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Biomedical subjects

W Kuhn

Publications and source records attributed to W Kuhn.

At least 199 records · Page 11Linked to original sources
PubMed1994

[Plasma and myometrium electrolyte changes in the last trimester of pregnancy].

It is well known, that magnesium can positively influence preterm labour and that the magnesium level in the plasma is significantly lowered whereby magnesium excretion increases during pregnancy. These results lead to the question, whether the magnesium content in the myometrium is also reduced during pregnancy and whether blood parameters correlate with the concentration of magnesium in the myometrium. Myometrial tissues and blood samples from 127 patients, who underwent a Caesarean section, were analysed for magnesium, calcium, sodium and potassium. Erythrocytes, haemoglobin, haematocrit and the hormones oestradiol, oestriol and progesterone were analysed in the serum. We found a decrease in magnesium in the myometrium (p < 0.01) and in the plasma (p < 0.05) during pregnancy. Magnesium in the plasma correlates with magnesium in the myometrium (p < 0.001). These results indicate, that hypomagnesinaemia during pregnancy decreases the magnesium level in the myometrium.

Cesarean Section↗
PubMed1994

[Gemeprost vaginal suppositories versus intracervical sulprostone gel administration for cervic priming in the 1st trimester. A tonometric controlled comparative study].

In a prospective, randomised study, 40 primi- and plurigravida were treated either intracervically with 50 micrograms Sulprostone gel or vaginally with a pessary containing 1 mg Gemeprost in order to soften the cervix prior to first trimester termination of pregnancy. Curettage was performed on average 6.0 and 3.2 hours, respectively, after prostaglandin administration. For objective demonstration of the priming effect, the force required for dilatation of the cervical canal was measured in Newton by a special tonometer before prostaglandin treatment and before operation. The free passability of the cervical canal, the maximal dilatability with a force of 10 N and the increase in dilatability after local prostaglandin application were measured. A modified visual analogue scale was used to evaluate the subjective pain experience. During the time between administration and curettage, no abortion occurred in any of the patients. There were no statistically significant differences between both groups regarding the free passability and the maximal dilatability, however, the increase in dilatability was significantly greater in the Gemeprost group. The visual analogue scale allows the patient to quantify, at least to some extent, her experience of pain, but there were no differences in the rate of uterine cramps between both groups; gastrointestinal symptoms did not occur. Both methods were found to be equally efficient; the advantages of Gemeprost are the ease of administration and the short application-curettage interval; however, the cost for one Gemeprost application is nearly 6-fold higher than that of one Sulprostone gel application.

Abortifacient Agents, Nonsteroidal↗
PubMed1994

[Taxol--a new cytostatic drug for therapy of ovarian and breast cancer].

Taxol is a cytostatic agent of plant origin with a complex structure and a special mode of action. Owing to the small content of this substance in the bark of the Pacific yew, from which Taxol is derived, it has only been available on a limited scale. Hitherto, Taxol's chemical structure has precluded the synthesis of large quantities of this cytostatic agent. Analogue substances can be obtained from the needles of the yew, although more efficient methods are needed for the manufacture of this medicine on a commercial scale. The present paper summarises the results of preclinical and clinical studies of patients suffering from ovarian and breast cancer. In phase I studies, it was possible to delineate the side effect profile of Taxol, neutropenia being dose-limiting in most investigations. The efficacy of Taxol on patients with ovarian cancer was initially demonstrated in phase I studies. These results led to phase II studies, in which response rates of 20-36% were obtained on patients with relapsing or therapy-refractory ovarian carcinomas. In phase III studies, the efficacy of Taxol combined with cisplatinum is currently being compared with the classical regimen of cisplatinum/cyclophosphamide. Further studies are under way testing Taxol in combination with G-CSF and cisplatinum. As a supplement to intravenous Taxol therapy, initial experience with intraperitoneal Taxol treatment is now available. Taxol's cytostatic efficacy has also been confirmed in the treatment of patients suffering from metastatic breast cancer with remission rates of 56-62%. Taxol is an important new cytostatic agent for the treatment of ovarian and breast cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast Neoplasms↗
PubMed1994

Effect of recombinant human interleukin-3 (rhIL-3) on persisting chemotherapy-induced thrombocytopenia.

A 57 year old woman with heavily pretreated advanced vaginal cancer (FIGO III) developed severe thrombocytopenia (7000/microliter) with bleedings after chemotherapy. This patient was treated with recombinant human interleukin-3 (rhIL-3) after 26 platelet transfusions (25 pooled transfusions and one HLA-matched platelet transfusion) had not been effective. Increase of thrombocyte counts began 2 days after rhIL-3 therapy. Side-effects due to rhIL-3 administration (flu-like symptoms) were mild and could be treated effectively with paracetamol and clemastin. These data support first evidence for efficacy of rhIL-3 in chemotherapy-induced thrombocytopenia and may open new perspectives for its clinical application.

Antineoplastic Agents↗
PubMed1994

Overexpression of the oncogene c-erb B2 in primary ovarian cancer: evaluation of the prognostic value in a Cox proportional hazards multiple regression.

To date, there are no prognostic factors in ovarian cancer that adequately account for tumor biology and disease behavior. In recent years, some reports have described the prognostic significance of the amplification and overexpression of the oncogene c-erb B2 in various human cancers. Concerning ovarian cancer, this is still a matter of discussion. In the present study, tumor tissue of 275 patients treated for ovarian cancer at the Department of Obstetrics and Gynecology of the University of Göttingen between 1982 and 1992 was immunohistochemically analyzed for overexpression of c-erb B2-encoded transmembrane protein p185. In 19% (51 of 275 cases), p185 overexpression was detected. The percentage of p185-positive cases varied from 7 to 46% according to histological subtype. Correlation with tumor stage and the degree of histological differentiation was not observed. Patients with p185-positive tumors had a significantly worse prognosis (p = 0.001); median survival was 20 months compared with 33 months for p185-negative tumors. In the Cox proportional hazards regression, p185 overexpression was identified as an independent prognostically relevant factor. These results suggest that overexpression of oncogene c-erb B2 in ovarian cancer characterizes a group with unfavorable tumor biology and a significantly worse prognosis.

ErbB Receptors↗
PubMed1994

Unaltered respiratory chain enzyme activity and mitochondrial DNA in skeletal muscle from patients with idiopathic Parkinson's syndrome.

There is good evidence that patients with Parkinson's disease have respiratory chain dysfunction in their substantia nigra. Since mitochondrial cytopathies due to enzyme defects in the respiratory chain are predominantly manifested in tissues with a high oxidative metabolism we analyzed oxidative energy metabolism in skeletal muscle from 6 patients with Parkinson's disease. Control muscles were from subjects of the same age group. Histological and histochemical analyses showed no morphological abnormalities found in mitochondrial myopathies. Biochemical analyses of the various complexes of the respiratory chain were normal. Since 13 subunits of complexes I, III, IV and V of the respiratory chain are encoded by the mitochondrial genome we performed Southern blot and PCR analyses in skeletal muscle from patients and controls and found no disease-specific increase in deletions or insertions of the mitochondrial genome. Therefore, we do not think that skeletal muscle reflects the mitochondrial disturbance in Parkinson's disease found in the substantia nigra.

Aged↗
PubMed1994

Visualization of blood flow in small ovarian tumor vessels by transvaginal color Doppler sonography after echo enhancement with injection of Levovist.

The echo-enhancing effect of an ultrasound contrast medium (Levovist) in color Doppler sonography of small vessels in ovarian tumors was studied in a group of 30 women. The vascularity of adnexal masses with a suspicion of primary carcinoma in 3 and benign lesions in 27 cases was investigated before and after injection of 300 mg/ml of Levovist. In 17 cases color flow mapping showed increased vascularity either in the cystic wall or in solid structures within the tumor. In all patients we observed enhancement of Doppler signal intensity. Our results show that Levovist facilitates waveform analysis in very small vessels with poor velocity patterns.

Adnexal Diseases↗
PubMed1994

[Characteristics and adequate clinical management of "ovarian cysts"].

Early diagnosis resp. prophylaxis of ovarian cancer is possible by removal of all postmenopausal cysts (adnexae plus cystic pathology) of more than 3 cm diameter and of premenopausal cysts showing persistence or progression after 6-8 weeks of sonographic control after the primary examination. The presented retrospective study revealed 2.5% malignancy in premenopausal cysts and 19.5% in the postmenopause. The removal of intact cysts is mandatory. Different technical methods are discussed. In the presented study there were no false negative findings, the rate of unnecessary operations was 5.6%.

Adult↗
PubMed1994

[Pathologic appendix findings in gynecologic operations].

We report our experiences on three cases with pathologic findings of the appendix vermiformis diagnosed during gynecological operations including mucocele, carcinoid and adenocarcinoma. Mucocele of the appendix is a descriptive term for an abnormal mucous accumulation distending the appendiceal lumen, which can be complicated by pseudomyxoma peritonei. Carcinoid tumours arise from the neuroendocrine system and present a characteristic morphologic picture. Predilicted sites are the appendix and the small bowel. Adenocarcinomas of the appendix that are not associated with mucoceles have a clinical course resembling large bowel cancer. Patients with pathological findings of the appendix may be asymptomatic or present with a palpable right lower quadrant mass and/or pain. We discuss differential diagnosis and present a spectrum of histologic findings.

Adult↗
PubMed1994

[Prevention of thromboembolism with low molecular weight heparin (Fragmin) in obstetrics].

A total of 130 obstetrical patients were treated with either low molecular weight (LMW) or unfractionated (UFH) heparin as part of prospective study comparing their efficacy in the prevention of thromboembolism. A single daily dose of 2500-5000 anti-Xa-units LMW heparin (Fragmin) or two to three daily doses of 5000 IU UFH (Liquemin) were given to two groups of 15 patients with therapeutic tocolysis and 50 patients with cesarean section. Patients with cesarean section were given 500 ml Dextran 60 i.v. during surgery followed by subcutaneous injection of heparin eight to ten hours after surgery. Heparin therapy was continued for ten days after surgery. None of the patients exhibited clinical signs of thrombosis. The majority of patients showed symptoms of local irritation at the site of heparin injection (69% of patients with LMW heparin; 80% of patients with UFH). Hematomas at the site of injection were significantly smaller when LMW heparin was used instead of UFH. A number of patients experienced headache after heparin application (10% of patients with LMW heparin; 13% of patients with UFH). There were no cases of post surgical haemorrhage. Comparison of daily profiles revealed a significantly higher anti-Xa-activity of LMW heparin compared to UFH. In contrast, other coagulation parameters were not different in the two experimental groups (antithrombin III, partial thrombin time, thrombin time). Hematologic parameters and liver enzymes were in the physiological range in both experimental groups and none of the patients exhibited signs of heparin induced thrombocytopenia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Mortality of premature infants 1980-1990: analysis of data from the Göttingen perinatal center].

We analyzed retrospectively (1980-1990) the causes of death and by using a logistic regression model the perinatal and neonatal risk factors influencing the mortality in preterm infants < 34 weeks of gestation (n = 1132). When comparing the interval from 1980-1986 to 1987-1990 we observed a decreasing mortality in infants < or = 1000 g from 57% to 19% as well as in the preterm infants > 1000 g from 8.3% to 3.0% (p < 0.001). The causes of death changed considerably. During 1980-1986 fifty-two (8.2%) out of the 632 preterm infants and during 1987-1990 only seven (1.3%) out of the 600 preterm infants died in the course of a severe respiratory distress syndrome or intracranial hemorrhages. From 1980 to 1986 21% (n = 10) and from 1987 to 1990 77% (n = 10) of the neonatal deaths in preterm infants > 1000 g were attributed to lethal malformations. In those infants without lethal malformations (n = 1109) we performed a logistic regression analysis. 87 (7.8%) of these neonates died. The risk of dying was significantly higher in infants born before 1987, in male newborns and in infants suffered from a severe respiratory distress syndrome III-IV or septicemia (p < 0.0001). An increasing gestational age of one week resulted in a lowered risk of mortality (odds ratio 0.59, p < 0.0001). Adjusted for these basic variables the mortality risk was also significantly higher for birth weights < or = 1000 g, low Apgar scores, peripartal acidosis, hypothermia and intracranial hemorrhages. An intrauterine growth retardation < 10. percentile resulted in a lower mortality risk.

Birth Weight↗
PubMed1994

Changes in binding capacity of sialic acid-specific lectins in the connective tissue of the uterine cervix during its physiological maturation.

The authors obtained small pieces of materials from portio vaginalis uteri of women being in postmenopause and premenopause, in different stages of pregnancy and parturition respectively after delivery. Biochemical investigations of these specimens were performed to study the background of physiological ripening of the uterine cervix. They examined the changes in activity of sialidase which cleaves terminal sialic acids. Investigations were performed with the use of Triticum vulgaris (WGA) and Limulus polyphemus (LPA) agglutinins (lectins) marked with FITC. These lectins bind specifically to the sialic acids. The evaluation of the lectin linkage was carried out with fluorescence microscope. Separately was evaluated the fluorescence of different extracellular matrix elements concerning the whole fluorescence of connective tissue as well. It was stated that the number of WGA- and LPA-binding sites of the uterine cervix compared to the non-pregnant state increases predominantly in the 1st trimester pregnancy. In relation to the 1st trimester we described a slight reduction of LPA- and WGA-binding sites in the 3rd trimester. The most impressing changes of LPA- and WGA-binding sites we observed during parturition in the extracellular matrix. These results coincide with the author's previous experience whereas the sialidase activity increases significantly during parturition. These data support the assumption that the terminal sialic acids and the sialidase play certain role in human uterine cervix during the gestational process. Their role at the time of pregnancy and delivery however remains to be cleared.

Cervix Uteri↗
PubMed1994

[HELLP syndrome].

The HELLP syndrome is a severe and life-threatening complication of preeclampsia with typical laboratory findings. The frequency of the disease is 1 to 150-300 live births in perinatal centers. The median gestational age at presentation is 34 weeks, however, the disease may also develop during the early postpartum period. Right upper quadrant pain is the most striking clinical symptom; in up to 15% of cases neither hypertension nor proteinuria is present on admission. For the detection of hemolysis determination of haptoglobin levels is the most suitable method. Coagulation disorders are more pronounced in patients with the HELLP syndrome as compared to those with preeclampsia without the HELLP constellation, however the full-blown syndrome of disseminated intravascular coagulation (DIC) is not a leading symptom but the consequence of delayed diagnosis and/or therapy of the primary disease. The course of the HELLP syndrome is unpredictable. On the one hand, complete reversal of symptoms under conservative treatment have been reported in individual cases, on the other hand, rapid, therapy-resistant deterioration of the disease had been observed in the majority of patients accompanied by severe complications (e.g. liver rupture). As a consequence the mother and the newborn need intensive care, and these women should be delivered in an obstetric intensive care unit. The maternal mortality reported from the international literature is 3.3%, and the perinatal mortality 22.6%.(ABSTRACT TRUNCATED AT 250 WORDS)

Critical Care↗
PubMed1994

Endometrial cancer screening.

Endometrial cancer is the most common malignancy of the female genital tract. The prognosis of the endometrial carcinoma is strongly correlated with the myometrial infiltration depth. Therefore, it is of utmost clinical interest to detect the malignancies at the earliest stage or even as a precancer. All approaches, like cytologies and uterine smears, have failed to fulfil prerequisites for screening of endometrial cancer. Measurement of the endometrial thickness by transvaginosonography (TVS) can define a risk group for endometrial cancer in postmenopausal women. Further investigations have to clarify whether the combination of TVS and color Doppler can reduce the number of false-positive findings.

Age Factors↗
PubMed1993

MRI and MRS studies on the time course of rat brain lesions and the effect of drug treatment: volume quantification and characterization of tissue heterogeneity by parameter selection.

Magnetic resonance imaging has been used to follow the time course of lesions induced in the rat brain as an animal model for characterization of the volume of the lesion. The dispersion in spin-spin relaxation has been used to characterize the nature of the brain lesion. Parameter selective estimation of T2, quantitative determination of the lesion size and volume selective in vivo proton spectroscopy have been employed for the purpose. The work has been carried out on rats which were subject to lesioning by ibotenic acid as a model for excitotoxicity and also on rats which received doses of ibotenic acid and subsequent doses of the NMDA antagonist drug MK 801 (dizocilpine). The time course of the progress of the lesions in untreated animals and the effect of neuroprotection by MK 801 was continuously monitored in all test animals. Further, a relatively new inhalation anesthetic agent, isoflurane, has been employed. A more logical and semiquantitative T2 bandwidth demarkation useful in distinguishing different degrees of lesioning from the onset and up to the 'edema' stage through penumbra (mild lesion), medium degree lesion and severe lesion has been proposed.

Animals↗
PubMed1993

Therapy with central active catechol-O-methyltransferase (COMT)-inhibitors: is addition of monoamine oxidase (MAO)-inhibitors necessary to slow progress of neurodegenerative disorders?

Neurotrophic factors, like e.g. nerve growth factor (NGF), neurotrophin 3 (NT-3) or brain-derived neurotrophic factor (BDNF) promote the survival and function of neurones in the peripheral and central nervous system. Dopamine or other biogenic amines induce the biosynthesis of neurotrophic factors in glial and neuronal cells. Therefore inhibition of enzymes, like the extraneuronal and neuronal located MAO or the predominantly glial situated COMT, which both metabolize catecholamines, may induce an increased biosynthesis of neurotrophic factors. Due to clinical studies especially MAO-B-inhibitors appear to slow the progression of neurological deficits in Parkinson's disease and the cognitive decline in Alzheimer's disease. On the one hand inhibition of COMT alone may also slow the metabolisation of biogenic amines in glial cells and may consequently induce synthesis of neurotrophic factors in glial cells. But on the other hand in vivo and in vitro studies show, that COMT-inhibitors may intensify the metabolisation of catecholamines in neurones by MAO, what may cause an enhanced generation of free radicals. This increase of free radicals may induce lipid peroxidation of membranes and therefore cause accelerated neuronal and glial cell death. For that reason we conclude, that centrally active COMT-inhibitors may only be used together with MAO-inhibitors in the neuroprotective treatment of neurodegenerative disorders. Medical treatment with both inhibitors will have to be performed very carefully due to cytotoxic effects of high catecholamine levels on neuronal and glial cells and due to possible prolongation or potentiation of the activity of several noradrenergic drugs in the periphery.

Animals↗
PubMed1993

Disturbance of colour perception in Parkinson's disease.

A computer-aided method for the determination of colour fusion time (CFT) was developed. CFT indicates the acuity of the perception of monochromatic contours. CFT was determined in 36 patients with Parkinson's disease (PD) and compared with a group of 36 age- and sex-matched controls. Patients with PD generally had a shortened fusion time, especially for dark-green, light-blue and dark-red stimuli. The results give evidence to the hypothesis of a colour perception disorder in PD. The physiological and pathoanatomical basis of this phenomenon is unknown, but a functional deficit of cortical neurons may be a probable cause.

Adult↗