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Biomedical subjects

A Graf

Publications and source records attributed to A Graf.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Monitoring umbilical cord puncture and intravascular transfusions with Doppler ultrasound].

Complications of percutaneous umbilical blood samplings and intravascular transfusions can be detected rapidly, easily and efficiently by Doppler ultrasound and therefore the operator can react as early as possible. In addition to real-time sonography Doppler ultrasound allows for assessment of haemodynamical changes due to intravascular transfusions both on the venous and arterial side of umbilical perfusion. Because of immediate recognition of bradycardia and other fetal cardiac frequency alterations as well as increase of resistance to blood flow on the arterial side the operator can react promptly. On the venous side correct application of transfused volume is monitored continuously by changes of flow velocity waveforms during injection and allows to assess dislocation of the needle.

Blood Flow Velocity↗
PubMed1995

Impact of trophoblast penetration through the basal membrane on the efficacy of drug therapy in tubal pregnancies.

Concentrations of beta-human chorionic gonadotrophin (HCG) of 2500 IU/l are generally considered to be maximal for successful drug therapy of tubal pregnancies [instillation of prostaglandin-F2 alpha (PGF2 alpha) or hyperosmolar glucose]. The purpose of our study was to ascertain if there was an association between the significantly higher failure rates above this threshold value and the histologically determined anatomopathological substratum. We therefore evaluated the impact of trophoblast penetration through the basal membrane of the Fallopian tube on the efficacy of drug therapy. Pre-operative serum beta-HCG concentrations were compared with the histologically determined trophoblast penetration, distinguishing between ectopic pregnancies with intra-luminal growths up to the myosalpinx, and those with extra-luminal growths going beyond the basal membrane and penetrating the myosalpinx. Basic data were obtained from a group of patients who received primary surgical treatment but it had never been the intention for them to receive drug therapy (independently of their initial beta-HCG values; group I, n = 43). These reference data were compared with the findings in preparations from another group of patients obtained during secondary surgical intervention, performed to achieve final cure of tubal pregnancy after failure of primary PGF2 alpha instillation (group II, n = 30). Group I patients showed a significantly higher rate of intra-luminal trophoblast growths (P = 0.0001) at beta-HCG values < 2500 IU/l; above this threshold value, extra-lumina spread was found significantly more often (P = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Chorionic Gonadotropin↗
PubMed1994

Identification of tryptophan and tyrosine residues in peptides separated by capillary electrophoresis by their second-derivative spectra using diode-array detection.

The use of diode-array detection allows the non-destructive identification of tryptophan and tyrosine residues in complex peptide mixtures separated by capillary electrophoresis. Second-order derivative spectra of both amino acids show significant differences while zero-order spectra are overlapping to a great extent. A mixture of peptides containing tryptophan and/or tyrosine residues was used to evaluate this method. Tryptic peptide maps of carbonic anhydrase and of the bacterial chaperonin protein GroEL, and of an autodigest of trypsin were characterized for tryptophan- and tyrosine-containing peptides. Automated spectra library search was performed successfully.

Amino Acid Sequence↗
PubMed1994

Lymphogenous metastasis in the primary carcinoma of the fallopian tube.

The bad prognosis of primary Fallopian tube carcinoma (FTC) is mostly ascribed to early lymphogenous metastasis. Yet, there is a lack of information on the tumor size at which lymph node metastasis must be expected to occur. Our study was therefore designed to correlate the anatomopathologic substratum and the histologic results with the lymph node status. Data were obtained from 21 women who received primary surgery, during which additional total pelvic and para-aortic lymphadenectomy was performed as well. The "surgical" staging was compared to the final clinical staging after histologic inspection of the lymph nodes according to the FIGO classification. Lymph node metastases never occurred as long as the tumor was confined to the tube (stage I). Lymphogenous dissemination set in only after further, local expansion of the tumor, involving the ovaries, the peritoneum, or the uterus (surgical stage II); 3 of the 7 patients of surgical stage II had to be reclassified to stage III because of manifest lymph node metastases. After the onset of intra-abdominal or general metastasis (stage IV), lymph node metastases occurred significantly more often (P = 0.048). Due to the specific lymphatic drainage, lymphogenous metastasis must be expected to spread as far as to the para-aortic region even in the early stages. Highly differentiated tumors (G I) do not disseminate into the lymphatic system, not even in advanced stages, whereas anaplastic tumors (G II and III) metastasize relatively early. As soon as metastasis has occurred, prognosis of life diminishes markedly, but not significantly (49 versus 24 months, P = 0.19). Correct FTC-staging is obtained only on the basis of pelvic and para-aortic lymphadenectomy.

Adolescent↗
PubMed1994

Evaluation of adjuvant therapy after surgery for primary carcinoma of the fallopian tube.

OBJECTIVE: To evaluate the impact of postoperative therapy (chemotherapy vs. irradiation) on overall survival. DESIGN: A nationwide retrospective analysis. SETTING: Hanusch-Krankenhaus, Department of Gynaecology, SUBJECTS: 115 patients with histologically proved primary carcinoma of the Fallopian tube: 49 received six treatment cycles of a cis-platinum regimen (group I), 24 patients were treated by full irradiation using 50 Gray minimum (group II). The two groups had a similar distribution of stage I and II; in the more advanced stages chemotherapy was the predominant method of treatment. RESULTS: The five-year survival rate was 53% for women receiving irradiation as against 27% for those given cis-platinum. If the analysis was restricted to those patients with comparable stage I and stage II lesions, the p-value (0.07) was of borderline significance. There was no advantage in adding abdominal to pelvic irradiation (P = 0.62). CONCLUSIONS: Stage I and stage II carcinoma is probably better treated postoperatively by radiotherapy than chemotherapy. Chemotherapy may have more therapeutic potential in patients with more advanced lesions.

Adult↗
PubMed1994

Primary fallopian tube carcinoma--a retrospective survey of 51 cases. Austrian Cooperative Study Group for Fallopian Tube Carcinoma.

OBJECTIVE: To evaluate retrospectively the importance of invasion beyond the basement membrane on overall survival in Fallopian tube carcinoma and its influence on the necessity of postoperative adjuvant therapy (stage 0 vs. stage I). DESIGN: In a nationwide analysis the data of 51 patients were evaluated. The participating departments provided the study center with histologic specimens. A re-staging was done according to the FIGO-classification for Fallopian tube carcinomas. Stage 0 patients received no further postoperative therapy, in stage I patients were divided in 2 groups to evaluate the impact of postoperative adjuvant therapy (chemotherapy vs. irradiation). RESULTS: Patients of stage 0 had a significantly better prognosis than patients of stage I (p = 0.035). Stage I patients treated by irradiation showed a significantly better prognosis than patients treated by chemotherapy (p = 0.017). CONCLUSION: Tumour penetration through the basement membrane causes prognosis to deteriorate significantly (5-year survival rate about 50% in stage I). Postoperative therapy is thus indicated with stage I disease. Irradiation seems to give better results than chemotherapy.

Adenocarcinoma↗
PubMed1994

[Surgical secondary measures in unsuccessful prostaglandin treatment of tubal pregnancy].

As local drug treatment grew more common, the risk of persisting trophoblast remnants increased in tubal pregnancies treated in this way. We studied the secondary surgical measures in 52 patients, who had to undergo surgery for a second time after tubal pregnancy treated with prostaglandins. The indication for revision was arrived at 30 times on the basis of laboratory parameters (increasing or constant beta-HCG) (Group I). Reoperation had to be performed 22 times because of acute clinical symptoms (Group II). Laparotomy was performed 40 times, repelviscopy 12 times. In patients of Group I, the rate of rupture, that, had already occurred at the time of secondary surgery, was significantly smaller (p < 0.0001); in that case secondary surgery was significantly more often successful (p < 0.06) in preserving the tubes. In case of constant beta-HCG values 11 patients (50% of Group II) developed acute symptoms; another 7 patients (31.8%) also had to be reoperated on due to acute complaints, although the values were already clearly reduced. The study proves, that tubal pregnancies can be reoperated with preservation of the tubes even after unsuccessful prostaglandin therapy. The starting position for secondary surgery with preservation of the tubes is much better before acute clinical symptoms occur.

Adult↗
PubMed1994

[HELLP syndrome and manifestation of type I diabetes mellitus in pregnancy].

HELLP syndrome (haemolysis, elevated liver function tests and low platelets) is a multiorganic disease and has been described in combination with pre-eclampsia/eclampsia, but even without symptoms of gestosis. There are signs, that HELLP syndrome represents an "acute status of autoimmunity". Since immune mechanisms play a fundamental role together with other factors in the development of type I diabetes mellitus, a combination of autoimmune reactions could explain the development of type I diabetes during an altered immune status. We report on the course of a pregnancy complicated by HELLP syndrome, which developed type I diabetes mellitus in the same pregnancy. A subsequent pregnancy with adequate diabetes therapy was uncomplicated and without recurrence of HELLP syndrome.

Adult↗
PubMed1994

[Capnothorax and subcutaneous emphysema in attempted laparoscopic suture of duodenal ulcer].

A 72-year old lady suffering from coronary heart disease was admitted with acute abdominal pain. Laparoscopy was performed and revealed perforation of a duodenal ulcer. The surgeon decided to suture the perforation via laparoscope. After an uncomplicated start he had to finish the laparoscopic procedure because of a massive hypercapnia and a developing subcutaneous emphysema. Laparotomy showed an iatrogenic perforation of the right diaphragm. A chest drain was inserted; after suturing of the perforated ulcer the abdomen was closed. The further hospital stay was uneventful. The possible causes for the increasing hypercapnia are discussed. We suggest close monitoring of patients during laparoscopy including capnometry and the anaesthesist should be aware of rare complications.

Aged↗
PubMed1993

Radical lymphadenectomy in the primary carcinoma of the fallopian tube.

The primary carcinoma of the Fallopian tube is a highly aggressive tumor which can spread by the lymphatic route. The object of the present study was to evaluate the impact of radical pelvic and para-aortic lymphadenectomy on overall survival. Radical lymphadenectomy was performed on twelve patients in addition to hysterectomy and bilateral adnexectomy (group I). Twenty-eight patients subjected only to hysterectomy and adnexectomy formed the control group (group II). On average 47.6 lymph nodes were excised per patient. As long as the carcinoma was limited to adnexa and uterus (stages I and II), no lymph node metastases were found, only in stages III and IV were lymph node metastases detectable. Even though the median survival time of group I was considerably higher than of group II (43 versus 35 months), there was no statistically significant difference between the two groups (P < 0.65). Patients with stage III and stage IV disease had relatively longer median survival times if they had a lymphadenectomy. However, the difference was not statistically significant (P < 0.91). We cannot therefore recommend routine radical lymphadenectomy for primary Fallopian tube carcinoma. Whether or not lymph node dissection would lead to better results from rational selection of patient for adjuvant therapy is not known.

Fallopian Tube Neoplasms↗
PubMed1992

Automated measurement of cell destruction: the Patimed system in comparison with conventional HLA typing and the cell mediated lympholysis test (CML).

The key role of HLA polymorphism in the pathogenesis of many diseases and in determining compatibility in transplantation makes it desirable to employ automated systems for identifying HLA polymorphism. For more than one year we have used the photometer system Patimed commercially available from the Leica company. We compared the results of the conventional cell-mediated lympholysis test and conventional serological HLA typing with the results obtained by the Patimed system. Despite some good preliminary results it would be premature, in our opinion, to recommend the Patimed system for routine assessment of killer cell activity whereas we can definitely recommend the Patimed system to define HLA class I and class II molecules serologically for research or routine purposes.

HLA Antigens↗
PubMed1992

[Automated measurement of cell destruction with the Patimed System in comparison with conventional HLA typing].

HLA molecules serve as identity markers for immunocompetent cells which respond to pathogens and transplant tissue antigens to distinguish self from non-self. The continuous discovery of new HLA polymorphisms which are associated with various diseases or are involved in graft rejection continuously increases the number of HLA antigens which need to be identified for each individual. We defined the HLA class I and HLA class II antigens with the NIH standard microcytotoxicity system and compared the results with those obtained using the commercially available automated Patimed system. Our results show that serological identification of HLA antigens with the Patimed system is reliable. It can be recommended for routine as well as for research purposes.

B-Lymphocytes↗
PubMed1991

Subcutaneous continuous infusion of ifosfamide and cyclophosphamide in ambulatory cancer patients: bioavailability and feasibility.

The oxazaphosphorines ifosfamide (IFO) and cyclophosphamide (CTX) are standard alkylating agents. Both drugs show an increased therapeutic index when given as a fractionated dosage over several days. Maximal fractionation is achieved by continuous infusion. We have studied the feasibility and bioavailability of a subcutaneously (s.c.) administered isotonic and neutral (pH 7) solution of IFO (10 h up to 5 days infusion) and CTX (12-24 h infusion) in patients with advanced cancer. A portable disposable gas-driven infusor syringe was used for ambulatory patients. Our results show 90%-100% bioavailability of s.c. IFO and CTX. The isotonic solution of IFO and CTX (pH 7) showed no significant local toxicity (one local infection in 51 cycles) during or after s.c. administration of 33 cycles with IFO and 18 with CTX. Haematotoxicity of both drugs was equal after s.c. and i.v. application. For IFO-treated patients no uro- or neurotoxicity was observed. We conclude that this novel continuous s.c. oxazaphosphorine infusion over a prolonged period is a rational, well-tolerated and economic way of delivering this drug on an outpatient basis.

Adult↗