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Biomedical subjects

R Steiner

Publications and source records attributed to R Steiner.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Tube-preserving endoscopic surgical procedures in unruptured tubal pregnancy. What significance does laser use have?].

Between 1985 and 1989 115 non-ruptured tubal pregnancies were operated upon, using a pelviscope and preserving of the tube. For the purpose of prophylactic haemostasis 2,5 I.U. ornipressin (Por 8) were injected into the mesosalpinx. The tube was opened (linear salpingotomy) by using various instruments. This method was used in 49 patients by means of the thermocoagulator and hooked scissors; with the remaining 66 patients the following laser systems were employed: CO2-laser (n = 13); Nd: YAG-laser by the contact method (n = 22); argon-laser (n = 31). No intraoperative complications were noted. Postoperative rebleeding occurred in three patients requiring subsequent treatment, and pelviscopy had to be repeated in two patients, because of incompletely removed trophoblastic tissue. The tubal condition (patency; occurrence of adhesion) was checked in 53 (47%) of the patients by means of hysterosalpingography (n = 15) or second-look pelviscopy (n = 38). Tubal patency/peritubal adhesion were found after conventional surgery in 64%/55% of the controlled cases and after laser salpingotomy in 90%/11%, respectively. Summing up, we can say, that the various laser systems are suitable for operating non-ruptured pregnancies due to their accurate incision and simultaneously coagulating effect. Due to the lower postoperative tubal occlusion rate and lower tendency to adhesion, it appears, that the laser systems are superior to the conventional endoscopy instruments, although the rate of complications was highest after CO2-laser application.

Adult↗
PubMed1990

The contact Nd:YAG laser: a new technique for conservation of the fallopian tube in unruptured ectopic pregnancy.

Between August 1986 and April 1988, 22 women with unruptured tubal pregnancy were treated by laparoscopy in the Department of Gynaecology and Obstetrics at the University of Ulm. Linear salpingotomy was performed using the contact Nd:YAG laser technique. The laser beam was delivered by special sapphire probes attached to a standard optical fibre for incision and coagulation. Two different shapes of sapphire probes were used. The specific laser properties and the application of vasopressin enabled treatment without any other incision instruments or coagulation agents. In one patient subsequent laparoscopy became necessary due to persisting trophoblastic tissue. Sixteen women were assessed subsequently by second-look laparoscopy or hysterosalpingography for tubal patency and possible formation of adhesions. In 14 (88%) women the tubes were patent, and in two women adhesions were seen.

Fallopian Tubes↗
PubMed1990

Light scattering by blood components after supplying glucose.

Investigations were performed in order to find out whether the glucose concentration in liquids can be determined by means of light scattering. Both static light scattering and photon correlation spectroscopy (PCS) were used. Neither of them revealed a possibility of determination of glucose concentration in a pure glucose solution. But for glucose-protein-solutions a clear correlation between intensity of light scattering and glucose concentration was detected due to glycosylation of proteins. In blood serum it is solely possible to measure non-enzymatic reaction products between glucose and proteins and to determine the influence of Amadori products on protein structure. Therefore not even indirect conclusions on the present glucose concentration are possible.

Blood Glucose↗
PubMed1990

[The significance of psychosocial factors for the course of breast cancer--results of a prospective follow-up study].

The meaning of psychosocial factors for the course of breast cancer--First results of a prospective research project. Studies investigating the meaning of psychosocial factors for the course of cancerous diseases have so far been contradictious. In this paper the basic datas and first results of a prospective research project on this topic covering 107 breast cancer patients are reported. Somatic datas such as stage of lymph-nodes, type of surgery and additional treatments (radiation therapy or chemotherapy), are less important for the coping process 6 months after primary treatment than the cognitive attitudes of the patients toward their disease. About 56 percent of the patients coped quite well with their disease, 44 percent showed difficulties. The group of patients whose somatic and psychosocial prognosis was judged rather unfavorably at the time of the first examination, showed the highest rate of recidivation and progredience in the follow-up of the first 12 months.

Adaptation, Psychological↗
PubMed1990

[Pelviscopic use of the CO2 laser in the treatment of polycystic ovary syndrome].

Nineteen infertile women with the typical clinical and endocrinological features of polycystic ovarian disease underwent laparoscopic CO2-Laser vaporization of the ovaries. Before laser treatment, six patients were amenorrhoeic, oligomenorrhea and monophasic temperature charts were observed in the remaining group. All were non-responsive to clomiphene citrate treatment. By contrast 80% of the postoperative cycles showed a bisphasic temperature pattern and high progesterone levels indicative of ovulation. Eight pregnancies were achieved in 7 patients. Measurement of basal hormone levels before and after the operation revealed a decline of androgens (androstendione: präop.: 2.77 +/- 1.0 ng/ml, postop.: 2.16 +/- 0.68 ng/ml, p less than 0.05).

Androstenedione↗
PubMed1990

[Linear salpingotomy in the treatment of unruptured tubal pregnancy. Animal experiment study, comparison of 3 laser systems (CO2, Nd:YAG contact, argon)].

The efficacy of three different laser systems for linear salpingotomy was tested in an animal model. For that purpose, the uterus horns of 22 white New Zealand rabbits were incised with the CO2-Laser, the Nd: YAG contact laser and the argon laser using the "bare fiber" technique. The length of uterotomy was between twice and three times of the diameter of the uterine horn. Secondary healing of the incision site was investigated macroscopically (patency, fistulas, formation of adhesions) and microscopically (quantity and quality of the scars) six weeks after the operation. Despite the different primary tissue effect of the laser systems we did not find any significant difference in our postoperative controls.

Animals↗
PubMed1989

Activation and release of enzymes and major basic protein from guinea pig eosinophil granulocytes induced by different inflammatory stimuli and other substances. A histochemical, biochemical, and electron microscopic study.

In order to investigate the availability and release of enzymes from eosinophilic granulocytes in response to a variety of stimuli, guinea pig peritoneal eosinophils were obtained after repeated intraperitoneal injections of freeze-dried Trichinella spiralis larvae. The activities of the enzymes peroxidase, arylsulfatase B, beta-glucuronidase, aminopeptidase, histaminase, cytochrome c oxidase, acid phosphatase, adenosine triphosphatase and glucose 6-phosphatase, and the major basic protein (MBP) were studied histochemically and, in part, also biochemically. Eosinophils were incubated with the following substances: histamine, platelet activating factor, calcium ionophore, compound 48/80, leukotriene B4, prostaglandins E1, and E2, heparin, and eosinophil-chemotactic factors from neutrophils and lymphocytes. Eosinophils displayed a selective and stimulus-dependent enzyme and MBP reaction. Calcium ionophore and compound 48/80 provoked a release of cytotoxic major basic protein, partly associated with peroxidase release, while leukotriene B4 and eosinophil chemotactic factors caused histaminase and peroxidase release and activated leucinaminopeptidase. Heparin and calcium ionophore induced release of both MBP and histaminase. These data support the concept that eosinophils exhibit either inflammatory or cytotoxic, or antiinflammatory properties upon stimulation by various agents.

Animals↗
PubMed1989

Clinical efficacy of amoxycillin/clavulanate in laparoscopically confirmed salpingitis.

To test the efficacy and safety of amoxycillin/clavulanate (Augmentin), 102 hospital patients with laparoscopically confirmed acute salpingitis were treated with parenteral amoxycillin/clavulanate (1.2 g qid for three days) followed by oral amoxycillin/clavulanate (two tablets of 625 mg tid for a further six days). Bacteriological samples were obtained from the cervix uteri and the pouch of Douglas. One hundred patients were assessable for clinical outcome using several variables including pain scores. Amoxycillin/clavulanate alone was effective in 95 patients (95%). Three patients (3%) responded to amoxycillin/clavulanate with marked improvement but another antibiotic was subsequently added to their treatment regimen. Treatment failed in two patients. At follow-up two weeks after hospital discharge, three patients (3.8%) had relapsed or were re-infected. Adverse drug events included one case of drug fever, one case of rash and one case of severe diarrhoea. Treatment was stopped in all three cases. Gastrointestinal reactions, mainly mild diarrhoea, were seen in 31 patients. No clinically relevant changes in haematological or clinical chemical indices were attributable to the amoxycillin/clavulanate treatment. We conclude that amoxycillin/clavulanate is a clinically effective and safe treatment for acute salpingitis.

Acute Disease↗
PubMed1989

Characterization of Micropolyspora faeni antigens by human antibodies and immunoblot analysis.

IgG, IgM and IgA antibody responses against Micropolyspora faeni (Mf) antigens were studied by means of immunoblotting experiments using 70 sera derived from three groups of farmers, namely patients with extrinsic allergic alveolitis (EAA) due to thermophilic actinomycetes (n = 25), patients without EAA but with hay exposure (n = 14), and patients suspected to have EAA (n = 31), and 27 sera from two groups of control persons (healthy laboratory workers, n = 13; healthy farmers, n = 14). Patients with EAA showed IgG, IgM and IgA antibody responses mainly against the antigens with molecular weights (MW) of 11, 12, 25, 35 and 60 kD ("major antigens"), and in addition, but less often, against six antigens with MW in the range of 15 to 62.5 kD ("minor antigens"). The other two groups of patients and also the exposed control persons showed very similar results; however, the antibody response in healthy farmers was substantially weaker in comparison to the three groups of patients and was almost limited to the major antigens with MW 11, 25 and 60 kD. Although patients with proven EAA had higher amounts of antibodies, there was no correlation between this antibody response and the onset of disease. The results indicate the necessity of including at least the major antigens with MW of 11, 25 and 60 kD in all extracts used for in vitro diagnosis of Mf-induced EAA.

Adult↗
PubMed1989

On narcissism. The Kleinian approach.

This article describes the Kleinian approach to narcissism. During the last 70 years, Klein and her followers came to the conclusion that clinically and theoretically speaking, psychoanalysts are dealing only with more or less severe forms of secondary narcissism. Freud's concept of primary narcissism is considered obsolete. Narcissism, according to the Kleinian approach, is a pathologic defense against the pain caused by the first primitive object relationship: that to the mother breast as described by Klein. Greed, destructive emotions, and impulses that manifest themselves through envy, omnipotent denial of dependence, megalomanic idealization of the self, and confusion with the external object erotization of destructiveness play a fundamental part in narcissism. Of particular clinical importance, in contemporary Kleinian thinking and analytic technique, is the concept of narcissistic destructive organizations as described by Rosenfeld, Meltzer, and Segal.

Humans↗
PubMed1989

[Causal attributions and coping with illness in patients with breast cancer].

The aim of the present study was to investigate whether breast cancer patients who attribute their disease to different causes differ in their ability to cope with the disease. A semistructured interview technique was used to question a total of 107 patients, six months after the operation, about the psychological stress involved in their disease and how they coped with it. In addition, two further questionnaires were used: the Freiburg questionnaire concerning adjustment to the disease (FKV) and another questionnaire to register the causes to which the patients attributed their disease (PUK). The results revealed that environmental pollution was the most frequent and important cause of disease mentioned by the patients. This mainly correlated with depressive adjustment to the disease. The same type of adjustment was also frequently seen in patients who attributed their disease to individual psychic problems. Daily stress mentioned as the cause of disease was additionally closely connected with the desire for social support. In accordance with the poor adjustment in connection with internal causes reported in the literature, it was further shown that attribution to psychic causes made psychic adjustment to the disease more difficult, at least within the first six months after the operation.

Adaptation, Psychological↗
PubMed1989

Primary culture of marrow core in collagen gels: modulation and transformation of endosteal cells. I. Morphologic observations.

It has been shown that collagen gels can be used as a culture matrix for the growth and proliferation of a variety of stromal and hemopoietic cellular elements. Since collagen is a physiologic matrix and allows the simultaneous growth and proliferation of a variety of cellular elements in three dimensional fashion, we used this method to culture 2 to 3 mm segments of trephined bone marrow. The gels were constantly bathed by RPMI 1640 medium containing fetal calf serum and antibiotic. Modulation, migration and transformation of endosteal cells were apparent under phase contrast microscopy and were confirmed in histologic sections. This study demonstrates for the first time that human marrow endosteal cells - the cells which line the bony trabeculae - are inducible and capable of modulation and transformation into stromal (fibroblast-like, macrophage-like, and fat-containing cells) and hemopoietic (round or spheroidal blast-like) cells. This report provides further evidence that endosteal cells can be considered the fixed (reserve) totipotential stem cells in the human bone marrow and are the equivalent of embryonal level undifferentiated mesenchymal cells which are capable of giving rise to the many different cell types that constitute the hemopoietic organ, i.e., bone marrow.

Adult↗
PubMed1988

Intracellular distribution of photosensitizing porphyrins measured by video-enhanced fluorescence microscopy.

The intracellular distribution of photosensitizing porphyrins with different amounts of aggregates was measured in a fluorescence microscope using video-intensified detection and image processing. Porphyrin fluorescence was localized in the plasma membrane, cytoplasm, nuclear membrane and nucleoli. The fluorescence intensity in the plasma membrane decreased with increasing aggregation of the photosensitizers. In addition, a redistribution of the porphyrin molecules from the plasma membrane to the nuclear membrane and adjacent intracellular sites was observed with increasing incubation time. Photobleaching of porphyrin fluorescence was most pronounced in the plasma membrane and least efficient within the nucleoli.

Chromatography, High Pressure Liquid↗
PubMed1988

Anogenital warts of the condyloma acuminatum type in HIV-positive patients.

Anogenital warts of the condyloma acuminatum type seem to occur quite often during HIV infection. These warts--according to our study--are not commonly caused by malignancy-associated human papilloma virus types, but by types 6 and 11 as seen in the nonimmune-compromised population. Widespread condylomata acuminata may appear in rather early stages of HIV infection and they may therefore represent early warning signs of HIV infection.

Adult↗
PubMed1988

["It is a new kind of diaspora ..." Some notes on the politics of psychanalysts emigration, according to E. Jones's correspondence with Anna Freud].

This paper is an attempt to describe the forced emigration of the Jewish and non Jewish German and Austrian psychoanalysts, to Great Britain and to America and other countries, during the nazi persecution started in Germany in 1933. The paper is mainly based on the unpublished correspondence between A. Freud and E. Jones and other documents. The paper deals with the two major waves of forced emigration from Berlin in 1933-1934 and from Vienna in 1938 and illustrates E. Jones's and A. Freud's attempts to organize and direct the emigration and all the problems, difficulties and political decisions connected with it. There were objective difficulties due to the economical and social situation of Great Britain and America at that time. Yet there were also the difficulties related to the internal conflicts of schools and personalities of the various national Societies belonging to the International Psychoanalytical Association chaired by Jones. Using some details of the correspondence, the paper tries to show the differences in tactics to deal with very delicate and complex issues, adopted by E. Jones and A. Freud at times, especially for what concerned the attempt to save psychoanalysis as an Institution in Germany. To illustrate the difficulties related to the acceptance of some psychoanalysts coming from Berlin or from Vienna, the paper focuses on W. Reich's episode as it was dealt with in the correspondence between A. Freud and E. Jones, and finally on the problems created in the British Psychoanalytical Society, by the emigration of S. Freud and his daughter to Great Britain.

Germany↗
PubMed1987

Electrophoretic mobility of corneocytes measured by laser Doppler spectroscopy.

A new approach studying the characteristics of the stratum corneum is presented: the electrophoretic mobility of corneocytes by laser Doppler spectroscopy. The detergent scrub technique was used for harvesting corneocytes from three body regions (forehead, palm, and sole) of normal persons (n = 20) under casual conditions and after thorough defattening of the skin with 70% isopropyl alcohol or petrol. Similarly, cells from the forehead, shoulder, and palm were obtained from 22 acne patients treated with isotretinoin (13-cis retinoic acid) 0.5-0.7 mg/kg body weight (b.wt.)/day for 12-16 weeks, and in patients receiving arotinoid (Ro 15-0778) 192 mg (n = 5) or 500 mg (n = 5) per kg/b.wt./day for 6 weeks (forehead and shoulder). In another experiment, cell suspensions with a pH ranging from 5.0-7.3 were evaluated. Measurements were performed by dynamic laser light scattering. This laser application allows exact electrophoretic mobility measurements in a short time (3 min). When cells pass the laser beam, the scattered light is frequency-shifted due to the optical Doppler effect. These frequency shifts are analyzed by the heterodyne light beating technique. The analog signal of the photodetector is converted into a power spectrum by Fourier analysis. This power spectrum represents the spectrum of electrophoretic cell mobility distribution. Results showed different electrophoretic mobility values for corneocytes dependent on the topographic region: forehead 1.18 +/- 0.16, palm 1.10 +/- 0.14, and sole 0.83 +/- 0.10 (means +/- SEM) micron cm/Vs. Defattening with isopropyl alcohol decreased the mobility values to 0.90 +/- 0.09 (p less than or equal to 0.01), 0.95 +/- 0.10, and 0.77 +/- 0.10 micron cm/Vs respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Acne Vulgaris↗