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Biomedical subjects

W Kuhn

Publications and source records attributed to W Kuhn.

At least 145 records · Page 8Linked to original sources
PubMed1996

Depression in Parkinson's disease: biogenic amines in CSF of "de novo" patients.

INTRODUCTION: Etiology of depression in Parkinson's disease (PD) is associated with serotonergic dysfunction. Previous studies, supporting this hypothesis, were performed on patients treated with antiparkinsonian drugs. To eliminate the influence of parkinsonian drug therapy and to elucidate significance of different biochemical pathways in PD associated with depression we determined levels of biogenic amines in cerebrospinal fluid (CSF) of 26 untreated "de novo" Parkinsonian patients. MATERIAL AND METHODS: Patients were scored with the Hamilton depression scale (HD) and subdivided into groups with HD score > or = 18 and HD score < 18. Diagnosis of depression was made according to DSM III R. Both groups were matched for age and motor disability. RESULTS: In both groups no significant differences appeared between CSF levels of dopamine, noradrenaline, 3,4-dihydroxyphenylacetic acid, homovanillic acid, 3-methoxy-4-hydroxyphenylglycol and 5-hydroxyindole acetic acid, determined by high-performance liquid chromatography. DISCUSSION: In contrast to previous studies on treated Parkinsonian patients no sign of altered serotonin metabolism especially in context with severity of depression in early stages of PD was found. Due to our results, we suggest, that biochemical markers of depression in CSF of PD may be influenced by antiparkinsonian therapy and that depression in PD may respond to serotonin reuptake inhibitors mainly in later stages of PD.

Aged↗
PubMed1996

Characterization of elastomeric materials by NMR-microscopy.

This review reflects a long experience with the application of NMR-imaging methods to elastomeric materials. The experimental techniques, used to obtain parameter selective NMR images (T1, T2, T1 rho-images), are described in detail and the methods required for the data analysis are explained. A special emphasis is put on the analysis of experimental errors within the framework of NMR-imaging. In order to make parameter selective images generally useful their information should be correlated to material properties, so that images of the material properties can be obtained. This is demonstrated for the case of crosslink density, which is certainly one of the molecular properties in rubber materials, exhibiting the main influence on mechanical and other material properties. Sulfur cured and carbon black filled technical rubbers with different degree of crosslink density and oxidative aging were investigated using parameter selective in aging techniques. The image data were analyzed by means of gaussian and multiexponential fitting procedures, revealing spatially resolved NMR relaxation parameters. The further interpretation of these parameters was based on physical models describing molecular motions in crosslinked polymers.

Chemical Phenomena↗
PubMed1996

Preoperative evaluation of ovarian tumors in the premenopause by transvaginosonography.

OBJECTIVE: The aim of the study was to establish reproducible sonomorphologic criteria by use of transvaginosonography in the preoperative evaluation of ovarian tumors in the premenopause. STUDY DESIGN: In a prospective study from 1987 to 1993 we investigated 1072 ovarian tumors. All tumors > or = 3 cm were included in the study. To avoid unnecessary operations, all tumors we rescanned after 6 weeks. The sonomorphologic criteria were correlated with the histologic findings. RESULTS: A total of 4.3% of ovarian tumors in the premenopause were malignant. In the special group of sonographically simple ovarian cysts we found 0.8% malignancies. The incorporation of a control scan after 6 weeks in the management of ovarian cysts reduces the number of unnecessary operations on functional cysts. Only 5.5% of the functional tumors were operated on. The risk for malignancy in cystic-solid ovarian tumors is 17.0%, the highest of all sonomorphologic tumor types. CONCLUSIONS: The use of reproducible sonomorphologic criteria in combination with a control scan in premenopausal women with ovarian cysts proved to be efficient to reduce the number of unnecessary operations and to evaluate the risk for malignancy.

Adult↗
PubMed1996

-Intravenous or oral etoposide therapy of platinum refractory ovarian cancer with early recurrence. Results of a prospective randomized study-.

121 patients with advanced ovarian cancer resistant to or relapsing following platinum-based chemotherapy participated in this prospective randomised multicenter study. The second-line treatment was indicated according to the relapse-free interval. 36 assessable patients were resistant to platinum-based chemotherapy or relapsed within 12 months following primary surgery. This group of patients with early relapse was randomized to oral or parenteral etoposide. 82 patients relapsed within an interval longer then 12 months following primary surgery; these patients with delayed relapse underwent a secondary tumour-debulking surgery. The data of this group of patients with delayed relapse will be published as soon as the time of observation allows adequate results. In this paper the efficiency of etoposide in the patients with early relapse is analysed according to the application form of the drug (oral vs. parenteral). No statistically significant difference in response rate, toxicity, and median survival time was found between the oral (n = 18) and parenteral (n = 18) treatment. In both application groups the response rate was 22%, the median survival time 14 and 13 months respectively. Alopecia and leucopenia were the most frequent toxicities. As a result etoposide is efficient in unfavorable ovarian cancer patients with early relapse. Because of better compliance etoposide should be administered parenterally. In respect of response rate and median survival time, etoposide is comparable with paclitaxel.

Administration, Oral↗
PubMed1996

[Neurinoma in the area of an episiotomy scar. A case report].

Neuromas are caused by lesions of intact nerves. They are defective regenerates and are characterised by benign neoplastic proliferation. Little is known about the presence of neuromas in episiotomy scars or at the vulva. The authors describe the course of a neuroma in an episiotomy scar on the basis of a case report by the Department of Gynaecology of the University of Göttingen. Only few case reports have been published. Preoperative diagnosis is based on suspicion; imaging methods fail to yield relevant information in the majority of cases. The number of undiscovered cases of neuromas after trauma of the perineum/of the vulva, the size of which is often just 1 or a couple of millimetres, may be higher than assumed; quite often a possible organic cause is excluded from the very beginning by assuming the cause was psychosomatic. If diagnosis proves difficult, simple resection of the tissue containing the focal point of the pain is the therapy of choice after detailed patient history exploration and gynaecological examination.

Adult↗
PubMed1996

Fibronectin in the plasma during pregnancy and parturition.

Fibronectin can be detected in the plasma and the extracellular matrix of the uterus of pregnant women. Studies so far have compared individual observations, whilst serial investigations during pregnancy, and during and after parturition have not been carried out. Plasma fibronectin levels were measured in 153 women with healthy pregnancies in relation to the gestational age. During parturition, blood was taken from the inception of labor through to parturition, and on the 1st, 3rd, and 5th days after parturition. The investigations of the plasma fibronectin level in pregnant women show constant concentrations up to the 35th week of pregnancy. From the 36th week onward the fibronectin rises significantly before dropping to the initial values at the start of labor. The elevated fibronectin concentration in the last 4 weeks before delivery could be explained both by renewed, elevated synthesis in the uterus and placenta as well as by lower consumption. The decline in the fibronectin level with the onset of labor could be caused by an elevated enzymatic induction in the uteroplacental unit in connection with the start of parturition.

Adolescent↗
PubMed1996

The corpus luteum insufficiency: a multifactorial disease.

The pulsatile release pattern of LH during the entire menstrual cycle is well defined; however, the response of corpora lutea to these LH pulses in patients suffering from corpus luteum insufficiencies (CLI) is largely unknown. Patients suffering from CLI were selected from infertile patients on the basis of low progesterone (P < 25 nmol/L) in a blood sample withdrawn during a monitoring cycle. During the next cycle, nine blood samples were collected during the follicular and luteal phase and follicular development was assessed by vaginal sonography. Of 109 patients who had a CLI in the monitoring cycle, 55 had a CLI again, and 38 women agreed to undergo assessment of pulsatile hormone secretion. These women again had P < 25 nmol/L at days 6 and 7 of the luteal phase and blood samples were withdrawn through antecubital vein catheters from 0900-1700 h at 10-min intervals on days 7, 8, or 9 following ovulation. From 38 patients with such defined CLI, 16 (42%) had no LH episode and significantly lower basal LH levels in comparison with 14 control subjects. Thirteen (34%) of the patients had normal appearing LH episodes despite too low P and E2 concentrations, but their CL did not react to the LH episodes. The remaining 9 patients (24%) had normal LH episodes; their CL reacted to these episodes, but their basal P levels were too low. In all blood samples LH was not only determined using an immunoassay but also by the mouse Leydig cell testosterone production bioassay. It could be established that no CLI exists, which is due to the release of bioinactive LH. It is anticipated that the differentiation of three different types of CLI, one of hypothalamic and two of ovarian origin, may allow the development of differential diagnostic and therapeutic tools in the future.

Adult↗
PubMed1996

Improved control of nausea and emesis with a new bromazepam-containing ondansetron regimen in ovarian cancer patients receiving chemotherapy with carboplatin and cyclophosphamide.

BACKGROUND: Ondansetron was found to be effective as an antiemetic in numerous clinical trials of highly emetogenic combination-chemotherapy regimens that included cisplatin. Its role in milder emetogenic regimes has not been fully defined. METHODS: This study investigated the efficacy of two different antiemetic regimes in thirty-five patients with ovarian cancer receiving 68 cycles of chemotherapy with carboplatin (350 mg/m2) and cyclophosphamide (600 mg/m2). Ondansetron (3 x 8 mg i.v.) was compared to a bromazepam-containing ondansetron regimen. RESULTS: Nausea was absent in 65% of chemotherapy courses in patients receiving the combination of ondansetron and bromazepam and in 38% of chemotherapy courses in patients receiving ondansetron alone. Complete control of emesis was achieved in 93% of the courses in patients receiving the combination and in 81% of the courses using ondansetron alone. CONCLUSIONS: The addition of bromazepam to ondansetron, and the extension of antiemetic prophylaxis to the day before and the day after chemotherapy improves the control of nausea and emesis compared to ondansetron monotherapy in patients with ovarian cancer.

Antiemetics↗
PubMed1996

Chromatic and achromatic visual evoked potentials in Parkinson's disease.

Chromatic and achromatic visual evoked potentials (VEP) were evaluated in 39 patients with idiopathic Parkinson's disease (PD) (age 64.0 +/- 8.6 years) and 43 healthy controls (age 62.8 +/- 8.7 years). The following pattern-reversal checkerboard stimuli were performed: (1) achromatic with luminance contrast 86% (achr.hk.) (2) achromatic with luminance contrast 20% (achr.lk.); (3) chromatic isoluminant blue-yellow (by.); (4) chromatic isoluminant red-green (rg.). The mean latencies N70, P100, and N135 of chromatic and achromatic VEP were significantly delayed in patients with PD as compared to controls. The highest rate (41.0%) of pathological findings could be demonstrated by achromatic stimulation (luminance contrast 86%). Isolated abnormalities of chromatic VEP (in combination with normal achromatic VEP) were found in 5 (12.8%) patients. The delay of VEP-latencies was significantly correlated with the severity of motor symptoms in PD patients. We conclude that VEP are valuable tools to demonstrate a dysfunction of the visual system in PD. Although chromatic VEP are less sensitive than achromatic VEP, the combination of both will increase the diagnostic yield. Therefore, there seems to exist a variety of individual characters of visual impairment in PD.

Adult↗
PubMed1995

Interleukin-1 beta and interleukin-6 are elevated in the cerebrospinal fluid of Alzheimer's and de novo Parkinson's disease patients.

Interleukin-1 beta (IL-1 beta), interleukin-2 (IL-2), and interleukin-6 (IL-6) were measured in the cerebrospinal fluid (CSF) and plasma of 12 control subjects, 11 sporadic Alzheimer's disease (AD) and 22 de novo Parkinson's disease (PD) patients using high sensitivity enzyme-linked immunosorbent assays (ELISA). IL-1 beta and IL-6 contents were significantly elevated in the CSF of de novo PD and AD patients in comparison to the control group. In contrast, the plasma levels were not significantly affected. IL-2 contents in the CSF and plasma samples were unchanged in the three groups compared. Because the two cytokines IL-1 beta and IL-6 are known to play a key role in the interaction between the nervous and immune system, e.g. in the so-called acute phase response, our results support the involvement of immunological events in the complex process of neurodegeneration in AD and PD.

Adult↗
PubMed1995

Primary tumor and metastasis in ovarian cancer differ in their content of urokinase-type plasminogen activator, its receptor, and inhibitors types 1 and 2.

The relevance of urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitor (PAI) type 1 in predicting the survival probability of patients with advanced ovarian cancer after radical surgery and adjuvant chemotherapy by assessing the patients' primary tumors has recently been shown by us (W. Kuhn et al., Gynecol. Oncol., 55: 401-409, 1994). In the present study, we determined uPA, uPA receptor, PAI-1, and PAI-2 concentrations in primary tumors and tumor-infiltrated omentum and retroperitoneal lymph nodes of ovarian cancer patients. The group consisted of 39 patients with advanced ovarian carcinoma stages Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) IIIc or IV; for comparison 7 patients with early carcinoma stage FIGO I were also included. In metastases of the omentum from ovarian cancer stage FIGO IIIc or IV patients, we noted a 4-fold elevated uPA content, a 2-fold increase in PAI-1, and also a significant increase in uPA receptor and PAI-2 over primary tumors. In metastases of the lymph nodes the levels of the respective antigens were also increased when compared to primary tumors. These data may indicate that elevated levels of components of the fibrinolytic system at sites of metastases may contribute to the aggressive potential of cancer cells by favoring their reimplantation and/or the consolidation of a new tumor stroma.

Adult↗
PubMed1995

Magnesium and calcium concentration in the pregnant and non-pregnant myometrium.

OBJECTIVES: To investigate the effect of labor on the magnesium and calcium concentrations in the human myometrium and to compare them with the concentrations in the non-pregnant uterus. METHOD: Samples of the isthmic part of the uterus were taken from 42 patients not in labor, 31 patients in regular labor during a cesarean section, and 37 premenopausal patients on whom a hysterectomy was performed. RESULTS: (i) The magnesium concentration dropped significantly during labor; (ii) the calcium concentration in the tissue showed no significant changes during labor; (iii) the magnesium and calcium concentrations were significantly higher during pregnancy; (iv) the distribution of electrolytes in the myometrium differed significantly in the corpus, isthmus and cervix uteri. CONCLUSIONS: The electrolyte concentration in the myometrium depends on the place of removal. A low magnesium concentration in the pregnant human myometrium could be a cause of premature labor.

Calcium↗
PubMed1995

A clinical, mammographic, sonographic and histologic evaluation of breast cancer.

OBJECTIVE: To evaluate histologic tumor size in comparison with preoperative determination of tumor diameter by palpation, mammography and sonography. METHODS: In a retrospective analysis we compared the histologic, clinical, mammographic and sonographic findings obtained from 160 patients with breast carcinoma. RESULTS: The histologically determined tumors showed an average diameter of 25.7 mm. By comparison, the average tumor diameter determined by mammography, sonography and palpation was 23.8, 26.1 and 30.6 mm, respectively. Mammography was capable of detecting 94.5% of breast carcinomas, breast sonography 91% and palpation 87%. The combinations of mammography and sonography or mammography and palpation detected 99% of carcinomas, and sonography and palpation 95% of carcinomas. CONCLUSION: As supplementary methods to preoperative clinical examination, mammography and breast sonography are mutually complementary, high-resolution imaging techniques of utmost importance in the preoperative diagnosis and surgical treatment of breast cancer patients.

Adult↗
PubMed1995

Interleukin-8 synthesis and the onset of labor.

OBJECTIVE: To examine the role of cytokines in cervical dilation. METHODS: In 55 patients undergoing cesarean delivery, we took samples from the lower uterine segment, the decidua, and the membranes. We determined the concentrations of interleukin (IL)-2, IL-8, tumor necrosis factor-alpha, matrix metalloproteinase (MMP)-8, and MMP-9 in the different tissues. RESULTS: Depending on the state of labor, we observed a significant increase (P < .001) in IL-8 concentrations in the lower uterine segment. The leukocyte enzymes MMP-8 and MMP-9 were highly significantly correlated with the IL-8 concentrations. CONCLUSION: Interleukin-8 is critically involved in the process of parturition in humans. Interleukin-8 concentrations in the myometrium, decidua, and membranes correlated strongly with the observed MMP-8 and MMP-9 concentrations.

Cervix Uteri↗