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Biomedical subjects

F Melchert

Publications and source records attributed to F Melchert.

At least 19 recordsLinked to original sources
PubMed1992

Increased detection of HPV 16 virus in invasive, but not in early cervical cancers.

Human papilloma virus type 16 (HPV 16) DNA is found in about 50% of cervical squamous cell carcinomas (SCCs), and this association has raised the possibility of a causal role for HPV 16 in cervical carcinogenesis. We have tested this hypothesis by assaying a series of biopsies (n = 119) ranging from normal mucosa to infiltrating SCC with the PCR-technique for the presence of HPV 16 DNA. While HPV 16 DNA was detected in 50% of our cases with invasive SCC, the incidence of HPV 16-positive samples was about 10% in all other biopsies ranging from normal mucosa to cases of carcinoma in situ. HPV 16 therefore appears to be involved in late tumor promotion but not in early tumor development.

Base Sequence↗
PubMed1992

[Fetal outcome of premature infants less than 1,500 g birth weight with special reference to surfactant requirements].

The objective of our study was to examine therapeutic success within a study group of 108 premature babies weighing less than 1500 g at birth. The foetal outcome was divided according to intrauterine betamethasone administration, method of birth and surfactant requirement. 59 of the babies did not require a surfactant factor, because within 12 hours it was possible, to reduce respiration to an O2 partial pressure of 20%. In 49 of the premature babies, this was not possible, and therefore, surfactant substitution was required, whereby this subject group was divided into surfactant responders and surfactant non-responders. In addition, we examined the influence of the method of birth on later survival and the occurrence of intraventricular haemorrhages in the children. A noticeably higher survival rate was determined in 81% of the children, born via Caesarean section, compared with 63% of premature babies, born via vaginal delivery. Likewise, detectable intraventricular haemorrhages (IVH) were significantly lower amongst premature babies delivered via Caesarean section (25%) than those delivered vaginally (37.5%). A considerable improvement in survival rates and a reduction in IVH was achieved by means of completed lung maturation with betamethasone (16 mg in 48 hours). 62% of premature infants with completed prepartal lung maturity did not require the administration of a surfactant due to the favourable respiratory situation. However, for those cases, where it was no longer possible to conduct lung maturation, only 46% did not require surfactant substitution. Therefore, it would appear advisable, to delay the delivery of premature babies weighing less than 1500 g in order to carry out lung maturity treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1992

[Infected chorionic hematoma as a cause of infection in the 2nd trimester].

Superinfected subchorionic haematomas are a rare septic focus in the 2nd trimenon. Symptoms being unspecific, the diagnosis has to be made by exclusion, in most cases. As the changes of a successful treatment of the manifest infection is poor, antibiotic prophylaxis as well as close laboratory controls and early antibiotic therapy should be discussed after sonographic diagnosis of an intrauterine haematoma. Two of our three patients reported on having suffered a miscarriage; only one pregnancy could be maintained after spontaneous depletion of the infected haemorrhage.

Adult↗
PubMed1992

[Struma carcinoid tumor within a dermoid cyst as an incidental finding in cesarean section].

A 25-year-old primigravida with breech presentation was admitted near term. During Caesarean section, a dermoid cyst of the right ovary was detected. The dermoid cyst was enucleated, preserving a plum-sized ovary. Histology revealed a strumal carcinoid within the excised dermoid cyst. From the histological point of view it was classified as a tumour of low malignancy. The clinical study provided no evidence of any metastases. On the 14th postoperative day the patient could be discharged from hospital subject to close aftercare control.

Adult↗
PubMed1992

[Magnetic resonance tomography as the basis for biomechanical analysis. The simulation of the birth process as an example of the expanded information potentials of segmental imaging procedures].

A method is presented that enables the use of (static) informations from magnetic resonance imaging (MRI) for (dynamic) biomechanical analysis. Using a specially developed software MRI pixel matrices are colour-coded and--according to the principle of same density--line data are created. After sectional attribution of the resulting polygons a three-dimensional mesh of so-called finite elements is created which can then be used in deformation analysis. This method is exemplified by a project dealing with the simulation of birth mechanics, which is finally aimed at validating the results from radiologic pelvimetry. First analyses show that even under foetal head moulding conditions, being considered as normal, such sensitive structures as the cerebellum, brain stem as well as the ventricles with the plexus chorioidei are to be found within the maximum isobars within a range of 104-140 N(10.6-14.3 kp).

Adult↗
PubMed1992

[Suitability of metric structural criteria in vaginal ultrasound assessment of the postmenopausal endometrium].

In 135 postmenopausal women ultrasonic findings of the endometrium were compared with the final histopathology. Object of this study was to evaluate the ability of metric structural criterions for a vaginosonographic screening of benign and malignant endometrial neoplasms. A sonographic assessment of the endometrium was possible in 97.8% of the patients; anatomic peculiarities such as calcified fibromyomata proved to be the main-impediments. By means of the criterions examined the sensitivity for the differentiation of inconspicuous and pathological findings was 100% with a 98.2% specificity; the rate of wrong-positive results was 1.6%. In 9.2% ultrasound was classified as conspicuous requiring further controls. According to these results the vaginosonographic assessment of the endometrium regarding its thickness and structure (homogeneity, echogeneity, median echo) can be recommended for a non-invasive screening for endometrial neoplasms.

Aged↗
PubMed1991

[Cytokine production by gynecologic cancers].

Aggressive polychemotherapy and ultraradical surgery had had only small benefits for patients with gynaecological cancer in recent years. That is why we measured cytokines in these patients to evaluate a possible future immune therapy. To investigate the influence of gynaecological cancer on in vitro and in vivo cytokine production of peripheral mononuclear cells (PBMC) from 27 patients with mamma carcinoma and 29 patients with cervical cancer, we evaluated the production of interferon-alpha (IFN-alpha), interferon-gamma (IFN-gamma) and tumour necrosis factor-alpha (TNF-alpha). We compared the immune function of these patients versus 20 patients who had had routine hysterectomies performed for non-malignant reasons and 20 healthy female controls. Blood for cytokine production was collected prior to surgery, for IFN-alpha-production two weeks after surgery and for all cytokines three months after surgery. Measurement of TNF-alpha-production did not differ significantly in all investigated groups. IFN-gamma-production was reduced by 50% in patients with mamma carcinoma in three months - possibly caused by chemotherapy and radiation. The amount of IFN-alpha production in cancer patients was dramatically reduced before primary therapy started. The low levels of IFN-alpha persisted for three months compared to the IFN-alpha production in non-cancer patients and healthy controls. The follow-up of patients with breast cancer undergoing chemotherapy showed a suppressive effect on immunological function in IFN-alpha. Our results demonstrate, that patients with breast cancer and cervical cancer showed a significantly reduced capacity to product IFN-alpha.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Prognostic significance of intrauterine hematomas in the 1st and 2d trimester for the course of pregnancy and labor].

The courses of 66 pregnancies with sonographic evidence of an intrauterine haematoma within the egg-membranes during threatened abortion, between 7th and 24th week of gestation, were compared to the courses of 55 patients at the same gestational age admitted to our hospital, during the same period, with vaginal bleeding only. The aim of our study was to determine the prognostic significance of intrauterine haematomata in the I. and II. trimester for the course of pregnancy and delivery. The abortion-rate after intrauterine haematomata was significantly increased to 17.5%, a high percentage of them taking a febrile or septic course. The rate of preterm labour in haematoma patients was significantly higher (34.5 compared to 12.7%, respectively), than that in patients, who were only bleeding; this, furthermore, was reflected by a strong trend of preterm delivery (21.9 compared to 12.9% resp.). The caesarean section rate of 55.8% in the haematoma group was found to be significantly higher than in the control group (16.7%), mainly due to a significantly increased proportion (23.1%) of abnormal foetal presentations. Abnormal placental stages had to be treated significantly more often after intrauterine haematomata (32.6%) than in the control group (9.3%); however, no differences could be found between the two groups in respect of metabolic or respiratory placental dysfunction. The parameters examined in this study were not influenced by the volume of the haematoma, although the spectrum of complications seemed to be correlated to the gestational age at the time of diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Spontaneous↗
PubMed1991

[Incidence of congenital infections].

The discussions on the pros and cons of obstetric screening for connatal infections have been going on for years. We, therefore, conducted a prevalence study of the most common connatal infections. HIV infection, rubella and syphilis were not subjects of this study. We analysed the relevance of these infections in 512 pregnant women and their newborn infants at the moment of delivery. Further serological tests were run three months post partum, if necessary even for a longer period. Cytomegaly IgG antibodies were found in 46% of the examined women, IgM antibodies in 1.3%. Women under the age of twenty and women of low social standing showed the highest rate of prevalence of infection with CMV. The prevalence of IgG antibodies against parvovirus B 19 was 29%. In 10 mothers, positive IgM titers were found at the time of delivery. In all these women, pregnancies had been uneventful. However, 9 mothers exhibited a significantly raised abortion rate within the last 20 months before delivery. 7 of 512 women turned out to be HBs antigen carriers, 3 women and their babies were anti-HCV positive. The prevalence of toxoplasmosis IgG antibodies was 36%, of IgM antibodies 5.3%. By further investigation (Toxo ISAGA, Toxo IgA) we were able to detect one child with connatal toxoplasmosis. We conclude, that screening for parvovirus B 19 and hepatitis C is required only, if there are contact or clinical hints that the patients might have acquired either one of these infections. But we postulate, that a routine screening programme for hepatitis B and toxoplasmosis should be carried out in all pregnant women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[The "other induction"--experiences and consequences in 281 deliveries following intravaginal administration of PGE2 tablets].

186 patients have been included prospectively in a study, aimed at analysing the course of birth after induction with 3 mg PGE2-tablets given intravaginally. These data are compared with those gained from a retrospective analysis of 95 patients using a dose of 2 mg. The total of the births within our clinic in 1986/87 functions as controls. Although in every case there has been an urgent need for the termination of pregnancy and there have been also unfavourable cervix findings in the 3 mg group, no differences could be observed in comparison to the control group concerning duration of cervical dilatation and expulsion, as well as foetal outcome parameters. When comparing the 2 mg and 3 mg groups, a certain superiority of the 3 mg dosage could be noted, leading to the opinion, that trial dosages of less than 3 mg should be abandoned. C-section rate was lowest and spontaneous birth rate was highest in the 3 mg group as compared to the 2 mg and the control groups. Permanent CTG-monitoring was not necessary. CTG-controls after 2 and 6 hours proved to be sufficient. Uterine hyperstimulation occurred in 2.1% of cases in both groups. In every case, prompt antagonization by means of high dose betamimetic therapy could be achieved. Due to reducing maternal and foetal side effects, the maximal mobility of the mother after tablet application, as well as, for the smooth congruence of cervical ripening and labour induction, the clinical use of the 3 mg tablet is a modern alternative to the classic oxytocin induction.

Administration, Intravaginal↗
PubMed1987

Ovarian carcinoma: increase in clinical validity by simultaneous determination of SRA and CA 125.

Ovarian carcinomas are distinguished by their polyclonality, i.e., heterogeneity and polymorphism of their tissue. There is no marker available complying with the clinical demands in the case of ovarian carcinoma regarding satisfactory sensitivity and specificity. Therefore, we have simultaneously determined two entirely distinct tumor markers, serum ribonuclease activity (SRA) and cancer antigen 125 (CA 125), recommended in the literature with respect to ovarian carcinoma. After evaluation by logistic regression analysis, we found a specificity of 93% together with a sensitivity of 97% for the simultaneous determination of SRA and CA 125 (37 ovarian carcinomas, 11 cases without pathological findings after treatment, 11 benign tumors of the ovary, 61 controls). The patients are not exposed to increased stress by this simultaneous determination method compared to the determination of a single marker. The increased clinical validity justifies the recommendation of routine simultaneous determinations of SRA and CA 125 for diagnosis and monitoring of patients with ovarian carcinoma.

Antibodies, Monoclonal↗
PubMed1985

[Metastatic breast cancer with involvement of the bone marrow, uterus and ovaries. A case report on diagnostic and therapeutic procedures].

The article reports on a clinically unusual case of a patient with carcinoma of the breast. The "initial sign" of the disease was relapsed hypermenorrhoic permanent bleeding with severe bleeding anaemia caused by a metastatic growth in the uterus. Surgery or cytostatic treatment did not seem possible at the outset, because thrombocytopenia (21,000/nl) progressed rapidly, associated with disseminated bone marrow metastases. The diagnostic and therapeutic procedure is described and discussed.

Adult↗
PubMed1985

[New developments in the area of markers in diagnosis and monitoring of ovarian cancer].

The diagnostic and prognostic prediction of ovarian carcinoma can be substantially improved by combining serological markers synchronized with radiological and morphological methods. The validity of the following markers was investigated in a prospective trial between 1977 and 1983: CEA, TPA, SP-1, SP-3, alpha-1-antitrypsin, alpha-2-macroglobulin, c-reactive protein. The results were correlated with those of the CA 12-5 determination. Pre-operatively, ovarian carcinoma was indicated by CA 12-5 (93.7%), sialyl transferase (65.6%), TPA (53.1%), CEA (28.1%). These markers would appear suitable to control the clinical course.

Antigens, Neoplasm↗