In 20 patients with suspected infertility, fallopian tube patency was assessed using Doppler-supplemented hysterocontrast sonography (HyCoSy). All patients underwent transvaginal HyCoSy with the contrast agent SHU 454/Echovist prior to laparoscopy with chromopertubation (chromolaparoscopy). Following application of the Echovist contrast medium, the fallopian tubes were visualized with B-mode scanning and tubal flow was evaluated by means of Doppler sonography. None of the patients received anesthesia. We found corresponding results with regard to the tube patency between HyCoSy and conventional chromolaparoscopy in 82.5% of cases. These results make transvaginal HyCoSy a suitable first-line diagnostic procedure in patients with infertility disorders.

Adult↗

PubMedDate not supplied

The renin-angiotensin-aldosterone system, antidiuretic hormone levels and water balance under tocolytic therapy with Fenoterol and Verapamil.

The effects of long-term infusion of fenoterol (a beta 2-sympathomimetic drug) in combination with the calcium antagonist verapamil on water balance, the renin-angiotensin-aldosterone system and antidiuretic hormone during pregnancy were studied. Within two hours of the start of infusion, plasma renin and antidiuretic hormone levels were significantly increased, but plasma aldosterone was strongly decreased. There was a concomitant marked reduction of urinary, sodium, and potassium excretion and a decreased creatinine clearance. The long-lasting reduction of urinary excretion which resulted in an elevated water retention is apparently due to other unknown factors. Results are discussed with special regard to the relationship between water balance disturbances and pulmonary edema.

Blood Chemical Analysis↗

PubMedDate not supplied

A new high sensitivity 19F probe for labeling cysteine groups of proteins.

A novel iodoacetamide label 4-perfluoro-tert-butyl-phenyliodoacetamide (PFP) containing nine fluorine atoms in equivalent positions has been synthesized. It provides a homogeneous 19F NMR resonance line which can be detected with high sensitivity when coupled to proteins. As an example, the sulfhydryl groups of actin have been labeled with PFP; < 100 nmol of this medium sized protein (corresponding to 2.5 mL of a 40 microM solution) can be detected easily in a single scan at 470 MHz.

Acetamides↗

PubMedDate not supplied

The importance of early laboratory screening methods for maternal and fetal outcome in cases of HELLP syndrome.

Over a period of 5 years and 3 months 50 patients with HELLP syndrome were treated at our hospitals. All of these patients fulfilled the criteria of this syndrome described by Weinstein. Pre-eclampsia with HELLP syndrome was either diagnosed correctly by the referring doctor or on admission by the obstetrician on the basis of the laboratory findings. The median time interval between admission and delivery was 3 hours (range: 0.5-40 hours). In 49 patients, Caesarean section was performed, one patient developed a HELLP syndrome 18 hours after vaginal delivery. The median gestational age at delivery was 35 weeks (range: 26-40). Only three of 51 infants died before delivery, and there was one neonatal death, resulting in a perinatal mortality of 7.8%. Apgar scores below 7 occurred in 15 of the newborns after 1 min and in only 2 after 5 min. In 47 cases, Caesarean section and hospital course were free of complications; in three patients postoperative hemorrhages required relaparotomy, in two of these patients puerperal hysterectomy had to be performed. In our experience, the relevant laboratory parameters should be determined in any pregnant women with right upper quadrant pain independent of the severity of pre-eclampsia in order to diagnose HELLP syndrome as soon as possible. Both early control and follow-up of the laboratory parameters and immediate delivery--by Caesarean section, if necessary--may lead to a reduction of maternal mortality and morbidity and to an improvement of perinatal results.

Adult↗

PubMedDate not supplied

Endogenous benzodiazepine ligands in human cerebrospinal fluid.

Human cerebrospinal fluid was chromatographed on Bio-Gel P-4. Fractions containing material with molecular weights less than 4000 Dalton were pooled and further fractionated by high pressure liquid chromatography on an UltroPack TSK column G 2000 SW. At least three peaks, which were free of salt and GABA, were shown to displace (3H)-diazepam in the receptor-binding assay. Two of these peaks inhibited diazepam-binding competitively as shown by Lineweaver-Burke and displacement analysis. Their activity could be enhanced by the addition of GABA to the assay mixture. Incubation of these two peaks with various enzymes indicated that at least part of the activity of the second peak is due to a peptide.

Benzodiazepines↗

PubMedDate not supplied

[Advantages of hyposensitization with a high dose of allergoid in pollen allergy].

Grass and rye pollen sensitive children were hyposensitized with glutaraldehyde-modified, tyrosine-adsorbed grass and rye allergoid. We evaluated the clinical efficacy and immunological changes associated with the administration of 3100 NOON-Units (NU) with 3 injections in 15 patients (group A) and 9100 NU with 6 injections in 13 patients (group B) preseasonally. No systemic side effects during therapy were observed. In patient's assessments, a clinical improvement was reported; however, group B achieved better symptom and medication scores. The latter group obtained slightly higher specific IgG levels than group A after two seasons of treatment, whereas the co-seasonal increase of specific IgE was higher in group A. Hyposensitization with grass and rye allergoid is a safe therapy, a better clinical and immunological effect being observed in a high dose regimen.

Child↗

PubMedDate not supplied

A new approach to phenotyping disseminated tumor cells: methodological advances and clinical implications.

At the time of primary therapy (surgery, systemic chemotherapy and/or radiation), disseminated tumor cells in the bone marrow can be found in almost one-third of patients with cancer of the breast, ovary, esophagus, stomach, colon, and other solid tumors. Whereas the prognostic impact of the mere presence of these cells is still a matter of debate, it has been shown that expression of tumor-associated antigens in disseminated tumor cells is linked to more aggressive disease. Therefore, further characterization of disseminated tumor cells at the protein and gene level has become increasingly important. To date, the most common detection method for disseminated tumor cells in the bone marrow is an immunocytochemical approach using cytokeratin-directed antibodies for detection of epithelial cells and the APAAP system for their visualization. We have established a new double immunofluorescence technique enabling simultaneous detection, phenotyping, and antigen quantification of disseminated tumor cells. Mononuclear cells from bone marrow are enriched by Ficoll gradient centrifugation and cytospins are prepared. Double immunofluorescence is performed using antibodies against cytokeratins 8/18/19 (mAb A45B/B3) and the uPA receptor CD87 (pAb HU277). CD87 expression is recorded by confocal laser scanning microscopy (CLSM) using fluorescence labeled latex beads as the reference; staining intensities of all the scans are then summed and quantified (extended focus). This protocol, originally designed for disseminated tumor cells in bone marrow, can also be applied to disseminated tumor cells in blood, to leukapheresis cells or to cells present in malignant ascites or other malignant effusions. The tumor cells detected may be used for gene and mRNA analyses. Furthermore, disseminated tumor cells also represent interesting targets for clinical studies on patient prognosis or prediction of therapy response as well as for specific tumor-biological therapies.

Biomarkers, Tumor↗

PubMedDate not supplied

The neuroimmune hypothesis in Parkinson's disease.

The role of immune mechanisms in the pathogenesis of Parkinson's disease is still a matter of controversy. Immunological abnormalities have been reported in various brain areas and in peripheral immune parameters. Beside antigen specific findings which might indicate an autoimmune process directed against dopaminergic neurons, non-antigen specific abnormalities have been found, which could be caused either by a disease specific process and/or by immunological properties of various anti-parkinsonian drugs, e.g. bromocriptine. Immune reactions may imitate or maintain the degenerative process. In this case possible neuroprotective strategies interfering with immune functions could be developed. Further investigations are necessary to elucidate the impact of immune mechanisms on the degenerative process in Parkinson's disease.

Animals↗

PubMedDate not supplied

Detection of micrometastases in sentinel lymph nodes of the breast applying monoclonal antibodies AE1/AE3 to pancytokeratins.

Sentinel lymph node excision in breast cancer is a minimally invasive diagnostic procedure for accurate staging of the axilla and for avoiding unnecessary axillary dissection. In patients with palpable breast cancer we injected microcolloidal particles of human serum albumin labelled with technetium-99m the day before surgery. The sentinel node was detected intraoperatively with a handheld gammaprobe and then removed. Complete axillary dissection was performed and the nodes inspected by routine histological examination. The axillary lymph node status was correctly predicted by the sentinel node technique in 32 of 33 breast cancer patients. Two cases of micrometastases escaped routine histopathological detection but were identified by immunohistochemical analysis applying the antibody AE1/AE3 to pancytokeratins. Immunohistochemical examination of the sentinel node improves the diagnostic security of patients with breast carcinoma by detection of micrometastases.

Adult↗

PubMedDate not supplied

[Acute fatty liver of pregnancy (AFLP) as a rare and severecomplication and differential diagnostic problem in the last trimester].

In context of hepatic failures in pregnancy HELLP-Syndrome is defining more and more the reflections of differential diagnosis. Therefore, the inclusion of very rare complications like the AFLP with an estimated incidence of 1:13,000 becomes difficult. Since 1940 250 cases are documented in the literature. Clinical features, approaches of therapy and pathophysiological ideas of the AFLP are also proofed as her role in the spectrum of liver-involved diseases of pregnancy.

Cesarean Section↗