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K Friese

Publications and source records attributed to K Friese.

At least 91 records · Page 5Linked to original sources
PubMed1994

[Ultrasound assessment of the postmenopausal endometrium. Is measuring thickness adequate?].

Sonographic assessment of the endometrium in postmenopausal women is generally based on total thickness as only criterion. The cut-off values recommended in literature, however, vary considerably. The purpose of this study was to examine the significance of sono-morphology besides biometry of the endometrium. If vaginosonography showed an endometrial thickness of 3 mm or less, all histological findings were inconspicuous; beginning at a thickness of 10 mm only hyperplasias, polyps and carcinomas were found. In the range between, including more than one-third of our patients, the structure can point out the type of histology: Homogeneity, low echogeneity and a median echo are not important findings, but inhomogeneity and high echogeneity point to pathological changes of the endometrium. Using combined, metric-structural criteria in vaginosonography of the endometrium, not only the predictivity, but above all the selectivity is improved.

Adenoma↗
PubMed1994

[Quantitative determination of fetal fibronectin in cervical smears: a new marker for evaluating the risk of premature labor].

There is a well-known correlation between ascending infection and preterm labour. Nevertheless, up to now an exact method to identify patients which are at high risk for preterm labour does not exist. Fetal fibronectin is an extracellular matrix protein, which is produced by fetal membranes. High concentrations are present in amniotic fluid, but not in cervical secretions in uncomplicated pregnancies (only in 3-4%). If there is an inflammatory mediated damage to fetal membranes (amnion/chorion) or a mechanical disruption caused by preterm contractions, fetal fibronectin should be released into the cervix and vagina. A prospective clinical study measuring quantitatively the content of fFN in cervicovaginal secretions in patients with preterm labour (n = 43), preterm rupture of membranes (n = 15) and 20 controls was undertaken. In 16 patients frequent specimen could be obtained over a period of several weeks. 14 of the 34 patients with preterm labour, which could be observed until delivery, delivered before term (< 37. WOP). In 13 fFN was present in a concentration > 75 ng/ml (sensitivity: 92.4%). 13 patients were negative for fFN and only one of these patients delivered before term (92% chance of term delivery in absence of fFN in cervicovaginal fluids). In 8 patients with beta-adrenergic treatment fFN was present. All patients delivered before term. The 15 patients with PROM had very high concentrations of fFN with a medium concentration of 967.3 ng/ml. 18 of the 20 control patients were negative for fFN (< 75 ng/ml), 2 had a slightly elevated concentration of 84 and 85 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Chorioamnionitis↗
PubMed1994

[Varicella infection at birth].

At birth maternal infection with the Varizella-Zoster-Virus (VZV) is very rare but poses a truly life-threatening risk to the newborn. The neonatal mortality rate is up to 20-30%, if the maternal VZV-infection occurs between day 4 ante partum and day 2 post partum. The mortality can be decreased, if labour is successfully delayed by tocolytic agents until VZV-antibodies produced by maternal immune response have passed the placental barrier. There are indications that the mortality may also be lowered by passive immunisation of the newborn, but further research is needed. We recommend strongly to check VZV-IgG-antibodies-titres promptly, if VZV-infection is suspected. Labour then should be delayed by tocolytic agents as described in 2 case reports to allow maternal IgG-antibodies to cross the placental barrier to the foetus.

Adolescent↗
PubMed1993

[Antibiotic therapy in pregnancy].

Antibiotics are the most frequently prescribed medications in pregnancy, their application and choice should be made according to the highest criteria. Penicillins and cephalosporins can be safely used in pregnancy, however, their side effects such as allergic reactions present a greater therapeutic problem. Tetracyclines, chloramphenicol and quinolones are strictly contraindicated in pregnancy. 5-nitroimidazole derivatives, aminoglycosides and sulfonamides are indicated only in severe infections. Not only the risk of malformation is increased in the embryonic stage, i.e. in the first 8 weeks of gestation, but also at the time of delivery with the use of drugs as sulfonamides, which can cause icterus.

Anti-Bacterial Agents↗
PubMed1993

[What is the predictive value of ultrasound diagnosis in suspected extra-uterine pregnancy in routine clinical practice?].

In this retrospective study the data of 340 patients who underwent invasive diagnostics in suspected ectopic pregnancy from 1985 to 1991 are being analyzed. The aim of this study is to examine the prognostic value of ultrasonic findings after the introduction of transvaginal sonography and highly sensitive urine pregnancy tests in the every day clinical routine. In transvaginal ultrasound significantly more direct signs of an ectopic pregnancy than in the abdominal technique were found showing a markedly higher positive predictive value: 93.5% for an extrauterine double ring, 90.7% for inhomogeneous adnexal masses with the simultaneous finding of echogenic fluid in the pouch of Douglas and 79.3% for isolated inhomogeneous adnexal masses. The predictive values for indirect sonographic hints of suspected extrauterine gravidity were 78.4% for an empty uterine cavity and 87.3% for echogenic fluid in the pouch of Douglas. With growing experience in the vaginal ultrasound technique the positive predictive values of all these signs reached 91% to 98%. Additionally the rate of false-negative urine pregnancy tests in patients with ectopic pregnancy sank with increasing sensitivity from 49% (1000 IU HCG/l) to 3.2% (50 IU/l). Summarizing all these factors the reliability of conservative diagnostic means in suspected ectopic pregnancy raised considerably from 56.4% to 94.3% during the course of our study.

Diagnosis, Differential↗
PubMed1992

[Fetal outcome of premature infants less than 1,500 g birth weight with special reference to surfactant requirements].

The objective of our study was to examine therapeutic success within a study group of 108 premature babies weighing less than 1500 g at birth. The foetal outcome was divided according to intrauterine betamethasone administration, method of birth and surfactant requirement. 59 of the babies did not require a surfactant factor, because within 12 hours it was possible, to reduce respiration to an O2 partial pressure of 20%. In 49 of the premature babies, this was not possible, and therefore, surfactant substitution was required, whereby this subject group was divided into surfactant responders and surfactant non-responders. In addition, we examined the influence of the method of birth on later survival and the occurrence of intraventricular haemorrhages in the children. A noticeably higher survival rate was determined in 81% of the children, born via Caesarean section, compared with 63% of premature babies, born via vaginal delivery. Likewise, detectable intraventricular haemorrhages (IVH) were significantly lower amongst premature babies delivered via Caesarean section (25%) than those delivered vaginally (37.5%). A considerable improvement in survival rates and a reduction in IVH was achieved by means of completed lung maturation with betamethasone (16 mg in 48 hours). 62% of premature infants with completed prepartal lung maturity did not require the administration of a surfactant due to the favourable respiratory situation. However, for those cases, where it was no longer possible to conduct lung maturation, only 46% did not require surfactant substitution. Therefore, it would appear advisable, to delay the delivery of premature babies weighing less than 1500 g in order to carry out lung maturity treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1992

[Infected chorionic hematoma as a cause of infection in the 2nd trimester].

Superinfected subchorionic haematomas are a rare septic focus in the 2nd trimenon. Symptoms being unspecific, the diagnosis has to be made by exclusion, in most cases. As the changes of a successful treatment of the manifest infection is poor, antibiotic prophylaxis as well as close laboratory controls and early antibiotic therapy should be discussed after sonographic diagnosis of an intrauterine haematoma. Two of our three patients reported on having suffered a miscarriage; only one pregnancy could be maintained after spontaneous depletion of the infected haemorrhage.

Adult↗
PubMed1991

[Cytokine production by gynecologic cancers].

Aggressive polychemotherapy and ultraradical surgery had had only small benefits for patients with gynaecological cancer in recent years. That is why we measured cytokines in these patients to evaluate a possible future immune therapy. To investigate the influence of gynaecological cancer on in vitro and in vivo cytokine production of peripheral mononuclear cells (PBMC) from 27 patients with mamma carcinoma and 29 patients with cervical cancer, we evaluated the production of interferon-alpha (IFN-alpha), interferon-gamma (IFN-gamma) and tumour necrosis factor-alpha (TNF-alpha). We compared the immune function of these patients versus 20 patients who had had routine hysterectomies performed for non-malignant reasons and 20 healthy female controls. Blood for cytokine production was collected prior to surgery, for IFN-alpha-production two weeks after surgery and for all cytokines three months after surgery. Measurement of TNF-alpha-production did not differ significantly in all investigated groups. IFN-gamma-production was reduced by 50% in patients with mamma carcinoma in three months - possibly caused by chemotherapy and radiation. The amount of IFN-alpha production in cancer patients was dramatically reduced before primary therapy started. The low levels of IFN-alpha persisted for three months compared to the IFN-alpha production in non-cancer patients and healthy controls. The follow-up of patients with breast cancer undergoing chemotherapy showed a suppressive effect on immunological function in IFN-alpha. Our results demonstrate, that patients with breast cancer and cervical cancer showed a significantly reduced capacity to product IFN-alpha.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Prognostic significance of intrauterine hematomas in the 1st and 2d trimester for the course of pregnancy and labor].

The courses of 66 pregnancies with sonographic evidence of an intrauterine haematoma within the egg-membranes during threatened abortion, between 7th and 24th week of gestation, were compared to the courses of 55 patients at the same gestational age admitted to our hospital, during the same period, with vaginal bleeding only. The aim of our study was to determine the prognostic significance of intrauterine haematomata in the I. and II. trimester for the course of pregnancy and delivery. The abortion-rate after intrauterine haematomata was significantly increased to 17.5%, a high percentage of them taking a febrile or septic course. The rate of preterm labour in haematoma patients was significantly higher (34.5 compared to 12.7%, respectively), than that in patients, who were only bleeding; this, furthermore, was reflected by a strong trend of preterm delivery (21.9 compared to 12.9% resp.). The caesarean section rate of 55.8% in the haematoma group was found to be significantly higher than in the control group (16.7%), mainly due to a significantly increased proportion (23.1%) of abnormal foetal presentations. Abnormal placental stages had to be treated significantly more often after intrauterine haematomata (32.6%) than in the control group (9.3%); however, no differences could be found between the two groups in respect of metabolic or respiratory placental dysfunction. The parameters examined in this study were not influenced by the volume of the haematoma, although the spectrum of complications seemed to be correlated to the gestational age at the time of diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Spontaneous↗
PubMed1991

[Incidence of congenital infections].

The discussions on the pros and cons of obstetric screening for connatal infections have been going on for years. We, therefore, conducted a prevalence study of the most common connatal infections. HIV infection, rubella and syphilis were not subjects of this study. We analysed the relevance of these infections in 512 pregnant women and their newborn infants at the moment of delivery. Further serological tests were run three months post partum, if necessary even for a longer period. Cytomegaly IgG antibodies were found in 46% of the examined women, IgM antibodies in 1.3%. Women under the age of twenty and women of low social standing showed the highest rate of prevalence of infection with CMV. The prevalence of IgG antibodies against parvovirus B 19 was 29%. In 10 mothers, positive IgM titers were found at the time of delivery. In all these women, pregnancies had been uneventful. However, 9 mothers exhibited a significantly raised abortion rate within the last 20 months before delivery. 7 of 512 women turned out to be HBs antigen carriers, 3 women and their babies were anti-HCV positive. The prevalence of toxoplasmosis IgG antibodies was 36%, of IgM antibodies 5.3%. By further investigation (Toxo ISAGA, Toxo IgA) we were able to detect one child with connatal toxoplasmosis. We conclude, that screening for parvovirus B 19 and hepatitis C is required only, if there are contact or clinical hints that the patients might have acquired either one of these infections. But we postulate, that a routine screening programme for hepatitis B and toxoplasmosis should be carried out in all pregnant women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Variability and reproducibility in the determination of left-ventricular heart volume by cine-MR. A comparison of measurement methods].

Sixteen normal individuals were examined on a 1.5 T instrument using gradient echo sequences (cine-MR). The results of various computations were tested with respect to agreement and reproducibility of the methods. The ejection fractions calculated from bi-plane and 3-dimensional reconstructed volumes showed very low standard deviations of mean values (SD less than 2%). Volumes calculated from a single plane produced the greatest scatter of mean values (SC approximately 5%). In all sixteen subjects, the MR findings showed good reproducibility. There was very little inter-observer variability (variability less than 5%). A comparison of various methods showed that bi-plane and monoplane volume calculations obtained by MR in the cardiac axis are more accurate than those obtained by echocardiography (MR:R greater than 0.75, p less than 0.001; echo:R less than 0.75, p greater than 0.05).

Adult↗
PubMed1991

Activation and activation-driven death of human gamma/delta T cells.

We have concentrated on three functional aspects of human gamma/delta+ T cells. (1) Peripheral blood gamma/delta+ T cells proliferate at a high frequency in response to heat-killed mycobacteria (M.tb.). We present evidence that the primary response of human gamma/delta+ T cells is restricted to those cells bearing a V gamma 9/V delta 2 receptor. (2) T cells expressing the alpha/beta TCR can be activated through the CD2 antigen via an "alternative" pathway. Activation requires the combined signaling of 2 mAb directed against two distinct epitopes of CD2. In striking contrast, cloned gamma/delta+ T cells are activated by a single immobilized anti-CD2 mAb directed against the sheep E-binding epitope of CD2. Stimulation of cloned gamma/delta+ T cells by a single anti-CD2 mAb results in IL-2 production, proliferation, and triggering of cytolytic effector function. (3) Cloned gamma/delta+ T cells are susceptible to programmed cell death (apoptosis) when stimulated simultaneously by anti-CD3/TCR mAb plus exogenous IL-2. The very same clones are activated, however, by the same stimuli in the absence of exogenous IL-2 (but in the presence of LCL feeder cells). This provides the basis for a model where extensive gamma/delta+ T cell proliferation is negatively regulated by antigen plus IL-2.

Antibodies, Monoclonal↗
PubMed1990

Differential effect of insulin and epidermal growth factor on the mRNA translocation system and transport of specific poly(A+) mRNA and poly(A-) mRNA in isolated nuclei.

The efficiency of efflux of rapidly labeled poly(A)-containing mRNA from isolated rat liver nuclei was found to be modulated by insulin and epidermal growth factor (EGF) in a biphasic but opposite way. At physiological concentrations (10 pM insulin and 1 pM EGF), maximal stimulation of the transport rate by insulin (to 137%) and maximal inhibition by EGF (to 69%) were obtained; at higher concentrations (greater than 100 pM and greater than 10 pM, respectively), the amount of poly(A)-containing mRNA released into the postnuclear supernatant was nearly identical with the level found in untreated nuclei (= 100%). Using mRNA entrapped into closed nuclear envelope (NE) vesicles as a model system, it was found that the modulation of nuclear efflux of mRNA by the two growth factors occurs at the level of translocation through the nuclear pore. The NE nucleoside-triphosphatase (NTPase) activity, which is thought to mediate nucleocytoplasmic transport of at least some mRNAs, responded to insulin and EGF in the same manner as the mRNA transport rate. The increase in NTPase activity caused by insulin and the decrease in NTPase activity caused by EGF were found to be due to changes of the maximal catalytic rate; the Michaelis constant of the enzyme remained almost constant. Investigating the effect of the two growth factors on transport of specific mRNAs, poly(A)-containing actin mRNA was found to display the same alteration in efflux rate as rapidly labeled, total poly(A)-containing mRNA. In contrast, efflux of histone H4 mRNA, which lacks a 3'-poly(A) sequence, decreased in response to insulin and reached minimum levels at the same concentration at which maximum levels of actin mRNA transport rate were obtained. Studying the mechanism of action of insulin and EGF on NE mRNA translocation system, insulin was found to cause an enhancement of NE-associated phosphoprotein phosphatase activity, resulting in a dephosphorylation of the NE poly(A) binding site (= mRNA carrier) and, hence, in a decrease in its affinity to poly(A) [the poly(A) binding affinity of the poly(A)-recognizing mRNA carrier within the envelope is increased after phosphorylation]. EGF, on the other hand, stimulated the protein kinase, which phosphorylates the carrier, and, hence increased the NE poly(A) binding affinity. Because the stage of phosphorylation of the mRNA carrier (which is coupled with the NTPase within the intact NE structure) is inversely correlated with the activity of the NTPase, an enhancement of poly(A)-containing mRNA transport rate by insulin and an inhibition by EGF are observed.

Adenosine Triphosphate↗
PubMed1990

[A semiquantitative assessment of aortic valve insufficiency by cine-MR compared to Doppler color echocardiography and cardioangiography].

A simple, reliable semiquantitative method for evaluating aortic valve insufficiency by means of cine MR is described. Ten normal persons and 36 patients with aortic valve abnormalities were examined in a 1.5 Tesla apparatus using ECG-triggered gradient echo sequences. The heart was imaged along its short axis. Semiquantitative evaluation of aortic valve insufficiency was calculated from an MRI index, which depends on the diameter of the aortic regurgitant jet and on its length; the results were compared with colour Doppler echocardiography and cardioangiography. The MRI index showed better correlation with cardioangiography (r = 0.92) than the correlation between the colour Doppler echocardiography and cardioangiography (r = 0.78). Over and under estimates are less common with MRI than with colour Doppler echocardiography. MRI showed very little interobserver variability (r = 0.96, p less than 0.001). Cine MR is a reliable method for demonstrating aortic valve insufficiency. Using the short axis of the heart, rapid semiquantitative evaluation of the aortic regurgitant jet is regularly possible.

Adult↗
PubMed1990

Effect of nonviable preparations from human immunodeficiency virus type 1 on nuclear matrix-associated DNA polymerase alpha and DNA topoisomerase II activities.

In a previous paper, we determined that treatment of lymphocytes with nonviable preparations of human immunodeficiency virus type 1 (HIV-1) results in an impairment of the phosphatidylinositol/protein kinase C pathway, most likely due to an inhibition of the cleavage of phosphatidylinositol bisphosphate into inositol trisphosphate and diacylglycerol, mediated by phospholipase C. Here we show that one consequence of these changes is a reduced phosphorylation of nuclear matrix-associated DNA topoisomerase II, resulting in an inhibition of the activity of this enzyme. Antibodies to the viral proteins suppressed the inhibitory effects caused by the HIV-1 preparation. Furthermore, the phytohemagglutinin A-caused augmentation of nuclear matrix-associated DNA polymerase alpha and beta activities was found to be abolished by coincubation with the HIV preparation or with the HIV-1 gp120. The phytohemagglutinin A-enhanced matrix association and processivity of DNA polymerase alpha was determined to be reduced if the lymphocytes were in contact with HIV-1 preparation. These results suggest that the reduced proliferative response of lymphocytes to phytohemagglutinin A in the presence of disrupted HIV-1 preparation is due to inhibition of at least two, perhaps separate, pathways, one involving protein kinase C resulting in a reduced phosphorylation of DNA topoisomerase II and the other changing the state of matrix association of DNA polymerase alpha and beta.

DNA Polymerase II↗