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Biomedical subjects

R Bollmann

Publications and source records attributed to R Bollmann.

At least 55 records · Page 3Linked to original sources
PubMed1998

Investigations on the detection of Chlamydia trachomatis infections in infertile male outpatients.

The determination of Chlamydia antibodies in serum is unsuitable for diagnosing infertility in men. The determination of secretory IgA in seminal plasma would seem to be of greater relevance. Since antibodies against C. trachomatis and C. pneumoniae can be detected, a species-specific test for the diagnosis of infections of the male genital tract should be used. Only at relatively high titers (> or = 1:400) do genus-specific tests agree with the species-specific micro-immunofluorescence test. Whether such values can be taken as a true indicator of a local, chronic infection remains to be investigated.

Adult↗
PubMed1998

[Diagnostic and predictive validity of DNA image cytometry in soft tissue tumors].

Malignant neoplasms are associated with chromosomal aberrations. This phenomenon called aneuploidy can be substantiated by interactive DNA cytometry and is accepted as a major prognostic parameter in tumor biology and oncology. In a retrospective study 114 non-infantile soft tissue tumors were analysed by DNA cytometry. The results were compared with classical morphological parameters. As a marker for malignancy in soft tissue lesions, DNA aneuploidy substantiated by cytometry has a sensitivity of 94% and a specifity of 82%: 50 of 53 malignant soft tissue tumors were DNA aneuploid; from 61 non-sarcomatous soft tissue tumors 11 were found to be aneuploid. These lesions were classified as intermediate dignity. No aneuploid tumor could be found among 30 histologically benign soft tissue tumors. The positive predictive value of DNA cytometry was 82%: of 61 aneuploid soft tissue tumors 11 were non-sarcomatous tumors with intermediate dignity. The negative predictive value of DNA cytometry was 97%: from 53 non-aneuploid soft tissue tumors only three were found to be sarcomas. Malignant soft tissue tumors demonstrate a significantly higher DNA-index (DI) and DNA grade of malignancy (DNA MG) than benign lesions. Our results show that DNA ploidy may serve as an additional parameter in problematic histological dignity assessments of soft tissue tumors. The histopathological grading levels of sarcomas show significantly different DI and DNA MG, so that DNA cytometry enables substantiated grading of soft tissue.

Aneuploidy↗
PubMed1998

[Increased CA-19-9 caused by a splenic cyst: a rare differential diagnosis].

Adenocarcinoma of the gastrointestinal tract, particularly primary adenocarcinoma of the pancreas lead to elevation of serum carbohydrate 19-9 (CA19-9) levels. Some benign disorders, like inflammatory diseases also cause CA19-9 tumor marker elevation. An extremely rare entity are benign splenic cysts which express this tumormarker as reported here.

Adult↗
PubMed1997

[Modern fetal autopsy oriented to clinical demands using technical information methods].

Modern ultrasonic diagnostic instruments with high resolution and color Doppler sonography allow the obstetrician to describe pathological findings very precisely and at an early stage of pregnancy. The use of high-resolution ultrasound makes it possible to detect heart malformations already between the 8th and 10th week of gestation. This development has essentially changed the clinical requirements on fetal autopsy which in its traditional way no longer meets the increased demands. Unless the pathologists faces this challenge the importance of fetal autopsy will diminish. Modern image databases and communication techniques allow the pathologist to have direct access to text and images of pre-findings by other clinics. Great importance, however, must be attached to the interdisciplinary cooperation with obstetricians and geneticists. We report on routine fetal autopsy by using an interdisciplinary database an the Charité.

Autopsy↗
PubMed1997

Prenatal diagnosis of ventriculo-coronary communications in a second-trimester fetus using transvaginal and transabdominal color Doppler sonography.

We report on the prenatal diagnosis of ventriculo-coronary communication associated with pulmonary atresia and an intact interventricular septum. The diagnosis was made by transvaginal color Doppler sonography at 17 weeks' gestation and confirmed by transabdominal sonography at 19 weeks. Color Doppler demonstrated the communication between the distal hypoplastic right ventricle and the right coronary artery, with the course of this vessel situated along the outer heart wall. Spectral Doppler assessment showed bidirectional arterial flow in this vessel. Extracardiac skeletal anomalies (cleft hands and feet) were also detected and classified as an ectrodactyly-ectodermal dysplasia clefting (EEC) syndrome. This led the parents to opt for termination of pregnancy. All findings were confirmed on autopsy. Using stereomicroscopy the malformations of the coronary system and main connections to the lumen of the right ventricle were additionally demonstrated. To our knowledge this is the first report on the identification of coronary artery malformations in a midtrimester fetus using transvaginal color Doppler. The early appearance enabled us to investigate the pathophysiological sequence of the combined defect. Further investigation might elucidate whether ventriculo-coronary communications arise secondary to pulmonary atresia and intact inter-ventricular septum, due to increased ventricular pressure, or are the primary defect leading to intrauterine pulmonary atresia or, indeed, whether both defects appear simultaneously.

Adult↗
PubMed1997

Doppler assessment of tracheal and nasal fluid flow during fetal breathing movements: preliminary observations.

Our aim was to determine if it was technically possible to assess fetal tracheal fluid flow during fetal breathing movements, and to compare the data obtained with those recorded in the fetal nasopharynx. Tracheal and nasal fluid flow was analyzed in ten uncomplicated pregnancies, the gestational age ranging between 28 and 38 weeks. Color Doppler was used to detect the fluid displacement in the trachea generated by fetal breathing movements. Spectral Doppler was then used to analyze the fluid flow velocity waveforms. During the same breathing episode, nasal fluid flow was assessed by the same technique. The inspiration and expiration times were variable and not statistically comparable for both nasal and tracheal flow. Peak velocities of inspired and expired fluid were higher in the trachea than in the nose (p < 0.05). We found that the peak velocity of tracheal flow waveforms was significantly higher for inspiration than expiration (p < 0.05). No significant differences were found in the time velocity integral between inspiration and expiration (p = 0.79). The calculated intratracheal flow volume displaced during one breathing cycle increased from 1.3 to 5.0 ml with advancing gestation. Assessment of nasal and tracheal flow, using color and spectral Doppler, is feasible in the human fetus. Intratracheal flow measurements may provide an insight into the effect of fetal breathing movements on lung fluid in the human fetus.

Female↗
PubMed1997

[Doppler examination of the fetal left and right pulmonary artery. Relation to fetal position and gestational age: a methodological study].

UNLABELLED: A Methodical Study: AIM OF THE STUDY: To analyse the feasibility of colour and spectral Doppler assessment of blood flow in the fetal right (RPA) and left (LPA) main pulmonary arteries in relation to fetal position and to gestational age. STUDY DESIGN: The fetal position was a priori divided into 3 types, depending on whether the fetal heart was visualised apically (Type 1), from the right side (Type 2) or from the left side (Type 3). Three groups A (19-25 weeks gestation), B (26-32) and C (33-39) including 33 consecutive pregnancies each, were examined to document the fetal position as well as the rate of the successful Doppler examinations of the RPA and/or LPA. RESULTS: The fetal position Type 2 was most common throughout gestation (in group A = 42%, B = 36%, C = 51%) followed by the type 3 and then type 1. The rate of successful Doppler records from the RPA and LPA depended on the fetal position: In Type 2 RPA in 98%; in Type 3, LPA in 100%; but the apical approach was not effective (< 40%). Depending on gestational age, the success rates for a Doppler examination of at least one vessel were high (> 85%), whereas successful examination of both vessels was unlikely (12%). CONCLUSIONS: In the second half of pregnancy, independent of fetal position, Doppler examination of at least one pulmonary artery is successful in most cases, whereas the assessment of both vessels is rather difficult.

Female↗
PubMed1997

Genotypic and phenotypic determination of five virulence markers in clinical isolates of Escherichia coli.

The presence of the virulence markers K1 capsule, serum resistance, aerobactin, S and P/PR fimbriae were examined in a total of 395 E. coli strains from different extraintestinal infections and in 81 faecal isolates of healthy volunteers using specific DNA probes and classical phenotypic methods. All markers were more frequently detected when genotypic assays were applied. The simultaneous occurrence of 3-4 virulence determinants was typical for isolates derived from patients with septicaemia or meningitis. Isolates from blood cultures and cerebrospinal fluid were expressing the virulence phenotypes to a greater extent than isolates from urine or faeces. The use of colony hybridization with specific oligonucleotide and polynucleotide probes for the detection of virulence determinants has been proven to be more specific and reliable than phenotypic approaches.

Bacterial Capsules↗
PubMed1997

Occurrence of S and F1C/S-related fimbrial determinants and their expression in Escherichia coli strains isolated from extraintestinal infections.

The presence of S and F1C/S-related fimbrial determinants was determined in 462 E. coli strains obtained from different extraintestinal infections and in 162 control isolates of E. coli by using two different DNA probes: an oligonucleotide probe consisting of three oligonucleotides that bind specifically to the S adhesin gene and a polynucleotide probe which is not able to distinguish between S, F1C, and S-related sequences. The expression of S and F1C phenotypes was tested by dot enzyme immunoassay with the corresponding monoclonal antibodies. S fimbriae genotypes were observed more frequently in septic (25%) and urinary (12%) isolates of E. coli than in faecal and water isolates (1%) and often occurred together with O2, O6, O18 and O83 antigens. F1C/S-related fimbrial DNA was detected with a higher frequency in UTI isolates (26%) than in septic (16%) and faecal (10%) isolates and was most frequently associated with O4, O6, and O75 serotypes. Since the production of S and F1C fimbriae was comparatively rare in all clinical and control isolates of E. coli, DNA hybridization assays which allow the sensitive and specific detection of fimbrial determinants even in the absence of their expression are preferable to phenotypic assays.

Adhesins, Escherichia coli↗
PubMed1997

[Normal value curves for intrauterine fetal blood gas and acid-base parameters in the 2nd and 3rd trimester].

OBJECTIVE: The aim of the study was to establish reference ranges for fetal blood gases and acid-base balance for the second half of the gestation. METHODS: 155 appropriate-for-gestational-age fetuses between 18 and 39 weeks of gestation underwent a diagnostic cordocentesis. From a specimen obtained from umbilical venous blood the acid-base balance and blood gases were evaluated using an AVL 995 blood gas analyzer. In detail, pH, oxygen partial pressure, and carbon dioxide partial pressure were measured and oxygen saturation, bicarbonate concentration and base excess calculated. Thereafter, a linear regression for gestational age was calculated and the 95% confidence interval established. RESULTS: pH, oxygen partial pressure, and oxygen saturation showed a significant decrease with advancing gestational age, whereas the carbon dioxide partial pressure increased. The ranges of bicarbonate and base excess did not differ significantly. CONCLUSION: The results give information about blood gases in the fetus under physiological conditions, and the reference ranges can be used for comparison in fetuses at high risk of hypoxia or acidemia.

Acid-Base Equilibrium↗
PubMed1997

Prenatal diagnosis of laryngeal atresia in two cases of congenital high airway obstruction syndrome (CHAOS).

Complete occlusion of the upper airways is known to cause secondary morphological changes, including bilaterally enlarged hyperechogenic lungs, dilated trachea, and hydrops. Prenatal diagnosis of upper airway obstruction has been described in several cases. In these reports, the diagnosis was primarily attributed to indirect signs, and the authors were in doubt as to whether the location of the obstructed area (larynx, glottis or trachea) could be precisely visualized by ultrasound. In this paper two cases are reported presenting the features of congenital high airway obstruction syndrome (CHAOS) diagnosed at the 22nd week of gestation. In both cases, the upper neck was perfectly visualized in a coronal plane. At the onset of fetal breathing movements, the stenotic larynx remained in a closed position. By positioning a colour signal on the fluid-filled dilated trachea, we noticed absence of flow throughout the onset of breathing activity. We conclude that the atretic area must be situated at the level of the larynx. Because of the poor prognosis of laryngeal stenosis and the presence of associated anomalies, both pregnancies were terminated in the 23rd week. This report shows that the application of colour and spectral Doppler may be helpful in the differential diagnosis of fetuses with CHAOS.

Adult↗
PubMed1997

[Ultrasound biometry of the fetal lung--measurement planes and reference values].

The aim of the study is to present biometrical data of the fetal lung measured in real-time sonography in mid-pregnancy. In 313 healthy fetuses of singleton pregnancies between the 15th and 30th week of gestation the fetal lung was measured in the horizontal, sagittal and frontal cross-sectional planes. In each plane the lung was measured in the following levels: clavicula, heart at the atrioventricular level (four chamber view) and diaphragm, as well as the lung length. During observation time all parameters showed a significant linear increase (r2 > 0.9; p < 0.001). Furthermore we found a high correlation between the same lung measurements collected in the different planes. The intraobserver variability was 3-8%. Such references of different planes could be helpful for differentiation of a small (hypoplasia) or a large lung (malformation).

Female↗
PubMed1996

Assessment of serum levels of alpha-1-microglobulin, beta-2-microglobulin, and retinol binding protein in the fetal blood. A method for prenatal evaluation of renal function.

The concentrations of alpha-1-microglobulin, beta-2-microglobulin, and retinol binding protein were determined in fetal blood sampled by cordocentesis. The blood values of 126 fetuses without ultrasonographic findings of urinary tract abnormalities as controls were found to be independent of the week of gestation. In nine fetuses affected by a severe bilateral renal dysplasia or agenesis, elevated values of alpha-1-microglobulin but normal values of retinol binding protein were obtained. The authors recommend the determination of alpha-1-microglobulin and, with some restriction, also of beta-2-microglobulin in prenatal renal function diagnosis.

Alpha-Globulins↗
PubMed1996

Neuroectodermal cyst may be a rare differential diagnosis of fetal sacrococcygeal teratoma: first case report of a prenatally observed neuroectodermal cyst.

In spite of the fact that most anomalies can be accurately diagnosed prenatally, one may be confronted with an extremely rare fetal abnormality that has never been described before. We report a case of a neuroectodermal cyst arising from the posterior neuropore. After 21 weeks of gestation a fetal anechoic intra- and extra-abdominal tumor was detected. The mass grew to 75 x 41 x 33 mm at 35 weeks. Initially it was believed to be a sacrococcygeal teratoma. Serial scans and Doppler ultrasound examinations were performed, which demonstrated fetal well-being. Color Doppler imaging failed to demonstrate increased tumoral perfusion. After elective Cesarean section, the tumor was excised. The postoperative course was complicated by recurrent infections of the urinary tract due to neurological damage to the bladder. There was also impaired function of the anal sphincter. The histological finding of a monolayer of neuroepithelial cells and melanocytes led to the diagnosis of a neuroectodermal cyst.

Adult↗
PubMed1996

[Three-dimensional ultrasound study (3-D sonography) of the female breast].

Three-dimensional sonography of the mamma with a Voluson annular array transducer (10 MHz) (Kretztechnik, Austria) is a new method applicable in differential diagnosis of mamma foci. 50 patients (19 of them with breast cancer) were thus pre-surgically examined. Both sectional and stereoscopic representations were made use of. The suspected diagnoses and their correspondences with post-surgical findings were compared to the correspondences obtained through 2D-sonography. 3D-sonography produced 4 cases of the incorrectly positive diagnosis breast cancer, 2D-sonography 2 cases of incorrectly negative diagnoses. Other advantages of 3D-sonography over 2D-sonography include: better judgement of the conditional of focal environs (infiltration), existence and form of intracystic structures and of multifocal disease, short duration of examination, possible re-diagnosing of stored data.

Breast↗
PubMed1996

Clinical importance and prognostic value of the image-DNA-cytometry for patients with gastric cancer.

Image-DNA-cytometric analysis was performed retrospectively on air-dried touch preparations from gastric carcinoma from 122 patients who underwent surgery from 1989-1994. The results of DNA cytometry were compared with conventional histologic staging and grading. Aneuploidy could be verified in 81 cases (66.3%), and a significant correlation was demonstrated between aneuploidy and a high incidence of lymph node metastases, whereas no correlation with tumor type and histologic grade was detected. Thus DNA ploidy may by useful in predicting prognosis in gastric cancer.

Adult↗