Search PubMed⌕ Search

Biomedical subjects

W Kuhn

Publications and source records attributed to W Kuhn.

At least 289 records · Page 16Linked to original sources
PubMed1989

Enzymatic collagen degradation in the pregnant guinea pig cervix during physiological maturation of the cervix and after local application of prostaglandins.

The role of enzymatic collagen degradation in prostaglandin-induced and physiological cervical ripening was studied in guinea pigs. The cervices were removed from (a) 8 non-pregnant guinea pigs, (b) 8 animals at day 45 of pregnancy, (c) 14 pregnant animals of comparable gestational age which had either an intracervical application of 0.2 ml 5% tylose or 10 micrograms sulprostone gel, and (d) 8 guinea pigs at day 63 to 65 of pregnancy. Collagenase activity was assayed in a highly specific and sensitive system using native collagen type I as substrate. Protease activity was measured by the method of Green and Shaw. Collagen fragments were identified by SDS-polyacrylamide electrophoresis (SDS-PAGE) of acetic-soluble fractions. Collagenase and protease activities were found in all extracts from the different groups. However, there were no differences in enzymatic activities between the non-pregnant, early-pregnant and late-pregnant cervical specimens. Prostaglandin pre-treatment of the cervix led to no significant increase in either collagenase or protease activity as compared to the control groups. The absence of typical collagen degradation products in the SDS-PAGE suggested that no significant collagen breakdown had taken place. In contrast to previously published literature, we conclude that enzymatic collagen degradation is unlikely to be a key factor in prostaglandin-induced and physiological cervical ripening.

Animals↗
PubMed1989

Unrecognized endobronchial intubation of emergency patients.

Although intubation of emergency patients in the field is a routine measure, endotracheal tube misplacement remains a serious problem. Using radiologic criteria, the frequency of undetected endobronchial intubation by physicians was determined retrospectively in 100 (78 traumatized) field-intubated adult patients (72 men and 28 women; age, 18 to 90 years; mean age, 39.1 years) consecutively admitted to the University Hospital of Tuebingen, Tuebingen, Federal Republic of Germany, between January 1987 and February 1988. Position of tube tip relative to carina was evaluated on anteroposterior chest radiographs made on admission. Inadvertent endobronchial intubation was not recognized by the physician and the admitting anesthesiologist in 7% of the reviewed cases, and endotracheal positioning of the tube tip near the carina (2 or less cm) occurred in another 13%. While unilateral intubation is not immediately catastrophic, the resulting systemic hypoxemia and hypercapnia are aggravated by potential accompanying injury (eg, lung contusion, hematothorax, pneumothorax, shock, or cerebrocranial trauma), which can lead to secondary damage (eg, acute respiratory insufficiency, ischemic brain damage). Evaluation of the depth of tube insertion with the aid of common clinical techniques is particularly unreliable in the case of thoracic trauma, aspiration, or previously existing pulmonary disease. Suggested measures for prevention of endobronchial intubation are improved and intensified training of emergency staff to increase awareness of and prevent the catastrophic effects of endobronchial malposition of the tube tip, tube shortening before intubation, assessment of insertion depth by checking length scale on the tube, and avoidance of patient head and neck movement.

Adolescent↗
PubMed1989

[Vaginosonographic measurement of the postmenopausal endometrium in the early detection of endometrial cancer].

Vaginosonographic measurements of the endometrium were performed in 155 postmenopausal women without abnormal gynecological findings and free of any clinical symptoms. An endometrial thickness of greater than or equal to 4 mm was clarified histologically by means of a curettage. We found endometrial carcinomas in seven cases, cervical carcinomas in one, endometrial polyps in ten and glandular-cystic hyperplasia in three cases. One patient showed an atrophic endometrium associated with a submucous myoma. In total, endometrial carcinomas were detected by sonography in 4.5% of our patients. On the basis of our preliminary results, we conclude that vaginosonographic examination of the endometrium is a highly sensitive (81%) and specific (89%) method, with good acceptance by the patients, in the detection of asymptomatic benign and malignant neoplasms of the postmenopausal woman.

Aged↗
PubMed1989

[Diagnostic in-vitro fertilization].

Unexplained sterility is one of the major problems in the treatment of childless couples. The reason for sterility can be the result of different factors such as andrological or anatomic-physiological dysfunctions. The therapeutic approach to treat patients with unexplained sterility at the Department of Obstetrics and Gynecology, University of Goettingen, is, to exclude those patients from further therapies who obviously have no chance to become pregnant by any technique of reproductive medicine. A so called "diagnostical IVF" gives information about the fertilization capacity of male and female gametes in vitro. The results of a one year study with 85 couples (tubal sterility = 57; idiopathic sterility = 28) indicated, that even with no differences in the number of oocytes retrieved, the fertilization and cleavage rates were significantly higher in the group of patients with tubal sterility (fertilization rate: 63.1% vs 46.1%; cleavage rate: 57.5% vs 40.6%). Thus the transfer rate in patients with unexplained sterility was about 15% lower (68.9%) than in patients with tubal sterility (85.6%). On the other hand, after embryo transfer the pregnancy rate was double in those patients with unexplained sterility (38.7 vs 15.7%). If there is no fertilization of the oocytes in at least two IVF cycles all attempts to fulfill the patients desire for a child seem useless. In contrast successful in vitro fertilization provide the bases for further intrauterine insemination cycles which can be assisted by psychotherapy. This regimen seems helpful to classify patients with unexplained sterility and avoids long lasting frustrating therapies.

Embryo Transfer↗
PubMed1989

The effect of R-(-)-deprenyl in de novo parkinsonian patients pretreated with levodopa and decarboxylase inhibitor correlated to depression and MHPG, HIAA and HVA levels in the cerebrospinal fluid.

1. The effectiveness and tolerability of deprenyl as an adjunct in the therapy of parkinsonism was studied in a double-blind trial comprising 30 de novo patients. 2. Two thirds of the cases that could be evaluated showed a statistically significant improvement while on adjuvant deprenyl therapy. 3. The improvements are shown in the replugging test, a subtest of the Motor Performance Test, and on the Columbia University Rating Scale. 4. There is no statistically significant correlation between improvement of motor response and depression. 5. Deprenyl seems to be less effective in patients with low contents of HIAA and HVA in the cerebrospinal fluid.

Benserazide↗
PubMed1989

Extrapyramidal features in central Lyme borreliosis.

We report 5 cases with an extrapyramidal syndrome resulting from Borrelia burgdorferi encephalitis which responded to antibiotic treatment. The acute onset of extrapyramidal features together with diffuse pain can be the leading symptoms of central borreliosis.

Basal Ganglia Diseases↗
PubMed1989

[Serum level of the tumor marker CA 125 before second-look laparatomy in primary epithelial ovarian cancer in relation to intraoperative findings].

Serum CA 125 levels were evaluated in 76 patients undergoing second-look laparatomy for primary epithelial ovarian cancer. The findings were related to the presence of intraabdominal tumor. CA 125 levels were greater than 35 U/ml in 26 cases in accordance to the intraoperative findings. CA 125 levels less than or equal to 35 U/ml were found in 50 cases out of which 29 were free of tumor, while 21 showed intraabdominal tumors. Thus a CA 125 level greater than 35 U/ml revealed to be a strong predictor of the presence of intraabdominal tumor. Due to low sensitivity monitoring serum CA 125 levels cannot replace second-look laparotomy.

Adult↗
PubMed1989

D-Arg-[Hyp3-D-Phe7]-bradykinin, a bradykinin antagonist, reduces mortality in a rat model of endotoxic shock.

The kallikrein-kinin system is activated during endotoxic shock, suggesting that bradykinin plays a role in the pathology of this disease. To test this hypothesis, a bradykinin antagonist, D-Arg-Hyp3-D-Phe7-bradykinin (NPC 567), was studied in conscious, chronically catheterized rats undergoing lipopolysaccharide (LPS)-induced endotoxic shock. LPS treatment resulted in an increase in circulating bradykinin from less than 23 pg/ml to 144 +/- 18 pg/ml at 1 hr. Intravenous administration of LPS resulted in a 38% drop in mean arterial pressure at 1 hr which was partially reversed by NPC 567. NPC 567 did not affect the moderate tachycardia observed following LPS. NPC 567 infusion at 8 nmol/kg/min dramatically reduced mortality from 100% to 50% at 24 hr (P less than 0.01). In response to LPS, blood thromboxane B2 (TXB2) rose from less than 200 pg/ml to 2,298 +/- 64 pg/ml, while 6-keto-prostaglandin-F1 alpha (6kPGF1 alpha) rose from 289 +/- 23 pg/ml to 7,927 +/- 822 pg/ml. NPC 567 reduced the rise in 6kPGF1 alpha by 42% (P less than 0.05), without affecting TXB2. In summary, NPC 567 reduced mortality in rats treated with LPS, reduced the rise in 6kPGF1 alpha and partially reversed the hypotensive effects. These results suggest that bradykinin plays a significant role in the pathology of endotoxic shock.

Analgesics↗
PubMed1989

[Changes in Tamm-Horsfall protein excretion in the urine of patients with hypertension in pregnancy].

In previous studies we detected an intensively stained protein band with an apparent molecular weight of 105 kD in the urinary electrophoresis pattern of healthy control subjects and pregnant women; this protein band was identified as Tamm-Horsfall protein by using Western blot. The aim of the present study was to determine the changes of this THP band in 64 patients with an uncomplicated course of pregnancy and 135 hypertensive pregnant women by use of a special urine preparation and a modified SDS-PAGE. The number of protein bands did not change in the course of pregnancy and in the post partum period. The THP band was constantly found in all these patients independent of the gestational age. In 83% of the hypertensive pregnant women we observed a marked reduction in intensity or complete disappearance of the THP band. These changes correlated significantly with the severity of the disease. Follow-up analyses in 39 of these patients showed, that in 22 cases disappearance of the THP band occurred simultaneously with and in 11 women before clinical manifestation of the disease. In 81 of the 85 hypertensive pregnant women complete reappearance of the THP band was observed 2 to 14 days after delivery. Our findings may reflect a transitory tubular dysfunction in cases of preeclampsia and support the hypothesis of an immunological pathogenesis of the disease.

Electrophoresis, Polyacrylamide Gel↗
PubMed1989

[Dose-dependent effect of locally administered sulprostone gel on serum luteal and placental hormones in cervix priming in the 1st trimester].

In a prospective, randomised study 30 primigravidae were treated with 25 micrograms, 50 mu, or 100 micrograms sulprostone gel in order to soften the cervix prior to first trimester termination of pregnancy. 10 multigravidae received only the gel vehicle tylose. 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 (PG) application and before operation. Serum progesterone, 17-beta-estradiol and hP1 levels were determined radioimmunologically prior to PG application and at two-hours intervals until curettage. A sonographic examination for determing the vitality of the pregnancy was performed before PG administration and immediately before the surgical intervention. There were no significant differences in the primig effect between the 50 micrograms and 100 micrograms sulprostone-treated group; the application of 25 micrograms sulprostone was significantly less effective. After 100 micrograms sulprostone gel abortion occurred in 2 patients, 6 women showed a marked decrease in hPl concentrations, progesterone levels were found to be reduced to 31.6-78.7% and 17-beta-estradiol to 10-40% of the initial values before PG application. We found a close time correlation between the occurrence of contraction-induced lower abdominal pain and the fall in hormone concentrations. No abortions occurred in any of the patients treated with 50 micrograms sulprostone gel; in 9 women without clinical symptoms no significant changes of the hormone concentrations were observed. In contrast to the previously published literature our results indicate that effective cervical ripening can be achieved by this method without disturbance of the feto-placental unit and the trophoblast respectively.

Abortifacient Agents↗
PubMed1988

Pharmacokinetic studies with sustained-release formulations of levodopa in healthy volunteers.

On the basis of the results of a large number of studies of the correlation between plasma levodopa levels and the occurrence of mobility disorders, it was concluded that side-effects such as dyskinesia, end-of-dose, peak-dose and on-off phenomena, which occur especially during levodopa long-term treatment of Parkinson patients, may be caused by fluctuations in the plasma levodopa levels. Some preliminary trials using sustained-release formulations were not up to expectations. Still, we studied the question of whether it might not be possible after all to obtain sustained plasma levodopa levels over prolonged periods of time with levodopa sustained-release (S. R.) formulations, without causing a high initial peak. For this purpose, we compared the pharmacokinetics of six different levodopa S. R. formulations with a standard preparation in two randomized cross-over trials in healthy male volunteers. Although the levodopa S. R. formulations prolonged the time to peak blood levels in all cases, a plateau that was constant over a longer period of time could not be obtained. However, none of the S. R. preparations studied gave rise to a high initial peak of the plasma levodopa concentration. The levodopa concentrations had again returned to endogenous levels within no more than 8 hours of administration of all six levodopa S. R. formulations.

Adult↗
PubMed1988

Sonographic detection of an asymptomatic rupture of the uterus due to necrosis during the third trimester.

This is a report on the first sonographic detection of a silent rupture of the uterus in the 33rd week of pregnancy of a 35-year-old patient. On the basis of the clear sonographic picture immediate cesarean section was (considered) indicated in spite of lack of clinical symptoms. The intraoperative situs confirmed the sonographic diagnosis of a ruptured uterus related to an old cesarean section, combined with partial necrosis of the lower uterine segment.

Adult↗
PubMed1988

Lipid metabolic changes during hormonal treatment of endometriosis.

Three groups of patients with pelvic endometriosis were treated with medroxyprogesterone acetate (MPA) 50 mg/day (n = 10), lynestrenol (LYN) 10 mg/day (n = 25) and danazol (DAN) 600 mg/day (n = 25) respectively. Total cholesterol, triglycerides, alpha-lipoprotein, prebetalipoprotein, beta-lipoprotein cholesterol, high-density (HDL) and low-density (LDL) lipoprotein and apolipoprotein A1 and B concentrations were determined before treatment and after 3 and 6 mth of therapy. Whereas lipid, lipoprotein and apolipoprotein levels did not change in the MPA group, the patients on LYN and in particular those on DNA showed marked changes in lipoportein patterns. Alpha-lipoprotein, HDL and apolipoprotein A1 levels fell, while beta-lipoprotein, LDL and apolipoprotein concentrations rose, these changes being statistically significant. No alterations were seen in the serum levels of cholesterol, triglycerides or prebetalipoprotein cholesterol. In view of a possible relationship between high LDL and low HDL levels and a risk of accelerated coronary arteriosclerosis in women it was concluded that progestogen-induced alterations in lipoprotein patterns should be avoided as far as long-term treatment is concerned and where additional risk factors are present.

Adult↗
PubMed1988

[Puerperal ovarian vein thrombophlebitis--a rare puerperal complication].

Puerperal ovarian vein thrombosis (POVT) commonly results from purulent necrotic endomyometritis. The incidence is published to be 1 in 600 deliveries, however, according to own data, the incidence is at least 10 times less frequent. According to the puerperal uterine drainage, the predominant location is the right ovarian vein in 90% of all cases. The leading symptoms are lower abdominal pain localized anteriorly to the psoatic muscle and a tender, barrel shaped unilateral tumor. Discrepancy between the grave clinical picture and the insignificant findings on gyn. examination is common. Ultrasound and computed tomography frequently add in the correct diagnosis. Antibiotic therapy and anticoagulation are recommended in an uneventful course. If clinical improvement is delayed despite non-invasive treatment, surgical intervention with resection of the involved veins and all septic foci becomes mandatory. Despite non-invasive and invasive treatment, pulmonary emboli or septic complication refractory to therapy may contribute to mortality. Therefore POVT should always be included in the differential diagnosis of those patients presenting with a variable fever curve or an unexplained septic course following delivery or miscarriage.

Adult↗
PubMed1988

[Changes in the urinary protein pattern in SDS polyacrylamide gel electrophoresis in normal and hypertensive pregnancies].

The urinary protein pattern was determined in 46 healthy male and female subjects, 64 patients with an uncomplicated course of pregnancy and 88 hypertensive pregnant women by use of a special urine preparation and a modified SDS-polyacrylamide gel electrophoresis (SDS-PAGE). There were no differences in the protein electrophoresis pattern between the control subjects, independent of sex and age, and the pregnant women. The number of protein bands did not change in the course of pregnancy and in the post partum period. In both groups, an intensively stained protein band with an apparent molecular weight of 105 kD was detected. In 71 of the 88 hypertensive pregnant women we found a marked reduction in intensity or complete disappearance of the 105 kD protein band. Follow-up analysis in 30 of these pregnant women showed, that in 24 cases disappearance of the 105 kD band occurred simultaneously with and in 6 women before clinical manifestation of the disease. There were no differences in the protein electrophoresis pattern between patients with preexisting renal or hypertensive disease and hypertensive women without a complicated history. In 49 of the 52 hypertensive pregnant women complete reappearance of the 105 kD band was observed 2 to 14 days after delivery. By using silver staining and Western blot, the 105 kD band was identified as Tamm-Horsfall protein. Our findings may reflect a transitory tubular dysfunction in cases of preeclampsia and support the hypothesis of an immunological pathogenesis of the disease.

Adolescent↗
PubMed1988

[Significance of early laboratory diagnosis for obstetrical procedures in severe gestoses and the HELLP syndrome].

HELLP syndrome is a severe complication of preeclampsia, incalculable in its course and involving high risk for mother and fetus. Over a period of three years and eight months a total of 24 patients with HELLP syndrome were treated at Göttingen University Gynecological Clinic and the Gynecological Clinic of Munich Technical University. In all cases the correct diagnosis had already been made by the referring physician or by the obstetrician on admission, taking laboratory parameters into account. The chief clinical symptom was upper abdominal pain, All of the patients presented with thrombocytopenia and elevated liver enzymes. The signs of hemolysis derived from the increased bilirubin concentrations and the LDH; in 13 cases fragmentocytes were detected in the peripheral blood smear. No indications of a pronounced DIG were found. The mean time elapsed between hospitalization and delivery was six hours (0.5-40 hours); 22 patients were delivered within 24 hours. Cesarean section was performed in all cases. The mean gestational age at the time of birth was 35 weeks (25-38). Three of 24 children died prepartially; with the surviving infants no major problems arose in the postnatal course. In 19 cases the abdominal cesarean delivery and clinical course were without complications. Reoperation, in two cases combined with a puerperal hysterectomy, was necessary in three patients, due to subfascial and intraperitoneal or retroperitoneal hematomas.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗