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Biomedical subjects

U Ulrich

Publications and source records attributed to U Ulrich.

At least 37 records · Page 2Linked to original sources
PubMed1998

Women of reproductive age with endometriosis are not osteopenic.

OBJECTIVE: To determine whether women of reproductive age with endometriosis are osteopenic and whether bone density decreases with higher stages of endometriosis. DESIGN: A multicenter cross-sectional study was performed. SETTING: Thirty-nine gynecological clinics in the United States, Canada, and Puerto Rico. PATIENT(S): Two hundred forty-one women of reproductive age with laparoscopically proved endometriosis. INTERVENTION(S): Diagnostic laparoscopy, bone densitometry. MAIN OUTCOME MEASURE(S): Endometriosis stages according to the criteria of the American Society for Reproductive Medicine, lumbar spine bone mineral density (L2-L4) as measured by dual-energy x-ray absorptiometry. RESULT(S): The mean lumbar spine bone mineral density, as well as the distribution of bone mineral density, of the women with endometriosis was similar to that of a normal population. There were no significant differences between endometriosis stage groups I-IV regarding bone mineral density as well as body weight, body mass index, and height. CONCLUSION(S): Women of reproductive age with endometriosis are not osteopenic. More advanced stages of endometriosis are not associated with a decrease in lumbar spine bone mineral density.

Adolescent↗
PubMed1997

Implementation of an osteoporosis research program with a mobile dual-energy X-ray absorptiometry unit: the Montana/Wyoming experience.

To expedite recruitment, and subject participation, for a large clinical osteoporosis therapy trial utilizing the bisphosphonate ibandronate, an integrated network of 13 satellite clinical sites was developed, linked by a mobile clinic vehicle transporting a dual-energy X-ray absorptiometry (DXA) unit. A predominantly rural area of the United States (Montana, northern Wyoming) was accessed for the project, due to the large pool of potential subjects living in this area who were not yet involved in osteoporosis clinical studies. The results of the project to date (through 10 months) confirm the feasibility of such a study design, with 1774 subjects screened by DXA for the study, and 280 (15.8%) accepted. The mobile DXA unit has functioned according to specifications for a stationary DXA machine, with the stability of spine phantom measurements over 10 months assessed as a coefficient of variation of 0.46%. The success of the project validates the concept of performing clinical osteoporosis therapy trials in previously underutilized rural community settings, facilitated by a satellite site network and mobile clinic.

Absorptiometry, Photon↗
PubMed1996

Endoscopic surgery for mature teratoma of the ovary.

BACKGROUND: This study was undertaken to assess the value of laparoscopic surgery as treatment for benign mature teratomas of the ovary. METHODS: A total of 70 patients treated exclusively with laparoscopic surgery for ovarian mature teratoma were studied. The tumors were either enucleated with preservation of the ovary or removed by salpingo-oophorectomy. RESULTS: Ovary-preserving surgery was performed in 60 cases; salpingo-oophorectomy was accomplished in 10 cases. All tumors removed were histologically benign. No surgical complications were encountered throughout the series. In eight patients who underwent primary ovary-preserving surgery, a second-look laparoscopy was undertaken with virtually no pathological findings noted. CONCLUSIONS: Our findings confirm those of other authors- when performed by experienced surgeons, laparoscopic removal of ovarian mature teratomas is a safe and recommendable alternative to laparotomy. Preoperative diagnosis and intraoperative inspection of the tumor must be as thorough as possible.

Adolescent↗
PubMed1996

Removal of gonads in Y-chromosome-bearing gonadal dysgenesis and in androgen insensitivity syndrome by laparoscopic surgery.

BACKGROUND: This paper addresses the value of laparoscopic surgery for the removal of gonads in patients with Y-chromosome-bearing gonadal dysgenesis and androgen insensitivity syndrome, who are otherwise faced with a high rate of gonadal malignancy. METHODS: Three patients with Y-chromosome-bearing gonadal dysgenesis and one patient with androgen insensitivity syndrome were operated upon laparoscopically. Removal of gonads was accomplished by their mobilization and dissection from the pelvic side walls, with ligation and transection of the utero-ovarian and infundibulopelvic ligaments. RESULTS: Surgery was without complications. Histological examination of the gonads showed complete removal and absence of malignancy in each patient. Patients were discharged the day after surgery. CONCLUSIONS: The laparoscopic approach is a safe and effective alternative to laparotomy in the management of patients with Y-chromosome-bearing gonadal dysgenesis and with androgen insensitivity syndrome.

Adolescent↗
PubMed1996

Reduction of postoperative adhesion formation after laparoscopic ovarian cystectomy.

The purpose of this randomized, open-label study was to assess the efficacy of the product Interceed absorbable adhesion barrier in the prevention of adhesion formation on the ovary after laparoscopic ovarian cystectomy. A total of 25 patients requiring laparoscopic bilateral ovarian cystectomy were enrolled into this study. After removal of ovarian cysts, peri-adnexal adhesions, and peritoneal irrigants, and the attainment of meticulous haemostasis, the random assignment of one ovary for wrapping with Interceed was revealed to the surgeon. The other ovary served as the untreated control. A follow-up laparoscopy was performed 8-30 weeks after the initial procedure in 17 patients. Significantly fewer adhesions formed at the Interceed treated ovaries compared with the control (untreated) ovaries (P < 0.05). In terms of adhesion-free outcome, 76% (13/17) of Interceed treated ovaries and 35% (6/17) of control ovaries were free of adhesions. A significant reduction was observed in the area of the sutured ovaries involved with adhesions when Interceed (6%) was used, compared with controls (20%). The reduction of adhesion formation was not related to the size of the cysts at the initial procedure. No adverse events were reported by any patient during the study. In conclusion, Interceed was found to be safe and effective in reducing the incidence of postoperative adhesion formation in patients undergoing laparoscopic ovarian cystectomy.

Cellulose, Oxidized↗
PubMed1995

Osteopenia in primary and secondary amenorrhea.

This study aimed at investigating the prevalence of osteopenia among a hypoestrogenic group of patients with primary or secondary amenorrhea. Twenty-seven patients with amenorrhea were examined. Sixteen of them presented with secondary amenorrhea (mean age 27.8 +/- 1.9 yrs), and 11 with primary amenorrhea (mean age 21.3 +/- 1.6 yrs). Ten regularly menstruating women (mean age 28.9 +/- 1.4 yrs) served as controls. Estradiol serum levels as well as lumbar spine bone mineral density were measured. All 11 patients with primary amenorrhea showed osteopenia with a mean bone mineral density Z-score of 71 +/- 2% and mean estradiol levels of 30.6 +/- 5.9 pg/ml. The secondary amenorrheic patients were significantly demineralized with a mean Z-score of 82 +/- 3%; 10 of them had osteopenia. Their mean estradiol levels were 34.3 +/- 2.9 pg/ml. The bone density in the primary amenorrheic patients was significantly lower as compared with the secondary amenorrheic women. In comparison, lumbar spine bone density in all control women was normal with a mean Z-score of 104 +/- 3%. In summary, 21 of the 27 patients had osteopenia, higher than that reported in post-menopausal women. Since it is not proven whether the bone mineral deficit of amenorrheic patients can ever be compensated, early diagnostic steps and estrogen-progestogen replacement for the prevention of further bone loss and subsequent fractures are recommended.

Adolescent↗
PubMed1995

[Clinical and endocrine effects of laparoscopic ovarian surgery in patients with polycystic ovary syndrome].

OBJECTIVES: Is minimal invasive ovarian surgery an alternative infertility treatment for patients with polycystic ovary (PCO) syndrome? METHODOLOGY: 52 anovulatory patients with the clinical and endocrine characteristics of PCO syndrome were treated with laparoscopic Nd: YAK (n = 11) or CO2 (n = 41) laser surgery to drain atretic follicles and destroy the ovarian stroma. RESULTS: Following surgical reduction of serum androgen and estrogen levels (p < 0,01), 83% of the PCO patients ovulated spontaneously or following ovulation induction; pregnancies occurred in 38%. At re-laparoscopies, 86% of patients had no periovarian adhesions. CONCLUSIONS: Since laparoscopic laser surgery is capable of inducing profound clinical and endocrine effects, it may represents a feasible alternative for infertility treatment in PCO patients.

Adult↗
PubMed1994

Management of peritoneal hemorrhage due to follicle rupture under anticoagulation therapy.

Severe bleeding into the peritoneal cavity from a ruptured ovulatory follicle is a rare complication in women receiving anticoagulation therapy. A number of both surgical and non surgical methods have been proposed to solve this problem. We adopted a novel therapeutic approach in a 40-year old patient who presented with recurrent acute hemoperitoneum under anticoagulation therapy for combined cardiac valve disease. The hemoperitoneum was successfully managed twice by laparoscopy. The patient then received intranasal GnRH analogue treatment together with transdermal estradiol and oral medroxyprogesterone-acetate. In this way ovarian sex steroids were replaced while cessation of ovarian function was achieved by the hypogonadotrophic condition. At the end of this mode of treatment no recurrence of a hemoperitoneum was seen in our patient. We therefore suggest that considerable gains may be expected from this method for the management of recurrent acute peritoneal hemorrhage caused by ovulation bleeding in patients under anticoagulation therapy.

Adult↗
PubMed1994

Endoscopic Nd:YAG Laser Coagulation of Intramural Endometriosis of the Bladder

Treatment of intramural endometriosis of the bladder using the Nd:YAG laser is described. An operative cystoscope fitted with a 600 &micro; fibre is introduced into the bladder. At a power setting of 50 W, superficial coagulation of the visible lesion is performed. The coagulation technique corresponds to that used for the treatment of superficial bladder carcinomas. Three patients were managed in this way. In all patients dysuria and hematuria either significantly decreased or disappeared altogether. No intraoperative complications were observed. This new technique appears to be superior to surgical excision techniques, especially in cases where the lesion is situated on the roof of the bladder. Further studies need to be conducted to compare results obtained from this technique with those of the CO2 laser or excision technique.

Journal Article↗
PubMed1994

Rapid increase in lumbar spine bone density in osteopenic women by high-dose intramuscular estrogen-progestogen injections. A preliminary report.

This prospective pilot study has been carried out to assess the effect of high parenteral doses of estrogens and progestogens on lumbar spine bone density in osteopenic women. Thirteen osteopenic women received 40 mg estradiol valerate and 250 mg hydroxyprogesterone caproate by intramuscular injections once a week for 6 months (so called "pseudopregnancy"). One g oral calcium was added. Six out of the 13 patients (49.5 +/- 4.8 y were peri- and postmenopausal = group A. Seven patients (21.5 +/- 2.2 y) suffered from primary and secondary amenorrhea, in 4 out of them due to gonadal dysgenesis = group B. Estradiol was measured by commercial radioimmunoassay. Bone density was determined by dual-energy X-ray absorptiometry (DEXA) of the upper 4 lumbar vertebrae. Lumbar spine bone density as well as estradiol serum levels were measured before and 3 and 6 months after therapy, respectively. Estradiol increased from 34.8 +/- 7.5 pg/ml to 3226 +/- 393 pg/ml after 3 months and to 2552 +/- 254 pg/ml after 6 months, respectively, in group A. Bone density increased by 15.3 +/- 3.6% within the first 3 months to a total of 18.8 +/- 3.9% after 6 months, respectively. Two patients we have controlled for two years, maintained this increase. In group B estradiol increased from 27.8 +/- 6.5 pg/ml to 3028 +/- 728 after 3 and to 2491 +/- 684 pg/ml after 6 months. Bone density in this group increased by 11.8 +/- 1.9% within 3 and to a total of 18.2 +/- 2.8% after 6 months.(ABSTRACT TRUNCATED AT 250 WORDS)

17 alpha-Hydroxyprogesterone Caproate↗
PubMed1994

Inhibition of human T cell leukaemia virus type I long terminal repeat expression by DNA methylation: implications for latency.

Human T cell leukaemia virus type I (HTLV-I) provirus DNA was found to be methylated in patients with adult T cell leukaemia. We have therefore examined the possibility that DNA methylation might contribute to HTLV-I latency. In vitro methylation of HTLV-I long terminal repeat (LTR)-chloramphenicol acetyltransferase or LTR-Luciferase constructs at eight HpaII sites, a subset of the eukaryotic methylation site CpG, resulted in a three- to fourfold inhibition of transcription in transfected cells. Inhibition of transcription by methylation of all CpG methylation sites using SssI methylase was much more pronounced (50- to 80-fold). As partial methylation of the LTR showed, methylation of the promoter region was responsible for most of the effect. Whereas cellular stimulation by a combination of phorbol 12-myristate 13-acetate and Tax was able to reverse the HpaII methylation effect, the inhibition by SssI methylation was not suppressible under these conditions. The results are in line with a possible function of DNA methylation in HTLV-I latency.

Adult↗
PubMed1994

Serotoninergic control of gonadotrophin and prolactin secretion in women.

OBJECTIVE: Due to conflicting observations from previous investigations, the role of serotonin (5-HT) in the regulation of the human menstrual cycle has not been clearly established. We have therefore investigated the possible participation of 5-HR in the control of gonadotrophin and PRL secretion in women, using the potent 5-HT3 receptor antagonist ondansetron as a pharmacological probe. DESIGN: Serum profiles of LH, FSH and PRL were obtained in 9 normally cycling women during a control and a treatment cycle, during which ondansetron (8 mg orally) was administered daily. On day 10 of both cycles, the serum pulsatility of LH, FSH and PRL was assessed by frequent blood sampling (at 10-minute intervals for 10 hours). Pituitary responsiveness was tested by administration of a GnRH bolus (25 micrograms i.v. after 8 hours). MEASUREMENTS: LH, FSH and PRL were serially determined in all blood samples by immunofluorescence assays. The resulting hormone data arrays were searched for significant fluctuations by the Cluster pulse algorithm. RESULTS: Compared with control cycles, the temporal organization and the endocrine characteristics of the treatment cycles remained virtually unaltered. Serotonin antagonism did not noticeably affect the LH pulse attributes (frequencies, interpulse intervals, amplitudes). Although FSH amplitudes declined markedly (P < 0.05), the remaining pulse attributes were unchanged. A clear increase (P < 0.05) in the PRL pulse frequency was noted, while PRL pulse amplitudes tended to increase (P = 0.1). Gonadotrophin and PRL release in response to GnRH administration was unaltered by ondansetron treatment. CONCLUSIONS: Serotoninergic blockade by a selective 5-HT3 receptor antagonist failed to modify pulsatile LH secretion, but induced distinct changes in episodic FSH and PRL secretion. Since the pituitary gonadotrophin and PRL responsiveness remained unaltered during 5-HT3 receptor blockade, the observed alterations in the FSH and PRL secretion presumably relate to altered hypothalamic regulation of these pituitary hormones. Thus, the central regulation of pulsatile FSH and PRL release in women appears to involve 5-HT3 receptor-mediated processes.

Adult↗
PubMed1993

[Experiences with colpocoeliotomia posterior within the scope of surgical laparoscopies].

Laparoscopically performed culdotomy is a safe and easy procedure to remove enucleated myomas or benign ovarian pathological structure. So far, we have not seen any culdotomy-related complications in a group of 19 patients treated in this way. All wounds healed by primary intention. Operating time exceeded the norm by 10 to 30 minutes. The use of an endobag in connection with culdotomy, effectively facilitates removal of dermoids and myomas.

Colposcopes↗
PubMed1993

Chronobiology of prolactin secretion in women: diurnal and sleep-related variations in the pituitary lactotroph sensitivity.

While a nocturnal rise accounts for the marked circadian variability of prolactin (PRL) secretion in humans, the mechanisms subserving this neuroendocrine manifestation are still obscure. Since gonadotropin-releasing hormone (GnRH) stimulates PRL under physiological conditions, we questioned whether changes in the pituitary lactotroph sensitivity to GnRH during the 24-hour cycle may contribute to the expression of circadian PRL rhythmicity. Accordingly, 8 women were studied in the early follicular phase of their cycles (days 2-5) on 6 occasions in random order: during daytime between 10.00 and 14.00 h ('day' studies), at night between 22.00 and 02.00 h, when the women were awake ('night' studies), and finally, during the identical night hours, when the women were asleep ('sleep' studies). On all occasions, blood was collected at 10-min intervals for 4 h, while either GnRH (25 micrograms i.v. bolus) or saline (as control) was injected twice within 2 h. As assessed by the net PRL increments (differences between unstimulated nadir and stimulated peak) and the areas under the PRL response curves, the PRL secretion was not substantially altered following GnRH stimulations during the day studies. In contrast, PRL release was markedly enhanced (p < 0.05 or less vs. day studies), when GnRH was administered during the night studies. This GnRH-stimulated PRL release was even further increased (p < 0.01 vs. day, p < 0.05 vs. night or saline studies), when GnRH had been given during sleep.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

["On the abdominal wall visible limit between the uterine body and cervix in labor". In memory of Ludwig Bandl (100th anniversary of his death)].

Ludwig Bandl, who is nearly forgotten today, was one of the most active gynaecologists in the 70s and 80s of the last century. We owe him the observation and the description of the uterine contraction ring at birth. After a promising start of his career in Vienna he was professor in Prague for only 20 days. He died mentally ill in Döbling, Vienna in 1892.

Austria↗