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Biomedical subjects

E Kofler

Publications and source records attributed to E Kofler.

At least 19 recordsLinked to original sources
PubMed1990

[Incidence and therapy of hyperstimulation following local prostaglandin administration for labor induction].

A major cause of concern with respect to local prostaglandin (PG) E2 application is uterine hyperstimulation. The purpose of the present study was to evaluate the incidence of hyperstimulation and the possibility of treating this complication. A total of 181 cases were registered in two obstetric centres over a 51-month period. The rates of hyperstimulation were 7.3% in the group receiving intravaginal PG E 2 tablets (3 mg), 2.9% with intravaginal gel (2.5 mg), and 0.5% with intracervical gel (0.5 mg). In 178 cases (98.3%) the infusion of a beta-2 adrenergic drug (hexoprenaline or terbutaline) led, without adverse effects, to the rapid resolution of the alarming findings. Caesarean section was necessary in 3 patients. Depressed Apgar scores and an umbilical artery pH less than 7.20 were uncommon and, indeed, no more frequent than in PG E 2-treated cases without hyperstimulation. We conclude that uterine hyperstimulation is uncommon after low-dose PG E 2 therapy and is usually rapidly reversible, without apparent untoward intrapartum or neonatal effects.

Adolescent↗
PubMed1990

Expression of P0- and P3-RNA from the normal and translocated c-myc allele in Burkitt's lymphoma cells.

We have studied the allele specific expression of c-myc P0- and P3-RNA in Burkitt's lymphoma (BL) cells. The steady state levels of P0-RNA show considerable variations in BL cells. Expression of P0-RNA was found to be restricted to the translocated allele, but could be induced by TPA from the normal allele. P0-transcription was particularly sensitive to inhibitors of protein synthesis compared to expression of P1-, P2- and P3-RNA. Transcription of P3-RNA is initiated in the first intron of the c-myc gene and has previously been described to be specific for translocated c-myc alleles in BL cells broken within exon 1 or intron 1. Here we show that P3-RNA is also expressed from an unrearranged c-myc gene. In the BL cell line Raji, substantial amounts of c-myc RNA are derived from the P3-promoter of the normal allele. This indicates that repression of the normal allele in BL cells does not include the P3-promoter. The potential coding capacity of P3-RNA is discussed.

Alleles↗
PubMed1989

Is induction of labor indicated in prolonged pregnancy? Results of a prospective randomised trial.

In 345 women with a favorable cervical score at due date, labor was either induced by means of intravaginal application of tablets containing 3 mg of prostaglandin E2 or spontaneous onset of labor was awaited until the 42nd week of pregnancy. Eighty percent of the nulliparae and 96.3% of the multiparae of the induction group gave birth within 24 h of the administration of the first tablet. All pertinent delivery intervals were significantly shorter in this group compared to those women where spontaneous onset of labor was awaited. The rate of operative deliveries was lower in the induction group. With the exception of 1 fetal death 3 days after due date, fetal outcome was excellent in both groups. Elective induction was at least equivalent to awaiting the onset of spontaneous labor and was not associated with higher complication rates due to the method of induction.

Clinical Trials as Topic↗
PubMed1988

TPA-inducible Epstein-Barr virus genes in Raji cells and their regulation.

A number of agents including the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) can induce an abortive virus cycle in the EBV nonproducer Burkitt's lymphoma line Raji. We describe the pattern of viral RNAs transcribed in uninduced cells and in cells treated with TPA for 8 hr, as analyzed by Northern blotting. By comparing the patterns of RNAs observed in cells treated with TPA, TPA plus cycloheximide, or cycloheximide alone, we have tested whether any EBV gene in TPA-treated Raji cells would be inducible directly by TPA in the presence of protein synthesis inhibitors, similarly to immediate-early genes induced by superinfection of Raji cells with P3HR-1 virus in the presence of cycloheximide. We demonstrate here that induction of all early EBV genes is dependent on ongoing protein synthesis. The experiments do not provide an answer to whether TPA acts by activating an initial step in the cascade of virus production or whether TPA has a simultaneous pleiotropic effect on the regulation of a large number of viral genes.

Genes, Viral↗
PubMed1988

The block of elongation in c-myc exon 1 is abolished in Burkitt's lymphoma cell lines with variant translocation.

Dimethylsulfoxide (DMSO) induces a block of c-myc RNA elongation in the human B cell line BJAB. In Burkitt's lymphoma cell lines with variant translocations, which are characterized by mutations in and around the first c-myc exon, DMSO is not capable of inducing the RNA elongation block. The action of DMSO is, however, not restricted to regulation at the level of RNA elongation. In the cell line BL2 with a t(8;22) translocation c-myc steady-state RNA decreased about 20 fold 1 and 2 h after DMSO treatment, followed by an increase to approximately initial levels after 4 h. During the time course of the experiment the usage of the dual promoter P1/P2 shifted from the ratio 3:1 in untreated cells to the ratio of 1:5 in BL2 cells treated with DMSO for 4 h. This promoter shift is presumably regulated at the transcriptional level. In BJAB cells an isolated intragenic transcription was detected at the boundary of intron 1 and exon 2. This transcription appeared 2 to 4 h after addition of DMSO when expression of the c-myc gene was downregulated by blocking RNA elongation at the end of exon 1.

Blotting, Southern↗
PubMed1986

[Experiences in 2,149 labor inductions using 3 mg prostaglandin E2 vaginal tablets. A retrospective analysis].

This study is a retrospective analysis of induction of labour by means of PGE2 tablets, one group being electively, the other group medically indicated; in all, 2149 primi- and multiparae during a period of 5 years. Application of the vaginal tablets containing 3 mg PGE2 was effected every 6 hours. Low-risk women stayed mobile up to the amniocentesis performed at about 4-5 cm. Patients with specific risks or spontaneous ruptures of the membranes were supervised correspondingly. About 80% of the primiparae, respectively 90% of the multiparae of the elective induction group delivered within 24 hours after the first application of a vaginal tablet. The rate of Caesarian sections was extremely low. As expected in patients in whom induction of labour was necessary usually before term, the percentage of successful inductions was lower and the rate of Caesarian sections higher. The foetal outcome in both groups in respect of Apgar scores, and the blood gases of the umbilical cord as well as length and weight ranged within the normal limits. The cleared perinatal mortality was 0% (1 congenital defect with death). This study shows that the good results of prospective studies with a smaller number of cases can be confirmed by a retrospective analysis of an extensive group of patients, demonstrating the increasing acceptance of induction of labour by means of PGE2 tablets in elective as well as in medical indications.

Administration, Intravaginal↗
PubMed1986

[Labor induction with 3 mg of prostaglandin E2 vaginal tablets. A renaissance of programmed labor? Results of a prospective randomized study].

Vaginal application of tablets containing prostaglandin at term in pregnant women with a favorable cervical score is a very efficacious method of induction of labour. Due to the motility of the women they consider this method of induction as almost natural. We, therefore, aimed at discussing the optimal procedure in low-risk pregnancies at due date, by means of a prospective randomised trial. In 345 women with a favourable cervical score, labour was either induced by means of intravaginal application of tablets containing PGE2 according to a precise plan, or spontaneous onset of labour was awaited while CTG-controls were performed on an outpatient basis every second day until the 42nd week of pregnancy was completed. 80 per cent of the nulliparas and 96.3 per cent of the multiparas of the induction group delivered within 24 hours of the first tablet application. All pertinent delivery intervals were significantly shorter in this group compared to those women where spontaneous onset of labour was awaited. The incidence of prolonged labour was low in both groups and not significantly different. Only 4.2 per cent of the women in the group where spontaneous labour was awaited, reached the completed 42nd week of pregnancy. Only one woman had to be induced because of a suspicious CTG. The rate of operative deliveries was lower in the induction group (1.1% versus 3.8% Caesarean sections). With the exception of one foetal death due to a cord complication three days after the due date the foetal outcome was excellent in both groups. The acceptance of the procedure was tested by means of a questionnaire during the post partum period.(ABSTRACT TRUNCATED AT 250 WORDS)

Cesarean Section↗
PubMed1985

Aberrant c-myc RNAs of Burkitt's lymphoma cells have longer half-lives.

BL67 and BL18 are Burkitt's lymphoma cell lines with t(8;14) translocations (the breakpoint is in the first exon and first intron, respectively) in which the mu-heavy chain switch region is fused to the c-myc gene in head to head orientation. In both cell lines only aberrant c-myc RNAs are found. BL67 cells contain two c-myc RNA species of 2.4 and 3.5 kb. The 2.4-kb RNA is initiated at several cryptic promoters in the first intron. The 3.5-kb RNA is transcribed from the immunoglobulin heavy chain anti-sense strand across the breakpoint of the translocation into the first exon of the c-myc gene and is then normally spliced using the physiological splice donor and acceptor sites of the c-myc gene. BL18 contains c-myc RNA of 2.4 kb initiated at cryptic promoters in the first intron and additional RNAs of 0.90 kb and 0.74 kb transcribed from the dual c-myc promoters on the reciprocal fragment of the translocation. The cytoplasmic turnover of these RNAs differs significantly from that of the normal c-myc message. The 3.5-kb RNA of BL67 cells and the 0.90-kb and 0.74-kb RNAs of BL18 cells, which are both hybrid molecules consisting of c-myc and immunoglobulin sequences, have a half-life of several hours in contrast to the normal c-myc message with a half-life of 15 min. The aberrant 2.4-kb c-myc RNAs of BL67 and BL18 cells are also more stable than the normal c-myc message and disappear with a half-life of 50 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Burkitt Lymphoma↗
PubMed1985

Lectin binding sites in cultured human breast cancer cells.

Two estrogen-sensitive (ZR 75.1 and 734 B) and two estrogen-independent (BT 20 and Hs 578 T) human breast cancer cell lines, and one larynx carcinoma cell line (Hep. 2), were investigated immunocytochemically for the occurrence of lectin binding sites. Peroxidase-labeled peanut agglutinin (PNA) was used. PNA binding sites could be observed in estrogen-sensitive cell lines only. In ZR 75.1, the most estrogen-sensitive cell line, PNA binding sites were also observed without neuraminidase pretreatment. In our study, PNA binding is associated with the biological estrogen dependence of the tumor cells.

Breast Neoplasms↗
PubMed1984

[Therapeutic effect of intravaginal application of estriol tablets in the treatment of pathological cervical factor as a cause of sterility].

81 women were included in a prospective randomised 12-year personal study. The "pathological cervical factor" was confirmed by periovulatory daily examination of the quality of the cervical mucus, using a new modified scheme of cervical score by examining the oestrogenic activity in the vaginal smear and results of sperm-penetration tests after Sims- Huhner , partly also by periovulatory determination of the concentration of luteinising hormone in the serum. The presence of ovulatory cycles could also be determined by regular registration of the cycle length, measurement of the basal body temperature and partly by premenstrual endometrium biopsies; these determinations were of course effected during cycles without therapy. All 81 cases with abnormal preovulatory production of cervical mucus were treated in a total of 234 cycles by intravaginal application of oestriol tablets 1 to maximal 3 mg daily for 1 or more subsequent cycles. On the basis of these criteria, the quality of cervical mucus and postcoital tests improved with a satisfying intravaginal resorption of the oestriol tablets; no side effects were seen. After this therapy, very good results were obtained with intravaginally administered oestriol tablets in 59.3% of the patients with a pregnancy rate of 27.2%; 24.7% of the cases only showed a moderate improvement of the mucus; 16.0% did not respond to oestriol treatment and, therefore, had to be considered as therapeutic failures. The present study again confirms the results of other investigators on the local effectiveness of intravaginal application of oestriol tablets.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Oxytocin and the initiation of human parturition. IV. Plasma concentrations of oxytocin and 13,14-dihydro-15-keto-prostaglandin F2 alpha during induction of labor by artificial rupture of the membranes.

The influence of artificial rupture of the membranes on plasma levels of 13,14-dihydro-15-keto-prostaglandin F2 alpha (PGFM) and oxytocin was examined in 23 pregnant women at term. Serial blood samples were collected before and 15 minutes, 2 hours, 5 hours, and 8 hours after artificial rupture of the membranes. A significant rise in the concentration of plasma PGFM was observed at 15 minutes in the majority of women (20 of 23), but the magnitude of this early rise or the lack thereof was not related to the subsequent course of labor. The concentration of plasma PGFM at 2 hours was, on the other hand, significantly correlated with the induction-delivery interval. Amniotomy, by itself, induced labor and delivery when the increased PGFM levels were maintained from 2 to 5 hours after the procedure (n = 16). In those cases where Pitocin stimulation was required for adequate uterine contractions, it was found that plasma PGFM levels had declined to initial values at 2 hours. Pitocin infusions then partially reversed this decline. In one patient, the cervix failed to dilate in spite of prolonged Pitocin infusion which did not induce significant uterine contractions, and the infusion did not reverse the marked fall in plasma PGFM after the early but transient rise. Mean plasma oxytocin levels did not rise significantly during labor induced by artificial rupture of the membranes and were, on the average, similar to the levels observed during the first stage of spontaneous or oxytocin-induced labor. Considering the previously demonstrated maximal levels of uterine oxytocin receptors in early labor, the absence of a rise in the plasma oxytocin levels does not negate a role for oxytocin in working synergistically with prostaglandins in the mechanism of labor.

Amnion↗
PubMed1983

[Importance of oxytocin sensitivity for the spontaneous onset of human labor].

The significance of oxytocin for the onset of labour in humans is disputed, mainly because there is no increase in oxytocin concentration in the peripheral maternal blood before onset of labour. However, Fuchs et al. have recently shown that the concentration of oxytocin receptors in the myometrium is significantly higher directly before onset of labour than at the onset of spontaneous contractions. To establish a correlation with the clinical sensitivity to oxytocin, the authors determined the oxytocin sensitivity by means of intravenous administration of 3 X 10 m I.U. of oxytocin with continuous tocographic recording. Parallel to this determination, the cervical score was measured according to Bishop. The patients were 26 healthy pregnant women in whom both parameters were determined daily until onset of spontaneous labour pains. The sensitivity to oxytocin increased significantly during the last few days before spontaneous onset of labour. On the day before onset of pains, almost all of the pregnant women showed maximum sensitivity to oxytocin. Parallel to this, the cervical, scores also increased; on the day before onset of labour pains, almost all pregnant women had a cervical score of 5 or more than 5. On the basis of these results, which concur accurately with the results of measurement of oxytocin receptor concentrations, it is definitely possible to refute the arguments that oxytocin is irrelevant for the onset of labour because its concentration in the maternal plasma does not increase before the pains begin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Effect of cervical application of prostaglandin (PG) E2 on plasma 13,14-dihydro-15-keto-PGF2 alpha and oxytocin in pregnant women at term.

The concentrations of 13,14-dihydro-15-keto-prostaglandin F2 alpha (PGFM) and oxytocin were measured by radioimmunoassay in the peripheral plasma of 21 women with low Bishop scores in whom cervical ripening and labour were induced with a cervical cap containing 1.5 mg of prostaglandin (PG) E2, left in place for 6 h. Blood samples were taken before and at 3, 6, 9 and 24 h after the cap was applied. Four women (control group) had a cap without PGE2. Labour began in 13 women receiving PGE2, 12 of whom were delivered within 24 h. In these women plasma PGFM rose progressively to levels seen during spontaneous labour, paralleling the changes in cervical dilatation. The increase became significant at 6 h, when cervical dilatation was 4.5 cm (SEM 0.5). Plasma oxytocin also increased significantly while the cap was in place and then decreased. Plasma PGFM and oxytocin did not change in the control subjects, and in the eight women needing further induction of labour the initial rises were transient and not statistically significant.

Cervix Uteri↗
PubMed1981

Hematologic parameters and iron state in the perinatal period.

In 51 unselected mothers, we studied, before and after delivery: serum ferritin, serum iron, serum transferrin, the erythrocyte count, the hemoglobin concentration, the hematocrit, and the derived red cell indices. Eighteen percent of women showed a hemoglobin value below 120 g/l. The mean transferrin saturation (22 +- 7.6% (SD) and the mean serum ferritin (34 +/- 18 micrograms/l (SD) indicated a probable decrease of iron stores at term. Only three patients seemed to show hematological evidence of latent iron deficiency, and none had manifest iron deficiency. A decrease of iron stores is considered to be physiological. There was no apparent relation between iron store values and infant birth weight centiles. After delivery the changes in red blood indices showed a close correlation with the amount of blood lost during delivery. At 5 or 6 days post partum the serum ferritin level increased and values showed a wide scatter. As with other acute phase proteins, ferritin synthesis might be stimulated by the non-specific mechanisms during the perinatal period. Hence, after normal delivery serum ferritin levels do not necessarily indicate normal iron stores.

Birth Weight↗