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Biomedical subjects

A T Teichmann

Publications and source records attributed to A T Teichmann.

At least 19 recordsLinked to original sources
PubMed2002

Effect of two oral contraceptives containing ethinylestradiol and levonorgestrel on serum and urinary surrogate markers of endothelial function.

OBJECTIVE: To investigate the effect of two oral contraceptives containing 0.02 mg ethinylestradiol and 0.1 mg levonorgestrel (Formulation A, Leios), and the other containing 0.03 mg ethinylestradiol and 0.15 mg levonorgestrel (Formulation B, Stediril 30) on the serum and urinary concentrations of various markers reflecting the status of vascular tone and development of atherosclerosis. The adhesion molecules E-selectin, inter-cellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and homocysteine were included as serum markers and cGMP, prostacyclin and its antagonist thromboxane as urinary markers. METHODS: In a comparative, double-blind, randomized, parallel group study, 34 women received formulation A and 33 women formulation B. Serum samples were collected before treatment and after 3, 6 and 12 cycles. Nocturnal urine was collected before treatment and during cyclic treatment after 3 and 12 cycles. Serum and urinary markers were measured by enzyme immunoassays. RESULTS: E-selectin levels were significantly reduced by both contraceptives after 3, 6 and 12 months compared to pretreatment levels. A slight increase in ICAM concentrations was observed for both contraceptives after 6 cycles, but this fell to pretreatment levels after 12 cycles. VCAM values were significantly lowered after 3, 6 and 12 months by both contraceptives. No significant changes were found in serum levels of homocysteine. No significant differences were found between treatment groups for the serum markers. Both contraceptives significantly enhanced urinary cGMP excretion after 12 cycles. The prostacyclin metabolite remained unchanged in the case of both formulations, but the excretion of the thromboxane metabolite was significantly decreased after 12 cycles. Thus, the ratio of prostacyclin to thromboxane, decisive for the resulting effect on vascular tone, increased significantly. CONCLUSION: These results indicate that the low-dose oral contraceptives can reduce the production of adhesion molecules which play a crucial role in the early stages of atherosclerosis. In addition, these contraceptives can shift the balance of vascular tone towards dominance of vasodilatory substances after 12 cycles of treatment. Thus, the positive influence of these contraceptives on the various markers investigated may improve vascular tone and impede development of atherosclerosis.

Adult↗
PubMed2000

Effect of sequential estrogen/progestin treatment on biochemical vasoactive markers in postmenopausal women comparing oral and transdermal application.

PURPOSE: Estrogen replacement in postmenopause can elicit vasodilatory effects which may be important for cardiovascular protection. Progestin addition can antagonise this beneficial effect, but until now, only a few studies have been performed on this issue. In the present study the effect of estradiol as well as of added norethisterone acetate (NETA), a C19-progestin, on the renal excretion of various biochemical markers which can reflect vasoactive actions was investigated. METHODS: 37 postmenopausal women were treated for one sequential estrogen/progestin treatment cycle, i.e. two weeks with estradiol alone followed by two weeks with an estradiol/progestin combination. Both oral (n = 20) as well as 'complete' transdermal (n = 17) hormone substitution was applied, and the excretion of the following vasoactive substances or the stable metabolites, respectively, were measured in nocturnal urine prior to treatment, after 14 and 28 days: cGMP, which can reflect the production of nitric oxide, prostacyclin, thromboxane and serotonin. RESULTS: The excretion of cGMP was increased with both forms of administration during the estrogen phase as well as during the consecutive estrogen/progestin treatment. The prostacyclin-thromboxane quotient increased during estrogen phases, but decreased significantly by the addition of oral, but not with transdermal NETA, reflecting possible vasoconstrictory effects. Serotonin excretion increased, but this only was significant after the oral estrogen-only phase (2 weeks treatment), and after one cycle of complete transdermal treatment (4 weeks treatment), respectively. CONCLUSION: The observed effects can be explained by vasodilatory actions during the estrogen phases which can be maintained or even increased during the consecutive estrogen/progestin treatment suggesting a time-dependent beneficial estrogen effect. However, oral progestin addition may antagonise this effect already within two weeks of treatment whereby the prostacyclin-thromboxane quotient seems to be the most sensitive marker surrogating on vasoconstrictory progestin action.

Administration, Cutaneous↗
PubMed1998

[Rationale for prescribing oral contraceptives].

Strategies for prescribing oral contraceptives (OC) are explained with particular emphasis on individual conditions which can be helpful to optimize the selection process out of the numerous on the market. While contraceptive efficacy unequivocally is regarded as high additional non-contraceptive benefits become substantial criteria for an individual decision. Antiandrogenic properties of progestogens like cyproteroneacetate clearly determine their preference in the presence of unwanted clinical signs and symptoms of hyperandrogenism. In most of the non androgen-related conditions the estrogenicity of a preparation as a result of the dose of ethinylestradiol and dose as well as antiestrogenic potency of the progestogen accounts for the majority of non contraceptive effects. Different progestogens are evaluated with respect to their antiestrogenic property. It is suggested to start treatment after selection of an appropriate progestogen with the lowest daily dose of both hormonal components and to continue intake at least for 3 to 4 cycles as long as no serious adverse events occur. In cases of persisting problems i.e. bleeding irregularities doses or dosing-schemes should be altered preferentially without switching to another gestagen.

Androgen Antagonists↗
PubMed1998

[Complications and results of peri-aortocoval lymphadenectomy in gynecology].

Periaortocaval lymphadenectomy has a low morbidity and mortality rate. The extent of affiliated procedures like radical hysterectomy and the general risk pattern of the individual patient determines the morbidity and mortality of the whole procedure. The necessary extent of periaortocaval lymphadenectomy can be derived from anatomic autoptic and histologic studies. The resection of 20 +/- 5 lymphatic notes can be achieved safely. This number can be regarded as a quality standard. The diagnostic impact on prognosis and therapy is well established while the therapeutic value of periaortocaval lymphadenectomy remains to be evaluated.

Adult↗
PubMed1997

Influence of norethisterone acetate and estradiol on the serotonin metabolism of postmenopausal women.

Previous studies have shown that estradiol increases urinary excretion of the main stable metabolite of serotonin, 5-hydroxyindole acetic acid (5-HIAA), reflecting an increase in serotonin production. In the present study, the effect of the progestin norethisterone acetate (NETA) on serotonin metabolism was investigated, both alone and in addition to estradiol replacement in 20 postmenopausal women. Urinary excretion of 5-HIAA was measured after treatment with NETA orally for 8 days, estradiol valerate orally for 9 days and a combination of both hormones for 12 days. 5-HIAA values, expressed as percentages of the pretreatment values, were significantly increased only after the estrogen treatment phase. NETA alone did not significantly alter the serotonin metabolite excretion; in combination with estradiol, the estradiol effect on serotonin metabolism was abolished. This indicates that adding norethisterone acetate to estradiol replacement therapy may have a negative impact on the effect of estradiol on serotonin metabolism.

Estradiol↗
PubMed1996

Effect of 17 alpha-ethinylestradiol, levonorgestrel, 3-keto-desogestrel, and gestodene on calcium influx via voltage-gated calcium channels in human aortic smooth muscles.

The effect of the synthetic estradiol, 17 alpha-ethinylestradiol, and three progestogens on calcium influx was investigated in cell cultures of human aortic smooth muscle. Neither the synthetic estrogen nor the progestogens levonorgestrel, 3-keto-desogestrel, and gestodene showed, in the concentration range of 10(-9) to 10(-6) M, a significant effect on calcium influx both alone or in equimolar estrogen-gestagen combinations. The results indicate that these substances, commonly used in contraceptive pills, do not change vasotonus interfering with calcium homeostasis.

Aorta↗
PubMed1996

Urinary cGMP excretion after hormone replacement therapy in postmenopausal women.

It is well established that estrogens and progestogens are able to influence the vasotonus in postmenopausal women. The present study was undertaken to find out if the NO/cGMP-system is involved in this hormone action. Urinary cGMP excretion which can reflect intracellular cGMP production elicited by NO (EDRF) was investigated in 20 postmenopausal women. In an open cross-over study design norethisterone acetate was administered orally for 8 days, estradiol valerate orally for 9 days and a combination of both substances for 12 days. After all three treatment phases urinary cGMP expressed as percentage of the pretreatment value was increased at a statistically significant level. Due to high individual variations no significant differences could be found among the values after the three treatment phases. It was concluded that the NO/cGMP-system may play a role in maintaining vasotonus in postmenopausal women under hormone replacement therapy.

Administration, Oral↗
PubMed1995

The influence of the dose of ethinylestradiol in oral contraceptives on follicle growth.

This prospective, randomized comparative clinical study involving 416 women investigated follicle development over a period of 12 oral contraceptive treatment cycles. Women were allocated to two groups, one group (n = 207) received a preparation containing 30 micrograms ethinylestradiol and 75 micrograms gestodene daily, and the other group (n = 209) received 20 micrograms ethinylestradiol and 150 micrograms desogestrel, daily. Follicular development was monitored by transvaginal ultrasonography of the ovaries, during days 18-21 in the pretreatment cycle and in treatment cycles 1, 3, 6, 9 and 12. Follicular development was found to be twice as frequent in the group receiving 20 micrograms ethinylestradiol/desogestrel as in the group receiving 30 micrograms ethinylestradiol/gestodene. For all cycles, follicles of 10-30 mm were found in 18% of women in the desogestrel group, compared with 9.7% in the gestodene group, whilst follicles with a diameter of >30 mm were present in 5% of the desogestrel group compared with 1.9% of the gestodene group. The difference between the treatment groups with respect to follicle diameters of 10-30 mm and >30 mm was statistically significant (p < 0.05 and p < 0.001, respectively). No ruptured follicles were observed in either group throughout the study, suggesting that there was no escape ovulation, however, there was one pregnancy in the desogestrel group that could not be explained either by drug interactions or missed pills. It can be concluded that the ethinylestradiol dose in an oral contraceptive has a significant effect on follicular ovarian activity, and that reducing the dose to 20 micrograms is associated with a significant increase in follicle size.

Adult↗
PubMed1990

Influence of oral contraceptives on drug therapy.

Interferences between drugs and oral contraceptives are considered to alter pharmacokinetics and thus the efficacy of steroidal hormones. It should be noted, however, that steroids can also modify the metabolism and pharmacodynamic effects of various substances. To the present knowledge, phase I (i.e., oxidation, demethylation) and phase II reactions (conjugation) are concerned. Drugs sharing those enzymatic systems with oral contraceptives experience either an increase in bioavailability by inhibition of oxidative metabolism or undergo accelerated elimination by induced conjugation. Such interaction may be of practical interest in subjects who take oral contraceptives and are simultaneously treated with antidepressants, antihypertensives, insulin, synthetic glucocorticoids, theophylline, and caffeine.

Biological Availability↗
PubMed1990

Premature rupture of the membranes and amniotic infections--the significance of laboratory tests.

White blood cell count (WBC), C-reactive protein (CRP) and elastase alpha 1-proteinase inhibitor complex (E alpha 1 PI) have been determined in 85 women during pregnancy and after birth to assess their diagnostic value in case of amniotic infection syndrome (AIS). In ten patients clinically diagnosed AIS could be confirmed by histopathological examination, five patients who fulfilled the clinical criteria showed no histological signs of infection. E alpha 1 PI levels were found to be elevated to above 200 micrograms/l in nine patients with clinical and histological infection and remained below this value in all but one of the cases not showing signs of AIS. On the other hand, CRP concentrations were elevated in five out of these ten women, but also showed false-positive values in patients without AIS; leucocyte counts above 15,000/mm3 have been observed in only one case before delivery. The application of betamethasone led to a marked elevation of leucocyte concentrations. CRP levels were raised substantially after birth, whereas E alpha 1 PI remained unchanged under both conditions. It is suggested that all three parameters should be taken into consideration to increase diagnostic reliability in case of suspected amniotic infections.

C-Reactive Protein↗
PubMed1990

[Surfactant substitution in severe respiratory distress syndrome in premature infants weighing less than 1,000 g].

19 preterm infants with severe respiratory distress syndrome (RDS) were treated with a single dose of natural porcine surfactant (Curosurf, 200 mg/kg). 9 patients had a birth weight of less than 1000 g (845 +/- 112 g, mean +/- SD and the mean gestational age was 27.2 +/- 2.1 weeks). The other 10 had a birth weight of greater than 1000 g (1521 +/- 218 g and a mean gestational age 31 +/- 2.8 weeks). Age at treatment was 3 h in infants less than 1000 g and 4 h in patients greater than 1000 g. Both groups of infants showed a rapid improvement in oxygenation and gas exchange within minutes after surfactant replacement. Exposition to greater than 60% and greater than 40% oxygen was identical in both groups. However, time in greater than 21% oxygen was significantly longer in infants less than 1000 g (median 30 days, 8.5 days in patients greater than 1000 g, p less than 0.01). The duration of mechanical ventilation was 33 days, in patients greater than 1000 g and 5 days; p less than 0.01. None of the infants developed a pneumothorax, but 6 out of 9 patients less than 1000 g developed mild bronchopulmonary dysplasia. 2 infants less than 1000 g died at day 5 and day 11 from cardio-circulatory arrest following ligation of a patent ductus arteriosus, and nosocomial septicaemia, respectively. Prolonged mechanical ventilation and exposure to oxygen in patients less than 1000 g cannot be attributed to surfactant deficiency alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Birth Weight↗
PubMed1989

[The value of leukocytes, C-reactive protein and granulocyte elastase in patients with premature rupture of fetal membranes and amniotic infection].

Serum concentrations of leucocytes, C-reactive protein (CRP) and elastase-alpha 1-proteinase inhibitor (E alpha 1 PI) have been determined in 85 women during pregnancy and after birth to assess their diagnostic value in case of amniotic infections (AI). In ten patients clinically diagnosed AI could be confirmed by histopathological examination, three patients who fulfilled the clinical criteria showed no histological signs of infection. E alpha 1 PI-levels were found to be elevated to over 200 meg/l in six patients with clinical and histological infection and remained below this value in all other cases whereas leucocyte- and CRP concentrations raised in five out of these eight women but also showed false positive values in patients without AI. The application of betamethasone led to a marked elevation of leucocyte concentration. CRP levels were raised substantially after birth, whereas E alpha 1 PI remained unchanged. It is suggested that all three parameters should be taken into consideration to increase diagnostic reliability in case of suspected amniotic infections.

C-Reactive Protein↗
PubMed1989

Embolization therapy in patients with severe arterial bleeding after hysterectomy.

The case history of a patient aged 41 years, who suffered recurrent hemorrhages following vaginal hysterectomy is reported. After several surgical interventions complete hemostasis was finally achieved by selective embolization of the internal iliacal artery. The application of this procedure is recommended in case of recurrent bleeding complications caused by pelvic surgery or neoplasms.

Adult↗
PubMed1989

[A new concept of psychosomatic research exemplified by premature labor].

One of the most serious problems of psychosomatic research is the adequate choice of the method applied to clinical questions. In the past empirical investigations have been based upon univariate and moreover linear correlations. In this study a multivariate nonlinear concept was developed which was generated in a first trial proven and confirmed prospectively in a second one using two sorts of mathematical analyses. The first included 35 patients with premature labour and 25 healthy pregnant women as controls. The latter was conducted with 238 patients being recruited in the first trimester of pregnancy, 30 of whom developed premature labour in the course of the study. Using a questionnaire consisting of the main aetiological variables identified in the basic investigation and using the statistical procedures mentioned above the occurrence of premature labour was predicted in more than 90%. Only one patient who was not suspected to develop premature uterine activity was not classified correctly. Besides clinical usefulness the model of research presented provides evidence for the most important aetiologic conditions of the disease as far as psychosocial factors are concerned and offers a new approach to quantifying research including somatic and non-somatic variables.

Adult↗
PubMed1988

Treatment of promyelocytic leukemia during pregnancy. A case report and review of the literature.

In spite of the fact that acute promyelocytic leukemia during pregnancy is rare and that there is little precedent in the literature for treatment with combined chemotherapeutic agents, the rate of success with current chemotherapeutic regimens is very encouraging. Judging from previous reports and our own experience, it is possible to give combination chemotherapy to pregnant women with AML/APL with the result that mother and infant survive, whereby the incidence of complication is within an acceptable range. No comprehensive studies on life-time teratogenic or carcinogenic effects are available at present.

Adolescent↗