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Biomedical subjects

H Hepp

Publications and source records attributed to H Hepp.

At least 127 records · Page 7Linked to original sources
PubMed1991

[Current possibilities in reproduction medicine. 1. Diagnosis].

The methods employed by assisted conception, presuppose a rational diagnostic evaluation. The endocrine work-up concentrates on demonstrating adequate ovulation. Today, apart from vaginal ultrasonography, this largely means LH determination in the urine in the middle of the cycle, together with progesterone measurements in the luteal phase. Recording the basal body temperature can offer no more than an orientation. The clarification of tubal patency is ideally served by laparoscopy with pertubation. With the aid of new sonographically visible contrast media, tubal flow can also be investigated using sonography. For the male work-up, classical evaluation of the ejaculate has declined in importance. As a means of establishing a fertility prognosis, forward progression, lateral movements of the head of the sperm, and functional sperm analysis (hamster oocyte penetration test) would appear most suitable.

Fallopian Tube Patency Tests↗
PubMed1991

[Current possibilities in reproduction medicine. 2. Spectrum of therapeutic procedures].

As measures of assisted conception, GIFT, ZIFT, TV test and insemination require patent Fallopian tubes. In the majority of cases, intra-uterine insemination is attempted before the invasive methods. Intratubal gamete transfer is employed in particular in the case of infertility that has resisted treatment for years, some forms of male subfertility, and in patients with endometriosis or other forms of genital pathology. In addition, ZIFT and the TV test permit an assessment of in vitro fertilization. In the case of IVF, the classical indication of microscopically non-treatable tubal occlusion has been expanded considerably. Although GIFT is associated with a pregnancy rate of between 30 and 40%, IVF is increasingly being used in women in whom GIFT is indicated, thus avoiding the need for laparoscopy. The alternative techniques of transvaginal GIFT or transvaginal embryo transfer cannot yet be definitively evaluated for clinical routine use. In view of the wide range of therapeutic possibilities, individual counselling of the patient is an essential requirement.

Embryo Transfer↗
PubMed1991

Carboplatin/etoposide as first-line chemotherapy in advanced ovarian carcinoma: a pilot study.

In a pilot study, 18 patients with advanced ovarian cancer were evaluated for tolerance and response to a combination treatment with a fixed dose of carboplatin (350 mg/m2 given i.v. on day 1) and escalated doses of etoposide (70-130 mg/m2 daily given i.v. on days 1-3) as first-line chemotherapy. The maximum tolerated dose of etoposide was 130 mg/m2 when given i.v. on days 1-3 in combination with 350 mg/m2 carboplatin given i.v. every 4 weeks. At these dose levels, bone marrow toxicity was manageable and did not appear to be cumulative. In all, 12 objective responses, including 9 complete responses (CRs) and 3 partial responses (PRs), were achieved in 18 patients; 6 of the 9 CRs were confirmed as pathological CRs by second-look surgery.

Aged↗
PubMed1990

Squamous cell carcinoma antigen and carcinoembryonic antigen levels as prognostic factors for the response of cervical carcinoma to chemotherapy.

Between January 1986 and December 1988, 36 patients with primary advanced or recurrent cervical carcinoma were treated with cytostatic drugs in our department. Treatment at first was a combination of cisplatin and etoposide. After August 1987, a combination of carboplatin and ifosfamide was used. In all patients showing primary response to therapy, the squamous cell carcinoma antigen (SCC) and carcinoembryonic antigen (CEA) levels fell rapidly to normal after one or two cycles. In contrast, clinical remission was not obtained in those patients with levels which remained high or rose again following an initial decrease. Chemotherapy is often the only available therapy for advanced cervical carcinoma or recurrent disease, although the results of treatment, especially in squamous cell carcinoma, remain poor. The course of the SCC or CEA levels can help to decide whether the patient would profit from a continuation of the therapy. With the tumor markers, treatment can be individualized so that, above all, cases of therapy failure or further tumor progression can be detected early and the patient can be spared the severe side effects of the treatment.

Antigens, Neoplasm↗
PubMed1989

[Immunologic assessment in habitual abortion].

Since 1985, after excluding nonimmunological reasons for habitual abortion, we have been performing an MCL, a cross-match, and an HLA typing in these patients. Those with a low MLC response and a negative cross-match are considered to be immunological aborters. Only three out of 42 examined couples showed a low response and in 21 of 24 tested couples the cross-match was negative. Of 36 patients with a high response, 10 had successful pregnancies; seven of them shared more than two HLA antigens. An immunological treatment is indicated in patients with low response and a negative cross-match. High responders should have another pregnancy without stimulation. HLA typing is without any consequences.

Abortion, Habitual↗
PubMed1989

[Intratubal gamete transfer].

Three years' experience with gamete intrafallopian transfer (GIFT) are reported. Between June 1985 and July 1988, 173 clinical pregnancies were achieved in 357 patients over 488 cycles; 34 biochemical pregnancies achieved have not been included. There were 44 spontaneous abortions (25.4%) and 13 ectopic pregnancies (7.5%). Multiple pregnancy occurred in 13.9%. In the group with long-standing sterility without successful treatment, a clinical pregnancy rate of 43.3% was achieved; in cases with andrological subfertility 29.6%; and in cases with genital pathology the pregnancy rate achieved was 31.7%.

Adult↗
PubMed1989

[Ethical aspects in the treatment of females with cancer].

Ethical aspects in oncology are relevant in four areas: (1) professional competence, (2) patient information, (3) truth and (4) supportive attendance. Professional competence is the ethical imperative in oncology. Only it can mediate between the realms of humanity and technology for the doctor and patient. Extreme opinions on the topic of truth are wrong. Aiding patients in dying, in the sense of aiding them during the process of dying, is aiding them in living. Professional competence, medical responsibility, and humanity are the basis of medical handling. What the doctor does is therefore always concrete philosophy (Jaspers).

Ethics, Medical↗
PubMed1989

Serum levels of CA 125 and histological findings at second-look laparotomy in ovarian carcinoma.

In a prospective study, the serum levels of CA 125 were estimated at regular intervals in 139 patients with ovarian carcinoma. Seventy-two of 78 patients with a second-look laparotomy had elevated CA 125 levels initially. The main aim of our investigation was the correlation of CA 125 levels with the histological findings at second-look laparotomy. A total of 26 patients were free from tumor. In each case CA 125 lay within the normal range. From the 46 patients where residual tumor was found, CA 125 levels were elevated in 23 cases, so that in 23 women with residual tumor, false negative levels were found. There were no false positive CA 125 levels. In all women with raised tumor marker levels at the time of the second-look laparotomy, tumor was found despite the often negative clinical or technical preoperative screening. A negative tumor marker at the time of the second look does not exclude residual tumor. For histological proof of complete remission, a second-look operation is imperative. If the CA 125 level is raised, the relevance of the planned second-look laparotomy is open to discussion.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1989

Experiences with SCC antigen, a new tumor marker for cervical carcinoma.

Squamous cell carcinoma (SCC) antigen was first described by Kato et al. in patients with carcinoma of the cervix uteri. SCC serum levels can be measured with a radioimmunoassay. In our investigation, 2.0 ng/ml was taken as the upper limit of the standard range. In 35 healthy women there were no elevated SCC serum levels. Eight of 40 patients with breast, endometrial and ovarian cancer had raised SCC levels. In only two of 12 patients with benign gynecological diseases, SCC was also elevated. Sixty per cent of the patients with primary and 73% of the patients with recurrent cervical cancer showed pathological values; CEA was elevated in 31% and 51% respectively. The absolute values increased with the stage of the disease. Sixty-nine per cent of patients with squamous cell carcinoma had elevated levels. In five of nine adenosquamous carcinomas SCC was pathological. SCC shows a high sensitivity for squamous cell carcinomas of the cervix uteri. The tumor marker might be helpful in the control of primary therapy and follow-up of cervical cancer patients.

Adenocarcinoma↗
PubMed1989

[The status of drug prevention of respiratory distress syndrome in German gynecologic clinics].

375 german departments of obstetrics with a total of 258,348 deliveries answered a questionnaire on the actual standards in obstetrical management for the prevention of neonatal respiratory distress syndrome. On the basis of these extensive data, results could be obtained about the time and the regimen of therapy as well as antenatal diagnostics of lung maturity. Furthermore the results document the treatment of high risk pregnancies like multiple pregnancies, diabetes mellitus, gestosis and PROM.

Ambroxol↗