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Biomedical subjects

L Mettler

Publications and source records attributed to L Mettler.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Induction of high titer mouse--antihuman spermatozoal antibodies by liposome incorporation of spermatozoal membrane antigens.

This is the first report of induction of high titer mouse-antihuman spermatozoal antibodies using a spermatozoal antigen incorporated in liposomes. The peptide antigens that were incorporated into pure phosphatidylcholine liposomes are known to react with the naturally occurring antibodies in sera of sterile patients. Electron microscopy and the complement-dependent glucose release tests indicated that the peptides were entrapped in the aqueous phase between the lipid bilayers in the liposome vehicles. This is in contrast to most other liposomal antigens that are expressed on the outer lipid surface. In view of the nontoxic nature of the liposomes these results could be of some interest in immunological fertility regulation trials with appropriate antigens in an allogeneic system.

Animals↗
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Monoclonal sperm antibodies: their potential for investigation of sperms as target of immunological contraception.

We generated 149 hybridoma cell lines secreting antibodies against human spermatozoal antigens of which antibodies from 136 hybridoma lines also reacted with seminal plasma constituents. The occurrence of common antigeneic determinants on spermatozoa and seminal plasma was further demonstrated by competitive inhibition ELISA tests. We found that seven hybridoma clones secreted antibodies reactive with spermatozoa but nonreactive with seminal plasma. Antibodies from 5 clones were sperm-agglutinating and from 15 clones sperm-immobilizing. Localization of sperm antigens reactive with the monoclonal antibodies was demonstrated by indirect immunoperoxidase staining. A synthetic decapeptide, earlier shown to be reactive with naturally occurring human iso- and autosperm antibodies, was shown to be reactive with the monoclonal antibody VII-5 in ELISA tests.

Agglutination↗
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Hysteroscopy: an analysis of 2-years' experience.

BACKGROUND: Over the years, hysteroscopy has been increasingly performed for various gynecological disorders. In this study, we present a review of hysteroscopic procedures performed over a 2-year period analyzing the complications associated with it. METHODS: Seven hundred twenty-six hysteroscopic procedures performed at the Department of Gynecology and Obstetrics, University of Kiel over a period of 2 years were reviewed retrospectively using the GynReg database in the department. Indications, intraoperative diagnoses, and complications were particularly highlighted. RESULTS: The most common indications for the procedure were abnormal vaginal bleeding, endometrial ablation, polypectomy, and myomectomy. The most common findings were uterine polyps, submucous myoma, and hyperplastic endometrium. The complication rate was 1.65% of total hysteroscopies. False passage and uterine perforation were the most common acute complications. No late complications occurred. CONCLUSIONS: Correlating our data with that found elsewhere, we find hysteroscopy to be a safe, minimally invasive procedure with a very low rate of complications.

Female↗
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Long-term results in the treatment of menorrhagia and hypermenorrhea with a thermal balloon endometrial ablation technique.

BACKGROUND AND OBJECTIVES: Evaluation of long-term results using a thermal balloon endometrial ablation technique to treat menorrhagia and hypermenorrhea, considered dysfunctional uterine bleedings. METHODS: A single-arm, prospective study with long-term follow-up of 48 months at the department of obstetrics and gynecology, University of Kiel, Germany. Following hysteroscopic evaluation of the uterine cavity and fractionated curettage, the Cavaterm endometrial thermal ablation technique was performed on 70 patients over the age of 40 with menorrhagia and hypermenorrhea in whom medical treatment had previously failed. The study included a group of 10 patients with adenomyosis and uterine fibroids. RESULTS: In 65 patients, a complete 48-month follow-up evaluation was possible: 58% of patients reported amenorrhea and 33% hypomenorrhea. Nine percent of patients remained eumenorrheic. Fifty percent of the small group with failed indications for the procedure had to undergo a hysterectomy. CONCLUSIONS: The Cavaterm thermal coagulation system in the earlier mode of application (15 minutes at a temperature of 70 degrees C and a pressure of 200 mm Hg) is a safe and highly effective method of endometrial ablation resulting in a minimal amount of posttreatment menstrual bleeding.

Catheterization↗
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Accuracy of laparoscopic diagnosis of endometriosis.

BACKGROUND AND OBJECTIVE: Laparoscopy is the standard method to visually identify endometriotic lesions under magnification within and outside the minor pelvis. The aim of this study was to analyze the accuracy of laparoscopic visualization in diagnosing the various endometriotic sites as confirmed histologically. METHOD: Presumed endometriotic sites were observed in 164 patients operated on under the clinical suspicion of endometriosis. Targeted biopsies were performed for histologic corroboration, comparing the laparoscopic findings and diagnosis to the histological results. RESULT: The histological reports of the biopsies confirmed the presence of endometriosis in 138 patients (84.1%), but in 26 patients (15.9%), no evidence of endometriosis was observed. 100% of "red" lesions, 92% of "black" lesions, and 31% of "white" lesions turned out to be endometriosis. Of the 264 various suspected endometriotic sites observed, 142 (53.8%) were confirmed histologically. The most accurate diagnosis was in lesions on the parietal peritoneum of the pelvis, confirmed in 9/9 cases (100%); the ovarian fossa, confirmed in 8/12 cases (66.7%); and the uterosacral ligaments and posterior surface of the broad ligament, confirmed in 83/138 cases (60.1%). As for the other sites, the histologic confirmation rates in the ovarian surface, bowel serosa, and vesicouterine fold of the peritoneum were 48%, 40%, and 13%, respectively. CONCLUSION: Endometriosis has a multiple appearance, and the lesions may be confused with nonendometriotic lesions. It is clear that a nonhistology-based diagnosis may lead to unnecessary prolonged medical treatment and operations and may delay the proper treatment measures from being applied. Therefore, a meticulous histological confirmation should still be the first step in the laparoscopic diagnosis and treatment of suspected endometriosis.

Endometriosis↗
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New adhesion prevention concept in gynecological surgery.

Postsurgical adhesion formation is a common but significant problem. This is the first clinical evaluation of a new barrier material designed to reduce or eliminate postsurgical adhesions. SprayGel can be delivered laparoscopically or via laparotomy to form a strongly adherent hydrogel film. In this multicenter study, we evaluated the safety and effectiveness of SprayGel absorbable adhesion barrier system in patients undergoing open or laparoscopic myomectomy procedures. Here, we discuss the results of our evaluation conducted at the University of Kiel and Polyclinic of Bordeaux, and assess some of the features of this novel adjunct to prevent formation of postsurgical adhesions.

Adhesives↗
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Experience of laparoscopic tubal surgery at the department of obstetrics and gynecology, University of Kiel, from 1999 through 2000.

OBJECTIVE: We analyzed the results of laparoscopic tubal surgery performed at the Department of Obstetrics and Gynaecology, University of Kiel, between 1999 and 2000. A retrospective review of 236 tubal surgical procedures was conducted: (1) patients with ectopic pregnancies, unilateral or bilateral tubal occlusions or alterations and (2) medically indicated sterilizations and salpingectomies. METHODS: Two specialists and 10 gynecologists in residency training performed the following 236 procedures: 64 salpingotomies, 74 salpingectomies, 25 salpingostomies, 8 tubal end-to-end anastomoses, 24 fimbrioplasties, and 41 tubal sterilizations. In June 2001, questionnaires were sent to all 236 patients who underwent laparoscopic tubal surgery to evaluate subsequent pregnancies. From the 195 answers received, 155 patients wished to have children and of these 79 (51%) became pregnant. In 8 tubal reversals, 6 pregnancies occurred, resulting in a 75% success rate. In the group of sterilizations and salpingectomies, no pregnancies occurred. RESULTS: A pregnancy rate of 51% resulted after tubal reconstructive surgery. After tubal sterilization, no pregnancies were observed in the following 3 years. CONCLUSION: Laparoscopic tubal surgery has surpassed laparotomic tubal surgery with comparable success rates. Laparoscopic tubal surgery is also a less traumatic procedure.

Fallopian Tube Diseases↗
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[Monoclonal antibodies Ki-Sp II-13 and VI-2 react with surface membrane of human spermatozoa].

Immunizing Balb-c mice with washed motile human spermatozoa enabled the production of 2 monoclonal spermatozoal antibodies designated Ki-Sp II-13 and Ki-Sp VI-2. Immunohistochemically Ki-Sp VI-2 reacts only with mature spermatozoa. The monoclonal antibody Ki-Sp II-13 recognizes besides spermatozoa also T- and B-lymphocytes. Electronmicroscopically both antibodies react with the surface membrane of spermatozoa in the area of the head, the neck and the proximal part of the tail. Functional tests show a high sperm-agglutinating and sperm-immobilizing activity, using different test systems for Ki-Sp II-13. Both antibodies proved to be IgG. On immunoprecipitation Ki-Sp II-13 was identified as IgG-2a and Ki-Sp VI-2 as IgG1. Immunoprecipitates of SDS-electrophoretically separated and radiolabeled sperm surface antigens revealed a molecular weight of 18 KD for Ki-Sp II-13 and of 24 KD for Ki-Sp VI-2.

Animals↗
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Biochemical characterization of a rat spermatozoal peptide antigen and the induction of a reversible immunosuppression of fertility.

A rat spermatozoal polypeptide with 40 amino acid residues and a N-terminal lysine was purified to homogeneity by high performance liquid chromatography. Following incorporation of the peptide into pure phosphatidylcholine liposomes and immunization of female Wistar rats, a significant reduction of fertility occurred (chi 2 = 6.4, P less than .01). Following 4 months of recovery after the immunization fertility rates returned to normal. No adverse side effects on vital organs from the immunization were detected by light microscopy. The results may be indicative of a pathway for immunologic regulation of fertility.

Animals↗
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Application of monoclonal antibodies for antigen mapping of male and female generative tissue.

With the single experiment of nature hindering the rejection of the fetus in the mother, new basic mechanisms of this immunological phenomenon can be studied. The technique of monoclonal antibodies provides a helpful tool for the study of membrane structural and cytoplasmic molecules. Hybridoma clones offer for the first time the possibility of obtaining unlimited amounts of almost pure antibodies or very high titers and of defined characteristics. The most common application with reproductive tract monoclonals are found as follows: 1) Immuno-assays; 2) Immuno-diagnostics; 3) Imaging of tumors; 4) Immuno-therapy; 5) Induction of anti-idio-types; 6) Fertility control; 7) Application in basic studies and mechanisms. The following interesting results were obtained in this area: 1) The biological role of hormones can be critically analysed by the use of highly specific non-cross-reactive monoclonal antibodies. 2) A synthetic decapeptide earlier shown by our group to be reactive with naturally occurring human iso and autosperm antibodies demonstrated to be reactive with the monoclonal antibodies Ki VII-5 presenting potentials for an investigation of sperm as target of immunological contraception for possible diagnostic and therapeutic use in immunologic infertility. 3) A specific post fertilization-development influencing antigen was identified by Menge using monoclonal antibodies. 4) Five hybridoma clones producing monoclonals to porcine zona pellucida were established, and showed a characteristic staining pattern of oocytes from human eggs, hamsters, rabbits and mice by immunofluorescence.

Abortifacient Agents, Nonsteroidal↗
PubMedDate not supplied

[Is the sperm bacteriology important for the results of in vitro fertilization?].

A total of 140 ejaculates from patients taking part in the in vitro fertilization program were examined. In 60 ejaculates (42.9%) bacteria concentrations of greater than 10(5)/ml were found. 80 (57.1%) of the probes were negative or had bacteria concentrations less than 10(4)/ml. Microplasma was found in 30 of the examined ejaculates (21.4%) and the second most frequent group of microorganisms were enterococci found in 15 patients (10.7%). Anaerobic organisms in concentrations of more than 10(5)/ml were detected. After insemination of one of more pelviscopically obtained oocytes with sperm of the husband in 14 out of 22 cases (63.6%) with bacteria concentrations greater than 10(5)/ml the cleavage of at least one oocyte occurred leading to an embryo transfer rate of 63.6%. 14 of 31 ejaculates with negative bacteriological findings (45.2%) fertilized at least one of the inseminated oocytes. From the results obtained up to now any direct effect of microorganism contaminated sperm on the human in vitro fertilization system resulting in reduced fertilizations rates cannot be demonstrated. It can be said that there is no correlation between microbiological and cytological findings of ejaculates used for insemination of oocytes and the obtained fertilization, cleavage and embryo transfer rates in the human in vitro fertilization program here. But since the negative effect on implantation rates or embryonic development cannot be excluded detailed bacteriological examinations and probably antibiotic treatments may be recommended before admission of the in vitro fertilization program.

Embryo Implantation↗
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[New progress in detection of antigens from human ejaculate in relationship with human sterility (extraction with N-cetylpyridinium chloride) (author's transl)].

In an attempt to obtain certain sub-surface spermatozoa antigens, human spermatozoa were treated with N-cetylpyridinium chloride in basic buffer, The extract was further ultrasonated and separated with gel chromatography over a Sephadex--G--100 column. The obtained fractions were lyophilized and tested against human sperm agglutinating and sperm immobilizing sera, in order to detect their antigenicity. Positive and negative controls revealed intensive precipitations and no precipitations respectively. Fraction A4 reacted intensively with sperm immobilizing sera. The final objectives of these sperm antigens solubilization studies are twofold. On the one hand we are looking for a method to lower sperm antibodies titres in sterile females, and on the other hand we are seeking an immunological contraceptive method.

Antigens↗