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Biomedical subjects

G Sturm

Publications and source records attributed to G Sturm.

At least 37 records · Page 2Linked to original sources

[Preoperative reduction of uterine leiomyoma by the GnRH-analog goserelin (zoladex)].

The administration of GnRH analogues is expected to improve treatment by avoiding hysterectomy, since problems connected with the surgical removal of leiomyomata are correlated with their size. In this study the GnRH analogue goserelin in its depot formulation (Zoladex, ICI, Plankstadt) was used for treating isolated leiomyomata of the uterus. All patients were treated for 3 months before myomectomy was performed. The complete regression of a large myoma (206 cm3) was observed in 1 of 11 patients. In 5 cases a reduction in volume of more than 50% was achieved. Ovarian function was suppressed by goserelin, after a short-term stimulation, within 7 +/- 3 days. Serum levels of 17 beta-oestradiol were found to be generally less than 25 pg/ml. All patients reported climacteric complaints, but in no case had therapy to be discontinued. After cessation of goserelin, restoration of ovarian function was observed in all patients.

Adult↗

[The importance of the SCC antigen in the diagnosis and follow-up of cervix carcinoma. A cooperative study of the Gynecologic Tumor Marker Group (GTMG)].

SCC (squamous cell carcinoma) antigen is a subfraction of tumour antigen TA-4 isolated from cervical squamous cell carcinomas. Serum concentrations of SCC antigen were measured by radioimmunoassay in 382 control subjects, 70 women with cervical intraepithelial neoplasia (CIN), 517 with cervical carcinoma and 203 with other gynaecological carcinomas. Elevated SCC antigen levels (greater than 2.5 ng/ml) were found in 4% of normal controls, in 7% of women with CIN I-III, in 2%-23% with various forms of genital adenocarcinomas, in 55% with primary and in 76% of those with recurrent cervical squamous cell carcinoma. The positivity rate of the antigen was correlated with tumour stage (FIGO) and lymph node involvement of primary cervical squamous cell carcinomas. During long-term follow-up serum levels of SCC antigen were found to be concordant with tumour activity in 74% of cases. Patients with still elevated marker levels after therapy had twice the recurrence rate of women with normal serum values. Routine determination of SCC antigen during follow-up of cervical cancer is recommended.

Antigens, Neoplasm↗

Effects of two isomeric 1-aminoadamantanes on the membrane anisotropy and on alpha- and gamma-motoneurones excitability.

The structure-activity relationship of two isomeric 1-aminoadamantanes, 1-C-ethylaminoadamantane (D 174) and 1-amino-3-ethyladamantane (D 175), on membrane anisotropy and the excitability of neurons was studied in the CNS of the rat and in the decerebrated cat. Mass spectrometric analysis showed that after a single, 40 mg/kg dose, D 174 and D 175 were unevenly distributed within the CNS of the rat, moreover the distribution pattern of the two substances was different. As measured by fluorescence depolarization in controls the membrane anisotropy was found to be higher in the older parts as compared with the younger parts of the CNS. After i.p. application of 40 mg/kg the membrane anisotropy was reduced in the cortex by D 174, whereas D 174 and D 175 increased the rigidity in striatal membranes. If cortical membranes were incubated with the substances, the fluidizing effect of D 174 was more prominent than that of D 175. In the decerebrated cat only D 174 in a dose of 5 mg/kg i.p. raised the discharge of spinal alpha-motoneurones significantly. The results suggest that the membrane architecture is more affected by D 174 as compared with D 175 which is reflected by a greater effect on membrane anisotropy as well as on the activity of spinal alpha-motoneurones.

Adamantane↗

[New possibilities for differentiated therapy of leiomyoma of the uterus using the GnRH agonist zoladex].

In a 28-year-old patient with a large uterine leiomyoma, complete tumor regression was achieved by the LHRH agonist Zoladex (ICI 118.630) when administered three times. During the follow-up period of three months, new myoma growth did not occur. On the basis of this case study, it is necessary to discuss a new therapy concept for the differentiated treatment of uterine leiomyomata in young women with a desire for pregnancy.

Adult↗

[Triglyceride determination with the Sumal system in routine operations].

A micromethod for determination of serum triglyceride concentrations using the Sumal-system and the sampler Sumal PVS 100 will be described. The results show that the qualitative, technical and economic parameters of the method (coefficient of variation 5%, 500 specimens per day and examiner, cost of reagents 0.50 M per test) correspond to the requirements of standard techniques and methods used in prevention trials. The method is suitable for use in routine clinical laboratory.

Costs and Cost Analysis↗

Effects of daytime noise load on the sleep-wake cycle and endocrine patterns in man: II. 24 hours secretion of anterior and posterior pituitary hormones and of cortisol.

The present study examines the effects of auditory stress on the plasma levels of pituitary hormones and cortisol. Each of twelve healthy male subjects participated in two experimental series; during one of them they were exposed to 85 dB(A) industrial noise from 9:00 to 21:00 h. Blood samples were taken by an indwelling venous catheter for 24 h at intervals of 20 min from 8:00 to 8:00 h. The plasma levels of ACTH, growth hormone, prolactin, oxytocin, vasopressin and cortisol were determined. In all subjects except one noise stress affected the profiles of the pituitary hormones but the responses were interindividually different. The oxytocin level was significantly elevated (p less than .01), ACTH also responded but less clearly, whereas the other hormones reacted only in individual cases. During the subsequent night sleep only PRL concentrations were elevated above the baseline plateau in several subjects. It was concluded that in humans the pituitary responses to noise stress are highly individual.

Adult↗

Evaluation of preoperative blood tests for predicting deep vein thrombosis after total hip replacement.

Determinations of the total calcium content and aggregability of the platelets as well as tests of coagulation and fibrinolysis were carried out on 93 patients before undergoing total hip replacement. All patients received low dose heparin, solely or combined with dihydroergotamine. Twenty-six patients developed deep vein thrombosis (DVT) detected by the labelled fibrinogen uptake test and confirmed by ascending phlebography. Only a few tests, among them the total calcium content of platelets, showed a statistical difference between the patients who subsequently developed DVT and those who did not. Combination of several tests by a multivariate statistical analysis programme proved to have more predictive value than the analysis of single tests.

Adult↗

[The corpus luteum in the ultrasound image and its endocrine function].

The corpora lutea of 38 patients with sterility problems were sonographically measured. In a total of 51 cycles the corpus luteum values were compared with the estradiol (E2) and progesterone (P) plasma levels on the day of sonographic examination (SE). In 49 SEs performed immediately following ovulation the corpus luteum was cystic in 26 cases (means = 14.9 mm) and solid in 23 cases (means = 12.8 mm, p less than 0.05). The postovulatory differences between the corresponding E2 and P values, respectively, were not significant. In the midluteal phase the corpora lutea were cystic in 22 cases (means = 18.2 mm) and solid in 14 (means = 13.4 mm, p less than 0.001). Both E2 (means = 362.8 pg/ml) as well as P (means = 27.7 ng/ml) were higher in the women with cystic than in those with solid corpora lutea (E2 means = 222 pg/ml; P means = 19.4 ng/ml; p less than 0.01 in each case). When the patient collective was split into two groups, with and without stimulation therapy, a significantly higher E2 was only found in the "with therapy" group in patients with cystic corpus luteum in the midluteal phase. The size of the midluteal corpus luteum correlated in particular with the E2 plasma concentrations in all patients (p less than 0.005). Thus, in addition to sonographic measurement of the endometrium, sonographic demonstration of the corpus luteum is also useful in assessing the luteal phase.

Corpus Luteum↗

[Monoclonal antibodies in the diagnosis and follow-up of ovarian cancer. CA 125 as a tumor marker. A cooperative study of the Gynecologic Tumor Marker Group (GTMG)].

The clinical validity of using the cancer antigen (CA) 125--a surface antigen on malignant epithelial ovarian tumors--for diagnosis and follow-up of ovarian cancer was investigated in a cooperative study. Using a monoclonal antibody (OC 125) to detect CA 125, the sera of 850 patients were analyzed by immunoradiometric assay (IRMA-Kit Centocor). For 199 patients with ovarian cancer, a preoperative sensitivity of 83% and 74% resulted for the usual cut-off points (greater than or equal to 35 and greater than or equal to 65 U/ml respectively). The positivity rates and quantiles correlated with the stage of disease (FIGO) and with the tumor debulking achieved at primary surgery. The most frequent histological types (serous cyst-adenoma and the undifferentiated carcinoma of the ovary) showed the highest positivity rates (80% and 90%, respectively, for cut-off at greater than or equal to 65 U/ml). Elevated CA 125 values were found in 74% of the cases with a relapse and in 79% of the patients with advanced disease (cut-off, greater than or equal to 65 U/ml) in the follow-up of ovarian cancer. We recommend cut-off at greater than or equal to 65 U/ml, because the values for only 1% of the female healthy controls (n = 251) were above this level. Also 17% of the patients with adnexitis and 8% with benign neoplasias of the ovary showed elevated titers. Therefore CA 125 should not be used for mass screening of ovarian carcinoma. However, it is a helpful laboratory tool in the diagnosis of recurrence and the surveillance of patients with ovarian cancer.

Antibodies, Monoclonal↗

Circadian rhythm of serotonin binding in rat brain--I. Effect of the light-dark cycle.

High affinity serotonin binding to rat brain membranes showed a circadian rhythm with minimal binding at 1000 and a maximal binding at 0000. Brain serotonin levels were almost inverse to the rhythm of serotonin binding. Under reverse light-dark conditions, lights on from 1900 to 0700, a significant phase shift in serotonin binding and concentration of about 8-10 hr was found. The adaptation of the rats to the inverse light-dark cycle was ascertained by plasma ACTH and corticosterone assay.

Adaptation, Physiological↗

Simplification of the method of in vitro fertilization: sonographic measurements of follicular diameter as the sole index of follicular maturity.

As a simplification of the in vitro fertilization (IVF) procedure, repeated sonographic scanning of follicular diameters in stimulated cycles was performed, until the largest visible follicle reached a mean diameter of at least 20 mm, at which time human chorionic gonadotropin (hCG) was administered. Follicle puncture was performed either guided by sonography or by laparoscopy 34-36 hr after the hCG injection, and following insemination oocytes were cultured for 48-60 hr before embryo transfer (ET). Serum levels of luteinizing hormone (LH), prolactin (PRL), and estradiol-17 beta (E2) at the time of hCG injection as well as follicular fluid levels of follicle stimulating hormone (FSH), LH, and PRL as well as progesterone (P), testosterone (T), and E2 at the time of puncture were determined in retrospect using specific radioimmunoassay (RIA). It was found that the knowledge of a single value of LH or E2 in serum should have been of little additional value for the decision to give hCG in all stimulation models used: clomiphene + hCG, human menopausal gonadotropin (hMG) + hCG, and clomiphene + hMG + hCG. The concentrations of the three steroids measured in follicular fluid were, in a high proportion of the follicles, within a normal range in all stimulation models. The group receiving clomiphene + hMG + hCG appeared promising through its higher proportion of estrogenic follicles. It is concluded that sonographic measurement of follicular diameters may be used as the sole index of follicular maturity in an IVF program.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Regulators of steroid secretion and inhibin activity in human ovarian follicular fluid.

Inhibin activity from human follicular fluid was purified by successive chromatographies on Sephadex G-50, DEAE-Biogel A and orange A dye matrix. Inhibin activity was associated only with the protein(s) that bound to orange A (OrA-2). Daily injection of OrA-2, 1 h prior to hMG into 10-day-old female rats for 4 days caused a significant inhibition of hMG-induced estradiol secretion. In vitro, OrA-2 dose-dependently inhibited the amounts of estradiol secreted by porcine granulosa cells during a 3-h incubation. Orange A-unbound proteins, on the other hand, induced a dose-dependent increase in estradiol as well as progesterone secretion by porcine granulosa cells in vitro. Separation of stimulator from the inhibitor by orange A chromatography led to an increase in the relative inhibin activity (25-50-fold) as well as aromatisation-suppressing activity (60-fold). The results indicate a possible local action of hFF inhibin to regulate aromatisation activity.

Animals↗

Daytime noise stress and subsequent night sleep: interference with sleep patterns, endocrine and neurocrine functions.

The effects of strong daytime noise stress on subsequent undisturbed night sleep were studied in six male volunteers. They slept for seven consecutive nights in the laboratory, two nights being preceded by an 8 h exposure to 83 dB (A) pink noise. Continuously during all nights EEG, EOG, EMG, ECG and respiration were recorded. Additionally, during five nights, blood samples were taken every 30 min by an indwelling venous catheter for the determination of ACTH, hGH, PRL, TRP, 5-HT and 5-HIAA. After daytime noise load, increased sleep stage 4 stability, partly elevated hGH and PRL levels and decreased levels of the metabolites of the serotonergic system were found. This result may be explained by the assumption that high daytime noise stress is an additional load for the CNS which demands an intensification of recovery processes during the sleep of the subsequent night.

Adrenocorticotropic Hormone↗

[Significance of endocrine parameters of stress].

Thirty two male patients undergoing coronary bypass surgery were given low (group A, 0.01 mg/kg bw) and high dose (group B, 0.035 mg/kg bw) fentanyl anaesthesia. Haemodynamic and hormone responses were investigated from the beginning of anaesthesia until extracorporeal circulation (ECC) (group A: n = 16; group B: n = 16). Significant changes in haemodynamics occurred only in group A including an increase in heart rate (36%) and systolic arterial pressure (21%). Plasma vasopressin (ADH) levels rose significantly in both groups after the beginning or surgical procedure which was markedly less pronounced in patients with high fentanyl (group B). In group A (low dose) a second dose of fentanyl was given after sternotomy, which was followed by a significant decrease in ADH (80% from previous value). No significant variations could be demonstrated in plasma levels of cortisol, ACTH, and human growth hormone (HGH). The data stress the importance of plasma-vasopressin-levels in determining the endocrine stress response following trauma and operation. On the other hand there was a lack of correlation between trauma and pain and frequently reported patterns of the endocrine-metabolic stress response.

Adrenocorticotropic Hormone↗

[Calcium antagonists in anesthesia. Additive analgesia using nimodipine in heart surgery].

Stress and pain induced by surgical trauma seem to be attenuated when calcium antagonists have been applied. In order to ascertain the effect of nimodipine, a new strong acting calcium channel blocker on plasma levels of various stress hormones twenty patients undergoing cardiovascular surgery where investigated in two groups. Ten patients received high-dose fentanyl anaesthesia (mean: 2,45 mg fentanyl/patient), whereas another ten patients were treated with 0,1 mg fentanyl/patient in addition to nimodipine 1,0 micrograms/kgbw X min (from onset of anaesthesia until start of extracorporeal circulation). Between the two groups were no significant differences with respect to perioperative course and postoperative demand for analgetics. Plasma levels of ACTH, somatotropin, glucose and free glycerol were markedly elevated in all patients (n = 20) intra- and postoperatively, whereas cortisol and prolactin remained unchanged. The present data suggest an additive analgesic effect of nimodipine during surgery. This phenomenon is possibly due to a blocking effect of calcium channel blockers on nociceptive nerves. The present model assumes that calcium is essential in pain perception and that decreased calcium would result in analgesia.

Analgesia↗

In vitro inhibition of rat oocyte meiosis by human follicular fluid fractions.

We studied the effect of low molecular weight fractions of human follicular fluid (FF1) on rat oocyte meiosis and progesterone secretion by the granulosa cells. Steroid-free FF1 extracts were filtered through Sephadex G50 gel. One highly retarded fraction was obtained (GF-3), which was either used for testing or further purified by filtration on Sephadex G10, the G10-3 fraction of which was used for experiments. The GF-3 and G10-3 fractions of FF1 inhibited (in a dose-dependent and reversible manner) meiosis of isolated rat oocytes during a 4-h culture. Similarly treated fractions of serum had no effect. The inhibition was not abolished by ether extraction, trypsin treatment, heating to 56 degrees C for 1 h or boiling for 5 min, whereas heating to 105 degrees C for 18 h decreased the effect. Gonadotropin-stimulated progesterone secretion by cumulus and mural granulosa cells was also dose-dependently and reversibly inhibited by the GF-3 fractions. Our results confirm those obtained in earlier studies on porcine oocyte maturation inhibitor (OMI).

Animals↗