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W Schmidt

Publications and source records attributed to W Schmidt.

At least 163 records · Page 9Linked to original sources

[Histologic-histochemical and immunocytochemical investigations of cartilage canals in human rib cartilage].

In contrast to articular cartilage the hyaline rib cartilage takes up a special position due to its size, shape and the kind of mechanical stress as well. These facts may influence the metabolism of rib cartilage. In our histological, histochemical and immunohistochemical investigations on pieces of rib cartilages of 34 persons at the age of fourth fetal month up to 60 years we could regularly demonstrate cartilage canals containing blood vessels without any spatial or temporal relationship to degenerative changes in cartilage tissue. Many of these cartilage canals are located in the center of the rib cartilage. Blood vessels as well as neuronal structures in the connective tissue of cartilage canals were detected by means of antibodies against components of the vessel wall (Von Willebrand factor) and nerve fibers (PGP 9.5). Nerves may have sensoric or vasomotoric functions as well, and they may influence cell differentiation and regeneration processes, respectively. Cartilage can not be regarded as vascularized like other tissues, but cartilage canals may have great functional importance for the metabolism of rib cartilage.

Adolescent↗

Expression of transglutaminase K in normal cervix tissue and cervix carcinomas.

The localization and expression of transglutaminase K has been investigated immunohistochemically in normal cervix tissue (n = 15) and in cervix carcinomas (n = 23). The distribution of the transglutaminase K was compared with the staining patterns of cytokeratin 10, Ki-67, p53, and oestrogen and progesterone receptors in these tumours. Weak to strong membrane-bound immunoreactivity for transglutaminase K was detected in almost all cervix carcinomas analyzed. The immunostaining was heterogeneous, with visual differences between individual tumour cells. 66.7% of normal cervix tissues revealed no immunoreactivity for the transglutaminase K. In normal cervix tissue, the immunoreactivity was confined to upper cervix layers, predominantly to the superficial and intermediate cell layers. The intensity of both the immunostaining and the number of transglutaminase K-positive cells were upregulated in cervix carcinomas as compared to normal cervix tissue. When the coexpressions of transglutaminase K with markers of proliferation and differentiation were analyzed, no statistically significant correlation was found. Our findings indicate that (1) transglutaminase K is upregulated at the protein level in cervix carcinomas as compared to normal cervix tissue; (2) upregulation of the transglutaminase K in cervix carcinoma is not exclusively induced by alterations of epithelial differentiation or proliferation, but by different, unknown mechanisms; and (3) upregulation of transglutaminase K in cervix carcinomas may play an important role for the regulation of tumour invasive properties by modulating cell-cell interactions.

Biomarkers↗

Immunohistochemical analysis of DNA 'mismatch-repair' enzyme human Mut-S-Homologon-2 in ovarian carcinomas.

The human Mut-S-Homologon-2 (hMSH-2) gene product is a member of a highly conserved family of proteins involved in postreplication mismatch repair. We have analysed hMSH-2 expression in normal ovarian tissue (n = 15) and ovarian carcinomas (n = 40). hMSH-2 protein was investigated immunohistochemically on frozen sections using a highly sensitive streptavidin-peroxidase technique and a specific mouse monoclonal antibody (clone FE11). A hMSH-2-immunoreactivity score (hMSH-2-IRS) for semiquantitative analysis of hMSH-2 expression is presented. In normal ovarian tissue, we only found weak nuclear immunoreactivity for hMSH-2 in 60%, while the remaining 40% were hMSH-2 negative (mean hMSH-2-IRS: 0.73; SD: +/-0.70). All ovarian carcinomas analysed revealed moderate to strong nuclear immunoreactivity (mean hMSH-2-IRS: 8.05; SD: +/-3.65). hMSH-2 staining was heterogeneous, with visual differences between individual tumour cells. Expression of hMSH-2 protein was consistently and strongly upregulated in tumour cells of ovarian carcinomas as compared to normal ovarian tissue. No statistically significant correlation in comparing the labelling patterns for hMSH-2 with the labelling patterns for Ki-67 (mean percentage of Ki-67 positive tumour cells: 25.88%; SD: +/-18.43) was observed in ovarian carcinomas. Furthermore, no statistical significant correlations between hMSH-2-IRS and histological grading (p = 0.47), histological type of carcinoma (p = 0.706) or FIGO-classification (p = 0.054) were found. Our findings indicate that (a) hMSH-2 is expressed in normal human ovarian tissue, (b) expression of hMSH-2 is increased in ovarian carcinomas, (c) expression of hMSH-2 may be of importance for the genetic stability of ovarian carcinomas in vivo, (d) hMSH-2 mutations may not cause microsatellite instability in ovarian carcinomas, (e) hMSH-2 may contribute to mechanisms responsible for resistance to anticancer drugs.

Adenocarcinoma↗

Effect of freeze-thawing procedure on chromatin stability, morphological alteration and membrane integrity of human spermatozoa in fertile and subfertile men.

Cryopreservation is known to impair sperm motility and decrease the fertilization rate by detrimental effects on acrosomal structure and acrosin activity. However, the consequences of cryopreservation on the integrity of the sperm nucleus, chromatin stability and centrosome are less clear. The present study was designed to determine the effect of the freeze-thawing procedure on chromatin condensation (aniline blue staining) and the morphology (strict criteria) and membrane integrity of human spermatozoa. The structural and functional characteristics of the sperm plasma membrane were measured by the eosin-test and hypo-osmotic swelling test which were done separately. Sperm cryopreservation was performed on semen samples from two groups of men classified as fertile (n = 20) and subfertile (n = 72), based on their reproductive history and semen analysis according to WHO guidelines. The mean percentage of condensed chromatin, morphologically normal spermatozoa and membrane integrity in all semen samples investigated (n = 92) decreased significantly (p = 0.0001) after freeze-thawing, in comparison to the value observed prior to freezing. By comparing the semen samples between fertile and subfertile patients, significantly (p = 0.0009) greater damage was demonstrated in the subfertile than in the fertile group. Furthermore, no significant difference was observed between the two groups with regard to the morphological alteration and structural as well as functional damage of the sperm membrane. In conclusion, the freeze-thawing procedure significantly affects chromatin structure and sperm morphology, especially in the head and the tail regions, and this may explain the lower fertilization rate and IVF/ICSI outcome when frozen-thawed spermatozoa are used. In addition, this study demonstrates that chromatin condensation is a sensitive parameter for the evaluation of cryodamage of semen samples from fertile and subfertile patients, though subfertile patients with very poor semen characteristics have yet to be studied. It is therefore recommended that chromatin condensation be used as an additional parameter for the assessment of sperm quality after freeze-thawing.

Cell Membrane↗

Mast cell activation in children with migraine before and after training in self-regulation.

Migraine may affect as many as 9% of all schoolchildren and often presents with abdominal symptoms of pain, nausea, and vomiting. Even though the pathophysiology of migraine remains unknown, self-regulation techniques appear to be more effective in prevention of childhood migraine than conventional pharmacotherapy which is often associated with adverse effects. Mast cells have been implicated in the pathogenesis of migraine in adults, but have not been previously studied in children with migraine. Mast cells are found close to the vessels and nerves in the meninges where they can release multiple vasoactive, neurosensitizing, and pro-inflammatory mediators. Therefore, we investigated whether children with migraine may have increased urinary levels of mast cell mediators and whether practicing relaxation imagery exercises has an effect on the frequency of headache, as well as on mast cell activation. Urine was collected for 24 hours from children with and without migraine after a 5-day amine-restricted diet. Children with migraine also collected urine during migraine episodes. The mean levels of urinary histamine, its main metabolite, methylhistamine, and the mast cell enzyme, tryptase, were higher in children than generally found in adults, but they did not differ statistically in any of the categories studied. However, in 8 of 10 children who practiced relaxation imagery techniques and successfully reduced the number of migraines, the urine tryptase levels were also significantly lower. There was no relationship between successful practice and sex or age of the child. These results suggest that stress may activate mast cells which could be involved in the pathophysiology of migraine.

Child↗

Comparison between chromatin condensation and morphology from testis biopsy extracted and ejaculated spermatozoa and their relationship to ICSI outcome.

A significant association between male subfertility, imperfect spermiation and abnormal nuclear condensation has been suggested. The DNA content of spermatozoa might be responsible for inducing alterations in sperm morphology. The final nuclear shape, which is species-specific, depends on chromatin condensation during spermatogenesis as well as a precise organization of DNA within the nucleus. Many reports have described the association between disturbances in sperm chromatin condensation, morphology and male infertility. Chromatin condensation is achieved by gradual substitution of lysinerich somatic histones by testis-specific histone and finally by protamine. In this study two groups of patients were compared: the first consisted of 63 patients who had undergone intracytoplasmic sperm injection (ICSI) with freshly ejaculated spermatozoa whereas the second included 47 patients assigned to ICSI with testes biopsy-extracted spermatozoa. In both groups chromatin condensation was assessed by aniline blue staining and morphology evaluated according to strict criteria. The condensed chromatin and morphology of spermatozoa were significantly (P < 0.0001) less in the second group compared to the first. However the fertilization, cleavage, implantation and pregnancy rates were almost the same in both investigated groups. There was no significant difference between the two groups with respect to ICSI outcome. The percentage of chromatin condensation (nuclear maturity) and morphologically-normal spermatozoa were significantly higher (P < 0.0001) in the ejaculated spermatozoa than in those from testis biopsy but the ICSI outcome (fertilization, cleavage, implantation and pregnancy rates) was the same. In view of these results the fertilization capability and the embryo quality obtained using testis biopsy extracted spermatozoa is not influenced by chromatin condensation and sperm morphology in testicular sperm extraction (TESE)-ICSI programmes. Therefore, it could be said that neither chromatin condensation nor morphology of testis extracted sperm could predict the fertilization, implantation and pregnancy rate in TESE-ICSI programmes.

Adult↗

Plasma-electrolytes in natives to hypoxia after marathon races at different altitudes.

PURPOSE: It is well known that altitude natives differ from sea level natives in aspects of fluid and electrolyte homeostasis. METHODS: To evaluate exercise and environmental influences on the electrolyte and water status in hypoxia adapted subjects, we investigated 11 well-trained marathon runners (33.7 +/- 0.7 yr, 60.5 +/- 1.9 kg), native to an altitude above 2600 m, before and after two marathon races. One competition was held at moderate altitude (AM, 2650 m, 14 degrees C, 55% RH, running time 3 h 6 min +/- 22 min) and another under tropical conditions (HM, 470 m, 28 degrees C, 70% RH, running time 2 h 54 min +/- 30 min). Blood samples were taken 3 d before, immediately after, 1 h after, and 24 h after the races. RESULTS: The loss in body fluid was calculated to be 2.15 L during AM and 5.05 L during HM, respectively. It was compensated mostly by ingested fluids without electrolyte content and by metabolically produced water, which led to hyponatremia during AM (plasma [Na+] from 144.3 +/- 0.7 to 131.7 +/- 2.1 mmol x L(-1)). Severe dehydration without significant changes in plasma [Na+] could be detected after HM. Serum antidiuretic hormone concentrations and serum aldosterone concentrations significantly increased during both races and remained at a high level for at least 1h after both competitions. Serum atrial natriuretic peptide (ANP) concentrations were at a high level at rest, increasing during HM, and decreasing during AM. CONCLUSION: Under tropical conditions, we found a severe state of dehydration characterized by an extended ANP-response, which was not prevented by water intake during the race. Under hypoxic conditions, however, we found that hyponatremia had developed. This can be partly explained by pure water intake and metabolically produced water, and also, possibly, by a special hypoxia-induced effect.

Adult↗

On the role of gastrin-releasing peptide in meal-stimulated exocrine pancreatic secretion.

The contribution of gastrin-releasing peptide (GRP) in the physiologic pancreatic response to a meal is unknown. We therefore investigated whether immunoneutralization of GRP could influence the exocrine pancreatic response to a meal as well as plasma concentrations of the peptide hormones neurotensin (NT) and cholecystokinin (CCK). Modified Herrera fistulas were implanted in five mongrel dogs. After a standard meal, we analyzed plasma NT, CCK, and GRP, and protein and enzyme (amylase, lipase, trypsin) content of exocrine pancreatic juice. An unspecific rabbit immunoglobulin solution was administered intravenously as a control. This experiment was repeated with a specific anti-GRP-immunoglobulin. The i.v. administration of the anti-GRP-antibody significantly inhibited meal-stimulated pancreatic secretion. Integrated protein output decreased from 58.4 to 36.8 g/180 min (p < 0.05), as did amylase (2,102 to 1,145 KU/180 min; p < 0.05), lipase (2,258 to 1,172 KU/180 min; p < 0.05), and trypsin (5,321 to 4,990 U/180 min). Postprandially released NT decreased from 8,271 to 5,825 pmol/180 min (p < 0.05). In contrast, integrated amounts of CCK remained relatively stable with 473 to 611 pmol/180 min. The neuropeptide GRP is one of the biologically important regulatory factors influencing meal-stimulated pancreatic secretion, as well as the postprandial plasma level of the peptide hormone NT in the dog. These mentioned effects of postprandially released GRP seem not to be mediated by CCK in an endocrine manner.

Amylases↗

Malignancies of the uterine corpus and immunoreactivity score of the DNA "mismatch-repair" enzyme human Mut-S-homologon-2.

We analyzed human Mut-S-Homologon-2 expression in normal endometrial tissue (n = 15) and malignancies of the uterine corpus (n = 40). Human Mut-S-Homologon-2 protein was investigated immunohistochemically on frozen sections, using a highly sensitive streptavidin-peroxidase technique and a specific mouse monoclonal antibody (clone FE11). Human Mut-S-Homologon-2 labeling pattern was compared with the staining pattern of the proliferation marker Ki-67 in the same tumors. A human Mut-S-Homologon-2 immunoreactivity score (human Mut-S-Homologon-2-IRS: negative 0-1; weak 2-3; moderate 4-6; strong 8-12) for semiquantitative analysis of human Mut-S-Homologon-2 expression is presented. In normal endometrial tissue samples we found weak nuclear immunoreactivity for human Mut-S-Homologon-2 in 67%, whereas the remaining 33% were negative for human Mut-S-Homologon-2 (mean human Mut-S-Homologon-2-IRS 1.25 +/- 1.29). All malignancies of the uterine corpus analyzed revealed moderate to strong nuclear immunoreactivity (mean human Mut-S-Homologon-2-IRS 9.00, +/- 3.16). Human Mut-S-Homologon-2 staining was heterogeneous, with visual differences among individual tumor cells. Expression of human Mut-S-Homologon-2 protein was consistently and strongly upregulated in tumor cells of malignancies of the uterine corpus compared with normal endometrial tissue (human Mut-S-Homologon-2-PP p<0.001; human Mut-S-Homologon-2-IS p<0.001; human Mut-S-Homologon-2-IRS p<0.001). No statistically significant correlation in comparing the labeling patterns for human Mut-S-Homologon-2 with the labeling patterns for Ki-67 (mean percentage of Ki-67-positive tumor cells 22.00% +/- 17.20) was observed in malignancies of the uterine corpus (human Mut-S-Homologon-2-PP p=0.443; human Mut-S-Homologon-2-IS p=0.234; human Mut-S-Homologon-2-IRS p=0.173). Our findings indicate that human Mut-S-Homologon-2 is expressed in normal human endometrial tissue and that expression of human Mut-S-Homologon-2 may be of importance for the genetic stability of malignancies of the uterine corpus in vivo. (J Histochem Cytochem 47:113-118, 1999).

Base Pair Mismatch↗

Maternal and neonatal outcome of twin pregnancies complicated by single fetal death.

OBJECTIVE: To study the maternal and neonatal outcome of twin pregnancies complicated by the intrauterine death of one fetus after 20 weeks of gestation. DESIGN: Retrospective, observational study of 7 twin pregnancies out of 185 twin pregnancies with the diagnosis of a single intrauterine death over a 5-years period in a university hospital. RESULTS: The incidence of single fetal death in twin gestation after 20 weeks was 3.8% in the study population with a high incidence of intrauterine growth retardation (IUGR) of the remaining fetus and preeclampsia in the further course of pregnancy. The incidence of preterm delivery was 71% with a mean gestational age of 33.0 +/- 1.0 weeks. The median interval from diagnosis of single fetal death to delivery was 10.2 +/- 4.1 days (range 1-28 days). 5 of 7 (71%) cases were delivered by cesarean section for standard obstetrical reasons. Neither perinatal nor neonatal death of the remaining twin were observed. Two cases of neurologic injury were diagnosed after delivery by ultrasound and MRI. No maternal coagulopathy related to single fetal death occurred. CONCLUSION: Expectant management of single fetal death in twin pregnancies might be advisible under close surveillance of both, mother and the surviving fetus.

Adult↗

Nucleated red blood cells in cord blood of singleton term and post-term neonates.

OBJECTIVE: This study aims to determine if nucleated red blood cells are elevated in pregnancies that continue beyond 289 days of gestation. STUDY DESIGN: Cord blood was prospectively collected from term and post-term singleton gestations from August 1 to December 31, 1998. Umbilical artery nucleated red blood cells were counted per 100 white blood cells. The comparison was made between pregnancies ending at 261-289 days (37.1-41.2 weeks) of gestation and those ending after 289 days (> or = 41.3 weeks) of gestation. RESULTS: Cord blood from 304 cases was obtained and evaluated for nucleated red blood cells per 100 white blood cells. The mean value of nucleated red blood cells per 100 white blood cells in the post-term neonate group was significantly higher than in the term neonate group (median 6.5, range 0-24 vs. median 3.7, range 0-14; p < 0.05). The values did not vary by fetal presentation, mode or duration of delivery. Neonatal outcome was comparable between both study groups. CONCLUSION: In post-term gestation after 289 days nucleated red blood cells in cord blood are significantly increased. These results point towards a different fetal oxygenation in post-term pregnancies beyond 289 days of gestation and support the current practice of very close testing of fetal well-being under those circumstances.

Apgar Score↗

The effect of the Müller-Lyer illusion on map reading.

One important reason for studying visual illusions is that they can influence real-world perception as people interact with human-made displays. Three experiments examined how the Müller-Lyer illusion affects distance judgments and decision-making in the complex graphical context of a map by having subjects estimate the lengths of road segment lines framed by inward-going or outward-going wings in actual maps, in control displays that had the map context removed, and in simulated maps. The experiments showed that (1) outward-going wings led to higher distance estimates than did inward-going wings to the same extent both with and without the map context, (2) decisions based on distances determined from maps were affected by Müller-Lyer elements in the maps, and (3) map readers' measurement behavior influenced the effect of the Müller-Lyer elements in maps. The discussion focuses on how certain display manipulations and task manipulations affect the Müller-Lyer illusion. In addition, the discussion addresses the instances in which using a map might be affected by misestimation due to Müller-Lyer elements.

Adult↗

C1-esterase inhibitor and its effects on endotoxin-induced leukocyte adherence and plasma extravasation in postcapillary venules.

BACKGROUND: C1-esterase inhibitor (C1-INH) has been shown to have beneficial effects in patients with sepsis. However, the microcirculatory effects of C1-INH during sepsis are unknown. This study investigated the influence of C1-INH on leukocyte-endothelial cell adhesion, vascular leakage, and venular microhemodynamics in postcapillary venules of rat mesentery during endotoxemia. METHODS: Thirty-two anesthetized Wistar rats randomly received 1 of 4 treatments: pretreatment with infusion of C1-INH in a concentration of 7.5 U.kg-1 body weight (C1-INH-7.5 group, n = 8) or in a concentration of 15 U.kg-1 body weight (C1-INH-15 group, n = 8) followed by continuous infusion of Escherichia coli lipopolysaccharide (LPS). The LPS group (n = 8) was pretreated with saline solution 30 minutes before LPS infusion. The control group (n = 8) received equivalent amounts of saline infusion. Leukocyte adherence, red blood cell velocity, and vessel diameters in postcapillary venules of rat mesentery were determined every 60 minutes during a period of 120 minutes using in vivo videomicroscopy. Vascular permeability was determined by measuring the extravasation of fluorescence-labeled albumin. Venular wall shear rate was calculated from mean red blood cell velocity and vessel diameter. RESULTS: LPS infusion induced a decrease in venular wall shear rate and an increase in leukocyte adherence and vascular permeability in postcapillary venules of rat mesentery. All microcirculatory disturbances were attenuated by pretreatment with C1-INH, showing no significant difference between the 2 concentrations. CONCLUSIONS: Pretreatment with C1-INH attenuates endotoxin-induced leukocyte adherence and macromolecular leakage in postcapillary venules of rat mesentery, indicating that complement inhibition might be a therapeutic tool in the treatment of sepsis.

Animals↗

[Placenta morphology and Doppler ultrasound of umbilical cord vessels in premature infants].

OBJECTIVE: There is a raised morbidity and mortality in fetuses with pathological waveforms in the umbilical arteries. Less differentiation of the placental villi could (partly) explain this finding. MATERIALS AND METHODS: We examined a total of 51 placentas (28th to 35th week of gestation) as to a correlation between dopplersonographical findings in the umbilical arteries and placenta morphometry. RESULTS: In the groups with pathological waveforms there was not only a reduction in the weight of the placenta and child, but also less differentiation of the placental villi. The occurrence of so-called sprouts did not correlate with the dopplersonographical findings. CONCLUSIONS: The raised fetal morbidity and mortality in premature infants with pathological waveforms in the umbilical arteries can at least partly be explained less differentiation of the placental villi. We found no correlation with the occurrence of sprouts.

Adult↗

Immunohistochemical detection of apoptosis in the human term and post-term placenta.

PURPOSE: To study the incidence of apoptosis in human term and post-term placenta and to determine its presence in different areas of placentas of uncomplicated pregnancies. METHODS: A total of 15 placentas, 8 obtained from spontaneous deliveries and elective caesarean sections at term (37-41 weeks of pregnancy) and 7 from spontaneous deliveries and elective caesarean sections post-term (> 41 weeks of pregnancy) were included in this study. Apoptosis was identified by the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end-labeling method (TUNEL, Boehringer, Mannheim, Germany) in paraffin-embedded sections. RESULTS: Apoptosis was predominantly detected in trophoblast and stromal tissue. There were no significant differences in the incidence of apoptosis in different parts of placental tissue. A significant increase of apoptosis was seen in both trophoblast and stromal cells of post-term placentas (p < 0.05; p < 0.005). CONCLUSIONS: Apoptosis could be detected in the human term and post-term placenta, with increasing incidence in post-term placental tissue, suggesting a possible role of apoptosis in the mechanism of parturition and placental senescence.

Adult↗

Pain-relief and movement improvement by acupuncture after ablation and axillary lymphadenectomy in patients with mammary cancer.

INTRODUCTION: In the traditional Chinese medicine (TCM), pain and movement restrictions are considered as the result of a blocking of the "Jing-Luo-system" or of a disordered flow of the Jing-Qis in the "Jing-Luo-system". PATIENTS AND METHODOLOGY: In this study 48 patients with mammary cancer after ablation and axillary lymphadenectomy were treated with acupuncture (group I); a control group of 32 patients with the same operation but without acupuncture was compared (group II). RESULTS: The results showed a significantly higher maximum abduction angle (AA) at the first treatment immediately after acupuncture without pain (59.1 degrees vs. 80.4 degrees, p < 0.001) with respect to maximum tolerable pain barrier (73.6 degrees vs. 92.3 degrees, p < 0.001). Between group I (12.3%) and group II (50%) there was a statistically significant difference (p < 0.01) in the appearance of pain in the operation field in the rest position on the 5th postoperative day, while on the 7th postoperative day 8.3% vs. 12.5%) and at the time of discharge a significant difference could not be seen (p > 0.05). The percentage of patients with pain during arm movements showed a statistically significant difference between group I and group II on the 5th postoperative day (81% vs. 100%, p < 0.01), on the 7th postoperative day (43% vs. 96.9%, p < 0.01) and at time of discharge (27.1% vs. 65.6%, p < 0.001). The differences in the abduction angle between group I and group II were also statistically significant on the 5th postoperative day at indolency (89.3 degrees vs. 74.5 degrees, p < 0.001) with respect to maximum tolerable pain (105.8 degrees vs. 87.4 degrees, p < 0.001). The differences in the abduction angle on the 7th postoperative day at indolency (97.5 degrees vs. 81.2 degrees, p < 0.001) and at maximum tolerable pain (118.5 degrees vs. 93.4 degrees, p < 0.001) were statistically significant. This statistically significant difference in the maximum abduction angle between group I and group II at indolency (116.1 degrees vs. 91.5 degrees) with respect to maximum tolerable pain (129.4 degrees vs. 112.7 degrees, p < 0.001) could be observed until discharge. DISCUSSION: Acupuncture seems to be an effective treatment to relieve pain and improve arm-movements after ablation and axillary lymphadenectomy. The "Xie-technique" is used at the main acupuncture points and the patient's feeling must be particularly considered. The combination of the different main points with the correctly selected additional acupuncture points--referred to the basic state and the pre- und post-operative state of the patient--are very important for a successful application of acupuncture.

Acupuncture Analgesia↗