Biomedical subjects
Publications and source records attributed to D Kölle.
The influence of histamine, a biogenic amine known for many years, on the contractility of uterine specimens, was investigated. A highly significant (p > 0,0001) increase of uterine activity after the application of histamine 10(-6) M was observed, caused by a similar increase of frequency, duration and amplitude of the contractions.
OBJECTIVE: To improve the accuracy and speed of diagnosis of an ectopic tubal pregnancy by means of blood flow analysis in the tubal arteries. We hypothesized that invasion of the trophoblast increases blood flow in the tubal artery involved in ectopic pregnancy. METHODS: In 394 patients, using an endovaginal triplex color Doppler ultrasonography system, we performed qualitative blood flow analysis in the tubal arteries on both sides. The percentage of the between-side difference in tubal blood flow was calculated. RESULTS: There was an increase in tubal blood flow on the ectopic pregnancy side, and the mean between-side difference in tubal blood flow was 20.45% in the ectopic pregnancy group. In the control groups, the between-side difference was 2.95% (t = 21.5, P < .00001). Using a cutoff point of 8% for the percentage of the between-side difference in tubal blood flow, the method had a sensitivity of 85% and a specificity of 96% for diagnosing an ectopic pregnancy. The percentage of the between-side difference in tubal blood flow was independent of gestational age (Pearson correlation coefficient 0.081). CONCLUSION: The advantages of this new method for diagnosing tubal pregnancy are early detection, noninvasivity, and immediate results.
Ectopic pregnancy is not recognized in 5523% of all cases using state-of-the-art diagnostic procedures. In this study, blood flow in tubal arteries was measured using a transvaginal duplex Doppler ultrasonography system. A 3.5 MHz Doppler transducer coupled to a 5 MHz imaging transvaginal sector probe was used to depict flow characteristics in the tubal branch of the uterine artery. This was performed in 102 patients. There was a significant increase in the blood flow on the tubal gestation side (p < 0.0001; z = -4.08). This between-side difference was determined using qualitative frequency shift analysis. The mean reduction in the resistance index on the side with the ectopic pregnancy as compared to the contralateral side was 15.6%. These changes appear to be due to trophoblast invasion. Between-side differences showed no dependence on gestational age (between gestational weeks 4 and 12 postmenstruation). We compared these data with those from three control groups ('early viable intrauterine pregnancy', 'early intrauterine pregnancy failure', 'non-gravid state'). In all these control groups, the impedance to flow, expressed as 'resistance index', showed no significant between-side difference. All control groups had significantly higher mean resistance index values than the ectopic pregnancy side, but did not differ from the contralateral side of the ectopic pregnancy group. The advantages of this new method in diagnosing ectopic pregnancy are early detection, non-invasivity, and immediate results.
Erythropoietin levels have been determined in 24 patients with different gynecologic malignancies, who were treated with cisplatinum and endoxan. A statistically highly significant decrease was demonstrated 2 h after starting treatment with a further significant decrease at 6 h. After 12 h the erythropoietin concentrations returned to values similar to those before treatment started.
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After birth of an infant with a birthweight of 4000 g or more maternal glucose tolerance should be examined. We measured blood glucose values after a 100 g oral glucose challenge and compared them with serum fructosamine values of the same subjects. 40 women who had given birth to an infant with macrosomia (group I) were matched with 40 women who had delivered babies with normal birthweight (group II). Impaired glucose tolerance was found in 6 women (15%) of group I, and in one woman (2.5%) of group II. Fructosamine values were within the normal range in each of the seven women (1.74 + 0.2 mmol/l vs 1.73 + 0.2 mmol/l). Thus, fructosamine determination is not sensitive enough to detect impaired glucose tolerance in asymptomatic women post partum. It is not feasible to replace the oral glucose tolerance test in screening for gestational diabetes mellitus.
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368 urodynamically investigated women of the University Hospital of Innsbruck (Austria) were separated into four groups depending on their incontinence status (either stress incontinence or not) and depending on previous incontinence surgery. In this collective of patients, we compared the urethral length, the absolute and relative functional urethral length and the absolute and relative length from the bladder to the point of maximum urethral closure pressure with the patients' age and menopausal status. The analysis showed a dependence of the urethral length on age and menopausal status in women having undergone no previous incontinence surgery, who suffered from genuine stress incontinence. In these patients, the relative length from the bladder to the point of maximum urethral closure pressure also depended on the menopausal status. In women with no previous surgical treatment showing no symptoms of genuine stress incontinence, we could find a relationship between the age of the patients and the relative length to the point of maximum urethral pressure. Furthermore we could show that, in continent patients, the distance bladder - point of maximum urethral closure pressure was more often longer than 60% of the functional urethral length than in patients suffering from genuine stress incontinence.
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The coexistence of pheochromocytoma and primary adrenal Cushing's syndrome of the same adrenal gland has rarely been reported. We describe here the case of a female patient presenting with mild Cushing's stigmata, hypertension and diabetes mellitus in whom we diagnosed a pheochromocytoma of the left adrenal gland with coexisting non-ACTH-dependent cortisol hypersecretion. While hormonal work-up was still in progress, the patient became pregnant and wanted to carry her pregnancy to full-term. A laparoscopic adrenalectomy in the 17th week of gestation was decided upon and the patient accordingly prepared for surgery by pre-treatment with phenoxybenzamine. Successful surgery--the first ever reported laparoscopic resection of a pheochromocytoma in pregnancy--without perioperative complications was performed under general anesthesia, with the patient receiving peri- and post-operative hydrocortisone substitution. Pathohistological examination revealed a pheochromocytoma with positive immunostaining for interleukin-6 (IL-6) and negative immunostaining for ACTH, vasoactive intestinal polypeptide (VIP) and cytochrome P450, and with no signs of malignancy. A paracrine stimulation of the ipsilateral adrenal cortex by IL-6 produced by the pheochromocytoma, leading to cortical hyperplasia and subclinical Cushing's syndrome, is suggested by the positive immunostaining for IL-6 and the MRI findings. Post-operatively, secondary adrenal insufficiency ensued, necessitating continuing hydrocortisone replacement over 12 months. Hypertension resolved after surgery, and diabetes after the uncomplicated vaginal delivery at term.
The influence of serotonine, a vasoactive neurotransmitter, on the spontaneous motility of uterine strips was investigated. A highly significant (p less than 0.001) increase of uterine activity was observed when serotonine 10(-6) M was added to the perfusing medium.
The influence of naftidrofuryl, a serotonin blocking agent on the spontaneous motility of 25 myometrial strips collected during cesarean section was investigated. A highly significant (p less than 0.0001) reduction of the uterine activity after the application of naftidrofuryl 10(-6) was observed.