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Biomedical subjects

C Dorn

Publications and source records attributed to C Dorn.

At least 19 recordsLinked to original sources

[Preemptive randomized, double-blind study with lornoxicam in gynecological surgery].

AIM: Lornoxicam is a non opioid analgesic belonging to the oxicam group. The aim of this study was to determine whether lornoxicam has a preemptive analgesic effect. METHODS: This study was carried out in a randomized, double-blind fashion with 66 patients divided into three groups undergoing gynecological operations. Group I was administered 8 mg of lornoxicam i.v. preoperatively followed by an 8-mg bolus every 8 h for a total dose of 24 mg in the first 24 h. Group II was administered 8 mg of lornoxicam i.v. bolus before the end of the operation followed by 8 mg every 8 h for a total dose of 24 mg in the first 24 h. Group III was administered placebo before and after the operation and for the first 24 h. The effectiveness was assessed postoperatively using the visual analogue scale (at rest, on exertion) and by calculating the total analgesic consumption of morphine hydrochloride in the first 24 h following operation. Vital signs and side effects were documented. RESULTS: Groups I and II demonstrated significantly reduced pain scores compared to group III at various points in time. Group I also demonstrated a weakly significant reduction in analgesic consumption of morphine hydrochloride postoperatively compared to groups II and III. CONCLUSION: Lornoxicam administered preemptively appears to improve the quality of postoperative analgesia and lead to reduced consumption of opioid analgesics postoperatively in patients undergoing gynecological operations.

Adult↗

Lamotrigine monotherapy for control of neuralgia after nerve section.

BACKGROUND: We present six patients treated only with the new-generation anticonvulsant lamotrigine to define its sole effect on neuralgia after nerve section. METHODS: Previous surgical or pharmacological attempts failed to relieve this neuropathic pain in our patients. Before initiation of lamotrigine therapy, patients reported spontaneous and touch-evoked shooting pain followed by periods of burning pain. No breakthrough medication was needed during the maintenance phase of 1-23 months. Data were acquired by a pain diary on a weekly basis. RESULTS: With 75-300 mg of lamotrigine per day, the burning and shooting pain intensity was relieved by 33-100%. Most obviously, the attack frequency of the shooting pain was reduced by 80-100%. No adverse effects were observed. CONCLUSION: We conclude that lamotrigine may be beneficial in the treatment of neuralgia after nerve section following the failure of previous pharmacological or surgical attempts.

Adult↗

Cell-associated interleukin-8 in cord blood of term and preterm infants.

To assess the effect of gestational age and labor on the interleukin-8 (IL-8) concentration in whole cord blood and serum, IL-8 levels were determined simultaneously in cord blood serum and lysate in 134 infants. Following the elimination of some of the samples due to exclusion criteria, the data for 99 uninfected infants (71 term and 28 preterm) and 9 infants with neonatal bacterial infection delivered either vaginally or by elective or emergency cesarean section were analyzed. The effects of labor and gestational age were tested by analysis of variance. IL-8 was not detectable in the serum of 25 infants, whereas IL-8 levels in whole blood were measurable in all of the samples. The median IL-8 conncentrations in whole cord blood lysate were 106 pg/ml (range, 20 to 415 pg/ml) in preterm infants and 176 pg/ml (range, 34 to 1,667 pg/ml) in term infants. In contrast to the IL-8 levels in serum, IL-8 levels in whole blood were reduced after ECS. Gestational age had no independent effect on the IL-8 concentrations in either serum or whole blood; these concentrations increased in infected infants after labor. We conclude that the neonatal proinflammatory response to labor stress was more evident in the concentrations of IL-8 in whole blood than in serum. The levels of IL-8 in whole-blood lysate reflect proinflammatory stimulation in neonates and may be a useful diagnostic tool for the early diagnosis of neonatal infection.

Cesarean Section↗

The role of ovarian volume in an in vitro fertilization programme as assessed by 3D ultrasound.

The study was designed to investigate the role of ovarian volume, as assessed by three-dimensional (3D) sonography, in predicting conception in an in-vitro fertilization-embryo transfer (IVF-ET) programme. Transvaginal 3D sonography was performed in 152 cycles before initiation of ovarian stimulation (day 1) and on the day of oocyte retrieval. Ovarian volume showed no significant correlation with IVF outcome. On the contrary, all ovarian measurements were lower, albeit nonsignificantly, in the conception group. Fifteen patients (15/152, 9.9%) had a minimum unilateral ovarian volume of < or =3 mL (1 SD below the mean) on day 1 of the stimulation cycle. In this subgroup, the likelihood of conception was 6.7% (1/15) versus 21.9% (30/137) in patients with an initial minimum ovarian volume of >3 mL. This difference did not reach statistical significance. In both groups, cancellation rates due to poor ovarian response or lack of fertilization were similar. In conclusion, ovarian volumetry as assessed by three-dimensional ultrasound failed to predict conception in women undergoing IVF treatment.

Adult↗

Endometrial receptivity in an in vitro fertilization program as assessed by spiral artery blood flow, endometrial thickness, endometrial volume, and uterine artery blood flow.

OBJECTIVE: To investigate the role of sonographic parameters in assessing endometrial receptivity in an in vitro fertilization (IVF) program. DESIGN: Prospective clinical study. SETTING: University setting. PATIENT(S): One hundred thirty-five patients in our IVF program, selected prospectively on the day of oocyte retrieval. INTERVENTION(S): Transvaginal ultrasound examination was performed before oocyte collection. MAIN OUTCOME MEASURE(S): Association between implantation rate and spiral artery blood flow (primary outcome measure) and between implantation rate and endometrial measurements as well as uterine artery blood flow (secondary outcome measures). RESULT(S): Overall implantation rate was 23.7% per cycle. Subendometrial blood flow was detected in 113 (83.7%) cases, with pregnancy occurring in 21.2%. Mean spiral artery pulsatility index values were 1.12 +/- 0.28 and 1.21 +/- 0.27 for nonconception and conception cycles, respectively. Nondetectable spiral artery blood flow was not associated with a lower implantation rate. Neither endometrial thickness nor endometrial volume was correlated with the likelihood of successful implantation. Minimum endometrial thickness and volume associated with pregnancy were 6.9 mm and 1.59 mL, respectively. CONCLUSION(S): Neither Doppler sonography of the spiral or uterine arteries nor measurement of the endometrial thickness or volume allowed a reliable prediction of subsequent IVF outcome.

Arteries↗

[Concepts of quality assurance in obstetrics and gynecology].

The safeguarding of quality has reached an essential position in medical area. The creation of corresponding concepts with definition of tasks for quality assessment is one of the most important challenges for public health organizations and politicians. The still established projects in gynecology and obstetrics in Germany now carried out that the conscience for the necessity of quality safeguarding is in high gear.A summary of the quality safeguarding projects and tools is given.

Female↗

The DEAD box protein DP103 is a regulator of steroidogenic factor-1.

The nuclear receptor steroidogenic factor-1 (SF-1) is essential for development of the gonads, adrenal gland, and the ventromedial hypothalamic nucleus. It also regulates the expression of pivotal steroidogenic enzymes and other important proteins in the reproductive system. We sought to elucidate the mechanisms that govern the transcriptional activity of SF-1. We demonstrate here that a previously uncharacterized domain, located C-terminal to the DNA binding domain of SF-1, exhibits transcriptional repression function. Point mutations in this domain markedly potentiate the transcriptional activity of native SF-1. Using an SF-1 region that spans this proximal repression domain as bait in a yeast two-hybrid system, we cloned an SF-1 interacting protein that is homologous to human DP103, a member of the DEAD box family of putative RNA helicases. DP103 directly interacts with the proximal repression domain of SF-1, and mutations in this domain abrogate its interaction with DP103. DP103 is expressed predominantly in the testis and is also expressed at a lower level in other steroidogenic and nonsteroidogenic tissues. Functionally, DP103 exhibits a native transcriptional repression function that localizes to the C-terminal region of the protein and represses the activity of wild-type, but not mutant, SF-1. Together, the physical and functional interaction of DP103 with a previously unrecognized repression domain within SF-1 represents a novel mechanism for regulation of SF-1 activity.

Amino Acid Sequence↗

[Publishing guidelines on the internet].

Guidelines are well established in modern medicine as a tool of quality assurance. New developments in Information Technology (IT) alters strategies in communication, and influences the publication of important notes or research findings. Acceptance and efficiency of guidelines depends on promptness of publication. Using the internet to publish guidelines does not only improve success of transferal but also changes interaction between physicians and patients.

Evidence-Based Medicine↗

Quantitative assessment of subendometrial blood flow by three-dimensional-ultrasound is an important predictive factor of implantation in an in-vitro fertilization programme.

This study was designed to investigate the role of three-dimensional (3D) power Doppler sonography of the (sub-) endometrial area on the first day of ovarian stimulation in predicting the outcome of an in-vitro fertilization (IVF) programme. Among the 75 cycles analysed, the overall pregnancy rate was 20% (15/75) per cycle and 23.8% (15/63) per embryo transfer. Intra-observer variability of the colour histogram was checked in 14 patients with the results demonstrating a high level of agreement. Neither endometrial measurements nor uterine blood flow were correlated with the pregnancy rate. In contrast, all 3D indices were significantly lower in conception compared with non-conception cycles (P < 0.05). Logistic regression analysis found the subendometrial flow index to be the strongest predictive factor of IVF success among the tested sonographic parameters (P = 0.04). In conclusion, quantitative assessment of spiral artery blood flow may be of predictive value for implantation in IVF cycles even before ovarian stimulation therapy is started.

Adult↗

Transesophageal versus surface pulse oximetry in intensive care unit patients.

OBJECTIVES: To compare oximetric readings from the esophagus (STEO2) and the skin (finger, SSO2) with those obtained from arterial blood samples (SaO). In addition, to compare the influences of mean arterial pressure (MAP) and body temperature to the accuracy of STEO2 and SSO2 readings. DESIGN: Prospective, single-center study. SETTING: Surgical intensive care unit of an academic, teaching, and community hospital in Austria. PATIENTS: A total of 40 consecutive, severely traumatized or diseased, intensive care unit patients requiring mechanical ventilatory support and deep analgosedation. Patients had to be nonpregnant, > or =19 yrs of age, and without a disease or a trauma of the esophagus. INTERVENTIONS: Placement of an esophageal and a finger-pulse oximetry probe and a radial artery catheter. MEASUREMENTS AND MAIN RESULTS: STEO2, SSO2, MAP, and esophageal temperature were recorded continuously during a 4-hr period, and SaO2 was measured every 30 mins. The first outcome variable was the deviation of STEO2 and SSO2 from SaO2. The second outcome variable was the influence of MAP and body temperature on STEO2 and SSO2 regression analysis and repeated measures. Analysis of variance was used for statistics (p < .05 was accepted as significant). In patients with a MAP ranging from 29 to 111 mm Hg and a temperature ranging from 33.4 degrees C (92.1 degrees to 39.2 degrees C (102.6 degrees F), SSO2 measurements underestimate SaO2 by 2% to 4%. Whereas STEO2 matches SaO2, STEO2 was not dependent on MAP or temperature, but increased temperature or low MAP were associated with falsely low SSO2 readings. CONCLUSIONS: Assuming correct positioning of the probe, readings from the esophagus are more consistent with arterial oxygen saturation than readings from surface pulse oximetry. MAP or temperature changes do not influence STEO2, but they do affect SSO2. In critically ill patients, STEO2 appears to be a more reliable variable than SSO2.

APACHE↗

Function of steroidogenic factor 1 during development and differentiation of the reproductive system.

Intact reproductive development depends on steroids and other endocrine signals. Although recent discoveries have elucidated important steps of sexual differentiation, the intricate mechanisms that regulate the development of steroid-producing tissues remain elusive. In adults, complex feedback mechanisms determine the hypothalamic and pituitary regulation of steroid hormone biosynthesis. Steroidogenic factor 1 (SF-1), an orphan member of the nuclear receptor superfamily of proteins, plays a critical role in development and differentiation of the endocrine and reproductive systems. This review provides an overview of the function of SF-1, its mechanism of action, and a perspective on the interaction of SF-1 with other determinants of sexual differentiation. Whereas SF-1 is essential for the expression of numerous steroidogenic enzymes, its presence may not correlate with steroidogenic function. Moreover, diverse co-regulators modulate the influence of SF-1 on gene transcription. The significance of these interactions is discussed in the context of reproductive development and function. Other orphan or ligand-dependent nuclear proteins may share similar mechanisms.

Animals↗

Determination of total interleukin-8 in whole blood after cell lysis.

BACKGROUND: It has been shown that a high percentage of interleukin-8 (IL-8) in blood is cell associated. Recently, a simple method for determination of cell-associated IL-8 in whole blood after cell lysis has been described. The purpose of this study was to evaluate this method, to examine the influence of preanalytic sample handling, and to establish the concentration range of total IL-8 and its relation to age and sex in healthy subjects. METHODS: Total IL-8 content of whole blood was determined after lysing blood cells with Milenia((R)) cell lysis solution. IL-8 in the resulting blood lysate was measured with the IMMULITE((R)) IL-8 immunoassay. RESULTS: When freshly drawn blood was stored up to 48 h on ice, no significant changes in total IL-8 were measured in the subsequently prepared lysate, whereas with storage at room temperature, total IL-8 increased after 3 h from 94 +/- 13 ng/L to 114 +/- 16 ng/L (n = 10). In lysate stored for 48 h at 4 degrees C, marginal changes of the IL-8 concentration were noted, with storage at room temperature, only 76% +/- 5% (n = 12) of initial concentration was recovered. From lysate frozen at -20 and -80 degrees C, respectively, 84% +/- 4% and 93% +/- 2% of initial IL-8 was recovered after 70 days (n = 10). IL-8 was measured with comparable precision in plasma (CV, 3. 2-4.2%) and blood lysate (CV, 3.7-4.1%). When plasma was diluted with cell lysis solution, a slightly overestimated recovery (125% +/- 3%) was observed; for lysate specimens with a cell lysis solution content >/=75%, the recovery after dilution was 98% +/- 2%. In lysate prepared from 12 blood samples with exogenous IL-8 added, IL-8 recovery was 104% +/- 2% (recovery from plasma <35%). The median total IL-8 in blood lysates from 103 healthy subjects (22-61 years) was 83 ng/L of blood (2.5-97.5 percentile range, 49-202 ng/L of blood). In females but not in males, total IL-8 increased significantly with advancing age (P: <0.002). We found grossly increased total IL-8 in six pregnant women with amniotic infection syndrome. CONCLUSIONS: The evaluated method allows the assessment of total IL-8 in blood with good performance when appropriate conditions of sample pretreatment are considered. The values in healthy volunteers all were above the detection limit of the IL-8 assay; therefore, slight changes of total IL-8 could be noted. Thus, the present method is a suitable tool to study the diagnostic relevance of total IL-8 in blood.

Adult↗

Activation of luteinizing hormone beta gene by gonadotropin-releasing hormone requires the synergy of early growth response-1 and steroidogenic factor-1.

We have previously shown that early growth response (Egr) 1-deficient mice exhibit female infertility, reflecting a luteinizing hormone (LH) beta deficiency. Egr-1 activates the LHbeta gene in vitro through synergy with steroidogenic factor-1 (SF-1), a protein required for gonadotrope function. To test if this synergy is essential for gonadotropin-releasing hormone (GnRH) stimulation of LHbeta, we examined the activity of the LHbeta promoter in the gonadotrope cell line LbetaT2. GnRH markedly stimulated the LHbeta promoter (15-fold). Mutation of either Egr-1 or SF-1 elements within the LHbeta promoter attenuated this stimulation, whereas mutation of both promoter elements abrogated GnRH induction of the LHbeta promoter. Furthermore, GnRH stimulated Egr-1 but not SF-1 expression in LbetaT2 cells. Importantly, overexpression of Egr-1 alone was sufficient to enhance LHbeta expression. Although other Egr proteins are expressed in LbetaT2 cells and are capable of interacting with SF-1, GnRH stimulation of Egr-1 was the most robust. We also found that the nuclear receptor DAX-1, a repressor of SF-1 activity, reduced Egr-1-SF-1 synergy and diminished GnRH stimulation of the LHbeta promoter. We conclude that the synergy between Egr-1 and SF-1 is essential for GnRH stimulation of the LHbeta gene and plays a central role in the dynamic regulation of LHbeta expression.

Animals↗

Serum oxytocin concentration during embryo transfer procedure.

OBJECTIVE: To determine the effect of the embryo transfer (ET) procedure on serum concentration of oxytocin. STUDY DESIGN: Prospective clinical study of 10 women undergoing in vitro fertilization (IVF) treatment with ET in the Section of Reproductive Medicine and Endocrinology at the Department of Obstetrics and Gynecology, University of Bonn, Germany. Serial blood samples were collected in time intervals of 20 s during embryo transfer procedure and serum oxytocin concentration was measured. RESULTS: In the absence of tenaculum placement, none of the procedures associated with ET led to an increase in serum oxytocin concentration. When tenaculum placement was used, it was temporally (four out of five patients) associated with an elevation in oxytocin level, which remained elevated until of the end of ET procedure. CONCLUSION: Application of a cervical tenaculum during ET or possibly also during intra uterine insemination (IUI) procedure can stimulate the release of oxytocin in some patients.

Adult↗

Detection of Brucella species in organs of naturally infected cattle by polymerase chain reaction.

A polymerase chain reaction (PCR) assay was used to detect Brucella species in the uterus, udder, spleen, lymph nodes, kidney and liver of three cows which had been naturally infected in an outbreak of brucellosis, and the results were compared with the results of bacteriological investigations. All 18 samples reacted positively in the PCR, but five samples had weak bands after the electrophoretic separation of PCR mixtures. No Brucella strains could be detected in these five samples by bacterial cultivation, but all the other samples gave positive results. A pre-enrichment procedure was necessary for the PCR. A PCR with DNA from eight Yersinia strains gave no amplification product.

Animals↗

Nuclear receptor DAX-1 recruits nuclear receptor corepressor N-CoR to steroidogenic factor 1.

The orphan nuclear receptor steroidogenic factor 1 (SF-1) is a critical developmental regulator in the urogenital ridge, because mice targeted for disruption of the SF-1 gene lack adrenal glands and gonads. SF-1 was recently shown to interact with DAX-1, another orphan receptor whose tissue distribution overlaps that of SF-1. Naturally occurring loss-of-function mutations of the DAX-1 gene cause the human disorder X-linked adrenal hypoplasia congenita (AHC), which resembles the phenotype of SF-1-deficient mice. Paradoxically, however, DAX-1 represses the transcriptional activity of SF-1, and AHC mutants of DAX-1 lose repression function. To further investigate these findings, we characterized the interaction between SF-1 and DAX-1 and found that their interaction indeed occurs through a repressive domain within the carboxy terminus of SF-1. Furthermore, we demonstrate that DAX-1 recruits the nuclear receptor corepressor N-CoR to SF-1, whereas naturally occurring AHC mutations of DAX-1 permit the SF-1-DAX-1 interaction, but markedly diminish corepressor recruitment. Finally, the interaction between DAX-1 and N-CoR shares similarities with that of the nuclear receptor RevErb and N-CoR, because the related corepressor SMRT was not efficiently recruited by DAX-1. Therefore, DAX-1 can serve as an adapter molecule that recruits nuclear receptor corepressors to DNA-bound nuclear receptors like SF-1, thereby extending the range of corepressor action.

Adrenal Gland Diseases↗