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R Winter

Publications and source records attributed to R Winter.

At least 235 records · Page 13Linked to original sources
PubMed1989

[Expression of histocompatibility antigens in human pre-implantation embryos].

The expression of HLA antigens on polyploid human preimplantation embryos, obtained in an in vitro fertilization program, was investigated by indirect immunofluorescence test using a panel of well-defined monoclonal antibodies. Neither HLA class I antigens and beta 2-microglobulin, nor HLA class II molecules could be detected on blastomeres and the zona pellucida. It is supposed that the absence of HLA antigens on human preimplantation embryos may be one of the mechanisms important for the acceptance of the embryo by the immunocompetent mother.

Embryo Transfer↗
PubMed1989

Pelvic and paraaortic lymphocysts after radical surgery because of cervical and ovarian cancer.

To determine the incidence and clinical import of lymphocysts after radical gynecologic surgery including lymphadenectomy, we reviewed the records of 173 patients with cervical cancer and 135 patients with ovarian cancer who were followed up by computed tomography. Lymphocysts were found in 35 (20%) and 43 (32%) of the patients, respectively. Patients with cervical cancer and positive lymph nodes had a significantly higher rate of lymphocyst formation than did those with negative nodes (29% versus 14%, respectively, p less than 0.02). Age, type of lymphadenectomy, volume of fluid furthered by postoperative drains, disease stage, and tumor histology were not related to lymphocyst development. We saw no complications strictly attributable to lymphocysts. The clinical import and treatment possibilities are discussed.

Adenocarcinoma↗
PubMed1989

The effect of chemotherapy on lymph node metastases in ovarian cancer.

Twenty-six patients with ovarian cancer underwent pelvic and para-aortic lymphadenectomy at second-look or third-look surgery after complete chemotherapy. The frequency of positive nodes (65.3%) was the same as that found at primary lymphadenectomy. Patients who had received cisplatin had the same frequency of positive nodes as those who had received a schedule which lacked cisplatin. Node involvement was not associated with tumour residual after primary surgery. Survival was strongly associated with nodal status. A difference in survival among patients who underwent primary lymphadenectomy could not be demonstrated. Of all gynaecological malignancies, ovarian cancer has the highest rate of positive retroperitoneal nodes. Chemotherapy, even with cisplatin, seems to have no effect on tumour deposits in the nodes. It cannot be assumed that a cure is possible if disease persists in the lymph nodes after chemotherapy, even if the abdomen has been cleared by radical primary surgery. Thus, cytoreduction should encompass the retroperitoneal space, and lymphadenectomy should be an integral component of the operative treatment of ovarian cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

A database of genetically determined neurological conditions for clinicians.

Progress is reported in the establishment of a database of genetically determined neurological conditions. There are now 1,300 conditions and 3,400 references store on the hard disk of a microcomputer. The database is searched, and a differential diagnosis obtained, by choosing a small number of signs and symptoms from a comprehensive list of cardinal features.

Diagnosis, Computer-Assisted↗
PubMed1989

[Diagnosis of cardiac causes of cerebral embolism: a contribution to 2D echocardiography and long-term ECG].

Certain cardiac diseases are regarded as potential sources of embolic strokes. Due to the high risk of recurrent brain embolism diagnosis of a potential cardiac source implies therapeutic consequences in most cases. The contribution of 2D-echocardiography and of ECG Holter monitoring to the detection of possible cardiac sources of cerebral embolism is not yet fully established. We therefore performed 2D-echocardiography and 24-h Holter monitoring in 135 consecutive patients with regional cerebral ischemia. In 17 (12.6%) out of the 135 patients a potential cardiac source of cerebral embolism was found, four of them presented with two cardiac disorders compatible with a cardiac source of embolism. In 10 patients a cardiac disease as potential source of cerebral embolism was already detected during routine examination. 2D-echocardiography disclosed no cardiac embolic source, which was not suspected before but confirmed the diagnosis in five cases. Holter monitoring identified 16 cases with arrhythmias, which may cause systemic embolism. Among these cases seven were not detected during the routine examinations, all of them suffered from intermittent atrial fibrillation. It is concluded that Holter monitoring contributes more than 2D-echocardiography to disclose hitherto unsuspected potential cardiogenic sources of brain embolism.

Adult↗
PubMed1988

Lack of HLA class I and class II antigens on human preimplantation embryos.

The expression of HLA Ag on polyploid early human embryonic stages, obtained in an in vitro fertilization and embryo transfer program, was investigated by indirect immunofluorescence tests using a panel of mAb. Neither HLA class I Ag, beta 2-microglobulin, nor HLA class II molecules could be detected on blastomers. The zona pellucida also lacked these Ag, but granulosa cells expressed HLA class I Ag, beta 2-microglobulin, and HLA class II Ag. These results make it likely that the absence of HLA Ag is one of the mechanisms involved in protecting the implanting embryo from rejection by the immunocompetent mother.

Antibodies, Monoclonal↗
PubMed1988

Antibody guided targeting of non-small cell lung cancer using 111In-labeled HMFG1 F(ab')2 fragments.

Immunoscintigraphy using F(ab')2 fragments of tumor-associated monoclonal antibody HMFG1 was performed in 14 patients with primary and metastatic non-small cell carcinoma of lung cancer. The antibody was conjugated with diethylenetriamine pentaacetic acid and labeled with 111In. Quality control studies showed efficient incorporation of 111In onto antibody (5 mCi/mg), no significant loss of immunoreactivity, and in vitro and in vivo stability. The optimal time for imaging was between 48 and 72 h. Following i.v. administration, serum activity fell rapidly (t1/2a = 2.5 +/- 1.3 (SD) h; t1/2b = 42 +/- 4.5 h). The majority of the radioactivity was associated with the plasma and not with the blood cells. All patients had a significant concentration of 111In in the liver (approximately 20% of the injected dose, 48 h postadministration). No toxicity was encountered. No human antimurine-IgG antibody was detected in any of the patients within 4 months of follow-up, even in patients receiving two administrations of F(ab')2 fragments. Localization of all primary lesions and the majority (80%) of metastatic lesions was achieved. Seven of 14 patients were also studied using a 111In-labeled nonspecific antibody (Fab')2 fragment (4C4). In three patients the specificity index was higher than the other four (P less than 0.05). We conclude that although successful targeting of 111In-labeled (Fab')2 fragments of HMFG1 can be achieved in patients with non-small cell carcinoma of lung, observable tumor localization can also be achieved using a nonspecific antibody. Based on these findings, we recommend that in order to demonstrate specific radioimmunolocalization, patients with lung and possibly other tumor types should be studied using both specific and nonspecific antibodies.

Adult↗
PubMed1988

Genetic prediction in X-linked agammaglobulinaemia.

S21 (DXS17) and pXG12 (DXS94), two probes linked to the locus of X-linked agammaglobulinaemia (XLA), were used for genetic prediction in 13 such families. A method of allowing for nonallelic genetic heterogeneity was demonstrated in the calculation of the genetic risks, specifying a certain proportion of unlinked families. We further estimated the impact due to the uncertainty of the proportion of unlinked families on the final genetic risks in each family and this can be taken into account during genetic counselling.

Agammaglobulinemia↗
PubMed1988

The efficacy of EC-IC anastomoses: evaluation by directional c-w Doppler sonography.

We report the results obtained by means of directional c-w Doppler sonography on 33 patients with superficial temporal-to-middle cerebral artery anastomoses. The efficiency of the anastomosis was evaluated by the modified Pourcelot indices (relative end-diastolic flow velocities) of the preauricular superficial temporal artery and of the bypass-supplying branch at the edge of the burr-hole. The influence of intermittent compression of the bypass-supplying branch on the modified Pourcelot index of the ipsilateral common carotid was used as a further criterion in the sonographic evaluation. All efficient anastomoses, defined by a modified Pourcelot index of at least 0.20 at the edge of the burr-hole, exhibited a reduction of the relative end-diastolic flow velocity of 0.08 on the average in the common carotid during compression. In the 18 cases with unilateral occlusion of the internal carotid, bypass surgery was predominantly efficacious in those patients who showed a reduction in the sum of the modified Pourcelot indices of the remaining brain-supplying arteries of at least two standard deviations with respect to the mean of age-matched controls. The subgroups of patent and absent collaterals through the ophthalmic artery did not show any difference with respect to the percentage of efficient anastomoses. In all 4 patients with bilateral internal carotid artery occlusion, bypass surgery was effective, while 50% of the patients with intracranial carotid artery disease exhibited an insufficient anastomosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Pelvic and para-aortic lymphadenectomy in cervical cancer.

The surgical treatment of invasive cervical cancer must both remove the primary tumour and eliminate the paths by which it spreads--i.e., the lymphatics and the lymph nodes. In 359 patients, systematic pelvic lymphadenectomy yielded positive nodes in 30.3% of Stage Ib and in 44.7% of Stage IIb cases. In the 140 patients with positive nodes, the obturator group was involved in 76.4%, the external iliac group in 62.8%, and the presacral and subaortic nodes in only 4.3%. One node group was involved in 55% of the patients, two and three groups in 27.8% and 7.1% respectively. In patients with only one positive node group, the obturator nodes were involved the most often (31.4%), followed by the external iliac (21.4%) and parametrial nodes (9.2%). Nine patients with Stage Ib and 31 patients with Stage IIb disease underwent para-aortic as well as pelvic lymphadenectomy. Positive para-aortic nodes were found in 11.1% and 22.6%, respectively; 12.5% of these patients had major complications, but there was no surgical mortality. Since radiotherapy cannot sterilize positive nodes, systematic pelvic and para-aortic lymphadenectomy may improve the survival of such patients.

Aorta↗
PubMed1988

[Microsurgery of retinal detachment using biological implant material].

In addition to conventional synthetic materials (silicone sponges), dura is ideal for indentation and closure of retinal tears in detachment cases. It is histocompatible, easy to work with, and can be shaped to fit the tear or hole exactly. The authors tested the use of dura in 76 consecutive cases, which were followed up. The anatomic and functional results were similar to those obtained with classical indentation procedures. There were no infections or extrusions of the dura, and in particular no signs of scleral necrosis, which is sometimes seen in cases treated with silicone implants.

Biocompatible Materials↗