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Biomedical subjects

P Husslein

Publications and source records attributed to P Husslein.

At least 73 records · Page 4Linked to original sources
PubMed1998

Shedding of tumour necrosis factor receptors from purified villous term trophoblasts and cytotrophoblastic BeWo cells.

Within the placenta tumour necrosis factor-alpha (TNF-alpha) and its surface receptors TNF-RI and -RII have been detected on villous cyto- and syncytiotrophoblast and a role in trophoblast function/differentiation and turnover has been suggested. Here, we show for the first time that purified villous trophoblasts and cytotrophoblastic BeWo cells extensively shed TNF receptors, suggesting that release of these soluble proteins is an inherent property of trophoblasts. In supernatants of purified villous trophoblasts, TNF-RI and -RII increased from undetectable levels to 307 pg/ml and 484 pg/ml, respectively, within 12 h of cultivation. In BeWo cells, 26 pg/10(5) cells and 54 pg/10(5) cells of soluble TNF-RI and -RII, respectively, accumulated within 24 h of culturing. While forskolin did not alter TNF-RI expression, TNF-RII mRNA, protein and secretion were selectively up-regulated in these choriocarcinoma cells suggesting that elevation of cAMP levels could modulate cellular events by TNF-RII-mediated signal transduction. Interleukin-1, which greatly enhances TNF-alpha release from trophoblast cells, did not alter shedding of both receptors from villous trophoblasts or BeWo cells. Secretion of TNF receptors from the trophoblast may explain the high levels of soluble TNF-binding proteins in urine of pregnant women and could play a role in regulating TNF-alpha activity in the placental villus or protection against the cytotoxic effects of the cytokine.

Antigens, CD↗
PubMed1998

Influence of acupuncture on duration of labor.

The aim of this case control study was to evaluate the thus far controversially discussed influence of acupuncture (AP) on the duration of labor. Fifty-seven women with AP treatment (group A) were included in our study after spontaneous vaginal full-term delivery. The control group included 63 women (group B). Median duration of the first stage of labor was 196 min in group A and 321 min in group B (Wilcoxon 2-sample test, p < 0.0001). Median duration of the second stage of labor was 57 min in group A and 57 min in group B (Wilcoxon 2-sample test, p = 0.82). Thirty women had a premature rupture of the membranes (PROM), in group A 66.7% and in group B 33.3% (chi2 test, p = 0.02). Women without AP (group B) received significantly more often oxytocin during the first stage of labor compared with group A women (85 and 15%, respectively, chi2 test, p = 0.01) as well as during the second stage of labor (72 and 28%, respectively, chi2 test, p = 0.03). Our study suggests that AP treatment is a recommendable form of childbirth preparation due to its positive effect on the duration of labor, namely by shortening the first stage of labor.

Acupuncture Analgesia↗
PubMed1998

[Review, present and prospects of obstetrics].

During the last 25 years, the most impressive development in obstetrics has been the reduction of perinatal mortality from approximately 25 to below 6. Contrary to the expectations of those days, this has not been achieved by a decreased rate of premature births but by a better management of prematurely born babies, particularly by the induction of fetal organ maturity by corticosteroids and the antenatal transfer of high-risk pregnant women to a perinatal care centre. A more careful birth management and the corresponding ameliorations in neonatology (e.g. dosing of surfactants, less invasive methods of artificial respiration) have also contributed to the better results. The introduction of the prostaglandins to expel the fetus, the induction of delivery treatment of postpartal atonia were other milestones in the of obstetrics. Apart from these medical developments, sociological trends shaped obstetrics too, and these will influence it future: the increasing importance of the patient's will, paramedical factors in obstetrics and the heightened readiness to go to court in case of supposed damage. In obstetrics, the next few decades will show an uncheckable increase in the frequency of caesarean sections, due to - among other factors - the knowledge that vaginal deliveries cause injuries of the pelvic floor which have mostly been disregarded until now. Because of the expected decrease in birth rates, the increased number of doctors and midwives, the more and more demanding attitude of the population and the relentless readiness of supposedly injured patients to take legal action, the environment for obstetricians well become even more difficult in the future.

Austria↗
PubMed1998

Membrane thickness and PROM--high-frequency ultrasound measurements.

Premature rupture of the membranes (PROM) is still an unsolved problem in obstetrics. Neither prevention nor diagnosis nor therapy is readily available. The amniotic sac is stabilized mechanically by a dense network of collagenous fibres; in the event of PROM, the collagenous mesh is dissolved and the thickness of the amniotic sac is reduced. In a prospective study involving 32 patients, we measured the thickness of the membranes in vitro by high-frequency ultrasound and by light microscopy of histological sections, between gestational weeks 28 and 32. We compared 18 patients with premature rupture of the amnio-chorionic membrane with 14 patients following induction of labour, with intact membranes at the same gestational age in vitro. We were able to show that the membrane in the PROM group (0.54 +/- 0.9 mm) was markedly thinner with fewer collagenous fibres than in the control group (0.74 +/- 1.01 mm). The application of high-frequency ultrasound in vivo in PROM may become helpful for the prediction of PROM; further studies are therefore desirable.

Amnion↗
PubMed1998

Impact of maternal body build characteristics on newborn size in two different European populations.

The association patterns between maternal anthropometric characteristics (stature, prepregnancy weight, prepregnancy body mass index, pregnancy weight gain) and newborn size (birth weight, length, head circumference) were tested with 10,240 single births taking place between 1985 and 1995 in Vienna, Austria, and 3,452 single births taking place between 1989 and 1995 in Westerstede-Ammerland (Friesland), northern Germany. Maternal size and newborn size differed highly significantly (p < 0.001) between the two genetically and socioeconomically different population groups. Furthermore, the incidence of macrosomia among newborns (birth weight greater than 4000 g) was extraordinarily high (17.9%) in the Frisian group from northern Germany. In both populations taller and heavier women with a higher weight gain during pregnancy gave birth to heavier offspring. Nevertheless, the pregnancy weight gain, which indicates environmental conditions of the mother, had only a minor impact on newborn size compared with stature and prepregnancy weight, which reflect the maternal genetic potential to a higher degree.

Austria↗
PubMed1997

Interleukin-1 stimulates tumor necrosis factor-alpha (TNF-alpha) release from cytotrophoblastic BeWo cells independently of induction of the TNF-alpha mRNA.

Constitutive tumor necrosis factor-alpha expression (TNF-alpha) has been detected in first trimester trophoblast cells and differentiated syncytiotrophoblasts. However, molecules which induce TNF-alpha release from these cells and their mechanism of action have not been defined. We show for the first time that interleukin-1 (IL-1), a regulator of trophoblast development, induces TNF-alpha expression in proliferating cytotrophoblastic cells and purified term trophoblasts. Both IL-1alpha and beta stimulate TNF-alpha release from BeWo cells and TNF-alpha mRNA was transiently expressed. In growth-arrested/differentiated BeWo cells TNF-alpha mRNA was detectable without inducer, however, in the presence of IL-1beta TNF-alpha secretion was weakly stimulated compared to proliferating cells. Cycloheximide strongly increased IL-1beta-induced TNF-alpha mRNA concentration indicating that de novo protein synthesis is not required for TNF-alpha gene expression. However, treatment with cycloheximide did not prevent IL-1beta-stimulated release of TNF-alpha, indicating that the cytokine can regulate TNF-alpha secretion at a posttranslational level, independently of TNF-alpha mRNA induction. Besides demonstration of this novel mechanism of IL-1-stimulated TNF-alpha expression, our data indicate an important role of IL-1 in TNF-alpha production of cytotrophoblastic cells.

Choriocarcinoma↗
PubMed1997

Hypoxia downregulates continuous and interleukin-1-induced expression of human chorionic gonadotropin in choriocarcinoma cells.

The effects of hypoxia on JEG-3, BeWo, and JAr cells were investigated and it was demonstrated that choriocarcinoma cells can be used as a model to study the molecular mechanism of hypoxia-mediated repression of human chorionic gonadotropin (hCG). Cells were maintained under hypoxia (3.5 per cent O2) for 72 h without loss of variability, as demonstrated by the fact that 93-98 per cent of the cells excluded trypan blue. Up to 48 h, cell growth was not significantly influenced by hypoxia, and analysis by flow cytometry did not reveal major changes in cell cycle distribution. JEG-3, BeWo, and JAr cells which were grown for 48 h under hypoxia secreted 81, 67, and 71 per cent less hCG than cells cultivated under normoxic conditions. The extent of hCG reduction was dependent on the oxygen concentration. Moreover, release of the hormone from hypoxic JAr cells was not stimulated upon addition of interleukin-1 (IL-1). Treatment of JEG-3 cells with methotrexate (MTX) led to a 4.3-fold augmentation in hCG secretion and to an increase in the amount of G0/G1 cells. However, when cells were cultured in the presence of MTX and hypoxia, hCG secretion decreased 10-fold and beta hCG mRNA declined to almost undetectable levels suggesting that downregulation of beta hCG mRNA is the major cause of diminished hCG release under hypoxic conditions.

Cell Division↗
PubMed1997

The fast-reacting fetal fibronectin test: a screening method for better prediction of the time of delivery.

OBJECTIVE: Our aim was to determine from what time onward fetal fibronectin is consistently detectable in the cervicovaginal secretions before delivery and to what extent the actual time of delivery can be better determined by this procedure than by the sole use of the Bishop score. STUDY DESIGN: A fast-reacting fetal fibronectin test was performed on 206 women on their expected date of confinement. In addition, the cervical status was evaluated with use of a modified Bishop score. Follow-up evaluations were subsequently carried out in the course of the routine examinations. RESULTS: Women with a positive fetal fibronectin test result and a high Bishop score were delivered after a median of 1.7 days. Conversely, women with a negative fetal fibronectin test result and a low Bishop score were delivered after a median of 7.1 days. CONCLUSION: Determination of fetal fibronectin in combination with the Bishop score makes it possible to predict the actual time of delivery with a greater degree of accuracy.

Cervix Uteri↗
PubMed1997

Transfer of erythropoietin across the placenta perfused in vitro.

OBJECTIVE: The purpose of this study was to investigate the placental passage of erythropoietin in a placental perfusion model ex vivo. METHODS: In an open system 18 placentas were perfused on both the maternal and the fetal side. Erythropoietin and a reference substance were added to either the maternal or fetal perfusion medium. In the first series of experiments, radiolabeled erythropoietin was added to the perfusion medium in four different concentrations to help determine the transfer rate of erythropoietin. Based on the results of these experiments unlabeled erythropoietin was added to the perfusate in three different concentrations. Radiolabeled erythropoietin was used in addition to erythropoietin because measuring radioactivity in a gamma counter is less expensive than measuring by immunoassay. RESULTS: Accumulation of radioactivity in the venous portion of the fetal circuit was only 3.21% of the activity added to the maternal circuit. No evidence of transfer of erythropoietin to the contralateral compartment was noted, regardless of whether the test substance was added maternally or fetally. These results were independent of the concentration used. The reference compound antipyrine showed a mean transfer rate of 27.9%, which is in keeping with previous results. CONCLUSION: There is no transport of erythropoietin across fetal membranes. This finding is particularly remarkable in view of results published recently indicating the placenta as a site of erythropoietin production. The lack of its transport across the human placenta is most likely due to its high molecular weight.

Biological Transport↗
PubMed1997

Proliferative cell activity in correlation to human chorionic gonadotrophin release of trophoblast tissue of tubal pregnancy.

The degree to which the relative rise of serum human chorionic gonadotrophin (HCG) concentration was related to proliferative cell activity and the biological vitality of tubal pregnancy was investigated. Salpingectomy was performed in 15 patients diagnosed as having non-ruptured tubal pregnancy. Serum HCG was evaluated twice preoperatively, with a 48-h time interval. Proliferative cell activity was measured through the use of the cell proliferation marker 'Ki-67'. A significant correlation between the relative increase in HCG over a 48-h period, independent of the initial serum HCG value, and the biological cell activity of the trophoblast was shown. Furthermore, it became evident that cell activity was also correlated to the intracellular HCG of the trophoblast. The relative increase in serum HCG over a period of 48 h can serve as a parameter for the biological activity of the trophoblast in tubal pregnancies.

Cell Division↗
PubMed1997

A meta-analysis of low dose aspirin for the prevention of intrauterine growth retardation.

OBJECTIVE: To determine more precisely the effect of prophylactic low dose aspirin on intrauterine growth retardation and perinatal mortality. DESIGN: Meta-analysis of 13 published randomised clinical trials. METHODS: We searched 18 medical databases, including MEDLINE since 1964 and EMBASE since 1974, review articles and the references from each retrieved report to identify all studies evaluating the effect of aspirin in pregnancy and including both intrauterine growth retardation and perinatal mortality as outcome measures. RESULTS: Among 13,234 women from 13 studies between 1985 and 1994, aspirin showed a significant reduction in intrauterine growth retardation (IUGR) (OR 0.82; 95% CI 0.72-0.93; P = 0.003) and a nonsignificant reduction in perinatal mortality (OR 0.84; 95% CI 0.66-1.08; P = 0.18). Subgroup analyses revealed that aspirin was effective at lower doses between 50 and 80 mg/day (IUGR: OR 0.87; 95% CI 0.76-0.99; mortality: OR 0.90, 95% CI 0.70-1.16), but that the preventive effect was greater at higher doses between 100 and 150 mg/day (IUGR: OR 0.36, 95% CI 0.22-0.59; mortality: OR 0.40, 95% CI 0.16-0.97) and among women entered before the 17th week of gestation (IUGR: OR 0.35, 95% CI 0.21-0.58; mortality: OR 0.43, 95% CI 0.17-1.06). We did not identify any specific subgroup of women most likely to benefit from aspirin treatment. CONCLUSION: The results of this meta-analysis showed that early aspirin treatment reduced the risk of intrauterine growth retardation. Low dose aspirin should not be used routinely in pregnant women until those most likely to benefit from aspirin treatment have been clearly identified.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1996

Laparoscopic surgery in cases of ovarian malignancies: an Austria-wide survey.

The purpose of the study was to determine the frequency of discovering a malignant ovarian mass when laparoscopy is used to manage an adnexal mass. A countrywide survey was undertaken in Austria, comprising questions about ovarian malignancy detected or accidentally treated by laparoscopy. The response rate of 66.7% represented a total of 54,198 laparoscopies, 16,601 laparoscopic surgeries on adnexal masses, and 108 cases of ovarian tumors subsequently found to be malignant (96 well-documented). Twenty patients were treated with laparoscopy alone. In 22 cases, laparoscopy was followed by immediate laparotomy. A delayed laparotomy (3-1415 days) was performed in 54 cases. Staging revealed FIGO classifications from stages Ia to IV. The follow-up time ranges from 2 to 220 months. Four recurrences have been reported. Thirteen patients died of tumor progression. Laparoscopic surgery on ovarian malignancies is a rare situation (0.65% of all endoscopic surgeries on adnexal masses). In cases of malignancy, a laparotomy has to be performed to ensure optimal staging and treatment.

Adolescent↗
PubMed1996

The transfer of interleukin-8 across the human placenta perfused in vitro.

OBJECTIVE: To assess the placental transfer of interleukin (IL)-8 in vitro. METHODS: Eighteen placentas obtained immediately after delivery were perfused with a mixture of 125I-labeled IL-8 (IL-8*) and unlabeled IL-8 in two different concentrations. Antipyrine was coinfused in all experiments as a reference compound. Fetal-to-maternal and maternal-to-fetal perfusions were performed. Radioactivity was measured in a gamma counter at the end of each perfusion experiment. In four experiments, unlabeled IL-8 was analyzed in addition to labeled IL-8 to exclude a change in the IL-8/IL-8* ratio resulting from membrane transfer. RESULTS: Two of the 18 experiments had to be discarded because of poor transfer of antipyrine. There was only faint accumulation of radioactivity in the transplacental compartment, regardless of whether the test substance was added maternally or fetally. Because measurement of unlabeled IL-8 yielded negative results, the radioactivity is clearly attributable to free iodine 125, which is generated during IL radiolabeling or which disassociates from IL-8 in small amounts after radiolabeling. CONCLUSION: Interleukin-8 does not appear to cross the placenta by simple diffusion, regardless of the concentration or the perfusion rate. The impermeability of the placenta to the diffusion of IL-8 might explain why there is insufficient correlation between serum and amniotic fluid cytokine concentrations of pregnant women and the presence of the amnion infection syndrome.

Biological Transport↗
PubMed1996

Adjunctive antibiotic treatment in preterm labor and neonatal morbidity: a meta-analysis.

OBJECTIVE: To estimate the effect of prophylactic antibiotics on neonatal mortality and morbidity in patients with preterm labor, based on a meta-analysis of seven published randomized clinical trials. DATA SOURCES: We searched 18 medical data bases, including MEDLINE from 1964 and EMBASE from 1974, to identify all literature included under preterm or premature labor and antibiotics. We scanned all abstracts from the computer printouts, the retrieved full-text reports, the references from each retrieved report, and review articles to determine whether studies met our inclusion criteria. METHODS OF STUDY SELECTION: The following criteria were used to select studies for inclusion: article-original published report written in English; study design-randomized controlled trial; population-patients with preterm labor, defined as labor before 37 weeks' gestation; intervention-antibiotic treatment; and one or more of the following outcomes-neonatal mortality, sepsis, pneumonia, respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis. TABULATION, INTEGRATION AND RESULTS: We analyzed study patients and methods, and abstracted quantitative outcome data. For each outcome, both odds ratio (OR) and 95% confidence interval (CI) were calculated. Seven trials, published between 1989 and 1995 included a total of 795 patients. Adjunctive antibiotic therapy appeared to reduce the risk of pneumonia (OR 0.45, 95% CI 0.12-1.72) and necrotizing enterocolitis (OR 0.38, 95% CI 0.14-1.08) and to increase the risk of neonatal mortality (OR 3.25, 95% CI 0.93-11.38), but it had no effect on neonatal sepsis (OR 0.98, 95% CI 0.34-2.83), respiratory distress syndrome (OR 0.93, 95% CI 0.54-1.87), and intraventricular hemorrhage (OR 1.01, 95% CI 0.20-5.10). None of the effects observed reached a significance level of P < .05. CONCLUSION: The results of this meta-analysis do not support the routine use of adjunctive antibiotic treatment in patients with preterm labor diagnosed on the basis of subjective uterine contractions and the resulting cervical changes.

Anti-Bacterial Agents↗