[Non-puerperal granulomatous mastitis: sarcoidosis or nonspecific inflammatory reaction?].
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Adult↗
Biomedical subjects
A Bolte
Publications and source records attributed to A Bolte.
[On the value of "informational evening classes for mothers and fathers" within the scope of prenatal care].
In 1989, the Department of Gynaecology and Obstetrics, University of Cologne, questioned the 288 participants of the "informative evenings for mothers and fathers", a primarily preventive measure offered as a preparation for childbirth. The survey aimed at reviewing these evenings, i.e. to make a critical and exact evaluation of their usefulness and quality as one of the numerous events offered to expectant mothers. The following results were obtained: The women who visited the informative evenings were mostly pregnant for the first time, educated above average, for the most part working women and of German nationality. Their attitude towards preventive measures, i.e. regular check-ups during pregnancy as well as smoking behaviour, the wish to breast-feed and the attendance of other birth preparation courses, is well founded. Consequently, this group of women can be described as a highly selected. Their motivation to come to the evenings resulted mostly from the wish to obtain specific clinical information, to become familiar with the maternity ward, to meet midwives and doctors, in order to lose some of their fears and to increase confidence. Contents and structure of these evenings were mostly able to meet the expectations of the visitors. Unsatisfactory, however, was the low number of foreign woman, those with difficult pregnancies and women of a low social status i.e. patients, who above all, need intensive assistance and attention.
Adolescent↗
Natural lymphocyte cytotoxicity of women with different symptoms of toxemia.
Natural cytotoxic activity of lymphocytes from 113 pregnant women presenting one or more symptoms of the toxemic triad (E, P or H) was tested. According to the clinical symptoms, groups EH + H, EP + P and PH + EPH were formed. The control group consisted of 56 healthy pregnant patients. Significantly increased cytotoxicity was observed in toxemic pregnancies with proteinuria (group EP + P, 35.8 +/- 14.3%, P less than 0.001) and with proteinuria and hypertension (group PH + EPH, 27.2 +/- 13.3%, P less than 0.001%), but not in the group with hypertension (EH + H, 13.0 + 9.9%), compared to that of controls (11.0 + 11.5%). The relative number of patients with cytotoxicity greater than or equal to 40% was also higher in groups with proteinuria presenting with or without other symptoms of the disease. Increased cytotoxicity in proteinuric form of gestosis seemed to be independent of the incidence of low birthweight deliveries and intra-uterine growth retardation.
Adult↗
[Analysis of motivation of sterilized women requesting sterilization reversal].
Within the framework of this exploratory study, 37 sterilised women wishing to be refertilised, were questioned thoroughly on what had indicated their sterilisation and why they wish to be refertilised. Assuming the existence of an interactive behaviour pattern, we concentrated on the psycho-social circumstances accompanying the definitive decision to be sterilised. Here, a critical situation in the relationship between the partners at the time of sterilisation could be established as a prognostically unfavourable factor. Accordingly, 20 of the 37 patients developed the wish to be refertilized because of a new partnership. Those who felt induced by their gynaecologist or partner to undergo sterilisation had significantly more problems in overcoming the psychological stress accompanying such an operation than those who, after repeated consultations, had enough time and possibilities to make their own decision concerning contraception. Furthermore, sterilisation due to medical indication could be suggested as another highly critical factor, especially where the gynaecologist failed to give sufficient explanation of its medical necessity. With regard to the time set for the sterilisation, the study revealed that the patient's psychological condition after the operation was significantly worse, when sterilisation was carried out immediately after a delivery or an abortion. The fact that in such cases sterilisation is often followed by an increase in psychosomatic trouble and depressive states, of mind is also confirmed by literature. The results of the study are a practical contribution towards improving preoperative consultation and coordinating the course of action to be taken where a patient has the wish to be sterilised.
Adult↗
[Retrosternal lymph node metastases in breast cancer: lymphoscintigraphy and magnetic resonance tomography].
In 21 patients with breast cancer (pT1-4, N0, M0) internal mammary lymphoscintigraphy and magnetic resonance imaging (MRI) were performed to evaluate retrosternal lymph node metastases. In 6 patients normal findings of lymphoscintigraphy were confirmed by MRI. In the 15 patients with focal defects seen by lymphoscintigraphy no lymph nodes were found by MRI in 5 in the corresponding area, 5 showed normal-sized lymph nodes (less than 1 cm) and 5 enlarged lymph nodes indicating metastatic infiltration. In addition to internal mammary lymphoscintigraphy MRI may offer the possibility to improve TNM staging in patients with breast cancer.
Adult↗
Breast cancer imaging with radioiodinated oestradiol.
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Adult↗
Immunohistochemical detection of progesterone receptor in formalin-fixed and paraffin-embedded breast cancer tissue using a monoclonal antibody.
The potential for immunohistochemical detection of progesterone receptors (PRs) in routinely formalin-fixed and paraffin-embedded cancer tissues by use of the monoclonal antibody Mi 60-10 (mPR1, Dianova GmbH, Hamburg) was evaluated. The PR content of breast cancer tissue was investigated in 170 cases. A positive reaction to Mi 60-10 was found exclusively in the nuclei of benign or malignant epithelial cells. The distribution of PRs was heterogeneous. Immunohistochemical reaction was scored by multiplying the percentage of positive tumour cells by their prevalent degree of staining (Immunoreactive Score or IRS). The IRS values of formalin-fixed tissues (n = 170) were compared with those in snap frozen tissues (n = 82), with the PR content assayed by a DCC (dextran-coated charcoal) method (n = 170), with histopathological grading according to Bloom and Richardson and with the menopausal status of the patient. There was an acceptable ranked correlation (r = 0.74) between IRS in formalin-fixed and paraffin-embedded parts and snap frozen parts of the same carcinoma. A good correlation (r = 0.72) was also found, when the semiquantitative results of immunohistochemical PR detection in formalin-fixed and paraffin-embedded tissues were compared to PR concentrations measured by a DCC method in tumor cytosols. There was an 80% concordance between the two methods for qualitative discrimination of PR-negative and PR-positive carcinomas. IRS correlated significantly with the degree of histological differentiation of the tumors (P less than 0.001) but not with the menopausal status of the women (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Antibodies, Monoclonal↗
[Multifocal carcinoma of the upper female genital tract: diffuse Müllerian neoplasia].
The simultaneous occurrence of moderately differentiated mesonephroid adenocarcinomas of the endocervix and the ovary and a well differentiated adenocarcinoma of the endometrium in a 46-year-old woman are reported. The problems of classification as multiple primary neoplasma or as metastatic spread are discussed. Histogenesis of multiple primary epithelial malignancies of the female genital tract is explained by the theory of area response of embryologically related organs to an unknown carcinogenic stimulus.
Adenocarcinoma↗
[The status of prenatal lung ripening].
Morbidity and mortality of low-weight infants depend mainly on the respiratory-distress syndrome (RDS) and its complications, such as neonatal asphyxia and intraventricular haemorrhage. This underlines the importance of prenatal prevention of RDS. The results of the present multicentre studies demonstrate successful acceleration of fetal lung maturation by glucocorticoids and ambroxol. Both agents lower the RDS-rate two to threefold. The effectiveness in accelerating fetal lung maturation is comparable. In contrast to glucocorticoids, ambroxol seems to have no severe potential maternal or fetal side effects. We believe that prenatal prevention of RDS remains the treatment of choice even if neonatal surfactant therapy is expected to open up new aspects for the future.
Animals↗
[Alloimmune thrombocytopenia in the newborn infant caused by maternal PlA1 antibodies].
The case of pregnant woman, whose first child was born with neonatal alloimmune thrombocytopenia (NATP) and PlA2/PlA1 constellation, is used as an example to draw up a programme for the care of pregnant women whose children are expected to be born with NATP. In one of 2,000 to one of 3,000 cases, the PlA1-positive foetal platelets cause a sensitization of the PlA1-negative mother. Transplacental passage of maternal IgG alloantibodies leads to accelerated destruction of foetal platelets. The pathophysiologic process is similar to Rh-erythroblastosis foetalis. The infants show symptoms ranging from cutaneous manifestations to intracranial haemorrhages.
Adult↗
[Pregnancy-induced hypotonia. A prospective study of fetal development, labor and morbidity of newborn infants].
Maternal and foetal risk of hypotension in pregnancy were examined in a prospective study, comprising a total of 770 pregnant women i.e. 700 normotensives and 70 hypotensives. We conducted a minimum of 5 pressure controls beginning after the 20th week of gestation. All pressure controls were conducted by the same person and in each control 4 pressure values were taken (left and right arm, lying, standing). No difference was discovered in the statistical analysis of our data of pregnancy, delivery and foetal outcome. Our special interest was in the frequency of preterm delivery and foetal growth retardation. The rate was similar in the hypotensive group (6.7/3.1%) compared to the normotensive group (6.8/2.8%). From our results we conclude, that maternal hypotension is not a risk factor in pregnancy, and that no therapy is needed.
Acidosis↗
Detection of squamous cell carcinoma antigen in normal squamous epithelia and in squamous cell carcinomas of the uterine cervix.
Squamous cell carcinoma (SCC) antigen is a subfraction of tumor antigen TA-4 isolated from a cervical squamous cell carcinoma. The specificity of SCC antigen and the factors influencing its release into serum were evaluated. Antigen concentrations were measured in 157 tissue extracts and in 188 sera of patients with nonmalignant or malignant gynecologic diseases. A commercial radioimmunoassay based on polyclonal antibodies (Abbott Laboratories, North Chicago) was used. Cytosol concentrations were significantly higher (P less than 0.005) in normal squamous epithelia (means = 6040 ng/mg cell protein [CP]) and in squamous cell carcinomas (means = 2483 ng/mg CP) of the exocervix than those in normal columnar epithelia and in adenocarcinomas of the endocervix, endometrium, ovary, and breast (means = 1-508 ng/mg CP). Despite the high antigen concentrations in normal squamous epithelia, elevated serum levels (greater than 2.5 ng/ml) were almost exclusively found in patients with cervical squamous cell carcinomas. The sensitivity of SCC antigen as a marker for primary carcinomas was 61%, increasing from 29% in Stage I to 89% in Stage IV. The positivity rate was higher in women with well-differentiated (78%) and moderately differentiated carcinomas (67%) than in those with poorly differentiated tumors (38%). The results show that SCC antigen is not tumor specific. The release into serum is independent of local tissue content, but is apparently influenced by the infiltrative growth, the mass, and the degree of histologic differentiation of the tumor.
Adenocarcinoma↗
CA 125 in normal tissues and carcinomas of the uterine cervix, endometrium and fallopian tube. I. Immunohistochemical detection.
The distribution of cancer antigen 125 (CA 125) has been investigated in normal tissues and carcinomas of the Müllerian duct by immunohistochemical methods using the monoclonal antibody OC 125. Detection of CA 125 was most intense in cryostat sections and decreased in formalin fixed and paraffin embedded tissues according to the duration of fixation. Enzymatic digestion with neuraminidase or alkaline hydrolysis abolished specific staining suggesting the antigen is a sialylsaccharide bound to protein by alkali-labile linkage. Immunohistochemical staining demonstrated the presence of CA 125 in all normal glandular epithelia of the endocervix, endometrium and fallopian tube in different distribution patterns. In normal endometrium the cellular distribution pattern was related to the menstrual cycle. In endocervical, endometrial and tubal adenocarcinomas CA 125 was found in 73% of cases. In glandular structures the antigen was concentrated at the luminal surface of the tumour cells, in solid tumour areas it was spread throughout the cytoplasm or concentrated in large cytoplasmic vacuoles. The expression of CA 125 was considerably lower in solid tumour areas. These data show that CA 125 is not a true "tumour marker", but a product of female genital mucosae and of their cancerous derivates provided their synthesizing ability is not lost in the course of pathologic differentiation.
Antigens, Tumor-Associated, Carbohydrate↗
[Electronic data processing of the patient record for computer-assisted evaluation of pregnancy and labor].
This article describes an EDP-adequate data collection system which can also be used in the conventional way. The relational data base system used is PROFESSIONAL ORACLE, Revision 5.1.; the requisite hardware consists of 3 IBM-AT-compatible personal computers with a main storage comprising 4 MB, system MS/PC-DOS, and a hard disk of at least 20 MB. The standardized case history compiles the user to collect the data carefully and completely. Besides formulating research problems the system automatically prepares the discharge report. By means of statistical analysis a continuous internal quality assessment was realized.
Electronic Data Processing↗
Severe intra-uterine growth retardation: obstetrical management and follow up studies in children born between 1970 and 1985.
Peri- and postnatal data of 263 children with severe intra-uterine growth retardation (IUGR) born between 1970-75 (n = 145) and between 1976-85 (n = 118) are presented. The incidence of premature delivery in IUGR patients rose from 15% (1970-75) to 34% (1976-85). The rate of perinatal asphyxia in premature children with IUGR decreased from 64% during 1970-75 to 45% during 1976-85. Perinatal mortality in preterm SFD babies was higher in 1976-85 (20%) than in 1970-75 (14%), due to an 8-fold higher incidence of very low birth weight (less than or equal to 1000 g) SFD babies. Without this high-risk group perinatal mortality ranged between 2 and 3% in both groups. The incidence of deliveries by Cesarean section increased from 19 to 45% while vaginal deliveries decreased from 73 to 52% during 1976-85 compared with the 1970-75 age group. Follow up studies were carried out in 63 patients (1970-75) and in 41 patients (1976-85). Deficits of body height and weight persisted in one third of the patients, being severe in 10-20%. Infantile developmental milestones were retarded in 22-32%. Neurologic sequelae mostly of a mild degree were seen in 29% (1970-75) and 37% (1976-85). Psychologic testing showed abnormalities in 38% of the older age group, using the Göttinger Formreproduktionstest and in 21% of the younger age group, where the Denver Developmental Screening Test was performed. EEG investigations demonstrated unspecific abnormalities of a mild to moderate degree in one third of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Body Height↗
[Clinical relevance and pathognomonic significance of Actinomycetes colonization of intra-uterine devices].
Microbiological investigations were carried out on 524 intrauterine pessaries (IUP) from 488 patients. All patients underwent a gynecological examination on the occasion of IUP extraction. An actinomycete colonization of the extracted IUPs could be detected by culture in 8% of the cases. Actinomyces israelii was cultured most frequently. The raised detection of anaerobic bacteria in the endocervix of patients with actinomycin detection constitutes a potential danger for these women with regard to the development of genital actinomycosis. In addition, the clinical parameters document a higher susceptibility of these patients to ascending genital infections. The infectious morbidity is significantly raised.
Actinomyces↗
Immunohistochemical study of distribution of estrogen receptors in corpus and cervix uteri.
An immunohistochemical assay based on monoclonal antiestrophilin antibodies has been used to localize estrogen receptor (ER) in frozen sections of normal human endometrial, myometrial and cervical tissues from menstruating, hormonally treated, pregnant and postmenopausal women. Specific staining was confined to the cellular nuclei. In proliferative phase endometrium, postmenopausal emdometrium, and endometrium from patients treated with hormone ERs were easily detected in most glandular and stromal cells. After ovulation and in early pregnancy a quick and distinct decrease of ER expression was noted. This was especially the case with the more superficial layers of endometrium (endometrium functionalis), the majority of whose cells had either weak localization of ER or none at all. In the endometrium basalis, however, the reduction of ER localization turned out to be more moderate. More then half of the epithelial and stromal cells displayed nuclear staining, partly strong. The myometrium of the corpus uteri showed a similar ER localization and dependence on hormonal stage when compared with the endometrium functionalis. The endocervical mucosa displayed a high degree of ER expression in the proliferative phase, in postmenopausal women and in women who had been treated with hormones. Unlike the endometrium and myometrium, the endocervical glands underwent minimal changes in nuclear ER content during the menstrual cycle. Although the endocervical stroma showed cyclic alterations in ER levels, their reduction after ovulation was less marked than in the corresponding endometria. In cervical squamous epithelium ER localization was predominantly confined to the basal layers. In the course of cellular maturation, specific nuclear staining vanished. In the proliferative phase, after the menopause and in early pregnancy, the basal, parabasal and intermediate cells were specifically stained. In the postovulatory phase, However, nuclear staining was confined to the basal and parabasal cells. Hormonally treated squamous epithelia almost completely lacked nuclear ER localization.
Antibodies, Monoclonal↗
[Clinical aspects and prognosis of granulosa cell tumors of the ovary].
Symptoms, tumour morphology and clinical course were reviewed in 26 women treated at the department of obstetrics and gynaecology of the University of Cologne between 1965 and 1986 for granulosa cell tumours of the ovary. At the time of diagnosis 8 women were in a pre- and 18 in a postmenopausal state. The most common symptoms were irregular haemorrhages, in rare cases lower abdominal pain. Effects of raised estrogen stimulation were seen in 80% of patients. In 24 pre-operative patients, a lower abdominal tumour was diagnosed. 20 patients had lesions of stage I, 5 of stage III and one of stage IV. 21 tumours exceeded 5 cm median diameter. Polymorphic tumours were seen in 16 cases. 14 tumours had a high mitotic activity. Hysterectomy and bilateral salpingoovariectomy were performed in most cases, followed by additional irradiation in 9 and by chemotherapy in 4 cases. Only 3 patients were treated by unilateral salpingoovariectomy. To date 14 patients have no evidence of disease, one suffers from tumour progression and 9 died of the tumours. 2 women died for other reasons. The 5-year survival rate is 70%, the 10-year survival rate 64%. Old age, late progression of tumour stage, tumour diameter exceeding 5 cm, polymorphic tumours and high mitotic index correlated to the worsening prognosis. However, a poor result was also seen in monomorphic tumours with low mitotic activity. The nature of granulosa cell tumours can not be predicted by clinical or morphological criteria. Therefore it is suggested, that all granulosa cell tumours should be considered as malignant.
Adolescent↗