Biomedical subjects
Publications and source records attributed to W Schmidt.
A case of hematocolpos in a 17-yr-old girl is presented. The ultrasound findings are described and discussed. With careful ultrasound examination associated severe complications such as hematometra and/or hematosalpinx can be ruled out preoperatively.
Binding of 125I-labeled camel beta-endorphin (125I-beta C-endorphin) to cells of several mouse thymoma cell lines was examined and was highest to EL4 cells. 125I-beta C-endorphin binding to EL4 cells was temperature-dependent; it was further characterized at 4 degrees C and exhibited saturability, complete reversibility, structural specificity and pH-dependence. 125I-beta C-endorphin binding was not inhibited by the opioid pentapeptides [Leu] enkephalin or [Met] enkephalin (which share common sequences with the N-terminus of beta C-endorphin) or by the N-terminal beta C-endorphin fragments beta C-endorphin (1-16) or beta C-endorphin (1-27). In contrast, binding was inhibited by beta C-endorphin (1-31), indicating that beta C-endorphin binding to EL4 cells was with a C-terminal beta C-endorphin segment. We suggest that binding of beta-endorphin to such nonopioid binding sites may precede its apparent effects on the proliferation of T-lymphocytes (5,6).
Clones of mouse L-cells transformed with 21 cosmids containing 15 major histocompatibility complex class I genes of C57BL10 (H-2b) sperm cell DNA were analyzed for the expression of their transfected H-2 and Qa/Tla genes. Three cosmids contained a single gene, mapping to the H-2D region. This gene encodes the H-2Db alloantigen: mouse L-cells transfected with cosmids containing this gene reacted with monoclonal antibodies and alloantisera specific for the H-2Db antigen and expressed a 46-kd H-2 heavy chain associated with beta 2-microglobulin in their cell membranes. Furthermore, these transfected cells were stimulators of, and targets for, anti-H-2Db cytotoxic T-lymphocytes. Eighteen cosmids contained 14 different genes mapping to the Qa and Tla regions. L-cells transfected with these genes did not express class I genes reacting with alloantisera or monoclonal antibodies against Qa2, Qa4 or TL differentiation antigens. In particular, the Qa2,3 gene of C57BL10 was not identified.
The aim of this study was to investigate responses of human fetuses near term (37-42 wks) (increase/decrease of fetal heart rate and/or fetal motility) to acoustic stimuli. The study group consisted of 43 patients and the control group of 27 patients. Polygraphic recordings of 5 different fetal variables were carried out synchronously for the categorization of the actual fetal behavioural state according to Nijhuis et al. (Nijhuis, J.G., Prechtl, H.F.R., Martin, C.B., Jr. and Bots, R.S.A.M. (1982): Early Hum. Dev., 6, 177-195). Controlled acoustic stimulation was performed either with sine wave tone (2 kHz, 120 dB and 5 s duration) or modulated sine wave tone (0.5-2 kHz, 'sawtooth' modulation, 120 dB and 5 s duration). An additional group of patients received 'sham' stimulation. Overall 84 acoustic stimulations have been carried out. In 26 out of 84 stimulations (30%) a fetal response could be observed within 5 s after acoustic stimulation. In general, there were far fewer fetal responses in sleep states than in states of wakefulness. Whereas in state 1 F only 1 out of 28 acoustic stimulations was followed by an immediate fetal response, more responses were observed in state 2 F. An obvious increase in fetal reactivity to acoustic stimulation was noted in states of wakefulness (states 3 F and 4 F). Comparison between the true and sham stimulations revealed a relatively high level of spontaneous fetal activity (high variation of fetal heart rate and fetal motility) present in states 2 F and 4 F. This must be taken into account in all assessments of fetal responses.(ABSTRACT TRUNCATED AT 250 WORDS)
Sonographic examination of the female breast has now been generally accepted as a clinical examination method. 1 719 patients were subjected to echomammography within the framework of a prospective study. Histologically confirmed results were obtained from 496 palpable findings. Basing on these findings, the value of echomammography was developed in respect of preoperative clarification of palpable carcinomas of the breast. X-ray mammography served as reference method. In benign findings, echomammographic accuracy is 73%, whereas the accuracy of x-ray mammography was found to be 58% only. Fibroadenomas were recognised as a benign process by both methods with an equal quota of accuracy (71% and 73%, respectively). 82% of all fibrocystic mastopathy findings which could be localised via palpation, were sonographically graded as benign, whereas mammography classified only 49% as benign cases. This difference is statistically significant (p less than 0.001). Palpable carcinomas wee considered to be malignant via sonography in 91% of the cases (179 out of 197), whereas x-ray mammography yielded a rate of 82% only. The intraoperative T1 stage was established by sonography in 85% of the palpable carcinomas, whereas x-ray mammography yielded a figure of 76% only. These results underline the importance of echomammography in preoperative clarification of palpable carcinomas of the breast.
Results of sonographic determination of the length of femur between the 12th and 42nd week of pregnancy are presented. The length of femoral diaphysis was determined as part of a cross-sectional study on a total of 595 patients who were not at risk, and where the gestation age was known and confirmed. The growth function of the foetal femoral length was determined via a polynomic regression equation. The foetal femoral length growth presents a characteristic appearance between the 12th and 42nd pregnancy week. In the 12th pregnancy week it is 11 mm on the average, 33 m in the 20th, 58 mm in the 30th, and 76 mm at birth. After an almost linear progression up to about the 30th week of pregnancy, the growth curve gradually begins to flatten out from that time. The mean growth rate of foetal femoral length during the entire period under observation is about 1 to 3 mm per pregnancy week. The authors present a table showing the 95% interval for estimating the gestational age. A relatively accurate estimate of the gestational age is particularly possible in the "early" range between 5 and 32 mm (corresponding to the 12th to 20th week of pregnancy), namely, +/- 9.7 to 10.3 days (95% interval). In femoral measurement results 33 mm to 76 mm (corresponding to the 20th to 42nd week of pregnancy), the range of error of the estimate is +/- 20.6 days. Additional measurement of the foetal femoral length is useful for on-target diagnosis of malformations, for estimating the gestational age, for growth control/weight estimation, and, in certain cases, also for diagnosing the maturity.
The article reports on antepartal sonographic diagnosis and the course and completion of 27 cases with ventral abdominal wall defects. There were 17 cases of omphalocele, 4 cases of gastroschisis and 6 cases of complex ventral abdominal wall defects with associated malformations. In 23 of the 26 women examined prenatally via sonography (89%), the diagnosis was ventral abdominal wall defect. In the 3 cases not diagnosed via sonography, there was one case of intrauterine foetal death. In another case, Potter's syndrome with anhydramnion was found besides a foetal abdominal wall defect, whereas the last unrecognised case had been subjected to sonographic examination outside the hospital only. In 13 out of 17 cases (77%) with omphalocele there were additional malformations. On the other hand, no further associated malformations were seen in the 4 patients with gastroschisis. Complex abdominal wall defects (in the sense of total abdominal wall aplasias or thoracoabdominal gastroschisis, etc.) with multiple associated malformations occurred in the remaining 6 cases. The most frequently seen associated malformations in children with omphalocele were neural tube defects and skeletal malformations (35% each), followed by cardiac and vascular malformations and malformations of the digestive tract. In those women examined in our clinic via sonography who had foetal abdominal wall defects, amniotic anomalies were seen (hydramnion 44%, oligohydramnion 13%). Chromosomal anomalies occurred in omphalocele with 35% incidence. The results obtained point to the necessity of conducting detailed and accurate sonographic examination if a foetal abdominal wall defect is discovered, in order to exclude or confirm further associated malformations.(ABSTRACT TRUNCATED AT 250 WORDS)
The present paper reports on results of ultrasonographic examination in the identification of severe congenital malformations in the period between 1975 and 1982. The incidence of severe congenital malformations in relation to the total number of births during this period was 159 out of 11,372 (1.4%). In 144 cases with severe malformations at least one antenatal ultrasonographic examination had been performed. According to their topographic location, 42% of these were head/neural tube defects, 38% trunk/organ defects, only 2% were severe defects of the extremities and 18% were rare fetal malformations. As a result of previous ultrasonographic examinations at specialists' practices 60% of the cases were referred to the authors' clinic for further clarification with a correct diagnosis or a suspected fetal malformation. Of all the sonographically demonstrable structural defects of the fetus, 81% of all severe fetal defects seen at the authors' clinic during the period in question were identified correctly. If the observation period is divided into the years 1975 to 1979 and 1980 to 1982, there is a striking rate of increase in the number of antenatal ultrasonographic diagnoses which were correct, from 71% in the first period to 86% between 1980 and 1982. Most of the false-negative ultrasonographic findings were congenital cardiac abnormalities, since up to that point no special fetal echocardiographic examinations had been performed. In the entire period covered by the investigation there was only one false-positive finding ("Potter's syndrome"). Forty-six per cent of the ultrasonographically demonstrated severe fetal malformations were diagnosed before the end of the 24th week of pregnancy, and 54% after the end of the 24th week of pregnancy. Only in 60 out of 141 cases (43%) with severe fetal malformations was the quantity of amniotic fluid found to be normal; 26% of the cases had hydramnios and 31% oligohydramnios. Pathologic movement behaviour had been registered ultrasonographically in 43% of the cases with severe fetal malformations; biometric dimensions of the biparietal cranial diameter and the transverse diameter of the thorax (greater than 10th percentile to 90th percentile, according to the percentile growth curves of Schmidt, 1982) corresponding to gestational age had only been measured in 30% and 50%, respectively, of the cases with fetal malformations. During the entire period covered by the investigation, from 1975 to 1982, only 16 children born at term (between the 38th and 42nd weeks) had severe malformations which had not already been diagnosed.(ABSTRACT TRUNCATED AT 400 WORDS)
In 74 patients with normal pregnancy, termination of pregnancy was induced during 1980-1983 for medical reasons (12%) or for eugenic reasons (88%) in the second trimenon of pregnancy. We compared endocervical PG-E2 gel application (if necessary, several doses of 0.5 mg PG-E2 gel every 4-6 hours in 25 cases) with intramuscular application of sulproston (500 micrograms sulproston IM every 4-6 hours in 26 cases) and the combined endocervical application of PG-E2 gel (single administration of 0.5 mg PG-E2 gel endocervically) plus systemic application of sulproston (500 micrograms sulproston IM every 4-6 hours) in 23 cases. The average gestational age in the groups under comparison was 21 to 22 weeks of pregnancy. In the group with combined application, in endocervical PG-E2 gel application and systemic sulproston application IM, complete or incomplete abortion was seen after regular application within 20 hours in 100% of the cases. With regular PG-E2 gel application endocervically we found complete or incomplete abortion in only 79% of the cases within 36 hours, and with the IM application of sulproston in 94% of the cases under observation within 36 hours. Combined application of PG-E2 endocervically and systemic application of sulproston led to a statistically significant saving of sulproston (average total dose = 0.9 mg) together with significant reduction of the abortion induction interval to 8 hours after the first IM sulproston dose. (For comparison: Abortion induction interval after endocervical PG-E2 gel application = average 24.6 hours, and after IM sulproston application = average 15.9 hours).(ABSTRACT TRUNCATED AT 250 WORDS)
The present paper reports on the value of gynecological-clinical examinations and preoperative ultrasonography in the diagnosis of benign and malignant ovarian tumors. Out of a group of 42 patients, in all of whom "ovarian cyst" had only been diagnosed clinically, 14% were not found to be suffering from this condition at surgery. In a comparison of preoperative gynecological-clinical and ultrasonographic findings (in 68 patients) it proved possible to determine the side on which the tumor was localized, its actual size, the extent to which it was delimited from the uterus, and its consistency (whether solid or cystic) significantly better by ultrasonography (p less than 0,01). However, the results of this study indicate that 2% of the cases diagnosed ultrasonographically as "benign ovarian tumor/ovarian cyst" are likely to be ovarian carcinomas. In the group of patients with malignant ovarian tumors also (42 patients), there was a significant difference in the preoperative diagnosis "suspected ovarian carcinoma". On the basis of clinical findings it was only diagnosed in 45%, while it was found in 74% by ultrasonography (p less than 0,01). In 3 cases with ovarian carcinoma there was no pathologic palpation finding, and in only one other case was a "suspected ovarian cyst" diagnosed. By means of ultrasonography, on the other hand, all of the cases of ovarian carcinoma were classified either as "ovarian carcinoma" or as "cystic-solid/complex abdominal tumor". The most frequent diagnoses on the basis of the sonographic scan (approx. 90%) were cystic-solid ovarian tumors, followed by cystic-ventriculated ovarian tumors with solid portions and finally solid ovarian tumors with only a few cystic portions.(ABSTRACT TRUNCATED AT 250 WORDS)
A bibliometric analysis of source items recently published in German-language gynaecology journals and one German-language journal covering a broader field of medicine yielded but one publication linked with prenatally diagnosed congenital malformations and their surgical treatment. Thus, journals usually assessed by the gynaecologist are in this respect at present not a useful source of information for the practitioner outside specialised centres. In order to explore the usefulness of Bildschirmtext (BTX, Videotex), a new electronic medium, as an alternative in counselling for congenital malformations and similar rare medical problems, an experimental database was constructed. Pages giving data on diagnostic pathways, incidence, prognosis, specialised treatment centres and suggested further reading on abdominal wall defects were compiled and are stored in a central computer of the German Federal Postal Services. Data are accessible via the regular telephone network and a specially equipped TV set. The method, although still experimental, is considered useful for offering medical intelligence to the medical professional outside specialised centres.
The opioid peptide beta-endorphin binds to specific nonopioid binding sites (Mr 72,000) that are present on the surface of thymoma cells. beta-Endorphin is then internalized, apparently via the Mr 72,000 species, and is subsequently found within intracellular, vesicular structures. This process is accompanied by the down-regulation of the Mr 72,000 binding sites. Our findings suggest that beta-endorphin may modulate cellular functions, such as T-lymphocyte proliferation, at intracellular rather than cell surface sites.
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In a consecutive series of 56 patients with acute myocardial infarction, ST segment depression and elevation in the electrocardiographic limb leads I, II, and III were summated for each patient before and immediately after intracoronary streptokinase infusion and the results compared with the angiographic findings. Forty three patients had angiographically confirmed reperfusion of an initially occluded vessel and showed a significant decrease in summated ST shift. The ST segment changes in the limb leads virtually returned to normal in all 43 patients, and in most, inverted T waves developed. Thrombolysis was unsuccessful in 10 patients, and the infarct related coronary artery was already patent in three. When these two groups are combined, all 13 patients without reperfusion showed no significant change in summated ST segment shift. During percutaneous transluminal angioplasty inflation of the balloon in the vessel that was previously occluded simulated reocclusion and was followed by new ST elevation if the artery supplied viable myocardium. In a further consecutive study of 54 patients with anterior myocardial infarction, the precordial R waves and Q waves were studied over the four to six months following infarction using a standardised 48 electrode mapping system. All patients underwent a repeat angiogram after four to six months. In 36 patients the infarct related vessel was patent. They showed a significant mean increase in summated precordial R wave amplitude and a reduction in the mean number of precordial leads without R waves. In 18 patients with unsuccessful thrombolysis or reocclusion there was a further reduction in mean summated R wave amplitude and an increased number of precordial leads not showing R waves. Precordial R wave mapping seems to be a valuable non-invasive method of assessing the salvage of myocardium after reperfusion and the damage caused by reocclusion. Loss of R waves in the acute phase of myocardial infarction does not necessarily mean an irreversibly damaged myocardium.
Normal values for fetal spleen dimensions are proposed, including longitudinal, coronal, and transverse diameters, the perimeter, and the estimated volume. Similar values were then obtained in cases of Rh-immunization and prolonged premature rupture of the membranes. A good correlation between amniotic fluid optical density and fetal spleen size was found. Only severely affected fetuses showed splenic values above the upper limit. Since sonographic examination can be regarded as a reliable method, nomograms can be useful in detecting growth disorders of the fetal spleen and thus provide a new complementary method to identify possible fetal diseases of genetic disorders.
Fetal clavicular length was measured sonographically in 85 fetuses with gestational ages ranging from 15 to 40 weeks. Biparietal diameter (BPD) and femur length (FL) were also measured. A linear correlation was found between clavicular length and gestational age (coefficient of correlation = 0.81). A simple relation was found: The gestational age in weeks is approximately equal to the length of the clavicle as expressed in millimeters. The measurement of clavicular length can be a useful parameter for the estimation of gestational age and in the detection of congenital anomalies that affect the clavicles. Clavicular measurements may also prove useful in the detection of macrosomic fetuses at high risk for obstructed labor or shoulder dystocia.
In 56 spontaneously hypertensive rats of the Muenster strain, either parabiosis or cross circulation was performed with normotensive Wistar Kyoto rats. Crossed circulation was made through the common carotid arteries and external jugular veins using a peristaltic pump. In parabiosis and in cross-circulation experiments, hypertension was transmitted from spontaneously hypertensive to normotensive rats. Nephrectomy or adrenalectomy in the spontaneously hypertensive rat before cross circulation abolished this effect. After volume depletion in the hypertensive animals, hypertension was not transmitted either. Furthermore, the effect of plasma fractions from essential hypertensives (n = 20) on blood pressure of normotensive rats was studied. Substances with molecular weights higher than 6000-8000 and lower than 500 were removed from 60-ml plasma by ultrafiltration and dialysis. After chromatography on a Bio-Gel P-4 or P-2 column, three to four fractions were formed according to the results of UV spectrophotometry and concentrated to 0.5 ml. One fraction from hypertensive plasma containing substances with molecular weights between 1000 and 2000 increased blood pressure in the rat by 16.3 +/- 8.2 mmHg within 10 minutes when injected intravenously. The respective fractions from normotensive rat plasma increased blood pressure by 3.6 +/- 2.1 mmHg (p less than 0.01). The results demonstrate a circulating hypertensive factor both in spontaneously hypertensive rats and in essential hypertensives, which may be crucial for the pathogenesis of essential hypertension.
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