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Biomedical subjects

H Steiner

Publications and source records attributed to H Steiner.

At least 145 records · Page 8Linked to original sources

Helospectin and pituitary adenylate cyclase activating polypeptide in the human vagina.

Helospectin and pituitary adenylate cyclase activating polypeptide (PACAP), both recently isolated from the poisonous saliva of the American lizard or from ovine hypothalamus respectively, belong to the same peptide family as vasoactive intestinal polypeptide (VIP), peptide histidine methionine (PHM) and glucagon. In the present study, occurrence and distribution patterns of nerve fibers containing helospectin- and PACAP-like immunoreactivity in the human vagina were investigated by immunohistochemistry. Double immunofluorescent labeling showed that helospectin or PACAP are co-expressed with VIP and PHM within subpopulations of VIP-immunoreactive nerve fibers. Nervous structures containing helospectin and VIP were particularly numerous in the internal mucous lining of the vagina and in free epithelial nerve endings, and an abundant network of nerve fibers surrounding blood vessels was detected. Nerve fibers co-expressing PACAP and VIP were more numerous than those expressing helospectin and VIP and were mainly found in close association with blood vessels as well as beneath and within the epithelium. Due to the lack of non-rabbit helospectin or PACAP antibodies, possible co-localizations between these two peptides could not be investigated at this time. The localizations demonstrated suggest possible roles of the two peptides in the regulation of local blood flow and lubrication of the vagina.

Adult↗

Three-dimensional ultrasound in prenatal diagnosis of skeletal dysplasia.

A lethal form of bone dysplasia, platylospondylic lethal chondrodysplasia, was diagnosed prenatally using three-dimensional ultrasound. The various types of three-dimensional imaging mode provided diagnostic details not available by conventional two-dimensional ultrasound. The diagnosis was made after referral in the 23rd week of gestation, allowing termination of pregnancy due to the poor prognosis. Prenatal sonograms were compared with postnatal radiographs.

Adolescent↗

The relationship between peak velocity in the fetal descending aorta and hematocrit in rhesus isoimmunization.

OBJECTIVE: To correlate the peak velocity in the fetal descending aorta, as measured by pulsed Doppler ultrasound, with fetal hematocrit values assessed by funipuncture in pregnancies complicated by rhesus isoimmunization. METHODS: One hundred twelve consecutive funipunctures were performed on 33 rhesus-negative gravidas of 21-36 weeks' gestation (median 30). Doppler flow, corrected for angle, was measured on the fetal descending aorta with pulsed Doppler equipment immediately before funipuncture. Differences between observed peak velocities and the calculated gestational age-dependent upper confidence limits (delta peak velocities) were compared with corresponding differences between observed hematocrits and the calculated lower confidence limits (delta hematocrits), and a regression analysis on the above paired difference values was performed. In addition, the correlation coefficient between delta peak velocities and delta hematocrits was calculated for the first procedure per pregnancy only. RESULTS: The mean peak aortic velocity of anemic fetuses was higher than that of unaffected fetuses (P < .001); delta peak aortic velocities correlated negatively with delta hematocrits (r = -0.66, P < .001). The correlation coefficient between delta peak aortic velocities and delta hematocrits for the first procedure peer pregnancy only was r = -0.72 (P < .001). Prediction of fetal anemia by Doppler using gestational age-dependent 95% confidence limits was possible with positive and negative predictive values of 73 and 66%, respectively. CONCLUSION: Peak aortic velocity, a noninvasive assessment of fetal anemia, may be used as an additional test for monitoring pregnancies complicated by rhesus isoimmunization. However, the limited predictive capacity hampers its clinical usefulness.

Anemia↗

[Monitoring umbilical cord puncture and intravascular transfusions with Doppler ultrasound].

Complications of percutaneous umbilical blood samplings and intravascular transfusions can be detected rapidly, easily and efficiently by Doppler ultrasound and therefore the operator can react as early as possible. In addition to real-time sonography Doppler ultrasound allows for assessment of haemodynamical changes due to intravascular transfusions both on the venous and arterial side of umbilical perfusion. Because of immediate recognition of bradycardia and other fetal cardiac frequency alterations as well as increase of resistance to blood flow on the arterial side the operator can react promptly. On the venous side correct application of transfused volume is monitored continuously by changes of flow velocity waveforms during injection and allows to assess dislocation of the needle.

Blood Flow Velocity↗

Two approaches to the measurement of adaptive style: comparison of normal, psychosomatically ill, and delinquent adolescents.

OBJECTIVE: This project evaluated the discriminant validity of two self-report measures of adaptive styles. METHOD: The Weinberger Adjustment Inventory, which assesses distress, restraint, denial, and repressive defensiveness, and the Bond Defense Style Questionnaire, which assesses immature, neurotic, and mature defenses, were administered to 272 adolescents: normal comparison group boys (n = 63), normal comparison group girls (n = 68), girls with psychosomatic disorders (n = 75), and incarcerated delinquent boys (n = 66). Multivariate analyses of covariance, analyses of covariance, and discriminant analyses (with socioeconomic status and age as covariates) were conducted. RESULTS: Adaptive styles from the Defense Style Questionnaire differentiated the adolescent groups better than did the Weinberger Adjustment Inventory styles. CONCLUSION: Measurement of adaptive style by the Defense Style Questionnaire may be a useful adjunct to other measures of psychopathology and can assist in assessment of risk, treatment planning, and treatment progress.

Adaptation, Psychological↗

Solitary giant xanthogranuloma and benign cephalic histiocytosis--variants of juvenile xanthogranuloma.

Sequential biopsies taken from a patient with a solitary giant xanthogranuloma, an exaggerated macronodular (> 5 cm in diameter) variant of juvenile xanthogranuloma, and from a patient with benign cephalic histiocytosis, revealed a characteristic time sequence of histopathological findings. Early stages of the diseases showed a monomorphous infiltrate of mononuclear vacuolated histiocytes positive for KiM1p, HAM56 and factor XIIIa and were characterized by clusters of comma-shaped bodies. This was followed by a polymorphous mixture of various mononuclear and multinucleate histiocytes additionally labelling with KP1 (CD68) and, in occasional cells, for the adherence of peanut agglutinin. A variety of ultrastructural changes were found, including dense and regularly laminated bodies or lipid droplets. Our findings indicate that both entities are variants of a xanthogranulomatous reaction.

Antibodies↗

Dermal spindle cell lipoma: plexiform and nodular variants.

We report on eleven cases of a distinctive dermal spindle cell lipoma characterized by a mixture of mature adipocytes and spindle-shaped cells in a fibromucinous background. Six lesions showed a moderately well circumscribed plexiform pattern, five a well demarcated nodular pattern with compression of surrounding connective tissue and prominent stromal fibrosis. Clinically, the plexiform type mostly occurred in the thigh-groin-buttock area and the nodular type in the head-neck or acral location. While plexiform lesions were predominantly seen in middle-aged females, nodular types occurred in young adults of either sex. No recurrence was seen in five patients with follow-up. The tumour cells were vimentin positive and a thin cytomplasmic rim of S-100 protein positivity was seen in mature adipocytes. Ultrastructural studies revealed lipoblastic differentiation of spindle-shaped cells with lipid droplets and basal lamina formation. Dermal spindle cell lipomas seem to be the dermal counterpart of the most subcutaneously located spindle cell lipoma.

Adipocytes↗

Persons of lesser values--moral argument and the "final solution".

For many persons, 'Holocaust-abomination' is a fixed point on their moral compass: if anything can be evil, it was. Yet at least one of the justifications deployed by its perpetrators (the eugenics argument) involves widely-held values concerning human health and procreation. Hence persons endorsing many current activities based on those values (e.g. genetic counselling) have been charged with being on a morally deplorable slippery slope. This paper sketches the necessary structure of a moral position capable of consistently embracing those values without placing its occupants on that slippery slope.

Ethical Analysis↗

Altered striatal function in a mutant mouse lacking D1A dopamine receptors.

Of the five known dopamine receptors, D1A and D2 represent the major subtypes expressed in the striatum of the adult brain. Within the striatum, these two subtypes are differentially distributed in the two main neuronal populations that provide direct and indirect pathways between the striatum and the output nuclei of the basal ganglia. Movement disorders, including Parkinson disease and various dystonias, are thought to result from imbalanced activity in these pathways. Dopamine regulates movement through its differential effects on D1A receptors expressed by direct output neurons and D2 receptors expressed by indirect output neurons. To further examine the interaction of D1A and D2 neuronal pathways in the striatum, we used homologous recombination to generate mutant mice lacking functional D1A receptors (D1A-/-). D1A-/- mutants are growth retarded and die shortly after weaning age unless their diet is supplemented with hydrated food. With such treatment the mice gain weight and survive to adulthood. Neurologically, D1A-/- mice exhibit normal coordination and locomotion, although they display a significant decrease in rearing behavior. Examination of the striatum revealed changes associated with the altered phenotype of these mutants. D1A receptor binding was absent in striatal sections from D1A-/- mice. Striatal neurons normally expressing functional D1A receptors are formed and persist in adult homozygous mutants. Moreover, substance P mRNA, which is colocalized specifically in striatal neurons with D1A receptors, is expressed at a reduced level. In contrast, levels of enkephalin mRNA, which is expressed in striatal neurons with D2 receptors, are unaffected. These findings show that D1A-/- mice exhibit selective functional alterations in the striatal neurons giving rise to the direct striatal output pathway.

Animals↗

Tactile sensory input regulates basal and apomorphine-induced immediate-early gene expression in rat barrel cortex.

Clipping of mystacial vibrissae on one side of the rat's snout results in sensorimotor asymmetries in normal behavior and in behavior induced by the dopamine receptor agonist, apomorphine. Immediate-early gene expression, a marker for short-term changes in neuron function, was used to examine whether this sensory deprivation leads to functional changes in the somatosensory barrel cortex under experimental conditions which reveal behavioral asymmetries. The expression of c-fos and zif268 immediate-early genes was assessed with in situ hybridization histochemistry. Four hours after unilateral clipping of the mystacial vibrissae, the level of zif268 mRNA was reduced in the corresponding part of the contralateral barrel field. Injection of apomorphine (5 mg/kg) resulted in increased expression of both c-fos and zif268 immediate-early genes in cortex and striatum. This apomorphine-induced increase was blocked in the sensory-deprived somatosensory cortex. Laminar analysis of gene regulation showed that vibrissae removal affected immediate-early gene expression in all layers of the barrel cortex. These results demonstrate that: (1) basal zif268 gene expression in neurons of the somatosensory cortex is dependent on sensory input, (2) cortical immediate-early gene expression is increased after dopamine receptor activation, and (3) in the barrel cortex, this increase is also dependent on sensory input. We suggest that the observed reduction in gene expression after vibrissae removal reflects decreased activation of neurons in the barrel column by removal of sensory input.

Animals↗

First trimester three-dimensional ultrasound volumetry of the gestational sac.

First trimester amniotic fluid is an ultrafiltrate of maternal plasma and constitutes the major component of gestational sac volume (GSV). We hypothesized that GSV, assessed by 3-dimensional (3-D) ultrasound volumetry, would reflect function of the early uteroplacental unit and therefore provide a basis for predicting pregnancy outcome. We tested this hypothesis in 38 pregnancies which had first trimester GSV measurements by two investigators thus allowing determination of interobserver variation. Gestational age (GA) was based on a careful history and conventional 2-dimensional ultrasound measurements. Serum for beta-hCG, estradiol (E2) and progesterone (P) was obtained at the time of ultrasound examinations. "Normal" outcome was defined as confirmation of a viable fetus. "Abnormal outcome" was defined as either a "blighted ovum" or embryonic demise. Statistical analysis was performed by Independent t-test and regression analysis. There were 31 "normal" and 7 "abnormal" pregnancies studied between 5 and 11 weeks gestation (mean +/- SD 8.3 +/- 1.3 weeks). GSV was significantly correlated to GA (r = 0.74, P < 0.001), higher than to beta-hCG (r = 0.40, P = 0.034), E2 (r = 0.70, P < 0.001) and P (r = 0.21, P = 0.334), respectively. In the abnormal group 2/2 pregnancies with a twin sac had a GSV within 1 SD of the mean. 3/5 cases of missed abortions or blighted ovum had a GSV < 2 SD of the mean. The interobserver correlation was high (r = 0.99, P < 0.00f2p4This is the first clinical study investigating the diagnostic use of 3-D ultrasound volumetry in first trimester pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Amniotic Fluid↗

Pituitary function tests: comparison of ACTH and 11-deoxy-cortisol responses in the metyrapone test and with the insulin hypoglycemia test.

PURPOSE: To compare the sensitivity of ACTH and 11-deoxy-cortisol (comp. S) responses in the short metyrapone test and the latter with the insulin hypoglycemia test. METHODS: Retrospective evaluation of 115 short metyrapone tests and comparison of 18 pairs of metyrapone and insulin tests. 20 healthy controls and 95 patients with confirmed pituitary disease were studied. All hormones were measured by sensitive radioimmunoassays. RESULTS: In patients with pituitary disease not requiring hydrocortisone substitution (n = 70), the ACTH response in the metyrapone test was subnormal in 47 cases (< 33 pmol/L), the comp. S response (< 200 nmol/L) in 21 cases only. Comparison of the relationship between ACTH and comp. S with an ACTH-cortisol dose-response curve obtained in normal subjects shows that subnormal ACTH responses after metyrapone in the range between 13 and 33 pmol/L still generate normal comp. S responses. The results of the metyrapone test correlated significantly with those of the insulin test. CONCLUSIONS: Measuring plasma ACTH in the scope of the metyrapone test makes the test more sensitive to detect secondary adrenal insufficiency than with steroid measurements alone. Results of the metyrapone test correlate significantly with the cortisol response to insulin hypoglycemia.

Adrenocorticotropic Hormone↗

[HELLP syndrome and manifestation of type I diabetes mellitus in pregnancy].

HELLP syndrome (haemolysis, elevated liver function tests and low platelets) is a multiorganic disease and has been described in combination with pre-eclampsia/eclampsia, but even without symptoms of gestosis. There are signs, that HELLP syndrome represents an "acute status of autoimmunity". Since immune mechanisms play a fundamental role together with other factors in the development of type I diabetes mellitus, a combination of autoimmune reactions could explain the development of type I diabetes during an altered immune status. We report on the course of a pregnancy complicated by HELLP syndrome, which developed type I diabetes mellitus in the same pregnancy. A subsequent pregnancy with adequate diabetes therapy was uncomplicated and without recurrence of HELLP syndrome.

Adult↗

Three-dimensional ultrasound in obstetrics and gynaecology: technique, possibilities and limitations.

Three-dimensional (3D) ultrasound offers several options extending conventional two-dimensional scanning. Various imaging modes are available. Three perpendicular planes displayed simultaneously can be rotated and translated in order to obtain accurate sections and suitable views needed for diagnosis and geometric measurements. 3D ultrasound tomography combines the advantages of ultrasound, e.g. safety, simplicity of application and inexpensiveness, with the advantages of sequentially depictable sections in numerous rotatable and translatable sections. Surface rendering gives detailed plastic images if there are surrounding layers of different echogenicity allowing for the definition of a certain threshold. Transparent modes provide an imaging of structures with a higher echogenicity in the interior of the object. A combination of the two modes sequentially definable by the sonographer allows for the optimal viewing of structures. These imaging modes are innovative features which have to be evaluated for clinical applicability and usefulness. Digital documentation of whole volumes enables full evaluation without loss of information at a later point. 3D technology provides an enormous number of technical options which have to be evaluated for their diagnostic significance and limitations in obstetrics and gynaecology.

Female↗

Laparoscopic procedure for varicocelectomy.

OBJECTIVE: To report the results of laparoscopic varicocelectomy, a new surgical technique which presents minimal risks and provides an effective management of clinical varicoceles. PATIENTS AND METHODS: Between July 1991 and November 1992, 45 laparoscopic varicocelectomies were performed in 44 patients whose ages ranged from 11 to 41 years. Endoscopic ligation, carried out according to the technique described by Palomo, was performed in 14 patients. In the remaining 30 patients ligation of 31 spermatic veins was performed according to Bernardi's procedure. RESULTS: On post-operative follow-up symptoms disappeared in all the patients treated. Two of the patients showed persistent venous reflux on colour Doppler ultrasound examination. CONCLUSIONS: The excellent identification of the anatomical structures, the minimal surgical trauma, the decrease in post-operative morbidity and the quick convalescence of the patients have made this new technique a viable alternative to routine open high ligation.

Adolescent↗