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Biomedical subjects

P R Huber

Publications and source records attributed to P R Huber.

At least 19 recordsLinked to original sources
PubMed2000

S100A1, a new marker for acute myocardial ischemia.

The Ca(2+)-binding S100A1 protein displays a specific and differential expression in the human myocardium and is considered to be an important regulator of heart function. Because of its high expression levels in the heart we tested the performance of S100A1 as a diagnostic indicator of acute myocardial damage. Therefore, we established a S100A1-specific sandwich ELISA and determined the S100A1 plasma levels in patients with signs of acute myocardial ischemia. The concentration-time course of S100A1 was distinct from that of the "classical" biochemical markers, CK, CKMB, and troponin I, showing an early rise and a fast decline in plasma after the ischemic event. We suggest that S100A1 should be included in combinatorial measurements as an early diagnostic marker for ischemic coronary diseases.

Acute Disease↗
PubMed2000

Disordered calcium homeostasis of sepsis: association with calcitonin precursors.

BACKGROUND: Hypocalcemia and increased serum levels of calcitonin precursors are common in critically ill patients, especially in those with sepsis. We investigated calcium homeostasis in such patients. PATIENTS AND METHODS: Serum concentrations of total and ionized calcium and known factors influencing or reflecting calcium homeostasis were measured in 101 consecutive patients of a medical intensive care unit. Calcitonin precursor levels were determined using a highly sensitive radioimmunoassay. RESULTS: Critical illness per se was associated with decreased serum total and ionized calcium levels, which correlated with the severity of the underlying disease as measured by the APACHE II score. In addition, total and ionized hypocalcemia was more pronounced with increasing severity of infection (P < 0.02), and occurred in parallel with a marked increase of calcitonin precursors (P < 0.001). Mature calcitonin levels, however, remained normal. Changes of serum ionized calcium concentrations from admission to discharge correlated significantly with changes in the serum calcitonin precursor concentration (r2 = - 0.14, P < 0.001). Circulating vitamin D levels, parathyroid hormone levels and other markers reflecting calcium homeostasis did not correlate with the severity of infection. CONCLUSIONS: In critically ill patients with sepsis, markedly elevated circulating calcitonin precursors might play a role in the development of the pronounced hypocalcemia. The specific calcitonin precursor(s) responsible for this effect and the pathophysiological mechanism remain to be elucidated.

Adult↗
PubMed2000

Calcitonin precursors are reliable markers of sepsis in a medical intensive care unit.

OBJECTIVE: The diagnosis of infection in critically ill patients is challenging because traditional markers of infection are often misleading. For example, serum concentrations of calcitonin precursors are increased in patients with infections. However, their predictive accuracy for the diagnosis of sepsis in unselected patients in a medical intensive care unit (ICU) is unknown. Therefore, we compared the usefulness of serum concentrations of calcitonin precursors, C-reactive protein, interleukin-6, and lactate for the diagnosis of sepsis in consecutive patients suffering from a broad range of diseases with an anticipated stay of > or =24 hrs in a medical ICU. DESIGN: Prospective cohort study. SETTING: Medical intensive care unit in a university medical center. PATIENTS: 101 consecutive critically ill patients. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: Blood samples were collected at various time points during the course of the disease. Systemic inflammatory response syndrome, sepsis, severe sepsis, and septic shock were diagnosed according to standardized criteria, and patients were reclassified daily without prior knowledge of the serum concentrations of calcitonin precursors or interleukin-6. At admission, 99% of the patients had systemic inflammatory response syndrome, 53% had sepsis, and 5% developed sepsis during their stay in the ICU. Calcitonin precursors, C-reactive protein, interleukin-6, and lactate levels increased with the severity of infection (p < .01, one-way analysis of variance). In a receiver operating characteristic curve analysis, calcitonin precursors were found to be the most reliable laboratory variable for the diagnosis of sepsis as compared with C-reactive protein, interleukin-6, and lactate (p < .01, for each comparison). Calcitonin precursor concentrations of >1 ng/mL had sensitivity of 89% and specificity of 94% for the diagnosis of sepsis. High serum concentrations of calcitonin precursors were associated with poor prognosis (p = .01). CONCLUSIONS: In a medical ICU, serum calcitonin precursor concentrations are more sensitive and are specific markers of sepsis as compared with serum C-reactive protein, interleukin-6, and lactate levels.

Adult↗
PubMed1998

CA-125 concentrations in the serum and pregnancy outcome in IVF cycles.

PURPOSE: CA-125 has been proposed as a potential marker for endometrial receptivity in assisted reproduction. This study was designed to evaluate whether the levels of CA-125 in the serum of patients undergoing IVF-embryo transfer (ET) is correlated with the outcome. METHODS: Levels of serum CA-125 were measured on the day before and on the day of human chorionic gonadotropin (hCG) administration, ovum pickup (OPU), and ET in 74 patients undergoing 100 IVF cycles between January 1994 and March 1995. Patients were treated with a midluteal-phase gonadotropin-releasing hormone (GnRH) agonist protocol and follicular-phase human menopausal gonadotropin. RESULTS: One hundred oocyte retrievals resulted in 91 ETs, and 22 clinical pregnancies (22%/OPU and 24.2%/ET). The live-born rate was 21%/OPU and 23.1%/ET. Neither the CA-125 serum levels nor their increase from the day of hCG until the day of ET showed any prognostic significance to the outcome of IVF, and they were not correlated with the endometrium thickness or the number of oocytes retrieved or fertilized. CONCLUSIONS: The CA-125 serum levels in conventional IVF cycles were not correlated with the IVF outcome and yielded no prognostic information in a GnRH agonist down-regulation protocol.

Adult↗
PubMed1998

Prostate-specific antigen in the cerebrospinal fluid leads to diagnosis of solitary cauda equina metastasis: a unique case report and review of the literature.

A 79-year-old male patient presented with a subacute cauda syndrome caused by an intradural metastasis of the lumbosacral caudate fibres from an adenocarcinoma of the prostate, which had been treated 5 years earlier with external beam radiation therapy. Diagnosis could not be established by repeated magnetic resonance images (MRIs) during a 2-year period of increasingly severe radicular pain. Eventually, a small tumour mass could be visualized on the fourth MRI. Repeated normal serum prostate-specific antigen (PSA) did not hint at a prostate cancer metastasis (range 2.4-5.1 ng ml(-1)); however, PSA in the cerebrospinal fluid was found to be elevated (29.1 ng ml(-1)). Empirical radiation therapy of the caudate region did not improve radicular pain. Therefore, an exploratory surgical procedure was conducted, which confirmed the suspicion of an intradural prostate cancer metastasis. In conclusion, PSA in the cerebrospinal fluid provides a useful diagnostic tool for detecting intradural prostate cancer metastasis.

Adenocarcinoma↗
PubMed1998

General anaesthesia for surgery can influence circulating melatonin during daylight hours.

BACKGROUND: Both melatonin and anaesthetics have been shown to affect sleep and behaviour. The effect of general anaesthesia on circulatory melatonin has not been reported, but anaesthetic-related alterations in hormone profiles are known. We hypothesize that differences in recovery from anaesthesia may be associated with differences in circulatory melatonin levels because of melatonin's sedative effect in humans. METHODS: The influences of general anaesthesia and surgery on circulating melatonin, prolactin, and cortisol concentration were investigated in 32 female patients scheduled for elective gynaecological surgery to study differences in hormone profiles and responses during anaesthesia and the recovery period. Patients were randomly assigned to one of two groups. General anaesthesia was induced with either thiopentone/fentanyl (Group 1: n = 16) or propofol/fentanyl (Group 2: n = 16). Maintenance of anaesthesia was achieved with either isoflurane (0.8-1.0 vol%)/fentanyl (Group 1) or propofol (6 mg.kg-1.h-1)/fentanyl (Group 2) with a N2O/O2 flow ratio of 2:1 in both groups. During anaesthesia, patients' eyes were carefully taped shut to prevent light effects. Blood samples were taken before and after premedication, immediately before induction of anaesthesia, every 15 min during anaesthesia, and hourly in the recovery room for 8 h. The control group consisted of 6 healthy women who were not subjected to surgery, but who were in a similar environment, including light conditions, as the study groups. RESULTS: Isoflurane and propofol anaesthesia as well as darkness elicited elevated plasma melatonin levels that persisted in the recovery period in patients anaesthetized with isoflurane, but gradually decreased during the recovery of patients anaesthetized with propofol. Circulating prolactin and cortisol values were also elevated during anaesthesia and had similar decreases during the recovery period. CONCLUSION: Higher plasma levels of melatonin during the recovery period following isoflurane anaesthesia may, in part, explain increased sedation in these patients compared with patients who received propofol anaesthesia. However, the relationship between recovery from anaesthesia and plasma melatonin levels may not be simple and straightforward.

Adult↗
PubMed1996

CA 15-3: a multicentre evaluation of automated and manual tests.

The introduction of a new and automated CA 15-3 immunoassay (IMx Abbott) prompted us to compare the analytical performance of this new test with established tests from CIS ELSA, Sorin, and Boehringer Mannheim in a multicentre study. CA 15-3 measurements in blood samples of breast tumour patients, comparison of intra- and inter-assay variation, dilution linearity, and lower limit of detection are described. The study showed improved precision for the automated over the manual test systems (intra-assay variation: IMx < 5%, CIS ELSA 4-9%, ES 300 < 3% and ETI Sorin > 10%; inter-assay variation: IMx < or = 8%, CIS ELSA < or = 19%, ES 300 < or = 9% and ETI Sorin < or = 27%). Results on patients' samples (n = 101 to 184) showed highly comparable results; IMx vs CIS ELSA site 1: r = 0.950; IMx vs CIS ELSA site 2: r = 0.998; IMx vs ES 300: r = 0.980; IMx vs ETI Sorin: r = 0.931. Slopes of regression lines varied from 0.666 for IMx vs ETI Sorin to 0.988 for IMx vs CIS ELSA (site 1, where heparin plasma was used instead of serum as recommended by the manufacturer found to be only slightly dependent on assay ranges analysed by statistical procedures applied. Despite good correlations between methods, it is recommended that samples collected in the follow-up of disease and at higher CA 15-3 concentrations are analysed by the same test; a changeover to another test is not encouraged.

Automation↗
PubMed1995

In vivo and in vitro complex formation of prostate specific antigen with alpha 1-anti-chymotrypsin.

Complex formation of prostate specific antigen (PSA) with its inhibitor alpha 1-anti-chymotrypsin (ACT) in vivo and in vitro was studied. Patients with benign prostatic hyperplasia (BPH) were treated with the computer assisted device "Prostatron." This instrument acts by means of thermal destruction of prostatic tissue. The effect of the treatment was followed by measurement of serum PSA concentrations using commercially available immunoassays from Roche (Cobas Core), Wallac (Delfia) and Abbot (IMx) and Hybritech Tandem. Serum samples were further analyzed by molecular sieving on S.300 (Pharmacia) and analyzed for PSA by immuno assay. The complex formation of PSA with ACT in serum was studied, demonstrating this process to be influenced by external stimulus. Patient sera revealing initially normal PSA levels (3 to 5 ng/ml) were stimulated to very high levels of PSA (> or = 140 ng/ml) by Prostatron treatment. The absolute PSA level depends on the assay system and not only on the staging of the prostate tumor. In addition, complex formation was studied in athymic nude mice and in vitro revealing the possible pathways of PSA release. PSA from LNCAP cells kept in vitro show predominantly uncomplexed (free) PSA, whereas PSA from LNCAP cells injected into nude mice appears in the serum of the animals in complexed form. This demonstrates how in the immunization process free and complexed PSA serve as antigens in the standard procedure for the production of antisera for PSA. This model system also can be used for studies of the release mechanism of PSA into blood circulation.

Animals↗
PubMed1995

Serum free prostate specific antigen: isoenzymes in benign hyperplasia and cancer of the prostate.

Prostate specific antigen (PSA) in serum of patients with benign prostatic hyperplasia (BPH) or prostate cancer (P-CA) not bound to alpha-1-antichymotrypsin (ACT) was analyzed by chromatofocusing. The procedure allowed the simultaneous separation of complexed and free PSA and the fractionation of the free PSA fraction into several isoenzymes. The detection of the isoenzymes was strongly dependent on the combination of antibodies introduced in the applied commercially available immunoassays (Cobas Core, Delfia). Isoenzymes in sera of patients with benign prostatic hyperplasia were mainly situated in the pI range of 6.6 to 7.3. Isoenzymes in sera of prostate cancer patients or in PSA from LNCAP cells were mainly situated in the pI range 7.0 to 8.3. Neuraminidase treatment of the sera shifted the isoelectric points of all three sources towards more basic pHs. An irregular glycosylation process in the dysplastic cells of the prostate is suggested to be the cause for the shift of the isoelectric points. The difference of isoenzyme distribution along the pH axis is discussed as a diagnostic tool to differentiate between BPH and P-CA.

Cells, Cultured↗
PubMed1995

Cytokeratin expression in bovine corpora lutea.

Cytokeratin (CK)-positive cells were obtained from bovine corpora lutea. When cultured, these cells behave like CK-positive endothelial cells obtained from bovine large blood vessels. The origin of CK-positive cells has now been studied in 45 bovine corpora lutea of different estrous cycle stages. Additionally, 7 corpora lutea of pregnant cows were examined. The tissues were grouped into early stage (days 2 to 4), secretory stage (days 5 to 17) and late stage (days 18 to 21) according to gross morphology, wet weight and total progesterone content. One portion of a corpus luteum was used for immunohistochemistry, and another for Western blot analysis. Twenty-six of the 45 corpora lutea showed CK expression, as confirmed by immunostaining and Western blotting. Cytokeratin expression was found in all corpora lutea from the early stage, in 14 of 26 corpora lutea from the secretory stage, and 3 of 10 from the late stage. Early stage corpora lutea displayed "zonation" such that a high number of CK-positive luteal cells occurred in the region of the previous granulosa layer and a very low number in the previous thecal layer. Secretory CK-positive corpora lutea showed uniformly distributed, predominantly large luteal cells. In secretory corpora lutea of group A, CK-positive cells and a distinct microvascular tree were seen, the latter visualized by factor VIII-related antigen immunolabelling of endothelial cells. Group B showed none or very few CK-positive cells. Corpora lutea of pregnant cows behaved like corpora lutea of group B. Roughly 1% of CK-positive cells closely associated with the capillary wall were sometimes reminiscent of endothelial cell sprouts.

Animals↗
PubMed1994

Isolation of granulosa-like cells from the bovine secretory corpus luteum and their characterization in long-term culture.

BACKGROUND: The isolation of cells termed type 5 from the bovine corpus luteum was recently reported. Since these cells were reminiscent of immature granulosa cells, their morphological and functional relationship requires further investigation in view of the novel concept of corpus luteum growth. It suggests that putative stem cells of unknown origin supply the pool of small luteal cells. METHODS: Bovine corpora lutea were mechanically dispersed, cell suspensions separated over a Percoll density gradient, and type 5 cells purified by colony transfer. Granulosa cells were harvested from small-sized antral follicles. Observations were carried out at the light and electron microscopical level. 3 beta-Hydroxy-steroid-dehydrogenase was localized histochemically in addition to intracellular lipid droplets stained with nile red. Immunolocalization was used to study Factor VIII antigen presence, the architecture of the cytoskeleton, as well as the occurrence of neuronal cell adhesion molecules, and of neuronal cadherin-like molecules. The uptake of acetylated low density lipoprotein was examined. As for progesterone concentration, cells were seeded at low density on day zero. Cell numbers and progesterone levels of supernatants were determined on day 10 in culture. RESULTS AND CONCLUSIONS: Type 5 cells behaved morphologically like immature granulosa cells, yet the total cell number and the progesterone concentration differed for type 5 cells compared to granulosa cells. The addition of LH had no influence on the progesterone concentration as seen for either type 5 cells or for granulosa cells. It is concluded that type 5 cells, which were originally mistaken for microvascular endothelial cells, display similarities with immature granulosa cells. Type 5 cells may play a role in renewal of luteal cells.

Animals↗
PubMed1994

Long-term co-culture of bovine granulosa cells with microvascular endothelial cells: effect on cell growth and cell death.

The intraovarian axis between granulosa cells and thecal cells is regulated by locally produced autocrine and paracrine factors. Until now, microvascular endothelial cells (MVEC) have not been included in such studies. Bovine granulosa cells from medium-sized antral follicles were plated at low density into the lower compartment of 24-well-culture plates on day 0. MVEC derived from bovine corpus luteum were seeded on appropriate inserts and placed as the upper compartment on day 1. Control granulosa cell cultures and MVEC co-cultures were maintained in serum-containing medium. On day 21, control cultures displayed an epithelioid monolayer and the coculture displayed a multilayer. Histochemical staining for 3 beta-HSD activity and for the lipid droplet stain with the fluorescent dye Nile Red were strong, suggesting augmented steroidogenesis in the multilayer. Yet the progesterone levels of supernants corrected for 10,000 cells were similar in monolayers and in multilayers. Co-cultures contained approximately three times more granulosa cells than control cultures as evaluated with a Coulter counter. Additionally, the occurrence of dead cells was quantified with the fluorescent DNA stain, ethidium homodimer, in 11-day-old control cultures and MVEC co-cultures which were deprived of serum, MVEC, or both for an additional 40 h. Serum and MVEC suppressed the occurrence of granulosa cell death. It is concluded that MVEC produce survival factors for the growth and maintenance of granulosa cells.

Animals↗
PubMed1994

[PSA: a new prostatic marker. A help or an added factor of confusion?].

In patients with a normal digital rectal examination and serum PSA levels under 18.4 ng/ml Yang (i.e. under 10.0 ng/ml Hybritech or under 14.4 ng.ml with the Basel Cantonal Hospital assay), twice yearly then yearly follow-up examinations are sufficient. More closely spaced examinations and a transrectal ultrasound scan are appropriate in patients with abnormalities upon digital rectal examination, especially when serum PSA levels are consistently elevated.

Diagnosis, Differential↗
PubMed1991

[Clinical experience with Mercilon and Marvelon with special reference to ovarian function].

The effects of two oral contraceptive combinations either containing 0.020 mg ethynilestradiol (EE) + 0.150 mg desogestrel (Mercilon) or 0.030 mg EE + 0.150 mg desogestrel (Marvelon) were compared in two independent trials. Special attention was paid to serum levels of LH, FSH, prolactin, progesterone, testosterone, estradiol, SHBG in the first and efficacy, cycle control and tolerability in the second trial. The first trial included 71 women. Serum levels were determined in the cycle before treatment, in the third and sixth cycle of treatment and one cycle after treatment. The following difference was found: Women using the lower dosed preparation showed significantly less suppressed FSH values compared to women using Marvelon. Mean values of Estradiol and Progesterone were significantly suppressed 30% of our measurement in the lower dosed data sample showed extremely high Estradiol and Progesterone values. SHBG has increased by 200-300% and had no effect on prolactin and testosterone levels. In the second trial 781 women (5193 cycles) were evaluated. Assessment were made in the first, third and twelfth cycle of treatment. There were no marked differences between the two preparations with respect to normalisation of cycle length, bleeding duration and intensity. Differences occurred in frequencies of silent menstruation and breakthrough bleedings. They were more often by receiving 0.020 mg EE (7.7%, Mercilon) than with 0.030 mg EE (3.6%, Marvelon). With 0.020 mg EE a higher percentage of women showed body weight change. Blood pressure remained stable in both groups. Both preparations were very good tolerated with slightly more breast tenderness by taking 0.030 mg EE.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Epidermal growth factor receptor in adenocarcinoma of the kidney.

Epidermal growth factor receptor (EGF-R) was estimated in Hypernephroma by saturation analysis using 125-I EGF as ligand. Tissue levels of this oncogene related protein were increased five-fold (24 to 99 fmol/mg protein) in comparison with the surrounding tumor free tissue (3 to 18 fmoles/mg protein). There was no apparent correlation to the stage of tumor growth or tumor differentiation and there was no correlation of EGF serum levels with tumor growth. EGF serum levels in the tumor patients did not exceed levels in control patients.

Adult↗
PubMed1988

[Induction of follicle maturation with "pure" FSH in polycystic ovary syndrome].

The Polycystic Ovary Syndrome (PCO) is characterised by an elevated ratio of serum LH to FSH in presence of an intrafollicular deficiency of FSH activity. Ovulation induction by "pure" FSH seems therefore a reasonable approach to longstanding chronic anovulation in infertile patients suffering from PCO. 68 treatment cycles have been conducted in 30 patients with PCO and chronic clomiphene-resistant anovulation. Ovulation has been induced by HCG in 57 of the 68 cycles. The pregnancy rate was 58.6% per patient, the success rate 46.7% per patient. Clinical abortions occurred in 17.6% of the pregnancies obtained. 3 twins and 2 triplets have been delivered at term. A hyperstimulation syndrome (HSS) of grade I (WHO) has been observed in 19.1%, a HSS of grade II (WHO) in 8.8% of the treatment cycles. 46.3% of the 54 analysed cycles presented a premature LH-surge leading to an atresia of the dominant follicle. Considering the high incidence of a premature elevation of endogenous LH, an additional administration of exogenous LH should be avoided. This consideration as well as the good success rate in the present series speak in favour of using "pure" FSH for induction of follicular maturation in clomiphene-resistant PCO.

Adult↗
PubMed1987

Prostate specific antigen. Experimental and clinical observations.

A commercially available radioimmunoassay (RIA) for prostate specific antigen (PSA) was investigated in respect to its analytical specificity and its clinical applicability for the diagnosis of prostate cancer. PSA detected in serum by RIA was immunochemically identical to PSA found in seminal plasma. PSA is not a single protein but rather a group of isoproteins with different isoelectric points (pI) in the pH range 6-8. Furthermore PSA could be split in subunits by means of denaturing electrophoresis under reducing conditions. Unlike prostatic acid phosphatase (PAP) serum PSA was stable at room temperature. In sera of patients with benign hyperplasia of the prostate (BPH) two significantly different populations were found. The lower group (0.5-5.8 ng/ml PSA) had PSA values comparable to the control group of apparently healthy males (0.5-6.3 ng/ml). The higher group between 7.7 and 12.2 ng/ml was also characteristic for early stages of prostate cancer (T0 and T1). PSA seemed to be correlated to the tumor volume and allowed to differentiate between early carcinomas of the prostate and BPH or possibly T0/1 staged prostate carcinoma. PSA may be a screening method for early cancer of the prostate.

Acid Phosphatase↗