Search PubMed⌕ Search

Biomedical subjects

L Lampé

Publications and source records attributed to L Lampé.

At least 19 recordsLinked to original sources
PubMed2001

[Open heart surgery with extracorporeal circulation during pregnancy].

The incidence of heart disease in pregnancy has been gradually falling during the last three decades. Cardiopathy still remains a prominent cause of maternal and fetal morbidity and mortality. Most patients know about their heart disease long before conception, even though the potential risk factors of deteriorating cardiac function during pregnancy are generally not emphasized. These women when pregnant may develop heart failure due to the increased cardiorespiratory requirements. When medical therapy proves insufficient heart surgery becomes mandatory to save the patient's life. The pregnant state is not optimal for cardiac surgery as the principle interest of the mother and the fetus is different. We report on two pregnant patients who underwent unavoidable heart surgery with cardiopulmonary bypass and review the literature regarding the optimal management of open-heart operation in pregnancy aiming to decrease the feto-maternal mortality. The successful outcome of the cardiac surgery on pregnant women is determined by the severity of the preexisting disease, the surgical techniques, and the circumstances of the cardiopulmonary bypass. The best possible results can be achieved by providing preconceptional counseling for the cardiopathic patients regarding the relation between the preexisting risk factors and the adverse maternal and neonatal outcome. When heart surgery is mandatory in pregnancy the careful technical precautions and the continuous cardiotocography help to minimize fetal complications during the cardiopulmonary bypass (CPB).

Adult↗
PubMed2000

The role of preoperative brachytherapy as an adjunct to surgery and postoperative radiotherapy in the treatment of stage I endometrial carcinoma.

PURPOSE: Between 1978 and 1993, 817 cases of endometrial carcinoma were treated with simple hysterectomy with bilateral salpingo-oophorectomy. Five hundred and twenty-six cases had preoperative brachytherapy (Preo), and 291 cases underwent surgery without preoperative radiotherapy (Nopre). The aim of the study was to compare disease-free survival of the two groups. METHODS AND MATERIALS: Survival comparison of the two groups was controlled for postoperative treatment type, according to stage, histological type, degree of differentiation, depth of myometrial invasion and age. The life-table method was used for survival analysis. Cumulative disease-free survival probabilities were calculated as a function of the proportion of normal remaining life elapsed from the time of diagnosis. RESULTS: Five-year disease-free survival of patients with and without preoperative brachytherapy in stage IA, IB and IC was 93 and 93.6%, 93 and 94%, and 80 and 65%, respectively. In well differentiated tumors and poorly differentiated tumors, there was no difference in disease-free survival between patients with and without preoperative brachytherapy. Patients with moderately differentiated tumor treated with preoperative brachytherapy had significantly better disease-free survival than those without preoperative radiotherapy, however, this was confounded by uneven distribution of invasion depth. CONCLUSION: Preoperative brachytherapy plays a limited role in the treatment of early stage endometrial carcinoma.

Adenocarcinoma↗
PubMed1999

Placental macrophage contact potentiates the complete replicative cycle of human cytomegalovirus in syncytiotrophoblast cells: role of interleukin-8 and transforming growth factor-beta1.

Although syncytiotrophoblast (ST) cells can be infected by human cytomegalovirus (HCMV), in vitro studies have indicated that ST cells do not support the complete viral reproductive cycle, or HCMV replication may occur in less than 3% of ST cells. The present study tested the possibility that placental macrophages might enhance activation of HCMV carried in ST cells and, further, that infected ST cells would be capable of transmitting virus to neighboring macrophages. For this purpose, we studied HCMV replication in ST cells grown alone or cocultured with uninfected placental macrophages. Our results demonstrated that HCMV gene expression in ST cells was markedly upregulated by coculture with macrophages, resulting in release of substantial amounts of infectious virus from HCMV-infected ST cells. After having become permissive for viral replication, ST cells delivered HCMV to the cocultured macrophages, as evidenced by detection of virus-specific antigens in these cells. The stimulatory effect of coculture on HCMV gene expression in ST cells was mediated by marked interleukin-8 (IL-8) and transforming growth factor-beta1 (TGF-beta1) release from macrophages, an effect caused by contact between the different placental cells. Our findings indicate an interactive role for the ST layer and placental macrophages in the dissemination of HCMV among placental tissue. Eventually, these interactions may contribute to the transmission of HCMV from mother to the fetus.

Antigens, Viral↗
PubMed1997

[Surgical management of masculine trassexualism].

The authors report on the first Hungarian case of sex-transforming operation. They present details of the social history and management of their case leading up the decision for surgery. Preoperative assessment and medication, operation technique and postoperative care are also described in detail. The case report highlights the difficult ethical and legal issues which have to be considered when such surgery is requested. Following a series of in-depth psychological, gynaecological, urological and forensic consultations that had been carried out in order to be convinced about the patients's determination for undergoing sex-transforming operation, the authors were granted legal and professional license by the Hungarian Medical Research Council to carry out the procedure. Two years after the operation, the patient commented on her full satisfaction with the care he had received.

Adult↗
PubMed1995

Ovarian malignancies in childhood and adolescence.

We retrospectively reviewed all cases of ovarian malignancies during a 10-year period at the Department of Obstetrics and Gynecology, University Medical School of Debrecen, Hungary. The experience with 16 cases: three epithelial tumors, one granulosa cell tumor, 11 germ cell tumors (six dysgerminoma, four teratoma, one endodermal sinus tumor), and one metastatic ovarian cancer is discussed. Malignant ovarian tumors can best be treated with conservative surgery, followed by adjuvant chemotherapy. Survival mainly depends on tumor type and stage at the time of diagnosis.

Adolescent↗
PubMed1995

Interactions between human immunodeficiency virus type 1 and human cytomegalovirus in human term syncytiotrophoblast cells coinfected with both viruses.

Human cytomegalovirus (HCMV) and human immunodeficiency virus type 1 (HIV-1) may interact in the pathogenesis of AIDS. The placental syncytiotrophoblast layer serves as the first line of defense of the fetus against viruses. We analyzed the patterns of replication of HIV-1 and HCMV in singly an dually infected human term syncytiotrophoblast cells cultured in vitro. Syncytiotrophoblast cells exhibited restricted permissiveness for HIV-1, while HCMV replication was restricted at the level of immediate-early and early gene products in the singly infected cells. We found that the syncytiotrophoblasts as an overlapping cell population could be coinfected with HIV-1 and HCMV. HIV-1 replication was markedly upregulated by previous or simultaneous infection of the cells with HCMV, whereas prior HIV-1 infection of the cells converted HCMV infection from a nonpermissive to a permissive one. No simultaneous enhancement of HCMV and HIV-1 expression was observed in the dually infected cell cultures. Major immediate-early proteins of HCMV were necessary for enhancement of HIV-1 replication, and interleukin-6 production induced by HCMV and further increased by replicating HIV-1 synergized with these proteins to produce this effect. Permissive replication cycle of HCMV was induced by the HIV-1 tat gene product. We were unable to detect HIV-1 (HCMV) or HCMV (HIV-1) pseudotypes in supernatant fluids from dually infected cell cultures. Our results suggest that interactions between HIV-1 and HCMV in coinfected syncytiotrophoblast cells may contribute to the transplacental transmission of both viruses.

Antibodies, Viral↗
PubMed1995

Analysis of survival in stage Ib and IIa cervical cancer treated with or without preoperative local radiotherapy.

The impact of preoperative local radiotherapy on the survival of cervix carcinoma has been evaluated retrospectively in 324 Stage Ib and IIa cases treated between 1969 and 1986 at the University Department of Obstetrics and Gynaecology of Debrecen, Hungary. One hundred and ninety nine Stage Ib cases had radical hysterectomy, 132 of them following brachytherapy. Among 125 radically operated Stage IIa cases 95 had preoperative local radiotherapy. Stage-respective survival curves of patients treated by radical surgery with or without preoperative local radiotherapy were analysed by the life-table method. The use of preoperative radiotherapy was not reflected in better survival when compared to survival of patients without it. Results suggest that preoperative local radiotherapy has a limited role in the management of patients with Stage Ib and IIa cervix carcinoma.

Adolescent↗
PubMed1994

[Functioning conditions of laboratories dealing with cryopreservation of human pre-embryos].

The authors discuss about the functional conditions of the Human Reproductive Laboratories dealing with the cryopreservation of the human preembryos. They determine the safety specifications and recommend documentation of the cryopreservation based on their own practice. Finally they suggest the licensing-controlling system of the Human Reproductive Laboratories concerning cryopreservation of the human preembryos.

Cryopreservation↗
PubMed1994

[Ethical questions of oocyte donation].

The authors discuss about the ethical questions connected with the human egg donation. After expounding the indications of the egg donation they analyse the age limits of the donors and the recipients and the consequences of these age limits by the point of ethics. The selection of the donors, the types of them and the ethical relations of the donation rise a lot of questions. After wording the possible answers the authors state their standpoints.

Age Factors↗
PubMed1994

[Changes in cervical fibronectin levels during pregnancy, labor and in the postpartum period].

The authors analysed the fibronectin content of the uterine cervix during pregnancy and delivery. The aim of their investigation was furnishing data to the biochemical changes during cervical maturation. The ripening of the uterine cervix during pregnancy is a result of complicated interactions between different macromolecules, where the fibronectin plays a key role. The quantitative determination of the extracellular matrix fibronectin is impossible because its extraction from tissues recently is not solved. Taking this fact in consideration the authors choose a semiquantitative method, being reliable indicator of changes in fibronectin content of uterine cervix. They took small pieces of materials from portio vaginalis uteri of 139 women being in postmenopause and premenopause, in different stages of pregnancy and parturition concerning directly after delivery. The slides were incubated, with rabbit-anti-human fibronectin-FITC. The evaluation of fluorescence happened with an Axiophot (Zeiss) microscope. Authors stated that the fibronectin content in the cervical extracellular matrix and in the cellular membrane of fibroblasts increases during the 1st trimester pregnancy. This increase can be shown in the 3rd trimester as well and it drops significantly during delivery. They could not found any relationship between the leucocyte invasion observed during delivery and the changes of cervical fibronectin content. These observations call our attention to the importance of fibronectin in cervical ripening respectively dilatation and the need of further examinations.

Cervix Uteri↗
PubMed1994

[Sialidase activity in cervical connective tissue during cervix maturation and dilatation during labor].

The authors obtained small pieces of materials from portio vaginalis uteri of 122 women being in postmenopause and premenopause, in different stages of pregnancy and parturition concerning directly after delivery. Different biochemical investigations of these 30-200 mgs specimens were performed to study the physiological background of its ripening process. They examined the changes in activity of sialidase which cleaves terminal sialic acids. The authors performed these investigations with the use of Triticum vulgaris (WGA) and Limulus polyphemus (LPA) agglutinins (lectins) marked with FITC. The evaluation of the lectin linkage happened with fluorescence microscope. They evaluated the whole fluorescence of extracellular matrix but separately of different extracellular matrix elements as well. From their investigations was stated that the number of WGA and LPA binding sites of the uterine cervix increases predominantly in the 1st trimester pregnancy compared to the non-pregnant state. As compared to the 1st trimester they described a slight reduction of LPA- and WGA-binding sites in the 3rd trimester. The most impressing changes of LPA and WGA binding sites in the extracellular matrix were observed during parturition. These results coincide with the authors' previous experience whereas the sialidase activity increases significantly during parturition. These data support the assumption that the terminal sialic acids and the sialidase play a recently yet not cleared role in the ripening of the human uterine cervix during pregnancy and in dilatation at the time of parturition.

Adult↗
PubMed1994

Cervical cancer in young women: a poorer prognosis?

OBJECTIVE: The existence of an aggressive form of cervical carcinoma affecting young women is studied by survival analysis of a large patient population. METHOD: Between 1969 and 1986, 1577 cases of cervical cancer were treated according to well-defined policies at the University Department of Obstetrics and Gynaecology in Debrecen, Hungary. Patients' records were reviewed to obtain data for survival analysis. Kaplan-Meier survival curves were generated for each stage and stratified for age. The log-rank test was used to compare the survival of younger and older patients at each stage. Multivariate analysis was performed to control for stage and treatment type when 5-year survival trends across four different age groups were examined. RESULTS: Comparison of survival of patients under 35 and over 35 years of age, and also those under 40 and over 40 years of age revealed no significant differences. Five-year survival across the < 30, 30-39, 40-49 and > or = 50 years age groups showed no significant trend. No differences in survival were revealed when the comparison was controlled for stage of disease and treatment type. CONCLUSION: Results suggest that cervical carcinoma in young women is not more aggressive than in other age groups.

Adolescent↗
PubMed1994

Antibody-dependent enhancement of HIV-1 infection in human term syncytiotrophoblast cells cultured in vitro.

We examined if Fc receptor-mediated antibody-dependent enhancement (FcR-ADE) or complement-mediated antibody-dependent enhancement (C'-ADE) of virus infection can contribute to increasing replication of HIV-1 in human syncytiotrophoblast (ST) cells. Here we report that both FcR-ADE and C'-ADE may result in enhanced virus release from HIV-1-infected ST cells. We show that FcR-ADE of HIV-1 infection in ST cells is mediated by FcRIII and other FcR(s) belonging to undetermined Fc classes and does not require CD4 receptors, whereas C'-ADE uses both CD4 and CR2-like receptors. FcR-ADE seems to be more efficient in enhancing HIV-1 replication than C'-ADE. While FcR-ADE leads to increased internalization of HIV-1, C'-ADE does not result in enhanced endocytosis of the virus. In addition, antibodies mediating FcR-ADE are reactive with the gp120 viral envelope antigen, whereas antibodies involved in C'-ADE react with the viral transmembrane glycoprotein gp41. Data suggest that both FcR-ADE and C'-ADE may contribute to the spread of HIV-1 from mother to the fetus.

Cells, Cultured↗
PubMed1994

Potential contribution of human papillomavirus testing to cervical cancer screening.

A prospective study was carried out to assess the clinical value of HPV DNA identification in terms of cases missed by either cytology or combined cytology and colposcopy screening methods, 231 exfoliative cytology specimens and forty-one cervical tissue samples were analysed for the presence of HPV 6, 11, 16 and 18 DNA sequences using filter in situ and Southern blot hybridisation methods, 36% of cytology specimens examined by filter in situ hybridisation method were found to carry HPV DNA sequence. Forty-nine (27%) out of 184 cases without cytological evidence of neoplasia had a positive HPV test. Simultaneous colposcopic examination of these patients showed no abnormality in 17 cases. The relevance of HPV investigations was based on the characteristic HPV prevalence in preneoplastic and normal cervical tissue samples. The results suggest that traditional cervical screening may be improved by simultaneous HPV testing. According to the presented data, only a very small portion of a random patient population can be expected to carry HPVs without cytologic or colposcopic abnormalities.

Blotting, Southern↗
PubMed1994

Changes in binding capacity of sialic acid-specific lectins in the connective tissue of the uterine cervix during its physiological maturation.

The authors obtained small pieces of materials from portio vaginalis uteri of women being in postmenopause and premenopause, in different stages of pregnancy and parturition respectively after delivery. Biochemical investigations of these specimens were performed to study the background of physiological ripening of the uterine cervix. They examined the changes in activity of sialidase which cleaves terminal sialic acids. Investigations were performed with the use of Triticum vulgaris (WGA) and Limulus polyphemus (LPA) agglutinins (lectins) marked with FITC. These lectins bind specifically to the sialic acids. The evaluation of the lectin linkage was carried out with fluorescence microscope. Separately was evaluated the fluorescence of different extracellular matrix elements concerning the whole fluorescence of connective tissue as well. It was stated that the number of WGA- and LPA-binding sites of the uterine cervix compared to the non-pregnant state increases predominantly in the 1st trimester pregnancy. In relation to the 1st trimester we described a slight reduction of LPA- and WGA-binding sites in the 3rd trimester. The most impressing changes of LPA- and WGA-binding sites we observed during parturition in the extracellular matrix. These results coincide with the author's previous experience whereas the sialidase activity increases significantly during parturition. These data support the assumption that the terminal sialic acids and the sialidase play certain role in human uterine cervix during the gestational process. Their role at the time of pregnancy and delivery however remains to be cleared.

Cervix Uteri↗
PubMed1993

Comparison of four antiemetic regimens for the treatment of cisplatin-induced vomiting.

OBJECTIVE: To improve the treatment of cisplatin-induced acute emesis and vomiting, the adjuvant effect of two different doses of metoclopramide and metoclopramide plus droperidol was compared to a defined standard antiemetic regiment. METHOD: One-hundred and twenty-one consecutive cisplatin-based chemotherapy treatments for ovarian carcinoma were randomly assigned to receive standard plus no adjuvant (control, n = 24), high-dose metoclopramide (HDM, n = 33), very high dose metoclopramide (VHDM, n = 50) and very high dose metoclopramide plus droperidol (VHDM+DP, n = 14) antiemetic treatment. The number of vomiting episodes up to 4 h after the treatment were recorded and compared in the four different antiemetic groups. The effect of the number of previous chemotherapy cycles, the strength of previous antiemetic treatments, age and stage of disease on the number of vomiting episodes was also assessed. RESULT: The mean number of vomiting episodes during the first 4 h after the chemotherapy was 9, 6.4, 6.2 and 2.7 among patients receiving the standard HDM, VHDM and VHDM+DP antiemetic regimens, respectively. Analysis of variance of vomiting episodes confirmed significant differences between the groups (P < 0.001, F = 406.5, df = 120). The number of previous chemotherapy cycles and, to a lesser extent, the stage of disease, the strength of previous antiemetic regimens and the age showed significant correlation with the number of vomiting episodes (r = 0.443, -0.159, -0.14 and -0.009 respectively). CONCLUSION: Substantial improvement in the control of cisplating-induced vomiting can be achieved by adding high-dose metoclopramide and droperidol to a basic antiemetic regimen consisting prochlorperazine, dexamethasone and thiethylperazine.

Antiemetics↗
PubMed1992

[Importance of prognostic factors in the prognosis of cancer of the endometrium].

126 stage I and II endometrial cancer patients were followed up for at least 5 years to evaluate the impact of surgical-pathological risk factors on the survival. Out of the prognostic variables evaluated the age and clinical stage failed to influence the 5-year survival rate. The effect on survival of factors such as low grade of differentiation and the depth of myometrial infiltration was however significant, (p < 0.01 and p < 0.001 respectively). The early local recurrence has also significant negative prognostic value (p < 0.05). This latter can be effectively prevented through the prehysterectomy suture of the external cervical os. On the basis of their findings authors suggest to consider the grade and the depth of myometrial invasion beside the clinical stage at the determination of the extension of the surgical procedure and at the decision on the administration of postoperative irradiation.

Combined Modality Therapy↗