Biomedical subjects
Publications and source records attributed to R Bollmann.
Thirteen smears of middle ear cholesteatomas were investigated by the recently developed interactive DNA cytometry. The demonstration of DNA aneuploidy in 9 of the 13 cholesteatomas possibly indicates that these lesions are neoplasms.
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Cu/Zn superoxide dismutase (SOD) was quantified by enzyme immunoassay for prenatal diagnosis of Down's syndrome. Overall, 154 samples of amniotic fluid, 72 samples of amniotic cells and 31 samples of chorionic tissue were investigated. Due to the large biological variance of the SOD concentrations in normal pregnancies (range for amniotic fluid 10.5-154.9, for amniotic cells 40.0-338.8, and for chorionic tissue 132.2-649.5 g SOD/g protein) the cases of Down's syndrome detected by karyotype analysis were not reliably identified by Cu/Zn SOD quantification. As in erythrocytes obtained from patients with Down's syndrome, a trisomy 21 was easily and accurately detected in the erythrocytes from very small quantities (about 50 microliters) of umbilical blood. The SOD concentrations in normal cases (n = 40) varied between 11.4 and 17.3 and in the cases of trisomy 21, as confirmed by karyotyping (n = 4), between 22.5 and 23.2 ng/one million cells. SOD quantification in fetal erythrocyte is a helpful additional method in prenatal Down syndrome diagnosis under certain conditions, which are discussed.
Analysis of foetal haemodynamics using Doppler ultrasound is widely applicable in obstetrics in assessing foetal well-being. To evaluate the parameters of foetal circulation we examined 205 pregnant women to ascertain normal velocity ranges of the foetal internal carotid artery and the foetal renal artery. By establishing the ratio between the pulsatility indices of the foetal internal carotid artery, the foetal aorta and the renal artery of the foetus, standards of these were obtained. From this it seems to be possible to gain information on the extent and degree of the centralisation of foetal blood circulation.
134 borderline lesions of the cervix uteri (CIN I/II) were investigated by using the newly developed diagnostic method DNA-image cytometry (MIAMED-DNA, Wild-Leitz, Wetzlar). The demonstration of aneuploid cells served as a marker for prospective malignancy. 18 out of 35 cases, which proved to be CIN III in the follow-up, had a malignant DNA diagnosis. The sensitivity of the diagnostic DNA cytometry for prospective malignancy was therefore 51.4%. All 43 cases with a negative DNA diagnosis proved to be negative in the follow-up, so that the specificity of DNA cytometry was 100%. Suspicious DNA diagnosis in 26% of the cases proved to be CIN III in the follow-up. DNA cytometry seems to be a reliable method to predict the biological behaviour of borderline lesions of the cervix uteri in everyday practice.
Pulsed Doppler ultrasound was used in the differential diagnosis of 22 cases suspected of bilateral malformations of the foetal kidneys. In cases of kidney malformations, the pulsatility indices (PI) of the umbilical artery and the foetal aorta were in the normal range. In cases showing pathological PI values of both vessels, we found a severe intrauterine growth (IUGR) retardation with oligohydramnion. These results underline the importance of pulsed Doppler as a non invasive means in the management of oligohydramnions to differentiate among bilateral kidney malformations and IUGR.
The author describes a simplified method for the radiological demonstration of non-palpable breast lesions in operative specimens. The specimen is x-rayed with a wire grid let into the lid of a small plexiglass box. The box with the tissue is then sent to the pathologist. By comparing the radiograph with the specimen, the pathologist is able to orientate himself and to examine the area in question.
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The Doppler sonography enable as a new non-invasive procedure the assessment of the uteroplacental circulation. 209 blood flow measurements (pulsed wave Doppler) were recorded between the 20th and 40th weeks of gestation from the arcuate arteries in 130 women with uncomplicated pregnancy. The S/D Ratio, the Resistance Index (RI) and the Pulsatility Index (PI) were calculated. These Indices show throughout the observation time persisting low values which reflect the optimal uteroplacental circulation in a system with low downstream impedance. We found that the S/D Ratio and the RI are appropriate parameters in the qualitative analysis of the uteroplacental perfusion. On the other side we could demonstrate that the PI depends on the maternal heart rate which explains the high variability of the values. Therefore is the PI not appropriate for the impedance measurements in uteroplacental vessels.
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Blood flow velocity waveforms were recorded between the 20th and 40th week of gestation from the umbilical and fetal aorta (n = 230 each) in 130 uncomplicated pregnancies. The S/D ratio, the Resistance Index (RI) and the Pulsatility Index (PI) were calculated. In the umbilical artery the indices showed a significant decrease in the observation interval. In the fetal aorta we could not register any significant change of these indices. All values are presented as reference curves. The importance of the Doppler assessment of the circulation in these vessels for the management of high-risk pregnancy is emphasized.
Using the results of 2,130 assessments with pulsed wave Doppler-ultrasound we established an indication catalogue which reflect the availability in cases of high specificity of the method. The paper shows the modus of fetal monitoring by inclusion of the other obstetrical investigations in consequence of the Doppler-assessment and the frequency of repetition of it.
Using pulsed Doppler, blood flow in the cerebral arteries was measured to assess the fetal central circulation. The Pulsatility-Index (PI) was calculated as a qualitative parameter of flow velocity waveforms. In 418 normal singleton pregnancies we performed 558 measurements between the 27th and 40th week of gestation to get normal range values of the PI. The curve shows a small decrease in the observed interval. In cases of an intrauterine hypoxia the resistance of the central vessels decrease to render the distribution of the fetal blood volume. The result of this is a centralisation of the fetal circulation. 131 high risk pregnancies were investigated and in 21 cases such a centralisation was registered. The fetal outcome of these fetuses was significantly worse compared with fetuses having a normal central flow resistance. We found for example a higher rate of caesarean sections because of fetal distress when the Pulsatility-Index was below the 5th percentile. The sensitivity of the method in prediction caesarean section for fetal distress was 59.3%, the specifity 95.3%.
The humanus amorphus or acardiac twin is a very rare anomaly found only in monocygotic multiple pregnancies. In 8 twin pregnancies observed from 1977 to 1988 at the Charité-Hospital the findings of perinatal imaging diagnostics (sonography, amniofetrography, postnatal radiography) have been presented. For the prenatal diagnosis, especially for continuous prenatal control in these high-risk pregnancies, sonography seems to be the suitable method. However, an exact classification and morphological description of such monstrosities will be possible only by postnatal radiography (eventually in combination with a transumbilical angiography). Six ouf of eight cases were classified as an acephalous type, and two as an acardius anceps fetus.
The prenatal detection of congenital heart disease is rather seldom, compared with other fetal malformations. The paper considers the necessity of the development of fetal echocardiography and presents therefore an introduction for the prenatal sonographer. The fetal cardiac characteristics are first analysed, before considering the possibilities and frontiers of the investigation. The different available sonographic methods like the real-time, M-mode, pulsed Doppler and color Doppler are discussed and the importance of each one is emphasized. The indications for fetal echocardiography are further enumerated, as well as the possible consequences resulting from the diagnosis of a heart abnormality. Because of the sophisticated ultrasound devices needed for a precise diagnosis as well as the optimal postnatal care, suspected fetuses have to be referred to centers specialised in perinatal medicine.
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Resistance to serum and phagocytosis belong to the most important virulence markers of the bacteria. These properties enable the microorganism to have some selective advantage by overcoming of host defence, thus increasing the invasiveness of the bacteria. Determination of these properties make it possible to evaluate better the virulence of the facultative-pathogenic microorganisms and can therefore be used for microbiological diagnosis. The method used until now to test these characteristics are very time consuming. For these reason we have employed bioluminescence to determine the number of viable cells. This method is very suitable for this purpose.