti-emetic drugs were required. Alopecia was not observed, 20 patients had progressive disease (after 3-6 months: n = 8, after > 6 months: n = 12). The median survival for all patients was 24 (range 9.44+) months, and median time to progression 8 (range 3-24) months. CONCLUSIONS: Maintenance oral treosulfan was well tolerated in this pretreated patient population. In an attempt to further improve overall survival in ovarian cancer patients, prospective random assignment trials will be necessary to determine the benefit of this approach.

Administration, Oral↗

PubMedDate not supplied

Differential expression of apoptosis associated genes bax and bcl-2 in ovarian cancer.

The prognostic value of various molecular markers, which adequately account for the tumor biology and disease behaviour of ovarian cancer, is still unclear. Recent studies have focused on the role of genes regulating the balance between proliferation and cellular suicide, apoptosis. In the present study, tumor tissue from 215 patients with ovarian cancer was immunohistochemically analysed for Bax- and Bcl-2-expression. There was an association between Bcl-2-expression (30%) and factors of favourable prognosis. In contrast, Bax-expression (47%) was related to bad clinical outcome, especially in cases without concomitant Bcl-2-expression. In patients with Bcl-2-positive/Bax-negative tumors, overall survival was significantly longer (p = 0.0379) than in patients with Bcl-2- and Bax-negative tumors. Respectively, expression of Bax without Bcl-2-expression was correlated with bad clinical outcome (p = 0.033). The difference in overall survival was most striking (p = 0.0007) between patients with Bax-positive/Bcl-2-negative and Bcl-2-positive/Bax-negative tumors. This could also be demonstrated for the various subgroups of different tumor grade and stage. It may be speculated, that alteration of the Bax/Bcl-2-balance may influence the clinical course by deregulation of programmed cell death and altered sensitivity to chemotherapy.

Adenocarcinoma, Clear Cell↗

PubMedDate not supplied

Hormonal treatment with sex steroids in women is associated with lower p105 serum concentrations.

BACKGROUND: In breast and ovarian cancer patients elevated serum levels of the oncoprotein p105 were detected. We examined the influence of endocrine factors on the p105 serum concentration. MATERIALS AND METHODS: The sera of 115 and non-pregnant women were analysed. Of the premenopausal women (n = 77) hormonal contraception was used by 30 women, and of the postmenopausal women (n = 33) there were 15 women using hormonal replacement therapy (HRT). The serum specimens were analysed by ELISA. RESULTS: Women with hormonal contraception had significantly lower serum levels than premenospausal controls (82-138 fmol/ml, median 109 fmol/ml vs. 103-183 fmol/ml, median 130 fmol/ml; P < 0.001). In postmenopausal women with HRT serum levels were significantly lower than in postmenopausal controls (88-136 fmol/ml, median 117 fmol/ml vs. 99-261 fmol/ml, median 148 fmol/ml; P < 0.001). CONCLUSIONS: Sex steroids seem to modulate c-erbB-2 activity. These results are important with regard to clinical studies on p105 oncoprotein in cancer patients.

Contraceptives, Oral, Hormonal↗