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Biomedical subjects

A Göppinger

Publications and source records attributed to A Göppinger.

13 recordsLinked to original sources

[Does color Doppler complement breast examination?].

Improvements in breast cancer detection are underway with work being done on different imaging techniques and the assessment of abnormal vascularity. In an earlier study we used a 10 MHz CW Doppler pencil probe. In palpable carcinomas 94% had shown abnormal vascularity. However, in nonpalpable lesions, this method did not allow flow detection in combination with imaging. Recent developments in color flow mapping allow detection of small tumor vessels, which are invisible on B-mode ultrasound. Registration of vessels simultaneously to B-mode imaging allows this method to be used for nonpalpable lesions. The sensitivity of diverse Doppler instruments shows remarkable differences. This makes uniform evaluation of the method difficult. We examined 94 symptomatic women using different equipment. In 9 of 32 carcinomas no Doppler signals were found. However, CW Doppler showed low vascularity in these 9 false-negative cases. However, the variation of vascularity in malignancies does not yet allow routine application of this method and needs further scientific evaluation.

Breast Neoplasms

[Clinical aspects of HPV-16/18 associated cervical lesions].

In 147 patients with suspected dysplasia, the effect of HPV 16/18 infection on the spontaneous course of the cervical intraepithelial neoplasia (CIN) and on the success of conisation and laser treatment was studied. The patients with PAP II smears had a high incidence of HPV (67%). This was accompanied, however, by a high rate of regression and fluctuation of the various virus types. Of the untreated cases of CIN, the lesions associated with HPV 16/18, particularly after repeat virus DNA identification of this type, had a higher persistence rate than HPV 16/18 negative CIN. After local therapy by laser surgery or conisation of HPV 16/18-related CIN, persistent disease must be expected in 30%. CIN recurrence was significantly more frequent in HPV 16/18 positive cases. According to the results of the investigations, HPV typing appears to be a useful tool in deciding on the appropriate therapy only in cases of persistent CIN and in determining an HPV 16/18 positive at-risk group after local (laser/conisation) therapy.

Adolescent

Human papillomavirus DNA in invasive carcinoma of the vagina.

The presence of human papillomavirus (HPV) DNA in invasive carcinomas of the vagina, in their lymph node metastases, and in corresponding normal tissue was investigated by Southern blot hybridization with 32P-labeled HPV DNA. Tumor tissue from ten of 18 patients with vaginal carcinoma contained HPV DNA. Three of the 18 patients had a history of cervical neoplasia more than 14 years before the diagnosis of vaginal carcinoma. Five of 15 primary squamous cell carcinomas, one primary adenocarcinoma, and a vulvar recurrence of a vaginal squamous carcinoma contained HPV 16. A primary squamous carcinoma yielded HPV-related sequences. The HPV copy number varied from 0.5 to 50 per cellular genome. Four histologically positive inguinal lymph nodes from three patients contained HPV DNA. In six tumor-free control tissues from four patients, no HPV DNA was detected. No relationship was established between HPV positivity, HPV type, or copy number of the tumor and the grade of differentiation or keratinization or the clinical stage. After a median follow-up of 13 months, five of nine HPV-positive patients were alive without recurrence, whereas all seven HPV-negative patients had died because of disease. The results of this study indicate a possible major role of HPV in the development of vaginal cancer.

Adult

Localization of human epidermal growth factor receptor in cervical intraepithelial neoplasias.

Immunohistochemical staining of epidermal growth factor receptor (EGF-R) with a monoclonal antibody was performed in 43 biopsies of cervical tissue. The distribution of the receptors in normal cervical tissue differs from that of cervical intraepithelial neoplasia (CIN) and squamous cell carcinoma of the cervix. Whereas the staining reaction in normal squamous epithelium was confined to the basal and deep parabasal cell layer, in all cervical intraepithelial neoplasias, with or without human papilloma virus association, a homogeneous EGF-R staining reaction could be observed throughout the entire lesion. This means that the dysplasia cells of a CIN I-III, like the tumor cells of a squamous cell carcinoma, have a raised EGF-R content, which in the normal squamous epithelium is usually only found in the basal and deep parabasal cells that are capable of dividing. No EGF-R staining reaction could be detected in the higher, differentiated cell layers of the normal squamous epithelium of the cervix.

Adult

[Placenta percreta: a danger in pregnancy].

Repeated massive bladder haemorrhages of a patient during the 22nd week of her third pregnancy was treated symptomatically for more than three weeks. The cause of the bleeding could not be found. Only the knowledge of the clinical features of a placenta percreta led to the survival of the patient.

Adult

[CO2 laser therapy and typing of human papilloma virus in follow-up studies of cervix intraepithelial neoplasms].

In 104 woman patients with cervical intraepithelial neoplasia (CIN) I-III who had been treated between 1981 and May 1986 in the dysplasia consulting-room of the Department of Gynecology by means of conisation effected by laser, we checked on therapeutic success via cytology and colposcopy as well as by human papilloma virus (HPV) typing. In 90.3% of the cases 1.25 laser treatments sufficed for healing of the lesion. Relapses occurred mainly in severe intraepithelial neoplasias with identified HPV 16/18. Incidence of HPV was reduced from 56% before therapy to 13.3% after therapy. This shows that laser therapy can be regarded as an effective treatment of the causes of the disease even in CIN associated with HPV. The markedly increased relapse rate in CIN III (24%) makes a reliable follow-up mandatory especially in such cases.

Cervix Uteri

The effect of acetylsalicylic acid and indomethacin on the catecholamine- and oxytocin-induced contractility and prostaglandin (6-keto-PGF1 alpha, PGF2 alpha)-production of human pregnant myometrial strips.

The effects of acetylsalicylic acid (ASA) and indomethacin (IND) on the epinephrine and oxytocin stimulated contractility and prostaglandin (6-keto-PGF1 alpha, PGF2 alpha) production of superfused myometrial strips from the pregnant human uterus at term are reported. Without preincubation in ASA or IND epinephrine dose-dependently (10 ng/ml to 1 microgram/ml) stimulated the contractility and significantly increased the PG-release of the myometrial strips. The epinephrine induced increase in contractility was correlated to a higher increase in PGF2a production and a decreased 6-keto-PGF1 alpha/PGF2 alpha ratio (5.4 to 1.8). Superfusion of oxytocin increased myometrial contractions and PGF2 alpha release according to dose (3-12 microU/ml). However, 6-keto-PGF1 alpha production was not affected by oxytocin. Myometrial strips preincubated with ASA (100 micrograms/ml) or IND (10 micrograms/ml) demonstrated little spontaneous activity and the PG production was below the detection limit of the RIA. The stimulating effect of epinephrine and oxytocin on the contractility and PGF2 alpha release of the myometrial strips was inhibited significantly. During continuous superfusion of the ASA and IND preincubated myometrial strips with Tyrode's solution the inhibitory effect on spontaneous, epinephrine-, and oxytocin-stimulated contractility and PGF2 alpha release gradually declined over a period of 2 hours. This decrease of the inhibitory effect was more significant in ASA preincubated specimens. Our results demonstrate that spontaneous, epinephrine-, and oxytocin-stimulated contractility and PG release of human myometrial strips can be inhibited by ASA and IND and that this inhibitory effect is reversible. Furthermore our results suggest that in pregnant human myometrium the inhibition of PGF2 alpha production by ASA and IND is more pronounced than that of 6-keto-PGF1 alpha (PGI2).

Aspirin

Human papillomavirus standardization and DNA cytophotometry in cervical intraepithelial neoplasia.

Human papillomavirus (HPV) standardization and DNA cytophotometry were carried out in 29 cases of cervical intraepithelial neoplasia (CIN) grades I-III. A prognostically unfavorable DNA distribution pattern with an aneuploid stemline was found in 14 of the 16 dysplasias with HPV types 16 and 18, while in 11 of 13 dysplasias with HPV types 6 and 11 there was a favorable DNA distribution with a euploid-polyploid stemline. Among 178 colposcopically, cytologically and histologically confirmed cervical lesions, there was a statistically significant incidence of HPV 16/18 infections in severe dysplasias and carcinomas, while HPV 6/11 was found predominantly in mild cervical lesions. It seems that CIN can be divided into high- and low-risk lesions not only by the degree of severity and the DNA distribution pattern but also by HPV typing.

Adult

[Significance of intraoperatively obtained peritoneal cytology in malignant ovarian tumors].

The evaluation of 259 peritoneal cytologic specimens obtained intraoperatively in cases of malignant ovarian tumor revealed positive findings in 62.5%; findings were doubtful in 2.3% and unusable in 2.7%. In the cases with clinically apparent peritoneal carcinomatosis, (n = 175), cytologic tests were positive in 75%. Taking tumor histology into account the high proportion of positive findings among the non-classifiable tumors (11 out of 13) was striking. For this reason, in a second investigation, 144 peritoneal cytologic specimens taken exclusively from cases of serous carcinomas were studied with regard to their degree of differentiation, the time of removal, and tumor spread. The peritoneal cytology was positive in 33% of the cases without peritoneal carcinomatosis at the first operation and in 36% of the cases with only histologically detectable tumor remnants at the time of the second-look operation. With one exception, peritoneal cytology was also negative in 26 second-look cases without clinically or histologically detected tumors. The incidence of positive peritoneal cytology findings was significantly higher in serous tumors with low-grade differentiation.

Ascitic Fluid

The prognostic significance of the DNA distribution in squamous-cell carcinomas of the uterine cervix.

To establish the prognostic parameters of DNA distributions of squamous-cell carcinomas of the uterine cervix, cervical smears from 30 patients were examined cytomorphometrically ten years after the diagnosis had been made. Most of the patients had stage II cervical carcinomas that had been treated with primary combined irradiation. In the DNA histograms, the position of the stemline proved to be the prognostically significant factor. All of the patients with diploid or euploid-polyploid stemlines were still alive after ten years while only 17.6% of those with aneuploid stemlines have survived. No correlation between the ten-year survival rate and the proliferation rate of the tumors could be established.

Adult

[Noninvasive intracranial pressure measurement at the anterior fontanelle in the first days of life].

A continuous registration of intracranial pressure by aplanation-tonometry on the anterior fontanelle was performed in 12 healthy term newborns during the night hours of the first 3 days. The median intracranial pressure of the first day was 4.01 +/- 2.74 cm H2O. There was a slight increase between the first and the second day of life and a significant increase between second and third day up to 5.84 +/- 2.66 cm H2O. In our interpretation this result is a sign for the active reconfiguration of the skull by increasing intracranial pressure, which may be a consequence of changing tonus of cerebral vessels.

Cranial Sutures

Esterase XXVII. Purification and characterization of esterase-9A of mouse kidney.

Esterase-9A, which appears electrophoretically as a triplet of the bands III-50, III-40 and III-30, was isolated from the kidneys of male NMRI-mice by isoelectrofocusing and refocusing followed by repeated molecular sieve chromography. The overall purification was approx. 250 fold and each of the three bands was isolated separately. The band of the triplet nearest to the cathode, III-50, changed in vitro into the satellite bands III-40 and III-30 and, further, into the band III-22 not observed before in the homogenate. It is assumed that the band III-50 represents the original gene product. The molecular weight (45 000) of the band III-50 is identical with those of III-40 and III-30, as measured by analytical electrophoresis, whereas the molecular weight obtained by thin-layer chromatography was 51 000. There were no obvious signs that esterase-9 was composed of subunits. The Km constant for 4-nitrophenyl proprionate was identical for each of three bands. The esterase-9A is the first testosterone-dependent isozyme of the mouse carboxylesterase (carboxylicester hydrolase, EC 3.1.1.1) system which has been isolated.

Animals

[Experiences with HELLP syndrome].

Between 1988 and 1991 thirty-nine pregnant women suffering from HELLP-Syndrome were treated in our hospital. A retrospective analysis of clinical course and of the changes in the relevant laboratory values was performed. The incidence of the HELLP-Syndrome at Freiburg University Hospital was 0.85% for all pregnancies or 17% of the patients with toxaemia. 90% of the women were primipara, there was no prevalence of a certain group. The clinical course was characterized by the perseverance of symptoms for more than two weeks in 18% of the cases and a perinatal mortality of 25%, the latter mainly due to prematurity of the infants. This suggests that perinatal mortality due to respiratory distress syndrome can be reduced by conservative and expectative management of these patients. However on the other side a high rate of caesarean sections (77%) and sometimes even induced abortions were necessary to avoid maternal mortality and severe pre-or postpartal complications for these women.

Adult