[HIV infection and AIDS in pregnancy].
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Biomedical subjects
Publications and source records attributed to K Friese.
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Using the Geodia cydonium system, we showed that after incubation of competent sponge cells in the presence of lectin, phospholipase A2 was released from the cells. The substrates for this enzyme, phosphatidylethanolamine and phosphatidylcholine, were identified in the extracellular material of sponge tissue. In addition, the phospholipase A2 inhibitor calelectrin was identified by immunobiochemical techniques; this molecule was associated with the aggregation factor. Reconstitution experiments strongly suggested that phospholipase A2 catalyzed the release of arachidonic acid, which is then taken up by the cells. Intracellularly, arachidonic acid was metabolized primarily to prostaglandin E2. Inhibition studies revealed that prostaglandin E2 is involved in the ultimate increase of DNA synthesis. These findings suggest that the phospholipase A2-arachidonic acid system is involved in the matrix-initiated signal transduction pathway in sponges.
Foetal cystic hygroma is a congenital malformation of the lymphatic systems. Ten cases of foetal cystic hygroma were diagnosed prenatally during the second trimester, in a period of two years, at Ultrasound Unit of the Department of Obstetrics and Gynaecology of the University of Mainz, West Germany. Six foetuses had Turner's syndrome, one had a 47 X + 21 karyotype, two foetuses were cytogenetically normal and in one case tue chromosome cultures failed. Sonographic findings are demonstrated and compared to autopsy results. In addition, clinical management of foetuses with cystic hygroma are discussed.
For more than two years, all HIV-positive women were seen in the Department of Obstetrics and Gynaecology in cooperation with the Department of Internal Medicine of the University of Mainz, for medical care and therapy, if necessary. Of 40 HIV-infected female patients who were treated, 25 women were followed up every three to six months. Most of the latter live in rural areas or outside the cities in the State Rhineland Palatinate, FRG. 52% of them are or were former intravenous drug abusers, and 44% had been infected by sexual transmission. Only one-third use condoms during intercourse, another third reject this kind of protection. The rest are without cohabitation for various reasons. 23 pregnancies are known in this group and in 20% of the cases HIV infection were discovered during prenatal care. Gynaecological and obstetrical findings are reported. 80% of the patients have had a recurrent candida infection of the vagina, which was detected by culture. Immunologically, 75% of the patients belong to stage III (according to the CDC classification). Out of this group, more than 50% show less than 400 CD4 (+) cells/microliters. A positive result for HIV-Ag, anti-p41 and negative anti-p24 was seen in five cases. One of the four patients with AIDS died of a rapidly growing cancer of the cervix.
Quantitative and qualitative examinations of serum lipoproteins separated by use of discontinuous ultracentrifugation were performed in 17 lactating and 13 non-lactating healthy women 5 days and 5 weeks after delivery. In general a normalisation of the lipid parameters, which are increased during gestation, was observed during this period. Within 5 weeks after delivery all single parameters were in levels of normal non-pregnant women. A significant effect of lactation on the decrease of pregnancy-induced hyperlipoproteinemia after delivery could not be detected.
The value of magnetic resonance tomography in the diagnosis of carcinoma of the cervix was studied in a prospective series of 20 patients. The results were compared with those of computed tomography and with the clinical findings. The diagnosis depended on the postoperative histology. Gynaecological examination proved superior to imaging methods in determining the extent of local tumour spread. Tumour involvement of the regional lymphatic system was better demonstrated by MRT than by CT. Exact staging proved inadequate with both these methods and the new imaging methods have not produced any changes in operative planning or technique.
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Congenital posterolateral diaphragmatic hernia occurs in one out of 2,500 live births. Prenatal diagnosis is made via sonographic demonstration of the displaced abdominal organs that can be found in the thoracic cavity as a cystic or solid mass. Early antenatal evidence of this malformation can improve the normally poor prognosis of the newborn, as planned delivery and prompt operative treatment can be performed. Antenatal sonographic diagnosis of a left-side diaphragmatic hernia is demonstrated in two cases.
In a prospective study of 20 cases, the importance of nuclear magnetic resonance as a diagnostic tool in cervix carcinoma was investigated. The results were compared with those of the Computer tomography as well as with those of the clinical examinations. The histology served as "Standard". In the evaluation of the local tumor invasion the gynecological examination appeared to be the most important. The involvement of regional lymph nodes was detected more accurately by the NMR as compared to CT. The exact clinical staging was not achieved by either method; thus these new diagnostic methods do not alter the planning and the technique of the operation.
The angiographic picture of metastatic choriocarcinoma is well known since long, computertomographic findings, however, have not yet been described. The article gives a case-report and discusses the computertomographic picture of the disease.
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The seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections were prospectively assessed in 356 heterosexuals with STDs (sexually transmitted diseases) and compared to a control group of 381 healthy first-time blood donors. Eighty-one of 356 STD patients were anti-HBC positive (22.8%) compared to 14/381 blood donors (3.8%; p less than 0.001). In addition, 18 of the 81 anti-HBC positive STD patients, but none of the controls, were positive for HBSAg (p = 0.06). The prevalence for anti-HCV was also significantly higher in the STD group than in the controls (5.3% vs. 0.5%; p less than 0.001). Among the various STDs syphilis (anti-HBC: 67.5%; anti-HCV: 12.5%) and Chlamydia trachomatis infections (anti-HBc: 20.2%, anti-HCV: 8.1%) had the highest prevalence for both infections. This study provides strong evidence of heterosexual transmission of hepatitis B and C virus infections. Thus, heterosexuals with STDs or multiple partners should be actively vaccinated against hepatitis B.
In this report: Preterm birth will be characterized as a so far widely neglected public health problem in Germany. Actual evidence with respect to epidemiological and intervention knowledge will be summarized. Objectives, methods and routines of the BabyCare program will be presented. Associations between main risk factors and preterm birth will be calculated. Considerable deficiencies in nutritional habits and in micro nutritional intake will be summarized. And conclusions will be derived for future additional focussed actions in the prevention of preterm birth and other important complications in pregnancy within the program and for additional interventions in health policy which are imperative. It will be shown that the rate of preterm birth can be reduced and there is a high probability for further reduction by additional and targeted interventions in smoking, stress and especially nutrition.
Velocity encoded (VEC) cine MR imaging is a new noninvasive technique for the quantification of blood flow velocity in the cardiovascular system. Six patients with type B aortic dissection underwent VEC cine MR imaging at 1.5 T. This technique provides cine MR magnitude and VEC phase images at approximately 16 equally spaced intervals during an average cardiac cycle. A region of interest encompassing a vascular structure, i.e., false channel, provides a spatially averaged velocity for the time interval at which the image was acquired. Interpretation of velocity values from the 16 intervals during the cardiac cycle provides a temporally average velocity. Velocity mapping across the aortic lumen in these six cases showed average spatial and temporal velocity of 13.4 +/- 1.49 cm/s in the true channel and 3.1 +/- 0.84 cm/s in the false channel (p less than 0.05). The peak systolic velocity (temporal peak) was 43.6 +/- 7.20 cm/s in the true channel and 14.3 +/- 2.30 cm/s in the false channel (p less than 0.05). The flow volume per cardiac cycle was not significantly different between the ture (23.1 +/- 5.04 ml/cycle) and false channel (27.1 +/- 10.14 ml/cycle). There was substantial retrograde flow in the false channel of two patients. The intraobserver and interobserver variability was less than 10% (r = 0.98 to 0.99) for the measurement of flow parameters in both the true and the false channel. We conclude that VEC cine MR imaging demonstrates substantial differences in the hemodynamic pattern in the true and false channel in aortic dissection.
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The Thomsen-Friedenreich (TF) antigen (or, more precisely, epitope; Gal beta 1-3GalNAc-) has been known for a long time as a pancarcinoma antigen. Here we report the immunohistochemical identification of this carbohydrate antigen in the human placenta. Paraffin-embedded placental and decidual tissues of the first, second and third trimester were incubated with different monoclonal antibodies (A78-G/A7 and HH8) directed against the TF-epitope and stained with an immunohistochemistry system. We found a strong expression of the TF-epitope in the first trimester of pregnancy. In addition, we identified an expression of the TF-antigen in the second trimester of pregnancy but only in a few cases a positive staining in the third trimester of pregnancy.
INTRODUCTION: The aim of this study was to determine the tissue distribution of CA-125 in normal, hyperplastic and malignant endometrium. MATERIALS AND METHODS: Endometrial tissue was obtained from women in proliferative (n = 5), early secretory (ES; n = 4) and late secretory (LS; n = 4) phase as well as glandular-cystic hyperplasia (n = 5), endometrial polyps (n = 5), endometrial polyps caused by tamoxifen use (n = 5), adenomatous hyperplasia (AH) grade I (n = 5), grade II (n = 4), grade III (n = 5) and endometroid adenocarcinoma (n = 5). The CA-125 expression was evaluated with the semiquantitative IRS-Score. RESULTS: CA-125 expression was observed in glandular and luminal epithelial cells, being significantly higher during LS than ES. The highest CA-125 reaction was observed in AH III in glandular and luminal cells, which was statistically higher compared to all groups (except glandular cells: proliferative and LS; luminal cells: AH I-II, glandular-cystic polyps). DISCUSSION: CA-125 was expressed in normal, hyperplastic and malignant endometrial tissue with a cyclical expression in premenopausal endometrial glandular cells. Adenocarcinoma expressed CA-125 with a lower intensity. The highest expression was observed in AH III in luminal and glandular cells, therefore CA-125 could be a marker of malignant cell transformation.
INTRODUCTION: Phytoestrogens are a diverse group of nonsteroidal plant compounds that occur naturally in many plants. Because they possess a ring system similar to estrogens they are able to bind to estrogen receptors in humans. With this study we tested the effects of the phytoestrogens genistein and daidzein in cell proliferation and the production of progesterone and hCG in trophoblast tumour cells of the cell lines BeWo and Jeg3. MATERIALS AND METHODS: The phytoestrogens genistein and daidzein were incubated in different concentrations with trophoblast tumour cells. Untreated cells were used as controls. At designated times, aliquots were removed and tested for progesterone and hCG. In addition we tested the effects of phytoestrogens on cell proliferation. Different concentrations of genistein and daidzein were cultivated with trophoblast tumour cells. After designated times, 1 microCi thymidin-(methyl-3H) was added. Methyl-3H thymidin incorporation was tested and compared to incorporation results of untreated cells. RESULTS: With this study we could show that the production of the steroid hormone progesterone and the protein hormone hCG is influenced by the phytoestrogens genistein and daidzein in trophoblast tumour cells of the cell lines BeWo and Jeg3. We found a correlation between the effects on the proliferation and the production of progesterone and hCG at high concentrations of genistein and daidzein in the cell lines tested. With low concentrations of genistein and daidzein we observed a stimulation of the production of hCG and a weak inhibition of proliferation in both cell lines BeWo and Jeg3. DISCUSSION: The results obtained with this study suggest that only high doses of phytoestrogens (> 1 mumol/ml) can reduce the proliferation of trophoblast tumour cells significantly. Low doses of phytoestrogens induced a higher hCG production in both cell lines tested. Although high hCG production did not lead to a higher proliferation rate of the tumour cells tested, hCG is able to induce neovascularisation in tumour cells. In summary, with this in vitro study we showed that high doses of phytoestrogens inhibit proliferation and progesterone production in trophoblast tumour cells. High doses of phytoestrogens could be useful candidates for special diet programs for prevention and surgery for patients with this type of disease. In addition we found a useful cell culture model for the testing of new types of phytoestrogens.