Search PubMed⌕ Search

Biomedical subjects

W Kuhn

Publications and source records attributed to W Kuhn.

At least 253 records · Page 14Linked to original sources
PubMed1991

[Diagnosis of early extrauterine pregnancy by serum and Douglas pouch fluid hCG level].

In 44 patients with assumed ectopic pregnancy culdocentesis were carried out under transvaginosonographic control. In 23 cases, the clinical diagnosis ectopic pregnancy and in 16 cases, an early intact intrauterine pregnancy could be verified. Five patients had an early abortion. In all patients with an intact intrauterine pregnancy, the cul-de-sac liquid was serious. In 16 of the 23 cases of ectopic pregnancies, the fluid was bloody, 6 aspirates were bloody/serous and one serous. The findings in patients with an early abortion were as follows: three serous, one bloody/serous, one bloody. Further information could be gathered from the comparison of hCG-levels in simultaneously obtained serum samples and cul-de-sac liquid. All intact intrauterine pregnancies were associated with lower hCG-levels in the cul-de-sac liquid than in the serum (ratio: serum/cul-de-sac liquid greater than 1.3). In all ectopic pregnancies but one, we found an inverse constellation (ratio: serum/cul-de-sac liquid less than 0.7). In the described exceptional case the ratio was nearly 1 and when culdocentesis was repeated 5 days later, a ratio of 0.17 proved the clinically suspected ectopic pregnancy. In 3 cases of histologically confirmed intrauterine abortions, the hCG-level in the cul-de-sac liquid was lower than in the serum, in 2 cases of early abortions without histologically proved localisation the hCG-level was slightly above the level in the serum.

Abortion, Spontaneous↗
PubMed1991

The sensory tensor fasciae latae flap: a 9-year follow-up.

From January 1979 to April 1989, 19 neurosensory tensor fasciae latae flaps were used to cover ischial pressure sores in paraplegic patients. This flap provides protective sensation and improves the sensory control of the filling status of the rectum and the sitting control in a wheelchair. Patients were reexamined between 12 and 110 months; no recurrence or new pressure sores were seen. Indications, early and late complications, and evolution of the sensation are discussed.

Adolescent↗
PubMed1991

Endometrial stromal sarcoma of the uterus.

Uterine sarcomas are rare tumors constituting 1-3% of all uterine malignancies. These tumors are characterized by aggressive growth and by poor overall prognosis. There is much controversy concerning diagnostic criteria and the great variation in histology, as well as the role of radiotherapy and chemotherapy in the management of these tumors. We report a case of endometrial stromal sarcoma of the uterus in a 45-year-old woman. Total abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy was performed, followed by adjuvant radiotherapy and tamoxifen treatment. The patient has now been seen regularly for 2 years from the start of the treatment and at present there is no evidence of disease.

Antineoplastic Agents↗
PubMed1991

[What does 31 phosphorus magnetic resonance spectroscopy measure?A validation in healthy probands].

With 31P nuclear magnetic resonance spectroscopy skeletal muscle metabolism can be measured noninvasively. Aim of this study was to investigate intraindividual reproducebility, interindividual variability, and the correlation of the NMR parameters PCr, alpha-, beta-, gamma-ATP to graded exercise. Reproducebility and variability of PCr values were comparabel to changes of the pH value. Alpha-, beta-, gamma-ATP did not change during measurements. Correlations between the workload and the changes of the NMR parameters were rare. It was found that the intraindividual reproducebility is low and the interindividual variability is high. No systematic correlation between the NMR parameters and the workload could be seen. The termination of exercise in healthy volunteers is not explained by energy depletion but due to other mechanisms. There is no evidence that 31P NMR spectroscopy presents remarkable advantages for clinical purposes compared to well established diagnostic methods.

Aged↗
PubMed1991

[The value of 31 P nuclear magnetic resonance spectroscopy in follow up of Fontaine stage IIb peripheral arterial occlusive disease].

The method of nuclear magnetic resonance (NMR) spectroscopy compared to the parameters absolute-, pain-free walking distance and ankle/arm coefficient in Doppler pressure was used for observation of patients with peripheral arterial occlusive disease stage IIb according to Fontaine. While the classic parameters (walking distances, ankle/arm coefficient) described a homogenous group, NMR-spectroscopy parameters showed marked inter- and intraindividual variations during exercise. Further studies on high magnetic power fields, exercise patterns and muscle recreation analysis have to be carried out to develop a reliable system of non invasive muscle energy monitoring in vascular diseases.

Aged↗
PubMed1991

Definitive radiation therapy in the treatment of carcinoma of the uterine cervix. Treatment results and prognostic factors.

219 patients suffering from cervix carcinoma received definitive radiation therapy using moderate doses of external beam therapy and high dose-rate afterloading brachytherapy from 1979 to 1986. At five years, the actuarial survival (AS) for stage Ib patients was 81%, for stage IIa 53%, for stage IIb 56%, for stage IIIa 25%, for stage IIIb 33% and for stages IVa and IVb 0%. Significant prognostic factors for actuarial survival were FIGO stage, histological type, grading and, marginally, age of the patient at the time of diagnosis. The survival data censored for death caused by intercurrent disease (tumor related survival, TUS) at five years were: 90% (Ib), 66% (IIa), 63% (IIb), 50% (IIIa), 41% (IIIb) and 0% (IVa and IVb). The prognostic factors were stage and grading. Age and histology failed to be a significant prognostic factor. The disease-free survival (DFS) according to FIGO stage at five years were: Ib 84%, IIa 64%, IIb 59%, IIIa 50%, IIIb 38%, IVa and IVb 0%. Prognostic factors for disease-free survival were limited to FIGO stage and grading. The five-year local control results (LC) according to stage were 90% (Ib), 64% (IIa), 67% (IIb), 43% (IIIb) and 0% (IVa and IVb) with stage as prognostic factor. High dose-rate afterloading therapy for cervix carcinoma yields good results for local control and survival with a low ratio of severe side effects (6%). Radiation therapy eliminates the prognostic influence of histological type and grading of the tumor on local control. External beam and afterloading doses, however, are relevant factors for prognosis, if the patients are stratified by FIGO stage.

Adenocarcinoma↗
PubMed1991

[House dust mite allergy].

To study efficacy of a purified and biologically standardized house dust mite extract 66 allergic children were investigated. 26 patients on immunotherapy and 21 controls with symptomatic treatment only finished the study. A significant reduction of the skin reactivity associated with an increase of allergen specific IgG-antibodies was observed. However, no significant differences were found correlating the results of inhalative provocation tests, specific IgE antibodies and symptom scores. The immunotherapy with house dust mite extracts needs further evaluation.

Animals↗
PubMed1990

[Erectile dysfunction of male spinal cord injury patients].

Different problems regarding erectile dysfunction in men with spinal cord-injury are outlined. Neuroanatomical and neurophysiological aspects of erection and ejaculation are outlined and brought into relation with the different clinical pictures of such lesions. Different therapeutical possibilities are presented, particularly the new treatments like intracavernous papaverine (autoinjection), prostaglandin E1 and transcutaneous nitroglycerin; action, advantages and indications are discussed. The experience in ten para- or tetraplegic patients are discussed. It seems that even in spite of the higher price of PGE1 this treatment of the erectile dysfunction in spinal cord-injured men should be preferred, since it shows more advantages and less complications than other treatments.

Adult↗
PubMed1990

[24-hour blood pressure measurement in normal pregnancy in hypertensive pregnant patients].

Noninvasive 24-hour ambulatory blood pressure monitoring was performed in 17 normotensive and 19 preeclamptic pregnant women. The normotensive women showed a significant nightly decline in their systolic and diastolic blood pressure. In contrast, the preeclamptic women demonstrated either an attenuated circadian rhythm or no circadian rhythm at all. This result was even more pronounced in patients with severe hypertension, some of whom had a nocturnal increase in blood pressure in spite of being treated with antihypertensive drugs in an evening dose. The lack of nocturnal blood pressure decrease was also found 24 hours post partum. In summary, these results suggest that preeclamptic women are endangered by hypertensive emergencies mostly during the night. Therefore blood pressure controls should be extended into the night, and antihypertensive drugs should also be given in a sufficient evening dose.

Blood Pressure↗
PubMed1990

Urinary dopamine sulfate: regulations and significance in neurological disorders.

Dopamine-3-O-sulfate (DA-3-O-S) and dopamine-4-O-sulfate (DA-4-O-S) are important end products of L-dopa metabolism. Therefore they may give indications of disturbances in the peripheral metabolism of catecholamines, when measured in urine samples of patients with Parkinson's disease (PD). In addition, information about the reliability of DA sulfatation after L-dopa therapy may be of significance for its role in the elimination of DA from the peripheral nervous system. Although DA-3-O-S appears to be the predominant sulfo-conjugate in urine, there are no changes in PD nor in depression syndrome compared to controls with or without other neurological disorders. By contrast, DA-4-O-S is significantly decreased in de novo PD subjects. However, a similar reduction is notable in patients with other neurological disorders. In depressed persons the loss of this compound was less pronounced as compared to de novo PD. Treatment with combined L-dopa therapy caused increased excretion of DA-3-O-S, while changes in DA-4-O-S were only marginal. It is concluded that urinary DA-3-O-S cannot be used as marker for PD, while DA-4-O-S is significantly reduced in a variety of neurological disorders and in particular in de novo PD. Further studies are necessary to elucidate its role as possible peripheral marker to distinguish preclinical PD and depression syndrome.

Adult↗
PubMed1990

Oral immunotherapy with grass pollen in enterosoluble capsules. A prospective study of the clinical and immunological response.

In a prospective study spanning 2 years, 60 patients with grass pollen allergy were treated with either a low dose oral, a high dose oral or a subcutaneous hyposensitization regime. No significant improvement was seen in the orally treated patients whereas those on the subcutaneous hyposensitization regime demonstrated a decreased specific cutaneous reactivity, a rise in specific IgG antibodies and a reduction in symptoms. This study suggests that oral hyposensitization, even with enterosoluble grass pollen capsules, is ineffective.

Administration, Oral↗
PubMed1990

Collagenase activity in the cervix of non-pregnant and pregnant women.

Cervical biopsies were obtained from non pregnant patients and from pregnant at various stages of gestation and during labour. The tissues were extract with a Ca(++)-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 significantly elevated activity was only present in labour at 6-8 cm cervical dilatation. This provides direct evidence for the crucial role of specific collagen degradation during cervical ripening and dilatation.

Abortion, Induced↗
PubMed1990

Occurrence of human papillomavirus DNA types 16 and 18 (HPV-16/18) in cervical smears as compared to cytological findings.

Cervical smears from 2336 women were examined for the presence of HPV-16/18 by dot-blot hybridization using 32P-labeled HPV-16/18 DNA under high stringency conditions. The hybridization data were compared with cytological findings classified according to Papanicolaou. The ages of the patients ranged from under 20 to over 70 years. Ninety-eight (4.4%) of the 2237 cytologically normal cervical samples (Pap I and II) were HPV-16/18 positive. Thirteen out of 32 (40.6%) samples showing signs of mild and moderate dysplasia (Pap IIID) were found to be HPV-16/18 positive. In 5 out of 7 (71.4%) samples from women with severe dysplasia or carcinoma in situ (Pap IV) and in 9 out of 25 (32.1%) samples from patients with invasive cervical carcinoma (Pap V) HPV-16/18 DNA was detected. Thirty-two smears were from women with severe unspecific cervical inflammation (Pap III). Two (6.2%) out of them were HPV-16/18 positive. Normal smears showed an apparent age-dependent pattern of HPV-16/18 positivity with a peak prevalence of 10.6% among women younger than 20 years old. The majority of premalignant lesions was detected among women younger than 40 years old; whereas all invasive lesions were from women older than 39 years. Compared to the HPV-16/18 prevalence rate in normal smears, abnormal smears harbored HPV-16/18 DNA approximately 9 times more frequently. This finding supports the hypothesis that HPV-16/18 may be involved in the development of cervical cancer.

Adult↗