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Biomedical subjects

S Bussen

Publications and source records attributed to S Bussen.

15 recordsLinked to original sources
PubMed1999

Plasma endothelin and big endothelin levels in women with severe preeclampsia or HELLP-syndrome.

OBJECTIVE: To compare maternal and umbilical venous big endothelin (big ET) and endothelin-1 (ET-1) levels of pregnancies complicated by severe preeclampsia (PE) or HELLP-syndrome to those of a well-matched normotensive pregnant control group. METHODS: We measured plasma levels of ET-1 and big ET in 16 patients with severe PE and 14 patients with HELLP-syndrome by commercially available RIAs and compared them with those of well-matched normotensive pregnant controls. Additionally, the umbilical venous ET-1 and big ET levels were determined in 10 corresponding newborns. RESULTS: The plasma concentrations of ET-1 and big ET were significantly higher in patients with severe PE and especially in women with HELLP-syndrome when-compared with controls. The molar ratios of big ET to ET-1 were significantly lower in the two study groups. The levels of ET-1 and big ET were higher in umbilical venous plasma than in maternal plasma, but there were no significant differences in the umbilical venous concentrations between normotensive and by severe PE or HELLP-syndrome complicated pregnancies. CONCLUSIONS: These findings suggest that ET-1 may be considered as a marker of endothelial injury in by severe preeclampsia or HELLP-syndrome complicated pregnancies. The increase of the ET-1 plasma levels may be due, at least in part, to changes in the conversion of big ET to ET-1 by the endothelin-converting enzyme.

Adult↗
PubMed1999

Endocrine abnormalities during the follicular phase in women with recurrent spontaneous abortion.

The frequency of endocrine abnormalities during the follicular phase in non-pregnant women with a history of recurrent abortion was investigated in a case-control study. A total of 42 consecutive women with recurrent spontaneous abortion (three or more consecutive abortions, mean +/- SD: 3.9 +/- 1.1 range 3-8) with no parental chromosome rearrangement or uterine abnormality were studied during the early follicular phase under standardized conditions. Serum concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, androstenedione, testosterone, dehydroepiandro-stenedione, 17-OH-progesterone, oestradiol, progesterone and thyroid stimulating hormone (TSH) were measured by commercially available radioimmunoassays. Controls were 42 nulligravid females with tubal or male factor infertility without miscarriage. Mean (SD) concentrations of prolactin and androstenedione were 14.2 +/- 6.7 ng/ml versus 10.5 +/- 3.5 ng/ml (95% CI 0.8-6.1) and 2.3 +/- 0.9 ng/ml versus 1.7 +/- 0.6 ng/ml (95% CI 0.2-0.9) in the study and control groups respectively. The other endocrine parameters were comparable in both groups. Obesity [BMI weight (kg)/height (m2) > or = 25] was more prevalent (23 versus 5 women, P = 0.0001) in the study than the control group. Recurrent spontaneous abortion is associated with abnormalities in prolactin and androgen secretion during the follicular phase, suggesting an endocrine aetiology in this disorder. Reduction of body weight and correction of hyperprolactinaemia and of hyperandrogenism may reduce the rate of miscarriage in a subsequent pregnancy in these women.

Abortion, Habitual↗
PubMed1998

Prophylactic intravenous hydroxyethyle starch solution prevents moderate-severe ovarian hyperstimulation in in-vitro fertilization patients: a prospective, randomized, double-blind and placebo-controlled study.

A prospective, randomized, double-blind and placebo-controlled study was conducted to assess the effectiveness of i.v. administration of 6% hydroxyethyle starch solution (HES) in preventing moderate and severe ovarian hyperstimulation syndrome (OHSS) in patients in an in-vitro fertilization programme. A total of 101 women who had serum oestradiol concentrations >1500 pg/ml and/or more than 10 follicles on day of human chorionic gonadotrophin (HCG) administration were recruited into two groups: HES group (n = 51) received 1000 ml 6% HES; and the placebo group (n = 50) received 1000 ml of sodium chloride 0.9% solution at the time shortly after embryo transfer. Follow-up examinations 7 +/- 1 and 14 +/- 1 days after embryo transfer included transvaginal ultrasound (diameters of each ovary and maximum cysts, number of cysts, ascites), blood tests (serum oestradiol, progesterone, beta-HCG, C-reactive protein, blood count, plasma proteins, electrolytes, kidney function tests) and evaluation of abdominal pain, nausea, diarrhoea, abdominal swelling and weight gain. Only one moderate OHSS developed in the HES group whereas seven moderate-severe cases were observed in the placebo group (P = 0.031). Furthermore, serum oestradiol concentration, leukocyte count, increase in abdominal circumference and weight gain 14 days after embryo transfer were significantly higher in the placebo group. There were no differences between the two groups in terms of age, oestradiol concentration and number of follicles at time of HCG injection. Administration of 6% HES prevents the development of moderate-severe OHSS in risk patients.

Adult↗
PubMed1997

Serum levels of folate and cobalamin in women with recurrent spontaneous abortion.

We evaluated the folate and cobalamin status in 29 non-pregnant women with a history of recurrent spontaneous abortion (three or more consecutive) of unknown aetiology in comparison to 29 healthy nulligravidae of similar reproductive age (controls). Serum concentrations of folate and cobalamin showed no significant differences between the two groups. No correlation between age and vitamin concentrations was found. In the study group there was a significant negative correlation of the number of previous abortions and the concentration of serum folate. Patients with at least four previous miscarriages had significantly lower serum values of folic acid than women with three abortions, but not than controls. The underlying cause of this finding remains unclear. In conclusion, the serum concentrations of folic acid and vitamin B12 are not significantly altered in women with unexplained recurrent spontaneous abortions, and an association between a deficiency of these vitamins and an increased risk of pregnancy loss appears to be questionable in the majority of gestations.

Abortion, Habitual↗
PubMed1997

Dizygotic twin pregnancy after intracytoplasmic sperm injection of 1 day old unfertilized oocytes.

We report on a case where late intracytoplasmic sperm injection (ICSI) on unfertilized oocytes after standard in-vitro fertilization (IVF) cycles resulted in a dizygotic twin pregnancy. Fifteen oocytes were harvested from a patient with a history of salpingotomy. After a single cycle of IVF, only one oocyte showed two pronuclei. Subsequently ICSI was performed on six unfertilized metaphase II oocytes, and three of these oocytes showed two pronuclei. Three fertilized embryos were transferred (two derived from ICSI and one from IVF). A normal twin pregnancy resulted, and after delivery of two healthy boys the twins were confirmed to be dizygotic by DNA analysis of several loci. We conclude that at least one of the embryos was derived from the reinsemination by 'second day ICSI'.

Adult↗
PubMed1997

Relationship of bacteriological characteristics to semen indices and its influence on fertilization and pregnancy rates after IVF.

BACKGROUND: To determine if routine semen culture is useful in asymptomatic couples joining an in-vitro fertilization (IVF/ET) program. METHODS: Bacterial cultures and semen analysis according to WHO recommendations were performed on semen samples obtained before oocyte recovery from 88 asymptomatic couples undergoing IVF during a 7-month period. RESULTS: In 46 cultures at least one kind of microorganisms could be isolated. Forty-two cultures either contained bacterias regarded as normal skin flora (n = 14) or showed no growth of microorganisms (n = 28). No differences were found in sperm concentration, total sperm count and sperm morphology between the semen samples with positive bacteriology and those with negative culture results. Sperm motility was decreased before Percoll preparation if microorganisms were present. Positive culture results had no effect on either fertilization or pregnancy rates. CONCLUSIONS: These observations suggest that bacteriospermia is not associated with abnormal sperm function after Percoll preparation or adverse IVF outcome.

Adult↗
PubMed1997

Significant decrease of maternal serum serotonin levels in singleton pregnancies complicated by the HELLP syndrome.

The purpose of this study was to compare peripartum maternal and umbilical cord serum serotonin levels in singleton pregnancies complicated by the HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) or by severe preeclampsia with those of appropriate controls. The study population comprised 14 primigravidae women with class 1 or 2 HELLP syndrome (platelet count < 50,000 or < 100,000/mm3, elevated transaminase levels, evidence of hemolysis) and 17 women with severe preeclampsia (American College of Obstetricians and Gynecologists criteria). Serotonin was measured in maternal serum immediately before delivery and in umbilical cord serum by a highly sensitive 125I-radioimmunoassay. The control groups comprised 31 women who had uncomplicated deliveries at term (control group I) and another 31 at the gestational age matched to that of each patient (control group II). Maternal serum serotonin concentration was 59.5 +/- 36.1 ng/ml (mean +/- SD) in the HELLP group, versus 94.9 +/- 40.5 ng/ml in control group I (p = 0.043, U-test) and 88.7 +/- 29.4 ng/ml in control group II (p = 0.048). Levels in the preeclampsia group (51.6 +/- 32.2 ng/ml) were not different from those in the HELLP group but were equally decreased when compared to control groups I (p = 0.009) and II (p = 0.003). We have observed a similar depression of serum serotonin concentrations both in severe preeclampsia and in the HELLP syndrome, reflecting the decreased platelet content of serotonin. It is uncertain whether these changes may be causally involved in the pathogenesis of hypertensive disorders of pregnancy. Decreased serum serotonin concentration may serve as an additional marker for platelet activation in preeclampsia and in the HELLP syndrome.

Adult↗
PubMed1996

Prolactin response to metoclopramide and thyrotropin-releasing hormone in normoprolactinemic and hyperprolactinemic women: a comparison of diagnostic validity.

The objective was to define the diagnostic validity of prolactin response tests by comparing the stimulating effect of thyrotropin-releasing hormone (TRH) and metoclopramide on prolactin secretion in patients with and without functional hyperprolactinemia. Prolactin response studies were performed in 18 patients with functional hyperprolactinemia (defined as prolactin serum levels > or = 16 and < 50 ng/ml during the follicular phase without evidence of prolactinoma) and 18 controls with similar age who had normal serum prolactin levels. Tests were done on the 7th, 8th or 9th day of the follicular phase under standardized conditions (at 08.00-09.00, after a 1-h rest and overnight fasting) with 200 micrograms TRH or 10 mg metoclopramide i.v. After metoclopramide, higher maximal prolactin levels were observed in the study group as well as in the control group than after TRH (metoclopramide mean: 243 +/- 62 ng/ml vs. 181 +/- 100 ng/ml, U-test: p = 0.0019; TRH mean: 101 +/- 23 ng/ml vs. 41 +/- 20 ng/ml, U-test: p = 0.0001). There was no significant difference in the relative increment of prolactin serum levels between both groups, neither after metoclopramide nor after TRH (after metoclopramide, mean: 13.5 +/- 5.8 vs. 17.2 +/- 9.2, U-test: p = 0.137; after TRH, mean 3.6 +/- 1.1 vs. 3.8 +/- 1.9, U-test: p = 0.899). No correlation between prolactin basal and peak levels, either after TRH or after metoclopramide, could be found, neither in the study (metoclopramide test: p = 0.738; TRH test: p = 0.076) nor in the control group (metoclopramide test: p = 0.331; TRH test: p = 0.360). While significantly higher prolactin peaks were recorded after metoclopramide than after TRH in both groups, no difference in the response to TRH and metoclopramide, regarding absolute and relative increment, could be found.

Adult↗
PubMed1995

Surveillance of pregnant diabetics--comparison between outpatient and inpatient management.

From 1982 to 1993 67 diabetic women attended the University Women's Hospital obstetric clinic at Würzburg. These women were separated into two groups: group 1 (inpatient group) delivered between 1/82 and 7/87, group 2 (outpatient group) delivered between 8/87 and 4/93. Between 1982 and 1987 we used extensive inpatient care. But did not so after 1987. The fetus was monitored by ultrasound scans, cardiotocography, oxytocin stress test and doppler measurements. Nearly all patients used home blood glucose monitoring. We compared blood glucose levels, mode of delivery and fetal outcome for the two groups. There was no significant difference in the average blood glucose levels between the two groups. Cesarean section rates (37%) and gestational age at delivery (37 weeks) were similar in both groups. Fetal macrosomia (birth weight > 4000 g) occured more frequently in the outpatient group (group 1: 4%, group 2: 25%, P < 0.01). This fact did not effect perinatal morbidity. Postnatal metabolic disorders did not increase. Fetal anomalies occurred less frequently in the outpatient group (group 1: 7%, group 2: 2%, P < 0.05).

Adult↗
PubMed1995

Thyroid autoantibodies in euthyroid non-pregnant women with recurrent spontaneous abortions.

This study was undertaken to evaluate the incidence of thyroid autoantibodies in women with a history of recurrent (three or more consecutive) spontaneous abortions. A total of 22 euthyroid non-pregnant habitual aborters were analysed for thyreoglobulin and thyroid peroxidase antibodies; 22 nulligravidae and 22 multigravidae without endocrine dysfunction served as controls. Both thyroid antibodies were assayed using highly sensitive, commercially available enzyme-linked immunosorbent assay kits. Eight of the 22 women with recurrent spontaneous abortions (36%) but only two of the 22 nulligravidae controls (9%; chi 2 test, P = 0.03) and one of 22 multigravidae subjects (5%; chi 2 test, P < 0.01) demonstrated positive titres (> 100 IU/ml, as recommended by the manufacturer) of thyreoglobulin, thyroid peroxidase or both antibodies. The mean +/- SD antibody concentrations were 102.5 +/- 226.5 in the study versus 20.9 +/- 68.8 in the nulligravidae (U-test, P = 0.057) and 26.4 +/- 60.2 IU/ml (P = 0.097) in the multigravidae population for thyroid peroxidase, and 47.7 +/- 57.9 versus 24.1 +/- 31.9 (U-test, P = 0.051) and 28.1 +/- 27.9 IU/ml (P = 0.059) for thyreoglobulin. In conclusion, the incidence of thyroid antibodies in euthyroid women with habitual abortions appears to be significantly increased compared with the controls of reproductive age without previous abortions. Although the important issue of cause and effect has not been fully clarified, this finding suggests that thyroid antibodies may be a marker for autoimmune-mediated recurrent spontaneous abortions, not dissimilar to, for example, anticardiolipin.

Abortion, Habitual↗
PubMed1995

[The prognostic value of cathepsin D concentration in cytosol of primary breast carcinoma].

The concentration of total cathepsin D in tumor cytosol was measured in 300 patients with primary breast cancer treated at the Women's University Hospital in Würzburg between 10/86 and 9/92. Patients were followed for a median of 28 months. The level of cathepsin D was correlated with estrogen receptor status and tumor size but seemed to be independent of progesterone receptor status, histological grading, patient's age, axillary lymph node involvement and primary distant metastases. Overall survival, disease-free survival and metastases-free survival did not differ between patients with cathepsin D-levels above the median value of 47 pmol/mg of protein and patients with cathepsin D-concentration below 47 pmol/mg. Patients with node-negative disease and low cathepsin D-levels (< or = 47 pmol/mg) had a longer disease-free survival than those with cathepsin D-concentration > 47 pmol/mg (p < 0.05). Our findings could not confirm cathepsin D as a useful additional prognostic marker in all breast cancer patients. In the low-risk collective the measurement of total cathepsin D may be significant by isolating subgroups with a poorer prognosis who might benefit from adjuvant therapy.

Adult↗
PubMed1994

[Manifestation of Lyme arthritis in the puerperal period].

Lyme disease, a tick-transmitted spirochetal illness caused by Borrelia burgdorferi, usually begins with a characteristic erythema chronicum migrans accompanied by flu-like symptoms. This phase may later be followed by meningitis, neuritis, carditis or arthritis. Congenital abnormalities due to maternal infection during pregnancy have been described. We report on a case of a 36-year old V gravida III para. After a normal pregnancy and a Cesarean section the patient developed postpartal an acute Lyme arthritis.

Adult↗
PubMedDate not supplied

[Clinical aspects and therapy of amniotic fluid embolism. Illustration based on a case report].

A case of amniotic fluid embolism during the delivery of an at term pregnancy is reported. The 34-year old primipara with an unremarkable medical history suddenly suffered from a seizure in the second stage of labor. Shortly prior to this event, a prolonged fetal bradycardia was recorded. After forceps delivery a massive postpartum haemorrhage as the result of a consumption coagulopathy occurred. Immediate resuscitation with artificial ventilation improved the condition of mother and child. The substitution of packed red cells and platelets, fresh frozen plasma and other blood derivates was necessary. Mother and child survived without any physical damage or neurological deficit. Because of the clinical pattern we diagnosed an amniotic fluid embolism.

Adult↗