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Biomedical subjects

G Tscherne

Publications and source records attributed to G Tscherne.

At least 19 recordsLinked to original sources
PubMed1987

[Favorable concomitant effects and undesirable side effects of oral contraceptives].

Oral contraceptives can cause favourable or adverse unintended effects. Severe adverse side effects could be reduced by lowering the estrogen dose and lowering the dose and changing the structure of progestogens. So favourable side effects have gained in importance such as correcting disorders of the menstrual bleeding pattern, positive influence on functional ovarian cysts, benign breast diseases, the skin. Concerning the risk for neoplasm there is a certain protective effect against endometrial and ovarian cancer and no higher risk for breast cancer. Medically important adverse side effects on the cervix, the menstrual pattern, the liver and gallbladder, the central nervous system and psyche, or severe side effects like thromboembolic diseases are significantly reduced by dose reduced compounds containing newly developed progestogens. Interactions between oral contraceptives and other drugs are of little clinical significance.

Contraceptives, Oral↗
PubMed1987

[Pregnancy following cytostatic treatment of trophoblast tumor].

Observation of 18 pregnancies in 13 women who had undergone treatment for trophoblastic neoplasm with cytostatic drugs confirmed reports according to which the risk of miscarriage, premature birth, stillbirth, and severe congenital anomalies is not increased. Seven low-risk patients who had been treated with methotrexate gave birth to 10 children who were mature except for one pair of premature twins. Only one child had an anomaly, i.e. celiac disease, but this could not be linked to the prior treatment. Three high-risk patients who had been treated with methotrexate or methotrexate with actinomycin-D gave birth to four children, all of whom were mature and healthy. Intensive prenatal care, and in particular diagnosis at the beginning of pregnancy, are of great importance. At least one year must elapse between termination of chemotherapy and the beginning of a pregnancy. Effective contraception must be assured during this time.

Adolescent↗
PubMed1987

[Development of dysgerminomas from gonadoblastomas (report of 2 cases with XY gonadal dysgenesis)].

Gonadoblastomas have a propensity to give rise to malignant germ cell neoplasms. This report analyzes the clinicopathologic findings in two phenotypic females with features of 46, XY pure gonadal dysgenesis, who developed dysgerminomas in gonadoblastomas. All stages in the evolution of the dysgerminomas from the germ cells in gonadoblastomas were observed. The pathogenesis of the XY gonadal dysgenesis is briefly discussed. Finally the strict recommendation is given to remove the streak gonads with and without tumors in such individuals.

Adolescent↗
PubMed1986

[Selective venous catheterization in the evaluation of androgenism].

In cases of rapidly increasing androgenism, virilism and androgenetic cycle disturbances it is essential to exclude the presence of an androgen-producing tumour. Serum levels of testosterone above 1.5 ng/ml and dehydroepiandrosterone sulphate values above 6700 ng/ml are suggestive of tumour. Functional tests, laparoscopy and imaging modalities are often less efficient. Selective vein catheterisation enables the diagnosis and localisation of such hormone-producing neoplasms (Kirschner and Jacobs, 1971). This paper presents the case report of the diagnosis of a Leyding cell tumour of the right ovary by means of selective vein catheterisation. The tumour was not palpable and had not been detected on laparoscopy. The procedure is extensively described and discussed.

Adult↗
PubMed1986

[Value of laboratory parameters in androgenization in the female with special reference to the "free androgen index"].

The degree of androgynism (A) in women can be assessed via clinical data and by determining the levels of testosterone (T), dehydroepiandrosterone sulfate (DHEA-S) and testosterone binding globulin (TBG) in the blood. The determination of the "free androgen index" (FAI), the ratio of total T and TBG, helpful in estimating the level of free T in serum, conveys valuable additional information: in case of FAI below 1, a mild kind of A without elevation of free testosterone can be assumed. However, severe A with elevation of free testosterone and absolute hyperandrogynism is associated with FAI values above 1. In 63 women with signs of A the parameters mentioned above and the FAI were used to determine the degree of severity of A. These data were compared with the corresponding data of a control group. It could be shown that in women whose A was due to idiopathic hirsutism the increased level of bonded T played a causal role. The mean FAI in this group was 0.41. In contrast, in women with POC syndrome and androgynous cycle disturbances, the absolute hyperandrogynism with elevation of free T levels predominated. In these groups the mean FAI was above 1. However, women with male pattern bolding as single sign of A did not exhibit any significant difference in comparison to the control group. In this disease, the increased response of androgen receptors in the skin despite normal androgen levels seems to play a causal role. Two cases of androgen producing ovarial tumours and one case of adrenogenital syndrome were analysed separately.

Adrenal Hyperplasia, Congenital↗
PubMed1985

[The pulsatile administration of releasing hormone (GnRH) for the treatment of hypothalamic amenorrhea].

12 women with hypothalamic amenorrhoea (degrees II to IIIb) were given pulsatile releasing hormone in 14 treatment cycles. The minipump "Zyklomat" (Ferring Ges.m.b.H., Kiel) with a treatment set giving 0.8 mg LH-RH was used in all cases. In 86% (12 out of 14) of the treated cycles ovulation was recorded. 3 out of 8 women who desired a baby became pregnant. 1 of these pregnancies followed directly on a treatment cycle whilst the other 2 pregnancies resulted from spontaneous biphasic cycles following the treatment cycle. In 4 women pulsatile releasing hormone was used to examine the functional reaction of the pituitary gland and the ovary. In this group 1 spontaneous biphasic cycle was seen following the induced ovulatory cycle.

Adult↗
PubMed1979

[Amenorrhoea and hyperprolactinaemia (author's transl)].

Prolactin was determined by radioimmunoassay in the serum of 112 patients with primary or secondary amenorrhoea. 21 cases showed hyperprolactinaemia with levels above 25 ng/ml (18.7%). 10 patients with levels between 25 and 50 ng/ml showed heterogeneous clinical features. In nine women (8%) the prolactin level was above 100 ng/ml; they all had severe amenorrhoea. As a result of treatment with bromocriptine menstrual bleeding occurred in 4 out of 7 cases and 2 of these patients became pregnant. In 3 cases prolactin did not return to normal levels and in 2 out of these patients microadenomas of the pituitary gland were diagnosed by special methods. They were removed surgically by the transsphenoidal approach.

Adenoma↗
PubMed1979

Limits of therapy for malignant chorioepithelioma.

Report on two cases of malignant chorio-epithelioma following hydatidiform mole, both decreased 4 years after inception of the disease despite initially successful therapy and repeated remissions. In the first case a solitary pulmonary metastasis showing obvious de-differentiation and extensive local reparative processes was removed operatively. Associations to cytostatic medication are discussed. The second case was characterized by unusually extensive chronic pulmonary embolism with highly regressive choriocardinomatous aggregates. Death resulted unexpectedly from chronic dextrocardial insufficiency. It is stressed that the treatment is subject ot limitations of not only relative (i.e., resistance to cytostatics, inadequate treatment etc.) but also of an absolute nature, as in case 2.

Adult↗
PubMed1979

[New aspects of diagnosis, treatment and follow-up of trophoblastic tumours (author's transl)].

Diagnosis, treatment and follow-up of gestational trophoblastic tumours has become more efficient through the introduction of new methods like angiography, computer tomography and, especially, the determination of specific chorionic gonadotrophin. Exact diagnosis, with differentiation of high- and low-risk patients allows an individual approach to treatment. The results of these new diagnostic and therapeutic methods were studied in a department with a relatively high incidence of gestational trophoblastic disease in a European region, where trophoblastic tumours are generally rare. (Since 1971 16 cases of trophoblastic tumour and 68 patients with hydatidiform mole were treated in the department of Obstetrics and Gynaecology, University of Graz.) Schedules were drawn up for the diagnosis, classification of risk and for treatment. This may help to get good results and to prevent errors in the future. Long-term determination of HCG beta in the serum and also comparative follow-up of LH and HCG in urine led to the formulation of further characteristics of gonadotrophin secretion after hydatidiform mole and treatment of trophoblastic tumours. On the basis of the results a regimen has been formulated which seems to be optimal for the detection of tumour after hydatidiform mole and for the registration of the effect of treatment in case of trophoblastic tumour.

Adult↗
PubMed1979

[Radioimmunoassay of beta sub unit HCG following hydatidiform mole or chorionic carcinoma (author's transl)].

The radioimmunoassay of Beta Sub Unit HCG in the serum heralds a marked improvement in the diagnosis of gestational trophoblastic disease. In nine cases of hydatidiform mole and three cases of chorionic carcinoma serial examinations of the Beta Sub Unit HCG were performed. When the immunologic pregnancy test became negative following a hydatidiform mole or following treatment of chorionic carcinoma, the HCG excretion remained above detectable values for several more weeks. The decrease of Beta Sub Unit serum HCG was either linear or in fluctuations. The detection of fluctuations or a secondary rise in the Beta Sub Unit HCG titre permits the early diagnosis of invasive trophoblastic disease following hydatidiform mole or of insufficient treatment or recurrence in cases of chorionic carcinoma. Our results suggest that the optimal follow-up with Beta Sub Unit serum HCG is by weekly determinations until four consecutive determinations remained negative. This is followed by two determinations at bi-weekly intervals and thereafter monthly follow-up examinations.

Adult↗
PubMed1979

[Amenorrhoea and hyperprolactinaemia (author's transl)].

Prolactin was determined by radioimmunoassay in the serum of 112 patients with primary or secondary amenorrhoea. 21 cases showed hyperprolactinaemia with levels above 25 ng/ml (18.7%). 10 patients with levels between 25 and 50 ng/ml showed heterogeneous clinical features. In nine women (8%) the prolactin level was above 100 ng/ml; they all had severe amenorrhoea. As a result of treatment with bromocriptine menstrual bleeding occurred in 4 out of 7 cases and 2 of these patients became pregnant. In 3 cases prolactin did not return to normal levels and in 2 out of these patients microadenomas of the pituitary gland were diagnosed by special methods. They were removed surgically by the transsphenoidal approach.

Adenoma↗