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Michael K Bohlmann

Publications and source records attributed to Michael K Bohlmann.

6 recordsLinked to original sources
PubMed2005

Intraoperative venous blood sampling to localize a small androgen-producing ovarian tumor.

BACKGROUND: Among other causes of virilization, ovarian tumors can be the cause of excessive androgen production. We report the case of a Leydig cell tumor of the ovary where diagnostic attempts to localize the source of hyperandrogenism preoperatively failed owing to relatively small tumor size. CASE: A 36-year-old woman presented with clinical signs of severe virilization including progressive balding, increased hirsutism, secondary amenorrhea and enlargement of the clitoris. Extensive work-up included endocrinological tests, pelvic ultrasound, magnetic resonance imaging, chromosomal analysis, norcholesterol scintigraphy and selective venous sampling, without direct localization of the source of hyperandrogenism. Persistently high plasma testosterone prompted an explorative laparotomy. Intraoperative selective blood sampling of the ovarian veins and palpation gave evidence of a right ovarian tumor, which was then removed. Histological examination revealed the presence of a pure Leydig cell tumor. CONCLUSION: Exploratory laparotomy with intraoperative selective blood sampling of the ovarian veins might be a useful approach in patients without accurate preoperative localization of androgen-producing tumors of the ovaries.

Adrenocorticotropic Hormone↗
PubMed2004

Glucocorticoid administration in antiemetic therapy: is it safe?

BACKGROUND: Although glucocorticoids are often used in cancer therapy, in particular to enhance the effectiveness of antiemetic therapy, they have been associated with impaired tumor apoptosis and an increased frequency of metastases in some reports. The current study aimed to determine whether glucocorticoid treatment had an adverse effect on outcomes in patients with ovarian carcinoma. METHODS: Records of patients with ovarian carcinoma who were scheduled to receive at least six courses of systemic chemotherapy were reviewed. Patients were grouped into those who had or had not received corticosteroid medication as a part of general antiemetic prophylaxis before chemotherapy, and details of hematologic parameters during treatment and disease recurrence-free and overall survival were recorded. RESULTS: Altogether, 245 patients with ovarian carcinoma had received chemotherapy. Of these, 62 had been given concurrent glucocorticoid treatment and 183 had not. The two patient groups were well balanced with respect to disease stage and other prognostic factors. Kaplan-Meier analyses showed no significant differences in survival between the groups. Patients who received glucocorticoid treatment had significantly higher leukocyte values in the days immediately after chemotherapy, higher nadir leukocyte values, and higher counts before subsequent courses of chemotherapy (P < 0.01; Levene test, t test) compared with patients who did not receive glucocorticoid treatment. As a result, the initial treatment targets were achieved significantly more often in the glucocorticoid group (P = 0.007; chi-square test). CONCLUSIONS: There was no evidence that glucocorticoid treatment had a negative effect on outcomes in these patients. Glucocorticoids may exert protective effects on the bone marrow.

Adrenal Cortex Hormones↗
PubMed2004

Osteopontin is up-regulated in human decidual stromal cells.

OBJECTIVE: To analyze expression and regulation of osteopontin in human stromal endometrial and decidual cells. DESIGN: Study by immunohistochemistry, RNase protection assay, and in vitro study. SETTING: Academic research unit. PATIENT(S): Twenty-five fertile women. INTERVENTION(S): Expression of osteopontin mRNA and protein was analyzed by RNase protection assay (RPA) and immunohistochemistry in secretory endometrium and decidua. Regulation of osteopontin expression in endometrial epithelial cell and stromal cells was analyzed by incubation with 17beta-estrogen, progesterone, IL-1beta, IL-6, and LIF and by incubation with cell culture supernatants of decidual natural killer cells. Furthermore, osteopontin expression was studied in stromal cells, decidualized in vitro. MAIN OUTCOME MEASURE(S): mRNA and protein expression and regulation of endometrial stromal osteopontin. RESULT(S): Osteopontin mRNA and protein are expressed at increasing concentrations in human secretory endometrium and in decidua. High concentrations in total decidua were due to high osteopontin concentrations in decidualized stromal cells. Osteopontin mRNA and protein expression was not regulated by incubation of endometrial epithelial and stromal cells with steroids, cytokines, and natural killer cell supernatant for 6 and 24 hours. In contrast, decidualization of stromal cells for 7, 14, and 21 days resulted in significant up-regulation of osteopontin mRNA and protein. CONCLUSION(S): Osteopontin is expressed at high concentrations in secretory endometrium in epithelial cells and in decidua in stromal cells. Decidual stromal expression of osteopontin is up-regulated by decidualization.

Cells, Cultured↗
PubMed2002

Intracardiac resection of a metastatic choriocarcinoma.

BACKGROUND: Postpartal choriocarcinoma is a rare complication of pregnancy, which usually responds well to chemotherapy, even in advanced stages. Metastatic heart involvement typically characterizes a widely advanced disease, requiring palliative treatment. CASE: A 41-year-old woman with disseminated choriocarcinoma following a full-term pregnancy presented with clinical signs of severe dyspnea. Pulmonary hypertension and a floating left atrial tumor were diagnosed upon echocardiography. Tumor resection was performed by intracardiac surgery. Histological examination revealed a metastatic thrombus of a choriocarcinoma that had obstructed the right inferior pulmonary vein at the entrance to the left atrium. The patient was treated with high-dose chemotherapy. After a 1-year follow-up the patient continues to be in full remission. CONCLUSION: Tumor reductive surgery followed by high-dose chemotherapy might be a useful approach in patients with metastatic choriocarcinoma even in cases of rare tumor sites.

Adult↗