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Biomedical subjects

R Kirschner

Publications and source records attributed to R Kirschner.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Examination and treatment of gynecological bleeding disorders].

The investigation and treatment of gynaecological dysfunctional bleeding has remained largely unchanged since the problem was dealt with in a special issue of the Journal of the Norwegian Medical Association in 1976, in spite of the advent of modalities like endometrial cytology, hysteroscopy and vaginal ultrasonography, as well as knowledge about the relative lack of efficiency of dilatation and curettage in the investigation and treatment of the condition. We describe a modern programme for investigation and treatment of gynaecological dysfunctional bleeding. The programme relies on clinical assessment combined with medical therapy, with optional use of modern investigative modalities when indicated. In a strictly controlled outpatient programme the need for dilatation and curettage can be greatly reduced without jeopardizing the safety of the patient.

Adult↗
PubMed1992

Medical ethics and human rights violations: the Iraqi occupation of Kuwait and its aftermath.

Immediately after the liberation of Kuwait by a coalition of allied forces in March 1991, representatives of Physicians for Human Rights traveled to Kuwait and conducted an inquiry into human rights violations allegedly perpetrated by Iraqi forces. The inquiry focused on the abuses that were said to have occurred in health care institutions. Human rights abuses by the Iraqis in Kuwaiti hospitals were documented, but certain allegations proved to be unfounded. However, Kuwaiti abuses of those accused of collaborating with the Iraqi invaders, in particular Palestinian citizens of Kuwait, were also observed. The trip and inquiry generated questions about the scope and applicability of medical ethical principles to physicians in different cultures and in situations unlike those in which medicine is normally practiced. In light of the Kuwait experience, Physicians for Human Rights has drawn tentative conclusions about the universal nature of medical ethics.

Ethical Relativism↗
PubMed1992

[K-cell activity in patients with germ cell testicular tumors. Effect of cytostatic therapy].

The antibody-dependent cell mediated cytotoxicity of peripheral blood mononuclear cells from 92 patients with germinal cell tumours and 60 healthy male controls was measured against 0, Rh(D) positive human red blood cells sensitized with anti-D antibody. To determine the maximal K-cell activity the enzym-like kinetic model of citotoxicity was employed in which maximal activity was measured in presence of target-cell excess. To avoid variation due to the individual sensitivity of target erythrocytes red blood cells were obtained from a single donor. It was demonstrated that compared to the control group the K-cell activity of patients with germinal cell tumours was significantly enhanced. Cytotoxic activity of patients with clinically detectable tumours was significantly higher than that of patients with no detectable tumour. The K-cell activity of patients with detectable tumours was significantly increased after chemotherapy.

Antineoplastic Agents↗
PubMed1991

[Laser in gynecology].

During the last decade, the use of laser technology has become more common in operative gynaecology in Norway. The first modality to be introduced was the carbondioxide, CO2-laser, used together with the colposcope for the treatment of cervical intraepithelial dysplasia and condylomata. The same laser has also been employed through laparoscopic technique, with the aid of modern microvideofacilities. Finally, using the hysteroscopic technique, the Neodymium-Yttrium-Aluminium-Garnet, the Nd-YAG-laser, has been introduced for treating intrauterine conditions. The use of laser in operative gynaecology makes it necessary to change the attitude towards indications for operation. The possibilities are challenging, and the effect on the length of postoperative convalescence is especially rewarding. The introduction of lasers in gynaecology could have far-reaching consequences for efficient use of hospital resources.

Adult↗
PubMed1991

Treatment of tubal pregnancy by laparoscopic laser surgery.

We present 150 consecutive cases of tubal pregnancy treated by laparoscopic techniques. A three-puncture technique was used. 74 cases were treated conservatively by linear salpingotomy with carbon dioxide laser laparoscopy and 76 cases were treated nonconservatively through the laparoscope by salpingectomy or tubal resection. Contra-indications to laparoscopic surgery were haemodynamically unstable patient and interstitial pregnancy. Seventy-five per cent of all tubal pregnancies were treated by laparoscopy in the period studied. No complications were encountered during the laparoscopic operations. Two patients needed a second laparoscopy, while 2 others underwent a subsequent laparotomy. This study has shown that tubal ectopic pregnancies can in most cases be effectively managed by laparoscopic techniques.

Adolescent↗
PubMed1987

Molecular studies of ceruloplasmin deficiency in Wilson's disease.

Deficiency of serum ceruloplasmin is a characteristic biochemical abnormality of Wilson's disease, although the mechanism of this finding is unknown. Ceruloplasmin messenger RNA (mRNA) levels were therefore examined in five patients with Wilson's disease and five controls with other types of hepatic disease. Northern and dot blot hybridizations showed that detectable ceruloplasmin mRNA was present in all of the patients with Wilson's disease, including one patient with no detectable serum ceruloplasmin. However, the ceruloplasmin mRNA levels in the Wilson's disease patients were only 33% that of controls (P less than 0.001). In contrast, albumin mRNA levels in the Wilson's disease patients averaged 161% that of controls. In an attempt to better delineate the level of gene expression responsible for this decrease in ceruloplasmin mRNA, the nuclear run-on assay was used to analyze transcriptional rates. The amount of ceruloplasmin gene transcription in four Wilson's patients was decreased to 44% that of three controls. These results indicate that the diminished serum ceruloplasmin levels in patients with Wilson's disease are due at least in part to a decrease in ceruloplasmin gene transcription.

Ceruloplasmin↗
PubMed1980

Treatment of cervical intraepithelial neoplasia with local excisional biopsy and cryosurgery.

One hundred and ninety-eight patients with abnormal cytologic smears had extensive diagnostic biopsy of the portio combined with endocervical curettage. Severe dysplasia or cancer in situ was found in 57 per cent of the patients. During a period of observation of 6--42 months (average 18 months) the cervical intraepithelial neoplasia (CIN) regressed in 54 per cent. Cryosurgery was used to treat 93 patients with persistent CIN after biopsy. Treatment was successful in almost 70 per cent after one single application of cryosurgery. The complications were negligible. Treatment was less successful with increasing histological severity as well as with increasing age of the patients; this applies both to biopsy and cryosurgery. Cryosurgery is significantly less effective when the CIN is of both ecto- and endocervical origin. Extensive multiple biopsies of the portio in combination with endocervical curettage performed under general anaesthesia, followed by cryosurgery with persistent cytological abnormalities, are indicated as an alternative to conization, especially in younger patients with ectocervical CIN.

Biopsy↗
PubMed1979

Pregnancy in a non-communicating, rudimentary uterine horn. A reason for failed therapeutic second trimester abortion.

Anatomical aberrations in the female genital tract are due to maldevelopment of the Müllerian duct system. Various degrees of malformations are described (9). Some of these malformations are discovered during the investigation of amenorrhea, persistent dysmenorrhea or infertility, while others are discovered in connection with obstetrical problems. The incidence of uterine malformations is quoted as 1:1 500-2 000 (8, 11), the incidence of uterus unicollis bicornis being as rare as 1:100 000 (3). There is no unified nomenclature for the rare types of genital malformations. Semmens describes a group consisting of functional uteri of single Müllerian origin, labelled uterus unicollis bicornis with one rudimentary horn (8). Most rudimentary horns are hollow and allow the expansion of an up to 20 weeks pregnancy (3). Few cases of pregnancy in a rudimentary horn have been seen, causing complications during pregnancy and delivery, and when performing therapeutic abortions (2, 3, 4, 5, 6, 12).

Abortion, Therapeutic↗