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Biomedical subjects

J Martius

Publications and source records attributed to J Martius.

At least 19 recordsLinked to original sources
PubMed1997

Prevalence of human papillomavirus DNA in cervical tissue. Retrospective analysis of 855 cervical biopsies.

The histopathologic features of 855 cervical biopsies were correlated with the presence of human papillomavirus DNA using in situ hybridization (ISH) with biotin labeled type specific probes for Human Papilloma Virus (HPV) types 6, 11, 16, 18, 31, 33 and 51. HPV-DNA was found in 18% (13/72) of cervical intraepithelial neoplasia I (CIN I), 30% (35/115) of CIN II, 28% (57(206) of CIN III, in 84% (21/25) of flat condyloma and in 13% (15/112) of normal cervical tissue. HPV DNA was detectable in 11% (5/46) of cervical adenocarcinoma and in 21% (59/279) of squamous cell carcinoma (SCC) of the cervix. High risk HPV types were identified more often than low risk HPV types in CIN I, CIN II, CIN III and SCC. HPV type 16/18 predominates over HPV types 31/33/51 in CIN I, flat condyloma and in SCC. The prevalence of HPV was strongly associated with the grade of differentiation of SCC. It was identified in 59% (23/39) of well differentiated SCC, in 18% (25/142) of moderately differentiated and in 11% (11/98) of poorly differentiated SCC.

Adenocarcinoma↗
PubMed1996

Immunologic parameters in cord blood indicating early-onset sepsis.

Different immunologic parameters were measured in cord blood to test their usefulness in the early diagnosis of early onset sepsis. Cord blood levels of circulating intercellular adhesion molecule-1 (cICAM-1), interleukin-6 (IL-6) and interleukin-8 (IL-8) were significantly elevated in septic compared to nonseptic neonates. No significant difference between either population was seen for cord blood C3a and elastase-alpha 1-proteinase inhibitor complex (E alpha 1 PI). Measured concentrations of cICAM-1, IL-6 and IL-8 in fetal and maternal blood did not correlate, indicating that the neonate's response to sepsis is clearly different from the mother. Our data suggest that cord blood measurements of cICAM-1, IL-6 and IL-8 might be useful in identifying neonates with early-onset sepsis.

Escherichia coli Infections↗
PubMed1995

[Local therapy and adjuvant interferon therapy in genital papilloma virus infections].

OBJECTIVE: Is it possible to reduce the recurrence rates of HPV-positive genital tract lesions by systemic interferon alfa-2a in addition to local therapy? METHODS: Thirty-three of 63 patients with first manifestation of papillomavirus infection or monolocal manifestation were treated by local therapy. The other 30 patients with recurrent or multiorgan infections received 3 courses with 12 x 10(6) IU interferon alfa-2a subcutaneously. RESULTS: For the remaining 47 patients (16 were lost to follow-up) we found a significantly lower recurrence rate of 21% (5 of 24) in the group of interferon-treated patients compared to 52% (12 of 23) of patients treated without interferon. CONCLUSIONS: The systemic treatment of HPV-positive genital tract lesions with interferon alfa-2a in addition to CO2 laser surgery or cone biopsy seems to reduce the recurrence rates of HPV-positive lesions.

Adolescent↗
PubMed1994

Vaginal clear cell carcinoma in a young patient with ectopic termination of the left ureter in the vagina.

The association of clear cell adenocarcinoma of the vagina and vaginal adenosis with prenatal exposure to diethylstilbestrol (DES) is well-documented in the United States. In Europe, however, DES was never used in the therapy of threatened abortion and, therefore, clear cell adenocarcinoma and vaginal adenosis remained rare diseases. We report on the clinical and pathological features of a case of clear cell adenocarcinoma of the upper vagina in a 17-year-old German girl, who had a history of hypoplasia of the left kidney with an ectopic termination of the ureter in the upper vagina, removed surgically 2 years before. No previous report of a similar coincidence of vaginal clear cell carcinoma and a congenital disorder of the genitourinary tract exists. Congenital anomaly of the ureter interfering with the development and the differentiation of the distal Müllerian tract and its epithelium might have provided a similar histological basis for carcinogenesis in our patient to that in those provided exposed to DES.

Adenocarcinoma, Clear Cell↗
PubMed1993

Efficacy of clindamycin vaginal cream versus oral metronidazole in the treatment of bacterial vaginosis.

OBJECTIVE: To compare the efficacy and tolerance with 2% clindamycin vaginal cream versus oral metronidazole for the treatment of bacterial vaginosis. METHODS: This was a multicenter, randomized, double-blind study in which patients were randomly assigned to one of the following two regimens in a 1:1 ratio: clindamycin phosphate vaginal cream 2% (5 g intravaginally at bedtime for 7 days) plus two placebo capsules (twice a day for 7 days) or metronidazole 500 mg (two 250-mg capsules orally twice a day for 7 days) plus placebo vaginal cream (5 g intravaginally at bedtime for 7 days). The patients were seen for follow-up at 5-10 days and 25-39 days after completion of therapy. RESULTS: Seven investigators, four in Germany, two in Austria, and one in Switzerland, enrolled 407 patients. Four patients never received either protocol drug, leaving 403 evaluable for safety. Two hundred thirty-four patients were evaluable for efficacy. The analysis for all evaluable patients showed no significant difference between treatment groups. The cure or improvement rate at 1 month after therapy was 83% in the clindamycin group versus 78% in the metronidazole group. The incidence of drug-related adverse medical events was approximately 12% in both groups. CONCLUSIONS: Oral metronidazole and intravaginal clindamycin cream had a similar efficacy of 78 to 83%. Both drugs were tolerated, with vaginal candidiasis developing in 8.5 and 4.7% of the patients in the clindamycin and metronidazole groups, respectively.

Administration, Intravaginal↗
PubMed1993

Systematic serologic screening for toxoplasmosis in pregnancy.

OBJECTIVE: To determine which serologic method or combination of methods could most effectively identify acute toxoplasmosis during pregnancy and to assess whether systematic screening is practical and cost-effective. METHODS: Using basic serologic tests (direct agglutination test and immunosorbent agglutination assay), we screened 2104 women for toxoplasmosis. Immunoglobulin M (IgM)-reactive patients (IgM immunosorbent agglutination assay score of at least 3) were studied by differentiating serologic tests performed sequentially. RESULTS: Specific immunity was found in 874 pregnant women (41.6%); 155 (7.4%) were IgM-reactive and 12 (0.6%) had acute toxoplasmosis. Using a reduced immunosorbent agglutination assay score of at least 3 (normally a score of at least 6 is used), acute toxoplasmosis was identified in 11 women at their first prenatal visit, including two in whom acute infection would not have been detected by a score of 6 or more until 9 weeks later. One additional nonimmune patient with acute infection was identified only by follow-up serologic testing. CONCLUSION: Systematic screening followed by sequential differentiating serologic tests is practical and cost-effective for the diagnosis of acute toxoplasmosis during pregnancy.

Adult↗
PubMed1991

[Fever at delivery].

Explore the source record for details and available documents.

Bacterial Infections↗
PubMed1991

[The value of Gardnerella-vaginalis-culture in bacterial-vaginitis- score-confirmed bacterial vaginosis].

The relative value of a semiquantitative Gardnerella vaginalis culture for the diagnosis of bacterial vaginosis (BV) was studied in 113 women attending a STD clinic. The standard diagnosis of BV was based on the BV score, which is a 10-point grading system to evaluate gram-stained vaginal samples objectively and reproducibly. The sensitivity of G. vaginalis culture for the diagnosis of BV was 28%, while the specificity was 89%. The positive and the negative predictive values were 50% and 76% for G. vaginalis culture in our population. Our data suggest that G. vaginalis culture cannot be recommended for the routine diagnosis of BV. However, G. vaginalis culture will detect asymptomatic women with high vaginal colonization with G. vaginalis. Further studies are needed to find whether these women are at risk of developing BV.

Bacteriological Techniques↗
PubMed1990

The role of bacterial vaginosis as a cause of amniotic fluid infection, chorioamnionitis and prematurity--a review.

Antepartum bacterial vaginosis in pregnancy has been related to premature delivery, the recovery of microorganisms from amniotic fluid of women in premature labor with intact membranes, to histologic chorioamnionitis and to the recovery of microorganisms from the placenta or membranes. Microorganisms associated with bacterial vaginosis are commonly recovered from the amniotic fluid and chorioamnion of patients who deliver prematurely. In addition, bacterial vaginosis is associated with maternal infectious morbidity during labor and in the postpartum period. Very little is known of the pathophysiologic mechanisms by which bacterial vaginosis may cause preterm labor and/or premature rupture of the membranes. However, it is of interest to speculate on possible mechanisms. The high concentration of potentially pathogenic microorganisms in the vagina and cervix of pregnant women with bacterial vaginosis may increase the possibility of an ascending infection via the cervix, decidua, fetal membranes, maternal placenta, and amniotic fluid. Some of the bacteria associated with bacterial vaginosis such as Bacteroides sp. are particularly virulent. Certain bacteria produce enzymes that potentially could affect the fetal membranes or maternal deciduae. Bacteroides sp. and group B streptococcus produce proteases. Protease enzymes reduce the chorioamniotic membrane strength in vitro. It is even possible that a high concentration of bacteria in the lower genital tract could produce enough proteases to weaken the fetal membrane strength causing premature rupture of the membranes. Bacterial lipases could also produce tissue injury. Schwarz et al. demonstrated that lysosomes within fetal membrane cells contain phospholipase A2 in high concentrations. Phospholipase A2 is a precursor of prostaglandin synthesis and the destruction of lysosomes within deciduae or chorioamnion cells may induce prostaglandin synthesis resulting in uterine contractions. Bejar et al. found a high rate of phospholipase A2 production by Bacteroides sp., anaerobic streptococci, Fusobacterium sp., and G. vaginalis. Benett et al. demonstrated that bacterial products of group B streptococci, viridans streptococci, Escherichia coli and Bacteroides fragilis but not of Lactobacillus sp. increase the synthesis of prostaglandins in the membranes. Thus, selected bacteria, including some closely related to bacterial vaginosis may play a role in the initiation of uterine contractions by stimulating prostaglandin synthesis. In an alternative mechanism, either the release of prostaglandin in the membrane or uterine contraction could cause microbreaks of the membrane that allow bacterial colonization of the membrane.(ABSTRACT TRUNCATED AT 400 WORDS)

Amniotic Fluid↗
PubMed1988

A case-control study of chorioamnionic infection and histologic chorioamnionitis in prematurity.

To study the role of infection in prematurity, we studied the demographic and obstetrical characteristics, chorioamnionic cultures, and placental histologic features of women who delivered prematurely and compared these findings with those in women who delivered at term. Microorganisms were isolated from the area between the chorion and the amnion (chorioamnion) in 23 of 38 placentas (61 percent) from women with preterm labor who delivered before 37 weeks' gestation and in 12 (21 percent) of 56 placentas from women without preterm labor who delivered at term (odds ratio, 5.6; 95 percent confidence interval, 2.1 to 15.6). The most frequent isolates from the placentas of those whose infants were delivered prematurely were Ureaplasma urealyticum (47 percent) and Gardnerella vaginalis (26 percent). The recovery of any organism from the chorioamnion was strongly associated with histologic chorioamnionitis (odds ratio, 7.2; 95 percent confidence interval, 2.7 to 19.5) and with bacterial vaginosis (odds ratio, 3.2; 95 percent confidence interval, 1.1 to 6.6). When multiple logistic regression was used to control for demographic and obstetrical variables, premature delivery was still related to the recovery of organisms from the chorioamnion (odds ratio, 3.8; 95 percent confidence interval, 1.5 to 9.9) and with chorioamnionitis (odds ratio, 5.0; 95 percent confidence interval, 1.6 to 15.3). The proportion of placentas with evidence of infection was highest among those who delivered at the lowest gestational age. We conclude that infection of the chorioamnion is strongly related to histologic chorioamnionitis and may be a cause of premature birth.

Adult↗
PubMed1988

Lactate in fetal tissue during hypoxia; correlation to lactate, pH and base deficit in the fetal blood.

It was the aim of this study to investigate the relationship between the tissue concentrations of lactate in different organs, the blood lactate concentrations, and pH and base deficit in the extracellular fluid (BDecf) during fetal hypoxia. With regard to fetal blood analysis during labour the question is of major importance to what extent blood measurements can provide information concerning intracellular lactate concentrations, especially in the cerebral tissue. In 15 guinea-pig fetuses acute hypoxia was induced by anaesthesia, operative stress and abruption of the placenta. After puncture of the umbilical artery for blood analysis, tissue specimens were taken from the cerebral tissue, heart, liver, lung, muscle and fascia of the abdominal wall, bowel and kidney within 1 to 2 minutes and analyzed for lactate. The lactate concentrations were corrected according to the time interval from blood sampling to collection of tissue specimen. In acute hypoxia the lactate concentrations of the heart and the cerebral tissue were closely correlated to lactate, pH and base deficit measured in arterial blood. The tissue concentration of lactate in the heart and in the cerebrum exceeded the blood level approximately by 70 and 30-50%, respectively. At a pH greater than 7.10 and BDecf less than 8 mumol/ml, the lactate concentration in the cerebrum was about half the lactate concentrations leading to cerebral edema and cell necrosis in the hypoxic monkey fetus (Myers RE. In: Gluck L, ed. Intra-uterine asphyxia and the developing fetal brain. 1977, 37-97).

Acid-Base Equilibrium↗