[Treatment of female urge incontinence by local estrogen therapy].
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Biomedical subjects
Publications and source records attributed to C Schatten.
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A new strategy for tumor detection using immunoscintigraphic techniques was used in an attempt to improve the diagnostic potential of conventional external immunoscintigraphy. Twelve patients who were strongly suspected to either suffer from primary or recurrent ovarian cancer were investigated as follows: radioimmuno-scintigraphy (RIS) by means of radiolabelled antibodies was performed in all patients prior to operation (first or second look). During the operative procedure, which always took place immediately after completion of the diagnostic RIS, a hand-held gamma-ray detection probe, especially developed for this purpose was used for the purpose of identifying radiolabelled tumor sites intra-operatively in the open abdomen. In 10 out of 12 of the investigated patients, Radioisotope-Assisted Surgery (RAS) could be performed successfully. The count rates in cancer sites ranged from 150-250 cts per 6 s vs. 30-50 cts per 6 s in normal tissues. While the presence of malignant-tumor sites could always be predicted by conventional RIS, RAS failed twice, but revealed more accurate information concerning the real extent of the disease.
In recent years, accurate preoperative diagnosis has been increasingly emphasized as an important therapeutic aspect of urinary incontinence in women. One of the diagnostic modalities employed is the lateral urethrocystogram. 25 patients with recurrent stress induced urinary incontinence were subjected to a dura-sling operation. The median duration of incontinence-related problems until secondary surgery (loop surgery) was 2.6 years. Radiological investigations before and after loop surgery showed, that this operation produces good morphological results, if the preoperative diagnosis is accurate. In 84% of the patients the continence obtained was verified by clinical evidence and radiologic findings.
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In the course of a prospective study 43 women underwent axillary immunolymphoscintigraphy (ILS) shortly before a planned operation for suspected carcinoma of the breast. The aim was to test the feasibility of this procedure for the noninvasive staging of lymph-nodes. Three antibodies were used: HMFG-1 (3 patients), HMFG-2 (13) and 3C6F9 (27). The diagnosis was confirmed in 35 patients. They underwent radical mastectomy with removal of the lymph-nodes. There were marked differences in the usefulness of HMFG-2 and 3C6F9 for ILS in these circumstances. There were too few patients to evaluate HMFG-1. Sensitivity and specificity of the test were 0.57 and 0.83, respectively, for HMFG-1 and 0.83 and 0.93 for 3C6F9.
30 patients with a recurrent stress incontinence were undergoing a dura-sling operation. The mean period of incontinence complaints up to the second surgery was 2.6 years. In the follow-up investigation the urodynamic parameters showed a significant improvement of the UCP, the urethral functional length and the DepQ. One year after surgery 86% of the women showed both a clinical and a urodynamic continence. A short term of urination disorders has to be considered in a part of the cases.
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The C-reactive protein (CRP) concentration was determined in 25 infants whose mothers had presented with prolonged rupture of amniotic membranes (PROM) and/or amnionitis. CRP was positive (i.e. greater than or equal to 6 mg/l) within the first 6 hrs of life in 10 and negative in 15 infants. Clinically, all infants with positive CRP developed symptoms suggesting bacterial infection and both the absolute immature neutrophil counts as well as the ratio immature/total neutrophils were significantly higher in them on day 2 of life than in infants with negative CRP. Blood cultures were only positive in infants with positive CRP. Thus CRP can be regarded as an early marker for neonatal bacterial infection due to PROM and/or amnionitis.
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The incidence of clavicula fractures at the First Department of Obstetrics and Gynecology of the University of Vienna was 217/8383 (2,6%) deliveries in 1980 through 1984, whereas 248/5531 (4,44%) deliveries were noted at LKH Mödling. Higher birth weight and larger children result in a greater incidence of clavicula fractures. The greater percentage of children weighing more than 4000 gm and being larger than 52 cm at the LKH Mödling compared to that at the First Department of Obstetrics and Gynecology of the University of Vienna, i.e. 18,55% and 40,32% vs. 15,67% and 28,57%, resp. explains the higher incidence of clavicula fractures there.
19 patients with a known history of ovarian cancer were investigated by radioimmunoscintigraphy (RIS) to look for recurrent disease a few days before second-look surgery. The tumor-associated monoclonal antibody HMFG-2 (400 micrograms/patient) was injected intravenously after labeling with radioactive 123I (0.5-2.2 mCi/patient). Scans were reviewed for activity accumulations due to uptake of the tumor-associated antibody by tumor sites. In 15 out of the 19 cases the scan results correlated with the intraoperative findings. There were 2 false-positive and 2 false-negative scans, the latter in patients with subclinical disease. The smallest lesion detected by radioimmunoscintigraphy had a diameter of 1.5 cm. In 3 patients, tumor sites were identified that had been missed by all other routinely performed methods of investigation including transmission computed tomography. These data indicate that RIS is of considerable clinical value in the early detection and localization of recurrent ovarian cancer and may, therefore, improve the management of these patients.
OBJECTIVE: To test the hypothesis that serum levels of basic fibroblast growth factor (bFGF) are altered among women with pregnancy-induced hypertension (PIH) and are associated with disease severity. METHODS: We evaluated serum levels of bFGF in 46 women with PIH, 46 age- and parity-matched healthy pregnant women, and 46 healthy nonpregnant controls. Enzyme-linked immunosorbent assays were used to determine serum levels of bFGF. Results were correlated to clinical data. RESULTS: The overall mean serum levels of bFGF were 3.2 (standard deviation [SD] 9.3) micromol/L. Mean serum levels of bFGF in normal controls, healthy pregnant women, and women with PIH were 0 (SD 0) micromol/L, 2.6 (SD 6.3) micromol/L, and 6.8 (SD 13.8) micromol/L, respectively (P =.003) for normal controls compared with healthy pregnant women and P <.001 for healthy pregnant women compared with women with PIH). In a univariate logistic regression model bFGF showed a significant influence on the odds of presenting with PIH compared with healthy pregnant women (P =.002). The mean serum levels of bFGF in women with severe PIH and in women with mild PIH were 4.4 (SD 10.6) micromol/L and 9.5 (SD 17.3) micromol/L, respectively (P =.1). In a univariate logistic regression model bFGF did not reveal a significant influence on the odds of developing severe PIH (P =.3). CONCLUSIONS: Elevated serum levels of bFGF are associated with PIH, but bFGF does not seem to be a useful prognostic parameter for severe PIH.
PURPOSE: The detection of low/intermediate/high risk genital groups of human papillomavirus (HPV) in correlation with a growth-factor receptor c-erbB-2 in benign tumors of the mammary nipple. MATERIALS AND METHODS: Ten nipple duct adenomas (NDAs) and twenty papillomas, all embedded in paraffin and taken from the breast, were analyzed for HPV DNA of the low- and high/intermediate-risk groups. Polymerase chain reaction (PCR) with HPV consensus primers (types 6/11/16/18/33) and dot-blot hybridization with type-specific primers were used for the detection of these HPV-DNA sequences. Indirect in situ PCR (ISPCR) was also used in one case of an HPV-DNA-positive papilloma. In addition, we examined c-erbB-2 oncogene expression in NDAs and central carcinomas of the mamma from an immunohistochemical perspective. RESULTS: Using PCR and dot-blot hybridization we could not detect the gene sequences that are specific for the low- and high/intermediate-risk groups in any of the ten NDAs. Regarding the 20 cases of papilloma, a positive result for HPV types 6/11 was detected by indirect ISPCR; in one case in combination with a condyloma of the skin around the mammary nipple. The oncogene expression of c-erbB-2 displayed a strong signal in the papilloma cells and in the NDAs of the breast. CONCLUSION: Our results showed that the HPV-DNA types of the low- and high/intermediate-risk groups are without relevance for the pathogenesis of benign diseases of the nipple. It was, therefore, not possible to establish a correlation between the oncogene expression of c-erbB-2 and the HPV-DNA types.
OBJECTIVE: To evaluate placental expression and serum cytokeratin-18 in women with preeclampsia. METHODS: Serum cytokeratin-18 was evaluated in 44 women with preeclampsia and 44 healthy pregnant women using an immunoradiometric assay. Placental expression of cytokeratin-18 was investigated in specimens from 23 women with preeclampsia and 20 healthy pregnant women by immunohistochemistry. RESULTS: Median serum cytokeratin-18 in women with preeclampsia and healthy pregnant women was 106.7 and 76.0 U/L, respectively (P =.02). Among women with preeclampsia, serum cytokeratin-18 was significantly associated with severity of disease (P =.001) and showed a sensitivity (standard error) and specificity (standard error) of 85% (7%) and 65% (12%), respectively. In placental specimens, the cytoplasm of the syncytiotrophoblast stained positive for cytokeratin-18 with strong and widespread staining in 83% and 45% of placental specimens of women with preeclampsia and healthy pregnant women, respectively (P =.01). CONCLUSION: Elevated serum cytokeratin-18 values are associated with disease severity in women with preeclampsia. Our data provide additional evidence that the placenta might be the source of the elevated serum cytokeratin-18 values in women with preeclampsia.