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Biomedical subjects

A Huisman

Publications and source records attributed to A Huisman.

13 recordsLinked to original sources
PubMed2003

[Carcinoma of the fallopian tube after prophylactic laparoscopic ovariectomy in a patient with a BRCAI mutation].

A 48-year-old woman with a distended abdomen appeared to have ascites and was admitted to the gynaecological ward. At the age of 31 years she had been diagnosed with breast cancer and had undergone surgical breast conservation of the right breast. There was a history of both ovarian cancer and breast cancer in her family. Genetic evaluation showed that she was carrying a BRCAI germline mutation. At the age of 42 years she underwent a prophylactic bilateral laparoscopic ovariectomy and 5 years later she underwent a complete mastectomy due to breast carcinoma of the left breast. Two months later she developed ascites, a raised CA125 level and on a CT scan carcinoma of the peritoneum. During the laparotomy a fallopian tube carcinoma was found. After the uterus, fallopian tubes and omentum had been surgically removed, chemotherapy took place. The patient tolerated this well and the CA125 value decreased. Recently, the first molecular evidence was found that linked fallopian tube cancer to germline mutations in BRCAI patients. Patients harbouring a BRCA germline mutation not only have an increased risk of ovarian carcinoma but also of fallopian tube carcinoma. Therefore, in patients with a BRCA mutation, prophylactic surgery should take the form of an adnexectomy, not an oophorectomy.

Carcinoma↗
PubMed2002

[Pregnant and mentally incompetent].

Two women, aged 31 and 36 years, under treatment for schizophrenia and psychotic episodes, respectively, became pregnant and decided to discontinue their medication. Thereupon the psychiatric disorder recurred and they refused--i.e. they were unable--to consent to a proposed treatment or investigation regarding their pregnancies. The necessary consent had to be obtained from a legal guardian. This was the husband in the first, urgent case. In the second case approval from the judge was obtained for the patient to be admitted against her will to protect her life and that of the foetus. In the Netherlands obstetric intervention to protect the life of the mother or her unborn child is legally regulated by the Wet Bijzondere Opnemingen in Psychiatrische Ziekenhuizen (Act on Compulsory Admissions to Psychiatric Hospitals) and the Wet op de Geneeskundige Behandelingsovereenkomst (Act on Agreement Concerning Medical Treatment).

Adult↗
PubMed2001

Antioxidant capacity of mononitrosyl-iron-dithiocarbamate complexes: implications for NO trapping.

Using EPR spectroscopy, we show that the water-soluble mononitrosyl iron complexes with N-methyl-D-glucamine dithiocarbamate (MNIC-MGD) ligands can easily react with superoxide and with peroxynitrite. The reaction with superoxide transforms the paramagnetic MNIC-MGD complex into an EPR silent complex with a reaction rate of 3 x 10(7) (M.s)(-1). Suppletion of ascorbate partially restores the complexes to their original paramagnetic state. We propose that the reaction of MNIC-MGD with either superoxide or peroxynitrite leads to identical EPR silent complexes. Our results have important implications for the technique of NO trapping in biosystems with Fe-dithiocarbamate complexes, where mononitrosyl-iron complexes (hydrophilic as well as hydrophobic) are formed as adducts in the trapping reaction. This principle is illustrated by NO trapping experiments on viable cultured endothelial cells. We find that MNIC-MGD acts as a very potent and water-soluble antioxidant with an efficiency exceeding most SOD mimics. Moreover, by accounting for the EPR silent fraction of iron complexes, the sensitivity of NO trapping can be enhanced considerably. The method was demonstrated for hydrophobic iron-dithiocarbamate complexes in endothelial cell cultures, where sensitivity for NO detection was enhanced by a factor of 5.

Air↗
PubMed1998

[Myocardial infarct in the puerperium].

Two women of 34 and 31 years suffered an acute myocardial infarction in the puerperium. One of them had many risk factors for atherosclerosis: hypercholesterolaemia, hypertriglyceridaemia, diabetes mellitus, hypertension, obesity, nicotine abuse and a positive family history for cardiovascular disease. She had an occluded right coronary artery and was successfully treated with percutaneous transluminal coronary angioplasty. The other patient had an acute myocardial infarction after her first delivery. She was known with hypercholesterolaemia, obesity and nicotine abuse. During her latest pregnancy she was treated with acetylsalicylic acid. Again she developed an acute myocardial infarction in the puerperium, probably due to coronary dissection. Although the incidence of acute myocardial infarction is low in the peripartal period (less than 1 in 10,000) the diagnosis should be considered when a woman presents with chest pain or dyspnoea.

Adult↗
PubMed1991

[Hemorrheological modifications during normal pregnancy].

To investigate whole blood viscosity and its determinants during normal pregnancy we measured the changes in haematocrit, red cell aggregation, plasma viscosity and whole blood viscosity in 24 women during the course of their normal pregnancy. Red cell aggregation was measured by means of a syllectometer, plasma and whole blood viscosity by means of a Contraves LS 30 rotational viscometer. Red cell aggregation was found to increase during the whole course of normal pregnancy in spite of the physiological haemodilution. This increase could be attributed--to a great extent--to the increase in fibrinogen concentration during pregnancy. Plasma viscosity increased during the second and especially the third trimester of normal pregnancy, after a small decrease during the first trimester. Plasma viscosity represents a balance between the rising fibrinogen and the falling serum protein concentration. During normal pregnancy we found a decrease in whole blood viscosity at all shear rates until the 30th week, followed by a smaller increase between 30 and 37 weeks. The changes in whole blood viscosity were largely determined by the changes in haematocrit and to a smaller extent by the changes in plasma viscosity. The influence of plasma viscosity on the resulting whole blood viscosity increased at higher shear rates. At lower shear rates haematocrit was the most important determinant of whole blood viscosity. We did not find any influence of the increase in red cell aggregation on low shear blood viscosity as measured in a rotational viscometer. In our opinion the decrease in haematocrit during normal pregnancy not only compensates for the enhanced red cell aggregation, but even diminishes the resistance to flow in the intervillous space.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
PubMed1988

Red cell aggregation during normal pregnancy.

Red cell aggregation (RCA) is responsible for the increase in whole blood viscosity at lower shear rates. RCA depends on the concentrations of red cells and plasma proteins with a high molecular weight and a large and asymmetrical spatial structure such as fibrinogen, immunoglobulin M and alpha 2-macroglobulin. During normal pregnancy, changes occur in all these concentrations. In a prospective study these changes and their influence on the resulting RCA were investigated in 24 healthy women with normal pregnancies. RCA was determined by light reflection measurement (syllectometry). RCA considerably increased during normal pregnancy in spite of the physiological haemodilution. The aggregation half time, used as a measure for RCA, decreased from an average non-pregnant value of 5.6 s to 3.3 s at 37 weeks. Multiple regression analysis showed that the increase in RCA could be mainly attributed to the raised fibrinogen concentration. However, at 37 weeks other factors, in addition to fibrinogen, contribute significantly to the increase in RCA.

Erythrocyte Aggregation↗
PubMed1987

Whole blood viscosity during normal pregnancy.

In a serial study the changes in whole blood viscosity at different shear rates and its major determinants were determined in 24 healthy women with normal pregnancies. Whole blood viscosity and plasma viscosity were measured with a rotational viscometer. Red cell aggregation was measured by syllectometry. During normal pregnancy we found a decrease in whole blood viscosity at all shear rates until 29 weeks gestation, followed by a smaller increase between 30 and 37 weeks, which was most pronounced at higher shear rates, especially in nulliparae. The changes in whole blood viscosity were to a great extent determined by the changes in haematocrit and plasma viscosity. Haematocrit was more important for whole blood viscosity at lower shear rates, while plasma viscosity had more influence on high shear blood viscosity. The continuous increase in red cell aggregation had no demonstrable influence on low shear blood viscosity as measured in vitro in a rotational viscometer.

Blood Viscosity↗
PubMed1986

Increased 2nd trimester hemoglobin concentration in pregnancies later complicated by hypertension and growth retardation. Early evidence of a reduced plasma volume.

Second-trimester hemoglobin (Hb) concentration was measured in 1535 pregnancies. Mean Hb concentration was significantly increased in women who developed pregnancy-induced hypertension (PIH) in the last trimester before the 37th week (p less than 0.01). A similar trend was also observed in nulliparous women who gave birth to infants with a birthweight below the 10th percentile, especially in smokers. The highest Hb concentrations were found in women with both PIH and intra-uterine growth retardation (IUGR). These findings are in agreement with previous observations in smaller studies and indicate that a reduced plasma volume may already be present in the second trimester, before PIH and/or IUGR appear.

Blood Volume↗
PubMed1986

Early fetal growth retardation: obstetric background and recurrence rate.

The obstetric background of early fetal growth retardation, leading to intrauterine death between 25 and 34 weeks or to delivery before 34 weeks' gestation, was investigated in a group of 100 women. Hypertensive disorders were the most common causative factor (59%). Other causes included antepartum hemorrhage and congenital anomalies. In 20% of the cases no obvious explanation for the fetal growth retardation could be found. The recurrence rate of fetal growth retardation in 49 women who had a subsequent pregnancy was found to be nearly 50%. In one-third the severity of growth compromise was comparable to that in the previous pregnancy, whereas in the hypertensive group this incidence reached nearly 50%. Because of the poor prognosis in current and subsequent pregnancies, it is suggested that women with early fetal growth retardation should be treated at centers where all obstetric and neonatal facilities are available.

Female↗