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Biomedical subjects

T Steck

Publications and source records attributed to T Steck.

At least 55 records · Page 3Linked to original sources
PubMed1994

The impact of timing and frequency of prenatal visits on the outcome of pregnancy in the perinatal registry of Bavaria 1987-1988.

A retrospective analysis was made on the singleton births included in the Bavarian statewide perinatal registry (Bayerische Perinatalerhebung, BPE; 99,252 births from BPE 1987 and 79,661 births from BPE 1988) with respect to the timing of the first prenatal consultation and the frequency of visits during pregnancy. If the first prenatal visit was scheduled after 21 weeks, the rates of infants transferred to pediatric units relative risk (RR = 1.34, P < 0.0001, chi 2-test), of low birth weight (RR = 1.41, P < 0.0001) and of stillbirths (RR = 1.70, P < 0.025) were higher than if the first visit was at 9-12 weeks. Similarly, after < 4 prenatal visits, the rates of infants transferred (RR = 3.91), of low birth weight (RR = 9.18), of stillbirths (RR = 7.65) and of neonatal deaths (RR = 29.5) were significantly (P < 0.0001) higher than after > 10 visits. Prenatal care was defined as 'standard' if the initial consultation was scheduled at or before 12 weeks and whether 10-12 visits were completed during a normal duration of pregnancy. 'Below standard' prenatal care was associated with a higher rate of infants transferred (P < 0.01) and of stillbirths (P < 0.0005). Prenatal care was more frequently (P < 0.0001) classified as 'below standard' in mothers older than 39 years (40.45%, RR = 2.45) and in adolescent mothers (58.67%, RR = 5.12) than in those 25-29 years of age (21.71%), in fourth and subsequent (48.22%, RR = 3.44) than in first pregnancies (21.32%) and in foreign (39.65%, RR = 2.18) than in German mothers (23.19%).(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1994

A Rab4-like GTPase in Dictyostelium discoideum colocalizes with V-H(+)-ATPases in reticular membranes of the contractile vacuole complex and in lysosomes.

In the course of screening a cDNA library for ras-related Dictyostelium discoideum genes, we cloned a 0.7 kb cDNA (rabD) encoding a putative protein that was 70% identical at the amino acid level to human Rab4. Rab4 is a small M(r) GTPase, which belongs to the Ras superfamily and functions to regulate endocytosis in mammalian cells. Southern blot analysis indicated that the rabD cDNA was encoded by a single copy gene while Northern blot analysis revealed that the rabD gene was expressed at relatively constant levels during growth and differentiation. Affinity-purified antibodies were prepared against a RabD fusion protein expressed in bacteria; the antibodies recognized a single 23 kDa polypeptide on western blots of cell extracts. Density gradient fractionation revealed that the RabD antigen co-distributed primarily with buoyant membranes rich in vacuolar protons pumps (V-H(+)-ATPases) and, to a lesser extent, with lysosomes. This result was confirmed by examining cell lines expressing an epitope-tagged version of RabD. Magnetically purified early endocytic vesicles and post-lysosomal vacuoles reacted more weakly with anti-RabD antibodies than did lysosomes. Other organelles were negative for RabD. Double-label indirect immunofluorescence microscopy revealed that RabD and the 100 kDa V-H(+)-ATPase subunit colocalized in a fine reticular network throughout the cytoplasm. This network was reminiscent of spongiomes, the tubular elements of the contractile vacuole system. Immunoelectron microscopy confirmed the presence of RabD in lysosome fractions and in the membranes rich in V-H(+)-ATPase. We conclude that a Rab4-like GTPase in D. discoideum is principally associated with the spongiomes of contractile vacuole complex.

Amino Acid Sequence↗
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↗
PubMed1993

MHC class II compatibility in aborted fetuses and term infants of couples with recurrent spontaneous abortion.

Maternal-fetal histocompatibility for alleles at HLA class II loci, HLA-DQA1 and HLA-DQB1, was examined in 40 abortuses and 31 liveborn children of 68 couples with a history of idiopathic recurrent spontaneous abortion (RSAB) who underwent leukocyte immunization prior to the index pregnancy. Significantly more couples with RSAB shared two HLA-DQA1 alleles as compared with fertile control couples (0.18 vs. 0.03, respectively; P = 0.031). There were no differences in HLA sharing between couples with RSAB who experienced a repeat abortion in the index pregnancy as compared with couples with RSAB who were delivered of a liveborn child. Non-significant deficits of abortuses who were compatible for alleles at the HLA-DQA1 (6 observed vs. 8.5 expected; P = 0.225) and the HLA-DQB1 (7 observed vs. 9.2 expected; P = 0.254) loci were observed. A significant deficit of HLA-DQA1 compatible liveborn children was observed (1 observed vs. 5.5 expected; P = 0.0069). The overall deficit of HLA-DQA1 compatible fetuses (7 observed vs. 14.0 expected; P = 0.0018) after approximately 8 weeks gestation suggests that HLA-DQA1 compatible fetuses may be aborted early in pregnancy, prior to the time when fetal tissue can be recovered for genetic studies.

Abortion, Habitual↗
PubMed1993

[Is determination of the "free androgen index" for hormone screening in polycystic ovaries of value?].

In 82 females with hyperandrogenism and polycystic ovaries, the sensitivity and diagnostic accuracy of the free-androgen index (FAI) were compared with those of testosterone (T), free testosterone (fT), androstenedione (A), LH and the LH/FSH ratio. Normal ranges for each parameter were derived as 95th percentile in 53 healthy controls of similar age. T, fT, A, FAI, LH and LH/FSH were significantly (p < 0.001) higher in patients than controls. The sensitivity and diagnostic accuracy of the FAI (0.46 and 0.64) were lower than those of T (0.67 and 0.78) and A (0.56 and 0.73) and similar to those of fT and LH/FSH. The overall variance of the FAI was highest among all parameters. The FAI was significantly (p = 0.05) elevated in a subgroup with obesity (n = 34), whereas T and fT did not differ in obese and nonobese subjects with polycystic-ovary syndrome. We cannot recommend the routine measurement of the FAI in the rational laboratory evaluation of female hyperandrogenism for the following reasons. (1) The adequate normal range for the FAI (< 8.7) is substantially higher than previously thought in normal individuals, which has serious consequences for the accuracy of the test. (2) The values of the FAI showed the widest overlap with controls. (3) The significant positive correlation between FAI and fT allows the prediction of the FAI from the measurement of fT, rendering the determination of a second parameter for the free bioactive T unnecessary. (4) The FAI as well as sex-hormone-binding globulin are influenced by body weight, whereas T and fT are markers for hyperandrogenism independent of obesity.

Adult↗
PubMed1992

Maternal immunization by husband's leukocytes for repeated fetal death associated with mild pre-eclampsia--case report with successful outcome.

We report a case of repeated fetal death at 31 gestational weeks associated with mild non-proteinuric pre-eclampsia and intrauterine growth retardation. After double intradermal immunisation with paternal leukocytes, a third pregnancy proceeded uneventfully until it ended at 38 weeks. Maternal anti-paternal blocking antibody activity was assessed by the erythrocyte antibody inhibition (EAI) test. Serologic testing revealed that the couple did not share HLA class I antigens. The mechanisms underlying the likely benefit from immunotherapy are discussed.

Antibody Formation↗
PubMed1992

Increased risk for polycystic ovary syndrome associated with human leukocyte antigen DQA1*0501.

OBJECTIVE: The objective of this investigation was to identify genes that confer susceptibility to polycystic ovary syndrome. STUDY DESIGN: Nineteen subjects with polycystic ovary syndrome, hirsutism, and elevated plasma androgen levels and 46 fertile, female control subjects were studied. Alleles at the human leukocyte antigen DQA1 locus were identified with dot-blot hybridizations with allele-specific oligonucleotide probes. Associations between human leukocyte antigen DQA1 alleles and polycystic ovary syndrome were examined with logistic regression analysis. RESULTS: The frequency of the human leukocyte antigen DQA1*0501 was 0.50 and 0.26 in subjects with polycystic ovary syndrome and control subjects, respectively (corrected for multiple comparisons, p = 0.067). Homozygosity for this allele was also increased among subjects with polycystic ovary syndrome (p = 0.054). The odds ratios for having polycystic ovary syndrome associated with the *0501 allele and the *0501/*0501 homozygous genotype were 2.8 and 5.8, respectively. CONCLUSION: These data suggest that a polycystic ovary syndrome susceptibility allele is linked to human leukocyte antigen and that the susceptibility allele is recessive.

Alleles↗
PubMed1992

[Combined intra- and extrauterine pregnancy: a rare complication in legal abortion].

A case of combined intrauterine and extrauterine pregnancy as rare complication of legally induced abortion is reported. After several ultrasonic examinations, a concomitant ectopic gestation was suspected and subsequently confirmed on laparotomy and on microscopic examination. The early preoperative diagnosis of combined gestation is nowadays mainly based on its exact localisation by vaginal ultrasound. The ultrasonic signs and the predisponsing factors for the development of combined gestation will be discussed.

Abortion, Legal↗
PubMed1991

[Continuous pulsatile subcutaneous gonadotropin stimulation in polycystic ovary syndrome: a therapeutic alternative].

In order to improve the ovarian response to exogenous gonadotropins and to reduce the risk of the ovarian hyperstimulation syndrome and of multiple pregnancies, human menopausal gonadotropin (hMG) was administered by continuous pulsatile subcutaneous (s.c.) infusion via a portable pump. The effectiveness of pulsatile hMG treatment was first demonstrated in a control group comprising 7 females with regular ovulatory cycles, who underwent gonadotropin ovarian superovulation and subsequent IVF/GIFT procedures for tubal or male factor. All pulsatile s.c. hMG cycles were ovulatory and one clinical pregnancy was achieved. In this group, ovarian response was similar following intramuscular (i.m.) and pulsatile s.c. hMG therapy, with a marked reduction of preovulatory serum levels of oestradiol in the pulsatile s.c. hMG cycles. In a prospective study, 11 patients with overt polycystic ovary syndrome (PCO) who failed to ovulate in response to clomiphene, received i.m. hMG ovarian superovulation treatment in 19 cycles and pulsatile s.c. hMG in 21 cycles. Following i.m. hMG treatment, only 10 cycles were ovulatory; 7 cycles had to be cancelled for impending ovarian hyperstimulation syndrome. Following pulsatile s.c. hMG treatment, 15 cycles were ovulatory, only 3 treatment cycles had to be disrupted for multifollicular ovarian response. Both modes of treatment were similar in terms of requirement of hMG ampoules, number of preovulatory follicles, preovulatory serum levels of oestradiol and duration of the preovulatory oestradiol rise. The total duration of hMG treatment was significantly increased following pulsatile s.c. hMG. It is concluded, that in overt PCO syndrome, continuous pulsatile s.c. administration of hMG is an effective method to induce follicular maturation and to achieve ovulations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Serial scintigraphic imaging for visualization of passive transport processes in the human fallopian tube.

Spontaneous migration of a radionuclide tracer from the vagina to the peritoneum may be visualized by scintigraphic imaging (hysterosalpingoscintigraphy, HSS). A prospective study was designed to evaluate diagnostic criteria for normal tubal passage of a control group (n = 7) and to establish the predictive value of the HSS technique in defining functional deficiency in anatomically patent tubes. In 56 patients with tubal and unexplained infertility, a comparison between the results of the tracer migration study and of contrast hysterosalpingography and laparoscopy was made. The overall correlation was 65%. Clearly discrepant results (i.e. an abnormal migration pattern in anatomically patent tubes) were recorded in 18% and were positively, yet not significantly associated with tubal adhesive disease and with a history of tubal microsurgery. Interpretation of scans was equivocal in another 18% of patients due to undetectable ascension of the tracer to the uterus. It is suggested that the radionuclide is moved forward by the same passive transport processes which are concerned with support of the migration of spermatozoa to the ovum, and that failure of tubal migration of the tracer may render patients eligible for in-vitro fertilization/embryo transfer treatment.

Adult↗
PubMed1991

Response of gonadotropins to pituitary stimulation with luteinizing hormone releasing hormone is a more specific than sensitive parameter for the polycystic ovary syndrome.

Gonadotropin response to exogenous luteinizing hormone-releasing hormone (LHRH) was studied in two groups of patients with the polycystic ovary syndrome (PCOS). Group I (n = 44) was diagnosed as 'overt PCOS' based on clinical and endocrine abnormalities, and the typical ultrasonic picture of multicystic changes in an increased amount of ovarian stroma. Group II patients (n = 34), with similar clinical and hormonal changes, were classified as 'borderline PCOS' because endosonography of the ovaries was not conclusive. Serum gonadotropins were followed 15, 30, 45 and 60 min after administration of 100 micrograms LHRH intravenously. Plasma LH and the peak ratio of luteinizing hormone to follicle stimulating hormone (LH/FSH peak) after LHRH were significantly higher in Group I and II patients (p less than 0.001) than in controls (n = 11). There was a significant positive correlation between LH (r = 0.73 and 0.68, p less than 0.05) and LH/FSH ratio peaks (r = 0.61 and 0.68, p less than 0.05) after LHRH, and the basal values in each group. However, hyperreactivity of LH and the LH/FSH ratio after LHRH (defined as values exceeding the 95th percentile of control values) was only present in Group I in 38.6 and 56.8%, and in Group II in 47.1 and 73.5% of patients. It is concluded that: exaggerated LH release after LHRH is a typical yet not unique feature of PCOS and its sensitivity is inferior to its specificity; a higher rate for sensitivity is achieved when the LH/FSH ratio after LHRH (instead of LH release alone) is used; and that hyperreactivity of LH after LHRH is neither correlated with the plasma concentrations of total testosterone, free plasma testosterone or androstenedione, nor with the ultrasonic picture of the ovaries as significantly higher (p less than 0.05) LH and LH/FSH ratio peaks were found in borderline PCOS patients. While the heterogeneity of gonadotropin response to LHRH clearly limits its routine diagnostic use, the FSH and LH response is useful in patients with inconsistent clinical and ultrasonic features suggestive of PCOS.

Adolescent↗