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Biomedical subjects

W Kuhn

Publications and source records attributed to W Kuhn.

At least 235 records · Page 13Linked to original sources
PubMed1992

[Overexpression of c-erbB-2 oncogene in primary ovarian cancers: incidence and prognostic significance in 243 patients].

In ovarian cancers, no valuable prognostic factors are available so far for predicting biological behaviour and clinical outcome. During the last years, overexpression of c-erbB-2-oncogene has been reported to be a prognostic factor in various human carcinomas. Its prognostic value in ovarian cancer is still a matter of controversy. The records and histological specimens of 243 patients with primary ovarian cancer were reviewed. Overexpression of c-erbB-2-oncogene encoded transmembrane protein p185 was determined immunohistochemically using polyclonal and monoclonal antibodies. Of 243 investigated tumours, 45 (19%) were positive. We examined the relationship between p185 and clinical stage, histological type, grading and prognosis. p185 overexpression differs within the histological subtypes of tumours. No correlation was found between p185 overexpression and stage or histological grade. The follow-up data demonstrate that patients with positive staining for p185 have a significantly worse prognosis (p = 0.001) than those with negative staining. These results suggest that overexpression of c-erbB-2 oncogene is associated with higher biological aggressiveness and unfavourable course of disease.

Adenocarcinoma↗
PubMed1992

[The magnesium and calcium content of pre- and postmenopausal myometrium].

Magnesium and calcium, as well as sodium and potassium, have an important influence on the physiology of contraction of the uterus. The ionic concentrations in the pre- and postmenopausal myometrium were examined. We assumed, that there are differences in the electrolytic contents because of the different functions of the corpus, isthmic part and cervix uteri during pregnancy and throughout labour. Small tissue samples from 37 premenopausal and 20 postmenopausal patients, who underwent an operation with different indications, were dissected after hysterectomy. Magnesium and calcium levels were determined by atomic absorption spectrophotometry and potassium and sodium by emission spectrometry in the wet tissue. In both groups, we found significant differences of the electrolytic contents of the myometrium. In the premenopausal uteri, the magnesium levels decrease significantly (p < 0.001) from the corpus (mean = 4.14 mmol/kg) to the cervix (mean = 2.14 mmol/kg). The same scenario can be observed for the potassium levels (Corpus mean = 56.2 mmol/kg and cervix mean = 25.4 mmol/kg). In contrary, the calcium levels (Corpus mean = 1.60 mmol/kg and cervix mean = 2.26 mmol/kg) and sodium levels (Corpus mean = 69.3 mmol/kg and cervix mean = 93.0 mmol/kg) increase significantly (p < 0.001). In the postmenopausal group, we found slightly elevated concentrations of magnesium, sodium and potassium. Only the calcium content of the corpus uteri rises up to three times about 20 years after the menopause (from mean = 1.60 mmol/kg) (p < 0.001). The electrolytic contents in the myometrium were shown to be different in the corpus, isthmus and cervix uteri.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Paracrine actions of oxytocin, prostaglandin F2 alpha, and estradiol within the human corpus luteum.

Human luteal cells are known to interact in an auto- and paracrine fashion using a variety of substances, including prostaglandins (PGs), steroids, and peptides. In cultures of dispersed luteal cells obtained from several animal species prostaglandin F2 alpha (PGF2 alpha) and oxytocin (OXT) inhibit progesterone (P) secretion, indicating a luteolytic effect of these substances. The disadvantage of luteal cell cultures is that the different luteal cell types do not communicate with each other, i.e. auto- and paracrine effects cannot be studied. Therefore, we used a microdialysis tubing, which is implanted in human corpora lutea (CL) kept under short term organ culture conditions. Ringer's solution is pumped through the dialysis tubing, and substances secreted by the luteal tissue can be determined in the effluent fractions. This system also allows topical application of substances with putative intraluteal effects. In the present report we used PGF2 alpha, OXT, and estradiol (E2) to examine the effects of these substances on the respective other hormones and on P release from young human CL. Intraluteal application of PGF2 alpha stimulated OXT, E2, and P release. OXT was stimulatory to E2 and P secretion, an effect that can be blocked by a specific OXT antagonist and by tamoxifen. Elevation of intraluteal E2 concentrations also had marked stimulatory effects on P secretion. From luteal cell culture experiments it is known that PGF2 alpha and OXT have direct inhibitory effects on P production, but both substances stimulate E2 release. It was also shown that E2 counteracts the inhibitory effects on P release. Therefore, the PGF2 alpha- and OXT-induced E2 release may be responsible for the increased P release. This assumption is further substantiated by the observation that intraluteally applied E2 stimulates P secretion, and preexposure of human CL to tamoxifen prevents the OXT-induced stimulation of P, but not E2, secretion. We conclude that in young human CL, PGF2 alpha and OXT have dual effects: direct inhibitory effects on P release and E2-mediated stimulatory effects, which in young CL result in a net stimulation of P secretion.

Chorionic Gonadotropin↗
PubMed1992

Comparison of luteinizing hormone pulsatility in the serum of women suffering from polycystic ovarian disease using a bioassay and five different immunoassays.

Bioassays and immunoassays of protein hormones often read different parts of the molecule and give conflicting results. Therefore, we studied the LH bioactivity (bLH; mouse Leydig cell testosterone production assay) and immunoreactive LH (irLH) using five immunoassays [one conventional polyclonal RIA and four immunometric sandwich assays using monoclonal antibodies (mAB)] in five women suffering from polycystic ovarian disease (PCOD). Blood samples were taken from these patients at 10-min intervals for 24 h. Data were analyzed by the PC Pulsar pulse detection program. As described by others, bLH is increased in PCOD patients, and LH pulse frequency is largely accelerated (18-28 pulses/24 h). Almost every LH pulse was detected by the polyclonal RIA, whereas all mAB immunoassays detected significantly fewer pulses than the bioassay or the RIA. Occasionally, irLH pulses were detected by some assay systems when bLH activity did not increase, and there was a great difference in the temporal occurrence of bLH and irLH pulses. It is concluded that the type of immunoassay used for the detection of LH levels is also of importance for the number of detected LH pulses. Furthermore, each mAB immunoassay appears to detect different epitopes on the LH molecule, such that different conformational and/or glycosilated states are identified. Often, irLH pulses occur with no concurrent bLH pulses, which may indicate that the pituitary in PCOD patients releases pulses of biologically inactive LH in response to hypothalamic GnRH release. Hence, the pituitary gonadotrophs must be in some degree of synchrony in producing such biologically inactive material.

Biological Assay↗
PubMed1992

[Results of postoperative radiotherapy with iridium-192 in patients with ovarian cancer].

While the surgical and chemotherapeutic therapy is an established procedure for the treatment of ovarian cancer, the role of radiotherapy is not quite clear. We investigated whether the recurrence rate concerning the vaginal cuff and pelvis in ovarian cancer patients can be reduced by postoperative irradiation with afterloading technique. In retrospective analysis 20 patients with ovarian cancer, stage I-IV, received radiological contact therapy with 192-Iridium 2 x 7.5 Gy in 0.5 cm tissue depth after surgical and chemotherapeutic treatment. A control group of 20 patients with similar oncological parameters was formed. In both groups a local recurrence occurred in 6 women, which was confirmed clinically, histologically and by diagnostic devices. After 2 years, 6 of the irradiated patients survived and 11 of the control group. The results show, that the irradiation of the vaginal cuff, as applied in endometrial carcinoma, will not reduce local recurrence rate of ovarian cancer.

Aged↗
PubMed1992

[Breast carcinoma in pregnancy. Clinical, histological and immunohistochemical findings].

The hormonally induced changes in the breast during pregnancy make the diagnosis of breast cancer difficult. Furthermore, examinations during pregnancy tend to concentrate only on the pregnancy itself. In this report the clinical, pathological and immunohistochemical results from 7 patients with breast cancer during pregnancy are presented. All women first noticed the tumor by self-examination. The time periods between discovery of the tumor and medical treatment were between 4 and 22 weeks. An overexpression of c-erbB-2-oncogene coded transmembrane protein p185 could be demonstrated in 4 cases. Of the seven patients, 5 have already passed away. Three of the deceased had p185-positive tumors, and died 4, 8 and 21 months after diagnosis. The two p185-negative patients lived 34 and 65 months post diagnosis. Despite the small amount of cases presented, a trend can be seen that p185 may be an additional prognostic factor for breast cancer in pregnancy.

Adult↗
PubMed1992

[HELLP syndrome].

Explore the source record for details and available documents.

Asphyxia Neonatorum↗
PubMed1992

[Gaining uniform active muscle function by "in situ tendon transplant" in surgical rehabilitation of the upper extremity of tetraplegic patients. A case report].

The results of tendon transfers in the tetraplegic upper limb are encouraging. In contrast to the cases with peripheral nerve injury or polio, the availability of active muscles for transfers is very limited in tetraplegics. In both hands of a tetraplegic patient with Group 4 according to the international classification the brachioradialis was transferred to FPL and ECRL to FDP 2-5. The Zancolli-Lasso-procedure was performed in both hands as well as tenodesis of EPL proximally to the wrist. On the right side stabilisation of the thumb was achieved by CMS-1-fusion and on the left side the thumb got control by an abductor transfer using pronator teres and an interpositional tendon graft of the paralysed FDS 2. The result is described. Grip strength and Sollerman test were measured. Advantages and disadvantages of the two different procedures for thumb control are discussed, and the different abilities of gripping are shown.

Follow-Up Studies↗
PubMed1992

[Evaluation of the endometrium in postmenopausal women by means of vaginal ultrasound].

In the context of a prospective study, the authors carried out vaginal ultrasound examinations at the Gynecology-Obstetrics Clinic of Göttingen University of two groups of post-menopausal women: 233 women with hemorrhage and 539 who were asymptomatic. A diagnostic curettage was carried out in cases where the endometrium had a depth of at least 4 mm. The authors identified a 6% incidence of cases of adenomatous hyperplasia, 21% of endometrial cancer in women with hemorrhages and a 20% cancer rate in the asymptomatic women. Where the thickness of the endometrium was less than 4 mm, there were no cases of cancer. The infiltration depth examined microscopically was twice as great in the patients with hemorrhages (10 mm vs 4 mm).

Aged↗
PubMed1992

[The Hellp syndrome. Clinical and laboratory test results].

The Hellp syndrome is a complication of toxemia. It may occur before, during or after childbirth and may not be accompanied by any sign of toxemia. The main clinical sign is pain in the hepatic region. Haptoglobin is the most reliable parameter to demonstrate hemolysis, which is one of the disorders related to this syndrome. In the authors' opinion, early diagnosis and immediate delivery by Cesarean are the appropriate methods to use to reduce maternal and perinatal mortality. Conservative treatment is not generally effective and is dangerous.

Adolescent↗
PubMed1991

Collagenase activity in the human cervix uteri after prostaglandin E2 application during the first trimester.

Cervix biopsies were obtained during the first trimester from plurigravidae and primigravidae at various times after intracervical application of prostaglandin E2. The tissues were extracted with Ca(2+)-containing buffer, and collagenase activity was determined in these extracts using a solid phase assay in which triple helical 125I-labelled collagen was cleaved. Collagenase was detected in all samples but elevated activity was present only during a short temporal window after prostaglandin application. Maximal activity was observed 1 and 2 h after application of prostaglandin in multigravidae and 4 h in primigravidae. These data can explain why collagenase activity in cervical tissues after prostaglandin application had previously not been found. They indicate somewhat different mechanisms of cervical ripening in primigravide compared to multigravidae.

Cervix Uteri↗
PubMed1991

[Rehabilitation of paraplegic patients].

Comprehensive management and care of spinal-cord-lesioned patients start at the site of injury or at the moment of the onset of paralysis, depend with its consequences on the treatment in the acute phase, pass to the reactivation and rehabilitation phase and continue throughout all life of such patients. Considering that even a complete transverse lesion is only an instable, temporarily balanced situation, every small complication can destroy this balance and may lead from total independence to total dependence. Orthopedic, neurological, neurosurgical, urological, physio- or ergotherapeutic, socio-professional or other aspects in the field of comprehensive care and rehabilitation can never be analyzed or managed singularly, but have to be seen always in the context of the whole final outcome. The coordinating role of the paraplegiologist and the importance of adequate spinal cord injury units is stressed. The changing pattern of aetiopathogenesis or epidemiology of spinal cord lesions (increase of medical causes such as vascular lesions, tumors, infection disease) and the definition for rehabilitability due to the higher amount of elderly people will bring a new challenge for all careers in the field of rehabilitation.

Aftercare↗
PubMed1991

(-)-Deprenyl treatment of patients with Parkinson's disease does not affect erythrocyte catechol-O-methyl transferase activity.

(-)-Deprenyl has been increasingly used in recent years as an adjuvant with levodopa and a decarboxylase inhibitor in the treatment of Parkinson's disease. The inhibition of dopa decarboxylase and monoamine oxidase B resulting from this combination suggests that there may be a counter-regulatory increase in the activity of the third main enzyme in the catabolism of levodopa, i.e. catecholamine-O-methyl transferase (COMT). The current study on 36 patients with Parkinson's disease under long-term treatment with levodopa/dopadecarboxylase inhibitor showed, however, that the erythrocyte-COMT was unaffected by additional (-)-deprenyl medication. The patients in this study received levodopa and benserazide either with (-)-deprenyl (n = 21) or without (-)-deprenyl (n = 15). When allowance was made for the different genotypes, COMTLL, COMTLH, and COMTHH, there were no differences in the enzyme activities between the two treatment groups and the untreated controls (n = 26). On the basis of these results, consideration is given to the conditions in which COMT inhibitors are likely to be of value in the treatment of Parkinson's disease.

Aged↗
PubMed1991

Applications of chemical-shift-selective NMR microscopy to the non-invasive histochemistry of plant materials.

Chemical-shift-selective imaging at microscopic resolution has been applied to the study of various plant materials including orange peel, grape berries and both dried and undried fruits of fennel. It is shown that selective imaging of aromatics and carbohydrates as well as water and oil can be performed with in-plane resolution down to 13 microns and slice thicknesses of 1 mm or less, at a field strength of 4.7 Tesla. The noninvasive nature of the method gives it advantages over established methods of plant histochemistry which involve sectioning and staining to reveal different chemical constituents.

Fruit↗
PubMed1991

Intermittent urethral self-catheterisation: long term results (bacteriological evolution, continence, acceptance, complications).

Forty six (9%) out of 520 patients from the years 1976 to 1982 who used intermittent urethral self-catheterisation (IUSC) as the method of bladder drainage at the moment of discharge from the Swiss Paraplegic Centre of Basel were analysed during their rehabilitation period, on discharge, 3, 6 months later and again 5 years later regarding bacteriological changes and urinary tract infections, behaviour of some problem germs such as Proteus, Klebsiella and Pseudomonas, sterile versus clean catheterisation, catheterisation frequency, complications, continence and acceptance of this method. Only 22 patients continue IUSC, 5 have died, 6 use indwelling catheters and 13 are voiding their neurogenic bladder with other methods. Average time on IUSC was 6.6 years (0.5-13 years) in the women's group and 4.6 years (0.5-12 years) in the men's group. Of the remaining 22 patients on IUSC, 23% have sterile urines, 36.5% are infected with E. coli and Enterococci, 4.5% with Staphylococci and the remaining 36% still show the problem germs Pseudomonas (4.5%), Proteus (13.5%) and Klebsiella (18%), but there was a reduction from 19 cases with problem germs in 1983 to 11 cases in 1988. In 1988 5% women and 4% men changed from sterile to clean IUSC (2 out of 11 men using the same catheter for at least 1 week and 2 out of 10 women). The complication rate was astonishingly low during IUSC: being only 4.3% (2 male patients, one with stricture of the urethra and epididymitis, one with autonomous dysreflexia with bladder overdistension). No anti-cholinergic or alpha-stimulating agents were used nor continuous antibiotic-prophylaxis and only in one female patient was a bladder denervation procedure performed. No deterioration of the upper urinary tract was observed. The degree of continence remained stable throughout the follow-up, and the same applies to the acceptance of IUSC. The authors conclude that IUSC can be of great help in neuropathic bladder rehabilitation provided that the patients are properly selected, motivated and well instructed and followed throughout the years.

Adolescent↗
PubMed1991

[Gas embolism with cardiac arrest during hysteroscopy. A case report on 3 patients].

Hysteroscopy and laparoscopy are relatively non-invasive methods routinely employed in the investigation of infertility. The danger of air embolism during these procedures was recognized early, and carbon dioxide was substituted for air since it is more readily soluble in blood. In this report we describe 3 cases of circulatory collapse and cardiac arrest in healthy young women during routine hysteroscopy (out of a total of 62 patients during the period 1989-1990) which were most probably caused by massive carbon dioxide embolism. Premedication was with oral diazepam 10 mg. Anesthesia was induced with 0.1 mg fentanyl, 2.5 mg droperidol and 100 mg methohexital (100 mg propofol in one case). Intubation was facilitated with 2 mg pancuronium and 50-100mg succinylcholine. Anesthesia was maintained with nitrous oxide 66% and halothane. Ventilation was controlled with a tidal volume of 10 ml per kilogram body weight at a rate of 10 per minute. Monitoring included ECG, automated non-invasive blood pressure, capnometry, pulse oximetry and body temperature. Anesthesia was uneventful prior to insufflation. In each case the signs and symptoms began approximately 5-8 minutes after the start of insufflation and consisted of an initial tachycardia rapidly followed by ventricular dysrhythmias, bradycardia and cardiac arrest. The end-tidal CO2 decreased during the tachycardic phase and prior to asystole. The patients were cyanotic with engorged jugular veins. Resuscitation with closed chest heart massage and intravenous epinephrine or orciprenaline was successful in every case. The typical "mill wheel phenomenon" of gas embolism was audible on auscultation after heart activity had returned, but disappeared after about 5 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗