Search PubMed⌕ Search

Biomedical subjects

T Steck

Publications and source records attributed to T Steck.

At least 37 records · Page 2Linked to original sources
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

Thyroid antibodies and their relation to antithrombin antibodies, anticardiolipin antibodies and lupus anticoagulant in women with recurrent spontaneous abortions (antithyroid, anticardiolipin and antithrombin autoantibodies and lupus anticoagulant in habitual aborters).

OBJECTIVE: This study was undertaken to evaluate the incidence of thyroid autoantibodies in women with a history of recurrent spontaneous abortions (RSA) and to investigate their relationship to non-organ specific autoantibodies. STUDY DESIGN: 28 euthyroid non-pregnant habitual aborters were analysed for thyreoglobulin (TG), thyroid peroxidase antibodies (TPO), and autoantibodies to thromboplastin, cardiolipin and lupus anticoagulant. 28 multigravidae without previous abortions or endocrine dysfunctions served as controls. RESULTS: 11 of 28 women with recurrent spontaneous miscarriage (39%), but only 2 of 28 controls (7%) (Chi square test: p < 0.01) demonstrated positive titres of TG, TPO, or both antibodies, 12 patients were positive for antithrombin antibodies and 3 for anticardiolipin. Only one women was lupus anticoagulant positive. No significant correlation between thyroid antibody positivity and positivity for antiphospholipids (Fisher's exact test: p = 0.441), anticardiolipin (p = 0.664) or lupus coagulant (p = 0.607) was found. CONCLUSIONS: The incidence of thyroid antibodies in euthyroid women with recurrent pregnancy loss appears to be significantly increased compared with controls of reproductive age without previous abortions. No correlation between the presence of thyroid autoantibodies and non-organ specific autoantibodies could be established.

Abortion, Habitual↗
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

Eclampsia after polychemotherapy for nodal-positive breast cancer during pregnancy.

We report the case of a 39-year-old para-4 gravida-4 who received polychemotherapy 5-fluorouracil 600 mg/m2, cyclophosphamide 600 mg/m2 and epirubicin 50 mg/m2 for invasive breast cancer (pT2N2Mo) with extensive metastatic involvement of all 23 axillary lymph nodes removed at 29 gestational weeks. Soon after the second course of chemotherapy at 35 weeks, she developed two eclamptic tonic-clonic seizures which were treated by antihypertensive and anticonvulsive drugs and delivery of a healthy infant, 1650 g (< 10th percentile) by cesarean section. That this patient indeed suffered from eclampsia was supported by the findings of transient postpartum severe hypertension (peak 170/110 mmHg), proteinuria (peak 3.2 g/24 h), incomplete features of the HELLP syndrome (thrombocytopenia 81,000/mm3, haptoglobin < 10 mg/dl) and of DIC, and by the results of cerebral CT scanning showing two 1-cm ischemic lesions. Since the detrimental effect of antineoplastic agents on the rapidly proliferating trophoblast is well known and as abnormal placental function, such as in triploidy, trisomy or hydatiform mole, has been associated with an increased risk for preeclampsia/eclampsia, a possible causal relationship between polychemotherapy and the subsequent development of this rare disorder is suggested.

Adult↗
PubMed1996

Evaluation of a cut-off value for normal sperm morphology using strict criteria to predict fertilization after conventional in-vitro fertilization and embryo transfer in asthenozoospermia.

The predictive value of sperm morphology evaluation using strict criteria (MEUSC) on fertilization and pregnancy rates was evaluated in 60 couples undergoing in-vitro fertilization (IVF) and embryo transfer. In all, 47 of the male partners had a progressive sperm motility < 50% with a density > 20 x 10(6)/ml (asthenozoospermia) and 13 had normozoospermia. MEUSC was performed on the same semen sample that was used for IVF on at least 100 spermatozoa after Papanicolaou staining at x 1250 magnification. Defects in the head, mid-piece and tail were counted separately, borderline forms were classified as abnormal and the teratozoospermia index was calculated for each sample. Of the spermatozoa in the asthenozoospermic group, 13.0% were judged as normal on MEUSC versus 19.8% in normozoospermia (P = 0.0013). The number of normal spermatozoa on MEUSC correlated with the progressive motility in asthenozoospermia (rho = 0.41, P = 0.0043). Defects in the mid-piece (P = 0.0004) and tail (P = 0.025) were more common, and the teratozoospermia index (P = 0.015) was higher in asthenozoospermic than normozoospermic samples. The parameters of MEUSC did not correlate with the fertilization rate. In asthenozoospermia, differences in fertilization rates were calculated for each cut-off value between 4 and 10% normal spermatozoa on MEUSC. A cut-off value of 6% gave the best statistical power. If > 6% of spermatozoa were normal, a median of 66.7% of ova were fertilized, compared with a median fertilization rate of 35.4% if < or = 6% of spermatozoa were normal (P = 0.022). The highest cut-off value still giving significant discrimination was 8% (normal MEUSC > 8%, median fertilization rate 66.7%; < or = 8%, median fertilization rate 35.7%, P = 0.028), and this may be used as the critical value for normal morphology in asthenozoospermia. It is concluded that despite a significant linear relationship between morphology using strict criteria and progressive motility, MEUSC is still useful as a predictor for fertilization in asthenozoospermia. In cases of asthenozoospermia with < or = 8% normal spermatozoa on MEUSC, micromanipulation should be considered.

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

HLA-DQA1 and HLA-DQB1 haplotypes in aborted fetuses and couples with recurrent spontaneous abortion.

HLA haplotypes may be associated with spontaneous abortion through a variety of mechanisms, including maternal hyporesponsiveness to fetal alloantigens, maternal autoimmunity, and HLA-linked t-locus homologues. HLA-DQA1 and HLA-DQB1 haplotypes were determined in 37 couples with a history of recurrent spontaneous abortion (RSAB), 40 of their abortuses, and 20 fertile control couples. The distribution of haplotype frequencies did not differ between control subjects and RSAB wives, RSAB husbands, or abortuses. The frequency of the HLA-DR5-linked haplotype, DQA1*501/DQB1*301, which was considered a marker for immune hyporesponsiveness, did not differ between RSAB wives and control subjects (P = 0.353). The frequency of the autoimmune-associated HLA-DR3-linked haplotype, DQA1*0501/DQB1*0201, did not differ significantly between RSAB wives and control subjects (P = 0.103). The frequency of the DQA1*0201/DQB1*0201 haplotype in RSAB husbands was greater than the 95th percentile confidence limit of the frequency of this haplotype in control subjects. Among seven RSAB husbands who were heterozygous for this haplotype and did not share a DQA1*0201 allele with his wife, the haplotype was transmitted to 6 of 7 abortuses (3.5 expected). Although the small size of this sample precludes drawing conclusions regarding HLA transmission biases in RSAB couples, these data have generated a specific hypothesis regarding the DQA1*0201/DQB1*0201 haplotype that can be investigated in future studies.

Abortion, Habitual↗
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

-Assessment of the prevalence of pre- and perimenstrual symptoms in female personnel of a university clinic-.

OBJECTIVE: This retrospective inquiry was designed to clarify the associations between the premenstrual syndrome (PMS) and premenstrual symptoms and personal and demographic data. METHODS: The entire female staff of our University Hospitals (1,535 women) were asked to fill in a questionnaire on 29 physical and psychical symptoms. 491 answers (32.7%) of women with regular menstruations were evaluated. RESULTS: PMS was diagnosed in 7.7% (p = 0.0006) and premenstrual symptoms in 42.4% (p = 0.021). The symptoms were significantly influenced by age (p = 0.0049) and use of oral contraceptives (OC, p = 0.047), but not by the duration of use and parity. CONCLUSION: The woman's social and familial background has a considerable impact on the occurrence and severity of premenstrual symptoms. The significant positive effect of some OCs on PMS may be of therapeutic use.

Adolescent↗
PubMed1995

Sensitivity of plasma insulin levels in obese and non-obese women with functional hyperandrogenism.

Hyperinsulinemia has been implicated in the etiology of functional hyperandrogenism (FH). In a prospective controlled trial, we determined the sensitivity and diagnostic accuracy of fasting plasma insulin levels in 37 females of reproductive age with FH, who were further subdivided into obese (body mass index (BMI) > 25 kg/m2, n = 22) and non-obese (n = 15) groups, in women with (n = 30) and without (n = 7) polycystic ovaries on vaginal endosonography and in controls of similar age (n = 29) who were body mass-matched to the non-obese FH subgroup. Insulin, testosterone, androstenedione, luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH) ratio and dehydroepiandrosterone sulfate (DHEA-S) levels were measured by conventional radio-immunoassay. All hormonal parameters, including insulin (p , 0.0001), were significantly increased in the FH group vs. controls. Mean BMI and insulin did not differ between the subgroups with and without polycystic ovaries. Only insulin was increased (p = 0.0012) in the obese FH vs. non-obese FH subgroup. In the FH group, insulin showed the highest coefficient of variation (0.76) but also the best sensitivity (0.57) and diagnostic accuracy (0.73), equal that of testosterone (0.54 and 0.73, respectively). Insulin was more sensitive (0.72) than testosterone (0.59) in the obese FH subgroup, but less sensitive (0.27) than testosterone (0.47) in the non-obese FH subgroup. Multiple correlation analysis showed a significant linear relationship (p < 0.0001) between insulin and BMI but no correlation between insulin and the other parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Is insufflation with carbon dioxide as an ambulatory procedure for evaluating tubal patency obsolete today?].

UNLABELLED: Tubal insufflation with carbon dioxide is one of the ambulatory and non-invasive procedures in use for the evaluation of tubal patency. The aim of the present study was to investigate whether the findings obtained at tubal insufflation are reliable enough to avoid laparoscopy with instillation of dye for its inherent risk of severe operative complications. Diagnostic accuracy, positive and negative predictive value of tubal insufflation were compared with that of the reference method (laparoscopy) in 107 infertile patients of childbearing age without previous pelvic inflammatory disease, tubal or ovarian surgery. No result was obtained from tubal insufflation in 13 patients for intolerance or technical problems. The positive predictive value (percentage of correct positive findings, i.e., tubes patent) was 0.79 (130/165 tubes), the negative predictive value (percentage of correct negative findings) 0.43 (10/23) with an overall diagnostic accuracy (percentage of correct findings) of 0.74. If both tubes were reported patent on insufflation (68 patients), this finding was confirmed in 82% (56/68) on laparoscopy. The remaining 18% also include the rate of false negative findings (tubes falsely reported as occluded) on laparoscopy which may account for up to 10% according to the literature. False negative findings on insufflation were reported at a frequency of 21% (35/165 tubes). COMMENT: The diagnostic accuracy of tubal insufflation with carbon dioxide is definitely inferior to that of laparoscopy. In view of the frequency of false negative findings, its use as a screening procedure should be restricted to young patients with a low probability of tubal occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[The role of immunologic factors in the etiology of pregnancy-induced hypertension].

Pregnancy-induced hypertension (PIH) is a placental disease that mainly occurs in primigravidae, but its precise etiology is not yet known. It has long been considered that the protective effect of multiparity may be due to immunological factors. Here, we review epidemiologic data from the literature supporting the idea of a possible immunological basis of PIH. There are conflicting reports in the literature regarding the involvement of cellular and humoral mechanisms in the etiology of PIH, the impact of histocompatibility and the interactions between maternal and fetal genotype. Finally, the evidence for a common immunologic cause for pregnancy-induced hypertension and miscarriage is discussed.

Abortion, Spontaneous↗
PubMed1994

Vaginal clear cell carcinoma in a young patient with ectopic termination of the left ureter in the vagina.

The association of clear cell adenocarcinoma of the vagina and vaginal adenosis with prenatal exposure to diethylstilbestrol (DES) is well-documented in the United States. In Europe, however, DES was never used in the therapy of threatened abortion and, therefore, clear cell adenocarcinoma and vaginal adenosis remained rare diseases. We report on the clinical and pathological features of a case of clear cell adenocarcinoma of the upper vagina in a 17-year-old German girl, who had a history of hypoplasia of the left kidney with an ectopic termination of the ureter in the upper vagina, removed surgically 2 years before. No previous report of a similar coincidence of vaginal clear cell carcinoma and a congenital disorder of the genitourinary tract exists. Congenital anomaly of the ureter interfering with the development and the differentiation of the distal Müllerian tract and its epithelium might have provided a similar histological basis for carcinogenesis in our patient to that in those provided exposed to DES.

Adenocarcinoma, Clear Cell↗