Heparin-induced thrombocytopenia type II with pulmonary embolism after cesarean section.
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Adult↗
Biomedical subjects
M Friedrich
Publications and source records attributed to M Friedrich.
Heterologous mullerian mixed tumor after whole body irradiation because of Hodgkin's disease in stage IV.
PURPOSE: With an incidence of 1.5% of all malignant diseases of the uterus as specified in the literature, the mullerian mixed tumor is a rarity amongst the malignancies of the female genital tract. METHODS: A retrospective analysis of an individual case report with the occurrence of heterologous mullerian mixed tumor years after irradiation because of Hodgkin's disease. RESULTS: This case reports describes the occurrence of a mullerian mixed tumor 12 years after the treatment of Hodgkin's disease by whole body irradiation. To our knowledge, the incidence of a mullerian mixed tumor after the treatment of Hodgkin's disease has rarely been described up to now in the literature. CONCLUSION: This case report appears to indicate the possible carcinogenic potency of radiotherapy when administered many years before. A causal connection between the administration of whole body irradiation and the development of a mullerian mixed tumor cannot be established.
Aged↗
Analysis of the DNA "mismatch-repair" enzyme human mut-S-homologon-2 in endometrial cancer on protein- and RNA-level.
BACKGROUND: Microsatellite instability seems to be important in the development of various human cancers including sporadic endometrial cancer and is characterized by length changes at repetitive loci scattered throughout the genome. It has been shown that cancer predisposition is attributable to defects in any one of four genes, all of which encode homologs of the microbial mismatch repair proteins mutS and mutL. The human Mut-S-Homologon-2 gene (hMSH-2) specifies a mutS homolog, whereas hMLH-1, hPMS-1 and hPMS-2 encode homologs of mutL. MATERIAL AND METHODS: Freshly excised endometrial specimens (malignancies of the uterine corpus: n=50; normal endometrial tissue: n=20) were examined by immunohistochemistry (mAb FE 11, Dianova, Germany) and RT-PCR to analyze the expression of human MUT-S-Homologon-2 on protein- and mRNA-level. Most of the neoplasms of the uterine corpus were sporadic endometrial. RESULTS: In the immunohistochemical study, 25% of normal endometrial tissues were human Mut-S-Homologon-2 negative, while the remaining 75% revealed weak human Mut-S-Homologon-2 immunoreactivity (mean human Mut-S-Homologon-2 IRS: 1.52; SD: +/-1.42; mean human Mut-S-Homologon-2-PP: 12.12; SD: +/-10.31; mean human Mut-S-Homologon-2 IS: 0.98; SD: +/-0.81). All malignancies of the uterine corpus revealed strong nuclear immunoreactivity for human Mut-S-Homologon-2 (mean human Mut-S-Homologon-2-IRS: 9.12, SD: +/-3.34; mean human Mut-S-Homologon-2-PP: 81.82, SD: +/-15.67; mean human Mut-S-Homologon-2-IS: 2.58, SD: +/-0.71). In addition, expression of human Mut-S-Homologon-2 protein was statistically significantly upregulated in tumor cells of malignancies of the uterine corpus as compared to normal endometrial tissue on the protein level. In the RT-PCR study, the hMSH-2 gene was highly expressed in endometrial neoplasms on the mRNA-level. hMSH-2 expression was consistently increased in endometrial neoplasms compared to normal endometrial tissue. CONCLUSION: The expression of the human MUT-S-Homologon-2 is increased both on the protein- and on mRNA-level in endometrial neoplasms compared to normal endometrial tissue possibly caused by the neoplastic process driven by an increase in the rate of mutations in oncogenes and tumor suppressor genes.
DNA Repair↗
Vitamin D and breast cancer: new approaches for hormonal therapy of breast cancer.
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Animals↗
The clinical significance of antenatal pathological Doppler findings in fetal middle cerebral artery compared to umbilical artery and fetal aorta.
PURPOSE: To compare the diagnostic capacity of fetal Doppler velocimetry in fetal middle cerebral artery to umbilical artery and fetal aorta to the prediction of fetal outcome. METHODS: 229 patients between 28 weeks of gestation (weeks) and 40 weeks were examined by Doppler ultrasound in relationship to complications in gestation and labor, and fetal outcome. One thousand two hundred and seventy doppler blood flow velocity waveforms in the middle cerebral artery, umbilical artery and fetal aorta were recorded. Sensitivity of these vessels with regard to the prediction of intrauterine growth retardation, rate of cesarean section, preterm delivery and new-born depression was calculated. In all Doppler measurements there were no cases with absence of end-diastolic flow. RESULTS: The differences between pathological fetal outcome were not statistically significant, but diagnostic capacity of the middle cerebral artery velocimetry with regard to the prediction of pathological fetal outcome was on average 11% below the diagnostic capacity of the fetal aorta and umbilical artery. CONCLUSION: There is no benefit in examining fetal middle cerebral artery Doppler measurements in clinical routine in patients with normal velocity waveforms in the umbilical artery and fetal aorta.
Aorta↗
Reference ranges and standard percentile-curves for the Doppler indices RI and S/D ratio of the fetal middle cerebral artery. Color Doppler measurements in a perinatal centre.
PURPOSE: To perform reference ranges and standard percentile-curves for the Doppler indices resistance index (RI) and systolic/diastolic (S/D) ratio of the fetal middle cerebral artery, periodical color doppler sonographic measurements of 70 pregnant women in the 3rd trimester of pregnancy were done. METHODS: 600 Doppler flow measurements of the fetal middle cerebral artery between 28 and 40 weeks of gestation were performed. The patients had no previous obstetric complications, no apparent medical problems and no complications in pregnancy and labor. Percentiles curves were performed for the RI and the S/D ratio from the 10th percentile up to the 90th percentile. RESULTS: In the 3rd trimester of pregnancy fetal cerebral circulation shows an increase of the diastolic component and simultaneous decrease in cerebral resistance. The average S/D ratio in week 29 is 8.0, in week 34 6.0 and in the 40th week 3.5. The RI decrement is from 0.88 to 0.67. Other groups demonstrated similar ranges however absolute data are different. CONCLUSION: The increase in the diastolic component in the middle cerebral artery of the last third of the pregnancy demands reference ranges by using percentile curves. Knowledge of the reference range helps to discriminate between a normal fetal situation and disease. Because of different absolute ranges in the literature each perinatal centre should develop their own data.
Adolescent↗
Evaluation of the secretion of the atrial natriuretic factor (ANF) after laparotomy.
BACKGROUND: ANF is a potent diuretic, natriuretic and vasorelaxant hormone. The objective of the present study was to examine the effect of opioid receptor stimulation by morphine after surgery on endogenous ANF production and diuresis. METHODS: Prospectively, 11 women undergoing surgery for either uterine leiomyomas, chronic pelvic discomfort or desire for definitive contraception by laparotomy were evaluated. Venous samples were collected at fixed times. Concentrations of ANF were measured by commercially available radioimmunoassay test kits. Statistical analysis was performed by the Friedman Two way ANOVA. Kruskal-Wallis 1-way ANOVA and Mann-Whitney U-Wilcoxon Rank Sum W Test. The level of significance was set at probability below 0.05. RESULTS: There were statistically significant changes in the serum levels of ANF (p=0.0028), in pain score (p<0.0001) and urinary flow rate (p<0.0001) after operation, while the diastolic (p=0.0671) and systolic (p=0.0543) blood pressure showed slightly significant changes. CONCLUSION: Our results show that i.v. administered morphine induces a potent diuretic effect via activation of opioid receptors and suggest that this effect is due to the enhanced release of ANF. However the mechanism by which morphine induces the ANF release remains to be evaluated.
Adult↗
Demonstration of frequent occurrence of clonal T cells in the peripheral blood but not in the skin of patients with small plaque parapsoriasis.
Clinical, immunohistological, and molecular biological data suggest the chronic dermatosis small plaque parapsoriasis (SPP) to be a precursor of mycosis fungoides (MF). However, most data are contradictory and confusing due to inexact definition of SPP. Recently, clonal T cells were detected in skin and blood samples of early MF. Because demonstration of identical T-cell clones in skin and blood of SPP patients would indicate a close relationship of SPP to MF, we investigated the clonality of skin and blood specimens from 14 well-defined SPP patients. By a polymerase chain reaction (PCR) amplifying T-cell receptor gamma rearrangements and subsequent high-resolution electrophoresis, clonal T cells were detected in 9 of 14 initial and 32 of 49 follow-up blood samples, but in 0 of 14 initial skin specimens. Even a clone-specific PCR showing the persistence of the initial blood T-cell clone in 20 of 20 follow-up samples, failed to detect the T-cell clone in the skin. In 2 patients, the clonal T cells were shown to be CD4(+). For the first time, the majority of SPP patients was shown to carry a T-cell clone in the peripheral blood. Although a relation between circulating clonal T cells and SPP cannot directly be proven by the applied techniques, our results indicate blood T-cell clonality to be a characteristic feature of SPP and CTCL because analysis of multiple controls and clinical workup of our SPP patients excluded other factors simulating or causing a clonal T-cell proliferation. A sufficient cutaneous antitumor response but also an extracutaneous origin of the T-cell clones might explain the failure to detect skin infiltrating clonal T cells.
Aged↗
Interleukin 10 treatment of psoriasis: clinical results of a phase 2 trial.
OBJECTIVE: To determine the safety and clinical effects of interleukin 10 (IL-10) treatment of psoriasis. DESIGN AND METHODS: In an open-label phase 2 trial, 10 patients with psoriasis subcutaneously received recombinant human IL-10 over a 7-week period in a dosage of 8 microg/kg daily (n=5) or 20 microg/kg 3 times per week (n=5). Patients were followed up for an additional 5 weeks. RESULTS: The treatment was well tolerated. Antipsoriatic effects were found in all but 1 patient. A significant decrease of the psoriasis area and severity index by 55.3% +/- 11.5% (mean +/- SEM) was observed (P<.02). The antipsoriatic efficiency was confirmed by histological examination. Heterogeneity in the effectiveness was found among the patients, but seems to be independent of the dosage regimen. However, a tendency to a better response was found in the patients who received 20-microg/kg IL-10 3 times per week. Decreasing response in the delayed-type hypersensitivity reaction against recall antigens indicated immunosuppressive effects. Moderate effects on hematopoietic cells were observed. CONCLUSIONS: Our data suggest that IL-10 therapy for psoriasis is safe and possibly clinically effective. Consequently, its value in psoriasis and similar immune diseases should be further determined. Dose-finding, placebo-controlled, double-blind trials are necessary now.
Adult↗
Activation of Jak-Stat and MAPK2 pathways by oncostatin M leads to growth inhibition of human glioma cells.
Oncostatin M (OSM) is a cytokine of the IL-6 family that modulates the growth of various cell types, at least in vitro. We have recently described that OSM inhibits growth and changes cell morphology of human glioma cell lines. Although leukemia inhibitory factor (LIF) receptor components are also expressed by these cells, the response to LIF was significantly weaker compared to OSM. We have therefore analyzed the signal transduction pathways induced by these cytokines. While OSM induces a number of strong tyrosine phosphorylations, including Janus tyrosine kinases (Jak) and the signal transducer and activator of transcription (Stat) proteins, LIF induces only minor tyrosine phosphorylation of Tyk2 and Stat3. Specific activation of the tyrosine phosphatase SHP-2 as well as the mitogen-activated kinase 2 (MAPK2) was found in glioma cells upon OSM treatment. MAPK2 turns out to be a crucial mediator of the OSM effect in glioma cells since inhibition of MAPK activity by the Mek1 inhibitor PD98059 blocks the OSM-induced inhibition of DNA synthesis by about 70%.
Blotting, Western↗
Carcinosarcoma, endometrial intraepithelial carcinoma and endometriosis after tamoxifen therapy in breast cancer.
The fourth case of heterologous mesodermal tumour of the uterine corpus, that developed, years following tamoxifen therapy for breast cancer in a postmenopausal woman with no previous pelvic irradiation, is presented with coincidental endometriosis and endometrial intraepithelial carcinoma. This coincidence after tamoxifen treatment appears to be an indication for the possible carcinogenic potency of tamoxifen.
Aged↗
Combined approach for internal carotid artery stenosis and cardiovascular disease in septuagenarians--a comparative study.
OBJECTIVE: The best surgical approach for concomitant carotid artery and cardiac disease remains controversial. Many studies proved the safety and efficiency of simultaneous surgery. We aimed to demonstrate the same benefits for patients > or = 70 years. METHODS: We retrospectively evaluated 205 patients simultaneously operated upon between 1988 and 1998. Group A comprised patients < 70 years (n = 110), group B > or = 70 years, (n = 95). Risk factors, neurologic and cardiac history, angiographic findings, operative data, morbidity and mortality (30-day-postoperatively) were analysed. The mean age was 62 years in group A and 75 years in group B. All patients with symptomatic carotid artery disease, stenosis > 70% or ulcerative carotid disease had simultaneous surgery. Always, the carotid artery was addressed first. RESULTS: Patients in group B had a higher prevalence of peripheral vascular disease (P = 0.0005), renal insufficiency (P = 0.0011) and COPD (P = 0.03). Urgent operation was indicated in 19% of group A patients vs. 37% in group B. In group A 70% were asymptomatic regarding the carotid vs. 48% in group B. Left ventricular dysfunction was present in 45% (group A) and 58% (group B). In the present study 4% in group A and 7% in group B suffered a perioperative myocardial infarction. Pathologic changes of the contralateral carotid were found in 42 vs. 57% (A vs. B). Mortality due to cardiac causes was 1 and 5%, respectively. The combination of persistent neurologic deficit and neurologic death occurred in 3% in group A (n = 3) and 5% in group B (n = 5). Postoperative neuro-cognitive dysfunction was more common in group B (35 vs. 16%; P = 0.01). CONCLUSIONS: The incidence of persistent neurologic deficits and neurologic mortality in patients > or = 70 years is acceptable, and low in patients < 70 years. Preoperative risk factors are increasing with age and are related to the higher mortality in elderly patients. Due to our results we will conclude that the combined approach for carotid stenosis and cardiovascular disease is the method of choice in this high-risk population.
Aged↗
Expression of transglutaminase K in normal cervix tissue and cervix carcinomas.
The localization and expression of transglutaminase K has been investigated immunohistochemically in normal cervix tissue (n = 15) and in cervix carcinomas (n = 23). The distribution of the transglutaminase K was compared with the staining patterns of cytokeratin 10, Ki-67, p53, and oestrogen and progesterone receptors in these tumours. Weak to strong membrane-bound immunoreactivity for transglutaminase K was detected in almost all cervix carcinomas analyzed. The immunostaining was heterogeneous, with visual differences between individual tumour cells. 66.7% of normal cervix tissues revealed no immunoreactivity for the transglutaminase K. In normal cervix tissue, the immunoreactivity was confined to upper cervix layers, predominantly to the superficial and intermediate cell layers. The intensity of both the immunostaining and the number of transglutaminase K-positive cells were upregulated in cervix carcinomas as compared to normal cervix tissue. When the coexpressions of transglutaminase K with markers of proliferation and differentiation were analyzed, no statistically significant correlation was found. Our findings indicate that (1) transglutaminase K is upregulated at the protein level in cervix carcinomas as compared to normal cervix tissue; (2) upregulation of the transglutaminase K in cervix carcinoma is not exclusively induced by alterations of epithelial differentiation or proliferation, but by different, unknown mechanisms; and (3) upregulation of transglutaminase K in cervix carcinomas may play an important role for the regulation of tumour invasive properties by modulating cell-cell interactions.
Biomarkers↗
Immunohistochemical analysis of DNA 'mismatch-repair' enzyme human Mut-S-Homologon-2 in ovarian carcinomas.
The human Mut-S-Homologon-2 (hMSH-2) gene product is a member of a highly conserved family of proteins involved in postreplication mismatch repair. We have analysed hMSH-2 expression in normal ovarian tissue (n = 15) and ovarian carcinomas (n = 40). hMSH-2 protein was investigated immunohistochemically on frozen sections using a highly sensitive streptavidin-peroxidase technique and a specific mouse monoclonal antibody (clone FE11). A hMSH-2-immunoreactivity score (hMSH-2-IRS) for semiquantitative analysis of hMSH-2 expression is presented. In normal ovarian tissue, we only found weak nuclear immunoreactivity for hMSH-2 in 60%, while the remaining 40% were hMSH-2 negative (mean hMSH-2-IRS: 0.73; SD: +/-0.70). All ovarian carcinomas analysed revealed moderate to strong nuclear immunoreactivity (mean hMSH-2-IRS: 8.05; SD: +/-3.65). hMSH-2 staining was heterogeneous, with visual differences between individual tumour cells. Expression of hMSH-2 protein was consistently and strongly upregulated in tumour cells of ovarian carcinomas as compared to normal ovarian tissue. No statistically significant correlation in comparing the labelling patterns for hMSH-2 with the labelling patterns for Ki-67 (mean percentage of Ki-67 positive tumour cells: 25.88%; SD: +/-18.43) was observed in ovarian carcinomas. Furthermore, no statistical significant correlations between hMSH-2-IRS and histological grading (p = 0.47), histological type of carcinoma (p = 0.706) or FIGO-classification (p = 0.054) were found. Our findings indicate that (a) hMSH-2 is expressed in normal human ovarian tissue, (b) expression of hMSH-2 is increased in ovarian carcinomas, (c) expression of hMSH-2 may be of importance for the genetic stability of ovarian carcinomas in vivo, (d) hMSH-2 mutations may not cause microsatellite instability in ovarian carcinomas, (e) hMSH-2 may contribute to mechanisms responsible for resistance to anticancer drugs.
Adenocarcinoma↗
[Tubular ectasia of the rete testis as cystic space-occupying lesion of the testis--magnetic resonance tomography aspects in 5 cases].
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Adult↗
Pronounced cystic transformation of the Rete testis. MRI appearance.
BACKGROUND: Cystic transformation of the rete testis is a little-known partial or complete obstruction of the spermatozoa-containing secretion of the head of the epididymis. Depending on its severity, either ectasia or a cystic transformation occurs, which spreads to the network of convoluted seminiferous tubules in the mediastinum testis. Findings in contrast-enhanced MRI examinations are characteristic and may help to differentiate this benign entity from malignant neoplasia. The authors present two pronounced cases in different stages, documenting the broad spectrum of possible involvement.
Aged↗
Molecular analyses of the methane-oxidizing microbial community in rice field soil by targeting the genes of the 16S rRNA, particulate methane monooxygenase, and methanol dehydrogenase
Rice field soil with a nonsaturated water content induced CH4 consumption activity when it was supplemented with 5% CH4. After a lag phase of 3 days, CH4 was consumed rapidly until the concentration was less than 1.8 parts per million by volume (ppmv). However, the soil was not able to maintain the oxidation activity at near-atmospheric CH4 mixing ratios (i.e., 5 ppmv). The soil microbial community was monitored by performing denaturing gradient gel electrophoresis (DGGE) during the oxidation process with different PCR primer sets based on the 16S rRNA gene and on functional genes. A universal small-subunit (SSU) ribosomal DNA (rDNA) primer set and 16S rDNA primer sets specifically targeting type I methylotrophs (members of the gamma subdivision of the class Proteobacteria [gamma-Proteobacteria]) and type II methylotrophs (members of the alpha-Proteobacteria) were used. Functional PCR primers targeted the genes for particulate methane monooxygenase (pmoA) and methanol dehydrogenase (mxaF), which code for key enzymes in the catabolism of all methanotrophs. The yield of PCR products amplified from DNA in soil that oxidized CH4 was the same as the yield of PCR products amplified from control soil when the universal SSU rDNA primer set was used but was significantly greater when primer sets specific for methanotrophs were used. The DGGE patterns and the sequences of major DGGE bands obtained with the universal SSU rDNA primer set showed that the community structure was dominated by nonmethanotrophic populations related to the genera Flavobacterium and Bacillus and was not influenced by CH4. The structure of the methylotroph community as determined with the specific primer sets was less complex; this community consisted of both type I and type II methanotrophs related to the genera Methylobacter, Methylococcus, and Methylocystis. DGGE profiles of PCR products amplified with functional gene primer sets that targeted the mxaF and pmoA genes revealed that there were pronounced community shifts when CH4 oxidation began. High CH4 concentrations stimulated both type I and II methanotrophs in rice field soil with a nonsaturated water content, as determined with both ribosomal and functional gene markers.
Journal Article↗