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P Klein

Publications and source records attributed to P Klein.

At least 145 records · Page 8Linked to original sources
PubMed1991

[Functional and urodynamic results of Burch's colpopexy. A series of 173 cases].

The authors describe their experience with modified Burch retropubic urethropexy with a mean follow-up of 4 1/2 years; they clinically assessed 173 women. 114 of these had urodynamic studies. The long term objective success of this operative procedure, with a success rate of 95% in genuine stress incontinence and of 96% in correction of the cystocele, justify its use to cure urine loss in women with primary stress incontinence or after failure of a previous operation. The results do not get worse with a long term follow-up. The mechanism of action consists in improving the abdominal pressure transmission ration (+29%) with only a little decrease of the post-operative mean maximal urethral closure pressure (-8,8 cm H2O). The most challenging complication encountered was bladder instability (22.5%); post-operative retrocele or enterocele occurred in 15% of cases. The other side effects were dysuria, pubic pain and trachelocele. The rate of failure is nearly 5% mainly due to insufficient correction of the abdominal pressure transmission ration, or post-operative bladder instability or low urethral closure pressure.

Adult↗
PubMed1990

[Significance of revascularization in arterially-induced mesenteric infarct].

Until 1957 the only treatment of occlusion of mesenteric arteries was resection of the ischemic part of the bowel. A reduction of the extremely high mortality can be reached by the combination of mesenteric revasularisation with an optional resection of the necrotic parts of the bowel. Based on the experience with 57 patients operated on between 1970 and 1987, the survival rate (greater than 60 days after operation) could be improved by performing this regime. Reasons for this improvement are both the salvage of bowel length and the avoidance of the leak of bowel anastomosis. The latter was observed only in patients treated by bowel resection alone without revascularisation leading to death in three out of four cases.

Aged↗
PubMed1990

Mutagenic and genotoxic activities of extracts derived from the cooked and raw edible mushroom Agaricus bisporus.

A. bisporus has been reported to be carcinogenic to mice [Toth et al. (1986) Cancer Res 38:177-180] and mutagenic in Salmonella typhimurium [Sterner et al. (1982) Mutat Res 101:269-281]. The effects of different heat treatments on the mutagenicity of raw, cooked (boiled) and fried A. bisporus extracts in the S. typhimurium test is reported. The spectrum of potential mutagenic activity of A. bisporus extracts was tested in vitro in Syrian hamster embryo cells for selective DNA amplification and in primary rat hepatocytes for DNA single-strand breaks. DNA single-strand breaks were also determined in liver cells of rats and micronuclei were measured in bone marrow cells of mice in vivo following oral application of A. bisporus extracts. It was shown that the complex A. bisporus extracts per se are not detectably mutagenic in S. typhimurium and that the previously observed increase in number of colonies per plate is probably due to a histidine artefact. No indication of genotoxicity was seen in the two in vitro assays with primary mammalian cells with two different end points. No evidence of in vivo genotoxic effects was observed in the rat liver cells. Finally, A. bisporus was not genotoxic in the micronucleus assay of mouse bone marrow cells in contrast to its previously reported carcinogenicity in mice.

Agaricus↗
PubMed1990

Induction of selective DNA amplification and morphological cell transformation in Syrian hamster embryo cells.

DNA amplification is a frequently observed event in continuous cell lines and in tumors. It is likely that a common mechanism underlies the amplification of specific DNA sequences which confer drug resistance and genes which give a growth advantage to the tumor. To find a correlation between the induction of DNA amplification by chemicals and morphological cell transformation we treated Syrian hamster embryo (SHE) cells with diverse antineoplastic agents of different classes. Analysis of these agents seems to be important since they are potentially carcinogenic and resistance inducing. For the measurement of DNA amplification we established a new system using adeno-associated virus type 2 (AAV)-infected primary SHE cells as target cells and amplification of viral DNA as marker of DNA amplification. Simultaneously we determined morphological cell transformation in SHE cells. Our findings demonstrate that there is only a limited correlation between the induction of AAV DNA amplification and the morphological cell transformation in SHE cells. The newly established system of AAV DNA amplification appears to be a useful tool for the investigation of drug resistance in target cells of choice.

Animals↗
PubMed1990

Female urinary incontinence: comparative value of history and urodynamic investigations.

In order to identify the role of urodynamic investigation in relation to urinary symptoms, the authors assessed the diagnostic value of history and of urodynamic investigation in female urinary incontinence. 154 patients presenting with urinary incontinence were investigated prospectively, by standardised history and investigation of bladder stability and investigation of bladder stability and of cervico-urethral closure function. Clinical and urodynamic diagnostic conclusions were compared. Urodynamic results were highly discordant in the presence of clinical 'erethism', whilst agreement was more marked in the case of stress incontinence. Urodynamic investigation may be indicated after failure of medical treatment in the case of 'dysfunction'. By contrast, it is essential in stress incontinence in order to identify the mechanism or detect subclinical 'dysfunction'.

Female↗
PubMed1990

Primary CNS lymphoma: lymphomatous meningitis presenting as a cauda equina lesion in an AIDS patient.

Neurologic complications of the acquired immune deficiency syndrome (AIDS) most often present as brain dysfunction and/or a polyneuropathy. We describe a unique neurological problem of a woman with AIDS who presented with a cauda equina mass due to primary CNS lymphoma. She subsequently developed a fulminant lymphomatous meningitis and died. Although previously rare, primary spinal cord lymphoma is expected to be encountered more often with the current AIDS epidemic and may be difficult to distinguish from infectious mass lesions.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Conjugate addition ligands of opioid antagonists. Methacrylate esters and ethers of 6 alpha- and 6 beta-naltrexol.

Alpha- and beta-naltrexol derived esters 9 and 10 and ethers 11 and 12, each containing the alpha, beta-unsaturated ester functionality, were prepared as conformationally more flexible analogues of spiro-alpha-methylene-gamma-lactones 5 and 6. All were active in the opioid radioreceptor binding assay against [3H]bremazocine and more active against [3H]DAGO, indicating mu-subtype selectivity, but only ether 12 showed significant irreversible activity. We conclude that small structural changes, made in very closely related electrophilic opioids, lead to changes in receptor binding. All four compounds were long-acting antagonists to morphine in mice, with ester 10 being approximately equipotent with naltrexone.

Animals↗
PubMed1990

Electrophilic alpha-methylene-gamma-lactone and isothiocyanate opioid ligands related to etorphine.

Isothiocyanate and alpha-methylene-gamma-lactone analogues of 6,14-endo-ethenotetrahydrothebaine and -oripavine were prepared with the electrophilic groups being located at C-19 in the C-7 alpha-side chain. Isothiocyanates were prepared in the N-Me and N-CPM (N-cyclopropylmethyl) series, both as the phenols and 3-O-methyl ethers from the diastereomeric amines formed from reductive amination of thevinone (2) and N-(cyclopropylmethyl)northevinone (13). Although addition of the organozinc reagent from methyl alpha-bromomethacrylate to 25 failed, addition to 3-O-protected aldehydes 27 and 35 produced, after subsequent deprotection, alpha-methylene-gamma-lactones 29 and 37, respectively. In the opioid receptor displacement assays against [3H]bremazocine as the radiolabeled ligand, the phenolic compounds were most potent with N-CPM isothiocyanates 20 and 21 showing IC50s of 0.32 and 0.76 nM, respectively, and N-CPM alpha-methylene-gamma-lactone 37 having an IC50 = 1.0 nM. Compound 37 showed irreversible effects in the binding assay which were mu-selective, as demonstrated by analogous experiments using [3H]DAGO, and naloxone was found to protect against the irreversible effects. This observation suggests that a receptor-bound nucleophile is located at a position where it can readily reach the alpha-methylene group of lactone 37.

Chemical Phenomena↗
PubMed1990

[Mucoviscidosis and spontaneous pneumothorax--surgical risk and treatment by percutaneous fibrin pleurodesis].

From 1975 to 1987, 44 of 230 patients with cystic fibrosis under our care underwent a total of 66 operations. There were no direct intra- or postoperative complications. If an optimal and aggressive adjuvant treatment is given postoperatively, there are no increased risks associated with surgical procedures in cystic fibrosis patients. Treatment of spontaneous pneumothorax remains a problem. An alternative treatment for pneumothorax using transcutaneous fibrin pleurodesis is presented.

Child↗
PubMed1990

[Chronic atelectasis--an indication for lung resection in early childhood?].

Between 1980 and 1989, 69 children underwent lung resection in our department. 45 of them (25 boys, 20 girls, age 0-9 years) presented with atelectatic areas of the lung parenchyma, which had been demonstrated preoperatively in only 76%. Resections were performed for bronchial malformations (n = 7), sequestration (6), cysts (6), aspiration (1), pyocele following pulmonary artery ligation (1), upper lobe torsion (1), chronic pneumonia and/or bronchiectasis (14) and lobar emphysema with lung compression (10). The overall mortality was 4/45. Indications are discussed with special reference to the persistent or recurrent atelectasis.

Adolescent↗
PubMed1989

Focal cerebral infarctions associated with perivascular tumor infiltrates in carcinomatous leptomeningeal metastases.

Diffuse carcinomatous leptomeningeal metastases "carcinomatous meningitis") have the usual clinical course involving multifocal nerve root deficits and a variable diffuse encephalopathy. In contrast, we describe a patient with carcinomatous leptomeningeal metastases who presented with clinical signs of meningitis and focal cerebral infarction. Over an 8-month period, multiple cerebral infarctions and cranial neuropathies developed. Postmortem examination of the patient's brain revealed diffuse leptomeningeal infiltration by a signet-ring adenocarcinoma. The extensive involvement of the subarachnoid space with tumor was associated with dense neoplastic infiltration of the Virchow-Robin spaces. These perivascular tumor infiltrates were accompanied by multifocal mural invasion and, less frequently, by intravascular tumor cells obliterating the lumen. Focal hemorrhagic infarcts in the cerebral cortex corresponded to areas of microscopic vasculopathy. This case provides evidence that tumor-associated vasculopathy with resultant ischemia plays a role in the pathogenesis of focal cerebral infarctions in carcinomatous leptomeningeal metastases.

Adenocarcinoma, Mucinous↗
PubMed1989

Cerebellar ataxia.

Explore the source record for details and available documents.

5-Hydroxytryptophan↗
PubMed1989

[Erectile dysfunction following pelvic fracture and pelvic trauma].

In the course of this research a questionnaire was submitted to 209 male patients who had been treated in the surgical university clinic of Erlangen between 1976 and 1985, in order to get knowledge about possible complications in the form of erectile non-functioning. 29 of these patients had died in the meanwhile, 32 had moved to an unknown address. Among the other 148, 86 were willing to give some information. 44% of these people turned out to be suffering from an impotentia coeundi. Furthermore, we were able to prove that 40% of those patients for whom a large haematoma of the pelvis had been diagnosed were impotent. Finally, 73% of the patients who had additionally suffered an injury of the urogenital canal turned out to be impotent. On closer examination of the urogenital side-effect case of rupture of the bladder and as much as 87.5% in the case of lesions of the urethra. In connection with the urethra lesions reference is made to the controversial discussion about their therapy, with dichronous recanalling clearly being given preference as it involves considerably fewer complications compared to primary recanalling.

Adult↗
PubMed1989

DNA amplification in genetic toxicology.

Chemical compounds can cause amplification of specific DNA sequences. DNA amplification may result in an enhanced production of gene products which help cells to cope with the chemicals. This may lead to a resistance of the cells toward the agent. Additionally, initiation of transformation or progression of transformed cells to tumorigenicity may also involve DNA amplification. Therefore, it is of interest to study the potential of chemicals to induce DNA amplification. This report focuses on the investigation of a variety of chemicals in 2 systems with which the amplification of viral DNA is measured within cells in culture. One model system comprises the measurement of SV40 DNA content in an SV40-transformed Chinese hamster cell line following chemical treatment. Antitumor agents as well as genotoxic and non-genotoxic compounds were studied in this system as a first step to determine the DNA amplification-inducing potential of a variety of differently acting chemical compounds. Also, a novel assay based on adeno-associated virus infection of cells is described. This system may offer the possibility of studying DNA amplification in a variety of different target cells. For the future, the need is stressed to develop and analyze versatile systems to study amplification of specific target genes in untransformed cells and in tumor cells.

Animals↗