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Biomedical subjects

K Friese

Publications and source records attributed to K Friese.

At least 37 records · Page 2Linked to original sources
PubMed1999

Differential diagnosis of peri- and postmenopausal ovarian cysts.

OBJECTIVES: To test the value of preoperative and intracystic parameters in the differential diagnosis of ovarian cysts. METHODS: Criteria for admission of 58 patients were age > 47 years, complete history, detection of CA 125 serum level, and ultrasound findings. Tumor markers (CA 125, cancer-associated serum antigen (CASA), CA 72-4), hormones (estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH)), epidermal growth factor (EGF) receptor and c-erb B-2 amplification rate were detected in cyst fluid. RESULTS: Of the 58 subjects, 9 (15.4%) had functional cysts, 37 (63.8%) had benign tumors and 12 (20.8%) had malignant tumors. No functional ovarian cyst presented as echoic or multilocular cyst sonographically. The serum CA 125 values demonstrated significant differences between the non-malignant and malignant patient groups (P < 0.0005). The majority (63.8%, n = 37) of ovarian cysts were obtained at laparotomy, whereas only 36.2% (n = 21) were laparoscopically operated. The cyst fluid levels of FSH (P < 0.005) and LH (P < 0.05) were significantly lower in the functional group than in the benign or malignant group. Malignant cysts were significantly different from non-malignant cysts regarding low E2 (P < 0.01), high FSH (P < 0.05) and CASA (P < 0.02) values. There were no significant correlations between EGF receptor (P = 0.14) and c-erb B-2 (P = 0.06) gene amplification rates and malignant histology. CONCLUSIONS: Simple ovarian cysts combined with normal serum CA 125 levels are candidates for conservative follow-up or laparoscopy. The serum CA 125 is a powerful marker for prediction of histology in postmenopausal ovarian cyst. Laparoscopic surgery may be considered in patients with multilocular sonographic findings and normal CA 125 serum level. Combining serum CA 125 levels with cyst fluid parameters (E2, FSH, CASA) improves the sensitivity and specificity in predicting malignancy.

Age Distribution↗
PubMed1999

A cross-sectional study of workers in the chemical industry with occupational exposure to hexamethylenetetramine.

OBJECTIVES: To assess the health effects of hexamethylenetetramine (HMT) on the airways and the skin of workers in the chemical industry. METHODS: A cross-sectional study was performed with 17 employees of a HMT-producing chemical plant and 16 control subjects from the plant. In addition, we examined 4 out of 5 subjects who had left the production for medical reasons during the last 10 years. Anamnestic data, total and specific IgE to four environmental allergens, lung function and bronchial responsiveness to methacholine were assessed by standard procedures. Skin prick tests (SPT) and patch tests were performed with known sensitizing substances and HMT 100 mg/ml and 2% pet and aq. RESULTS: A high number of exposed subjects and controls reported symptoms during the previous year (64.7% vs 68.8%), most of them were not related to work. Work-related symptoms and objective parameters did not show differences between groups. No sensitizations to HMT as assessed by SPT or patch tests were found. Among those who had left the HMT production for medical reasons, 2 former baggers showed sensitizations to HMT by patch tests. These reported eczema during exposure but lost symptoms after removal from exposure. Geometric mean HMT concentrations as assessed by personal sampling were 0.3 [95% confidence intervals (CI) 0.1; 0.9] mg/m(3) in shiftleaders and 0.6 (95% CI 0.3; 1.1) mg/m(3) in baggers. CONCLUSION: High exposures to HMT may cause allergic contact dermatitis. There was no evidence of an increased risk for occupational asthma at mean airborne HMT concentrations below 1 mg/m(3).

Adult↗
PubMed1999

Breast reconstruction with latissimus dorsi flap: improved aesthetic results after transection of its humeral insertion.

Does transecting the tendinous insertion of the latissimus dorsi on the humerus improve aesthetic results and avoid the displeasing bulge in the armpit that sometimes occurs when the latissimus dorsi is used for breast reconstruction? In a prospective study, 60 patients who were having breast cancer surgery and simultaneous breast reconstruction using the latissimus dorsi flap were randomized for cutting (n = 29) or leaving intact (n = 31) the tendinous muscle insertion on the humerus. The cosmetic outcome was evaluated by patients and surgeons 6 to 12 months postoperatively. Patients reported good cosmetic results in 29 of 31 cases with the humeral insertion left intact and in 26 of 29 cases when the tendon was cut (p = 0.59), as compared with 21 of 31 cases versus 25 of 29 cases (p = 0.091), according to the surgeon's evaluation. A lateral bulge was more frequently observed by the surgeons in the group with intact insertion (10 of 31 patients), as compared with the group with a transected humeral insertion (2 of 29 patients). Discomfort caused by this bulge was reported by 19 of 31 patients with intact insertion, but only 3 of 29 patients with the tendon cut (p < 0.0001). The additional transection of the tendon was not associated with any complications. The additional transection of the tendinous humeral insertion of the latissimus dorsi muscle improves aesthetic results and avoids a displeasing bulge in the axilla when the latissimus dorsi flap is used for breast reconstruction.

Breast Neoplasms↗
PubMed1999

Interleukin-6 receptor is highly expressed in the ganglionic eminence of the human fetal brain.

The expression of interleukin-6 receptor (IL-6R) has been investigated immunohistochemically in seven fetal brains with special reference to the ganglionic eminence (GE), a part of the telencephalic proliferative zone. Between the 22nd and 28th gestational week the GE stands out conspicuously due to its very high amount of intensely IL-6R-immunostained cells. Adjacent brain areas exhibit only very weak immunoreactivity. Between the 32nd and 36th week a moderate IL-6R immunolabelling is seen in the remnants of the GE. IL-6 may activate the immature IL-6R-positive cells to secrete a protease which is likely to be involved in GE involution and, perhaps, in the development of hemorrhage frequently occurring in the GE of premature infants.

Antibodies, Monoclonal↗
PubMed1999

Antibiotics: treatment of preterm labor.

Our intention is to review recent data and provide recommendations for the use of antibiotics in cases of preterm labor or preterm premature rupture of the membranes (pPROM). Various studies assessing antibiotics as treatment for preterm labor demonstrate neonatal or maternal benefits only in certain circumstances. Antibiotic treatment should be given to patients with bacterial vaginosis and Trichomonas vaginalis. Currently, antibiotics should not be applied routinely to prolong pregnancy in women with preterm labor and intact membranes. However, antibiotic therapy should be given to patients with pPROM to prolong pregnancies at 24 to 32 weeks' gestation. Our management of pPROM up to 32 weeks' gestation includes use of corticosteroids, antibiotic (extended spectrum penicillins) and tocolytic treatment for preterm labor and pregnancy prolongation. We consider expectant management previous to evidence of intrauterine infection. In women with pPROM at 32 to 34 weeks we found it beneficial to deliver 24 hours after administration of corticosteroids or, in cases of intrauterine infection, immediately. Finally, we report on our research work regarding fetal brain development in preterm birth. Further studies will be necessary to clarify the role of the interleukin-6/interleukin-6 receptor pathway in the development of intracerebral hemorrhage frequently occuring in premature infants.

Adrenal Cortex Hormones↗
PubMed1999

[Rating of transvaginal sonography in the evaluation of postmenopausal bleeding].

OBJECTIVE: The purpose of this study was to evaluate transvaginal ultrasonography (TVS) in differential diagnosis of vaginal bleedings in postmenopausal patients. MATERIAL AND METHODS: Between January 1990 and December 1996, 1198 postmenopausal patients with vaginal bleedings were sent to our clinic for a histological evaluation. Eight hundred and seventy-nine patients (73.4%) were preoperatively scanned by transvaginal probe, and endometrial thickness (< 5, 5-7, 8-10, > 10 mm) was measured. RESULTS: Atrophy was found in 46.3%, endometrial polyps in 19.8%, endometrial cancer in 17.5%, and hyperplasia in 6.7%. An endometrial thickness of lower than 5 mm (p < 0.0001) was shown in TVS patients with atrophy in 71%, with endometrial polyps in 10.9%, with endometrial cancer in 3.9% and hyperplasia in 6.8%. In 55.2% of these eases with endometrial cancer the preoperatively estimated thickness was 10 mm or more. The additionally morphologic examination in cases with an endometrium smaller than 5 mm was false positive in 75% (9/12). Thus an endometrial thickness of > 5 mm had a sensitivity of 92.5%, specificity of 71.0%, positive and negative predictive value of 75.6, respectively 90.9% for the detection of endometrial pathology. CONCLUSIONS: TVS allows the detection of an endometrial pathology in the vast majority of patients with postmenopausal bleedings. In cases with a single postmenopausal bleeding and an endometrium smaller than 5 mm we recommend expectative procedures with repeated ultrasound examination of the endometrium.

Aged↗
PubMed1999

[Investigation of adhesion molecules (sVCAM-1) in serum of nonpregnant women, normotensive pregnant women and in patients with pregnancy complications].

OBJECTIVE: An increased expression of endothelial adhesion molecules combined with neutrophil activation in the placental bed is to be assumed aetiopathogenetically relevant in preeclampsia. MATERIAL AND METHODS: Ranges of sVCAM-1 serum concentrations of both control persons (29 nonpregnant and 25 normotensive pregnant women) and patients with different complications of pregnancy (HELLP-syndrome n = 10, preeclampsia n = 12, gestational hypertension n = 38, diabetes n = 24, growth retardation n = 21) were determined by means of ELISA. Frozen placental samples of 5 normotensive and 10 hypertensive pregnant women were investigated immunhistochemically to study the distribution of VCAM-1 in the placenta. RESULTS: Significantly elevated sVCAM-1 serum levels (p < 0.05) were identified in samples of patients with HELLP syndrome, preeclampsia, diabetes and gestational hypertension compared with serum levels of normotensive pregnant women. The cut-off level (97.5% percentile of normotensive serum levels) was calculated (775 ng/ml). VCAM-1 was localized immunhistochemically at capillaries of villi and main villi. CONCLUSIONS: There are closed relations between elevated serum levels of sVCAM-1 during pregnancy and diseases with vasculopathies of placental bed.

Adult↗
PubMed1999

[Determination of reference ranges and effect of maternal and fetal factors on insulin and C-peptide level in umbilical cord blood].

OBJECTIVE: The risks of pregnancy caused by maternal diabetes are well known. Patients with unrecognized gestational diabetes mellitus (GDM) represent a special problem. The aim of our study was to find out, whether the determination of insulin and C-peptide in cord blood serum offers a valuable tool for retrospective analysis. MATERIAL AND METHODS: In 600 paired serum samples from maternal venous blood and neonatal cord blood insulin and C-peptide were determined radioimmunologically. A reference group consisting of 338 mothers and their newborns was established by exclusion of all patients with known pregnancy complications. RESULTS: Positive correlations could be identified between fetal insulin and fetal C-peptide, as well as correlations of these parameters with birth weight and body length, with maternal values of insulin, C-peptide, body-mass index, weight, and weight gain during pregnancy respectively. Increased levels of cord serum insulin were found in complicated pregnancies as well as in patients with previous pregnancy losses, preterm deliveries or stillbirths. CONCLUSIONS: Cord serum insulin and C-peptide were found to be useful parameters for immediate postnatal identification of impaired glucose tolerance during the course of pregnancy.

Adolescent↗
PubMed1996

TNF-alpha mediated apoptosis of CD4 positive T-lymphocytes. A model of T-cell depletion in HIV infected individuals.

Apoptosis has been suggested to account for loss of CD4+ T-cells in HIV infected individuals. Aside from MHC II dependent superantigens no mediator for preferential apoptosis of CD4+ T-cell has been described. However, the expression of TNF-alpha is increased in HIV+ patients. Additionally, TNF-alpha is known as a potent inducer of apoptosis in a variety of cell types. We therefore investigated the capacity of TNF-alpha to mediate apoptosis in vitro preferentially in CD4+ T-cells from HIV+ individuals. In the presence of TNF-alpha, CD4+ T-cells from HIV+ individuals with more than 200 CD4+ T-cells/microl (classified CDC A1, A2, B1, B2) could be significantly depleted by apoptosis without a reduction of CD8+ T-cells. In cells from patients with less than 100 CD4+ T-cells/microl (classified CDC C3), TNF-alpha mediated apoptosis was not apparent due to an already immensely elevated rate of apoptosis observed in the absence of TNF-alpha. Here we demonstrate cord blood mononuclear cells as a model for apoptosis since these cells develop apoptosis at a similar rate as that of PBMC in HIV+ patients. More than 50% of TNF-alpha stimulated CD4+ cord blood T-cells were depleted within 3 days by apoptosis, whereas CD8+ T-cells, B-cells and NK-cells were not affected. In PBMC from healthy adults, a preferential loss of CD4+ T-cells mediated by TNF-alpha was not observed. A reduced production of IFN-gamma was observed in mononuclear cells from newborns and from HIV+ patients. Moreover, IFN-gamma and IL-2 could prevent TNF-alpha mediated apoptosis. Therefore, a reduced Th1-cell-function may contribute to TNF-alpha mediated apoptosis of CD4+ T-cells from these donor groups. Taken together, the data suggest that TNF-alpha probably is a mediator of the loss of CD4+ T-cells in HIV infected patients in vivo.

Adult↗
PubMed1996

Mycobacteria-reactive gamma delta T cells in HIV-infected individuals: lack of V gamma 9 cell responsiveness is due to deficiency of antigen-specific CD4 T helper type 1 cells.

Human gamma delta T lymphocytes expressing the variable T cell receptor elements V gamma 9 paired with V delta 2 are activated by antigen derived from Mycobacterium tuberculosis (M. tb.) and presented by antigen-presenting cells (APC). The subsequent proliferation is strictly dependent on the presence of CD4+ TCR alpha beta+ T helper type 1 (Th1) cells producing interleukin-2 (IL-2). In this study, we report that the reactivity of V gamma 9 cells to M. tb. stimulation in vitro was drastically decreased or absent in the majority of the analyzed HIV-1-infected individuals (CDC stages III and IV). We show that the failure of V gamma 9 cells from HIV+ individuals to proliferate following M. tb. stimulation was not due to an intrinsic qualitative or quantitative defect of gamma delta T cells but rather to a deficiency of M. tb.-reactive CD4 Th1 cells. Thus, V gamma 9 responsiveness could be restored if cultures of M. tb.-stimulated T cells from HIV+ donors were reconstituted with one of the following: (i) exogenous IL-2 (ii) purified CD4 T cells from allogeneic donors; or (iii) T cell-depleted APC from allogeneic donors. In the majority of HIV+ patients, the defective Th1 activity of M. tb.-stimulated CD4 T cells could be decreased neither by cytokines known to favor Th1 development (IL-12, interferon-gamma) nor by neutralization of the Th1-suppressing Th2 cytokine IL-10. We suggest that measurement of V gamma 9 cell expansion within M. tb.-stimulated peripheral blood mononuclear cells provides a sensitive assay for the functional capacity of antigen (M. tb.)-specific CD4 Th1 cells in HIV-infected individuals.

CD4 Lymphocyte Count↗
PubMed1995

Measuring the thickness--is that all we have to do for sonographic assessment of endometrium in postmenopausal women?

For sonographic assessment of the endometrium in postmenopausal women, measurement of the maximum thickness is used in many cases as the sole criterion. The cut-off values stated in the literature, however, vary considerably. This prospective study examined 200 female patients in order to ascertain the value of echomorphology in addition to endometrial biometry. Up to an overall endometrial thickness of 3 mm, we observed only histologies without any pathological findings, whereas from an endometrial thickness of 10 mm upwards, only polyps, hyperplasias and carcinomas were found. In more than a third of our patients, the endometrial thickness was between 3 and 10 mm where the structure of the endometrium could reflect the possible histological finding: homogeneity, low echo and a sonographically depictable central echo between symmetrical endometrial leaves were an indication for absence of pathological findings, whereas heterogeneity and high echogenicity were pointers for pathological changes. In contrast to the sole measurement of endometrial thickness in the postmenopause, the combined metric and morphological parameters improve not only the predictability of pathological findings but, above all, the selectivity of the vaginosonographic assessment of the endometrium in postmenopausal women.

Aged↗
PubMed1995

[Determination of cytokines and cytokine receptors in premature labor].

One of the leading causes of preterm labour is a subclinical intrauterine infection. The diagnosis of this inapparent infection is an unsolved problem, because clinical parameters show the infection mostly too late and cannot be used for early detection of women at high risk for preterm labour. A prospective clinical study measuring cytokines and cytokine receptor concentration in amniotic fluid from patients with preterm labour and preterm rupture of membranes (PROM) was undertaken to answer the question whether the amount of cytokines is positively correlated to the risk of preterm delivery. In 78 patients (43 controls, 23 patients with PROM, 7 with preterm labour and delivery < 37 weeks of gestation, 7 with preterm labour and delivery at term) amniotic fluid was collected and the following cytokines were measured by an ELISA: IL1 beta, IL2, IL6, TNF alpha, IFN gamma, TNF receptor 55 und 75, IFN gamma receptor, IL2 receptor. We found significant, in some cases highly significant differences in the cytokine content of amniotic fluid of patients with PROM compared with controls and patients with preterm labour and delivery before 37 weeks of gestation compared with controls. There were no differences between patients with preterm labour and delivery at term and controls. Amniotic fluid cultures were positive only in 20-25% of the cases and therefore not a predictive sign. The determination of cytokines in amniotic fluid of patients with preterm labour seems to be a good marker to predict the risk of preterm delivery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Sequence analysis of PCR amplification products of old formalin fixed conisation tissue sections].

OBJECTIVE: Standard analytical techniques (DNA hybridisation methods) require high-quality DNA. In very small samples and in processed tissue (e.g. analysis of DNA in paraffin-embedded archival tissues) these methods fail due to their restricted sensitivity. METHODS: In this study we used the considerably more sensitive PCR for analysis of HPV-16-e6/-e7 DNA in histologic cone biopsy sections. HPV-16-e6 and -e7 ORF were amplified, subcloned into M13mp18 and sequenced. RESULTS: The sequence is identical to the published e6/e7 sequence. CONCLUSIONS: Due to its high sensitivity the PCR is suitable to give answers to questions in cellular microbiology even in formalin-fixed paraffin-embedded tissues.

Cervix Uteri↗
PubMed1995

[Interferon-alpha controls HPV infection in cervix epithelium].

UNLABELLED: Decreased immune response is necessary for a prolonged HPV-infection and allows HPV to be virulent as an oncogene. This study shows that HPV-infection in cervical epithelium is determined by the immune system and IFN-alpha can be shown to be a prognostic parameter for the HPV-infection. The cytokines (IFN-alpha, IFN-gamma, and TNF-alpha) from stimulated peripheral blood mononuclear cells (PBMC) were measured using monoclonal IFN-antibodies and ELISA test. To detect HPV-16, PCR (e6 and e7 areas) was used, followed by southern-blot of the PCR-products. In all of our patients (n = 139) no cytological change was observed in the cervical epithelium over a period of 3 years. Comparison was made between 3 groups: 1: controls (n = 89, HPV-pos. n = 6) 2: registered prostitutes without drug abuse (n = 30, HPV-pos. n = 6) and 3: HIV-infected, previous drug users (CDC II, n = 20, HPV-pos. n = 2). RESULTS: The stimulated IFN-alpha values are highest in the control collective (169 +/- 35 U/ml) and are significantly lower in the prostitutes (98 +/- 26 U/ml, p < 0.05) and in the HIV-infected group (49 +/- 15 U/ml, p < 0.01). The difference between the latter groups being significant as well (p < 0.05). Dividing the controls into HPV-16 positive and HPV-16 negative subgroups, the IFN-alpha values are significantly higher in HPV-16 negative group (193 +/- 48 U/ml) compared to HPV-16 positive group (38 +/- 3 U/ml, p < 0.05). Also in the collective of prostitutes and HIV infected patients there is a similar significant difference between the HPV-16 positive and HPV-16 negative patients (Prostitutes: HPV-16 negative = 94 +/- 21 U/ml, HPV-16 positive = 36 +/- 7 U/ml, p < 0.05; HIV-infected: HPV-16 negative = 35 +/- 13 U/ml, HPV-16 positive = 13 +/- 3 U/ml).

AIDS-Related Opportunistic Infections↗