PubMed Health⌕ Search

Biomedical subjects

R Osmers

Publications and source records attributed to R Osmers.

At least 55 records · Page 3Linked to original sources
PubMed1992

Origin of cervical collagenase during parturition.

Cervical biopsy specimens were obtained under standard conditions from the posterior lip of the uterine cervix in 105 patients. A significant increase of collagenase activity was observed during parturition as determined with an assay with iodine 125-labeled native triple-helical collagen type I as the substrate. The collagenase was not likely to originate from cervical fibroblasts because in situ hybridization failed to detect synthesis of the specific procollagenase messenger ribonucleic acid. However, migration of polymorphonuclear leukocytes into the cervical stroma occurred on onset of labor, and an antibody specific for human leukocyte collagenase that did not cross react with fibroblast collagenase revealed the presence of the enzyme in the granules of polymorphonuclear leukocytes and subsequently in the extracellular matrix of the cervix. Therefore it is likely that the cells critically involved in collagen degradation during cervical dilatation are not resident fibroblasts but rather polymorphonuclear leukocytes emigrating from blood vessels.

Blotting, Northern↗
PubMed1992

[Imaging and functional parameters in diagnosis of obstructive nephropathy].

Obstruction of the kidney leads to terminal kidney failure within a few years. Therefore, early recognition of such obstruction is of importance. Non-invasive diagnostic ultrasound examination now allows intrauterine visualization of a suspected obstruction. However, the implications of such a dilated ureteral pelvic system are obscure. Whether there is obstruction or dilatation can only be evaluated postnatally by a nuclear technique. The aim of our study was to measure the recovery of kidney function. We investigated 13 kidneys of 9 newborns or small infants (up to 2 years). The follow-up was continuous for up to 29 days. The parameters were: urine output (24-h clearance), glomerular filtration rate, fractional excretion of sodium and potassium, free water clearance, total protein excretion, albumin and alpha 1 microglobulin excretion. The urine output fell from 0.3 to 0.12 ml/min within 14 days after relief of obstruction. The glomerular filtration rate rose from nearly 30 ml/min to about 50 ml/min within a week. The fractional excretion of sodium and potassium indicated recovery of the proximal tubli. The fractional sodium excretion fell below 1% within 4 days. The free water clearance reflects the concentrating ability of the kidney, and in kidneys from newborns it had only positive values, while in kidneys of children older than 6 months there were also negative values. The protein excretion and the albuminuria showed recovery of the glomerular as well as the tubular system.(ABSTRACT TRUNCATED AT 250 WORDS)

Alpha-Globulins↗
PubMed1992

[Evaluation of the endometrium in postmenopausal women by means of vaginal ultrasound].

In the context of a prospective study, the authors carried out vaginal ultrasound examinations at the Gynecology-Obstetrics Clinic of Göttingen University of two groups of post-menopausal women: 233 women with hemorrhage and 539 who were asymptomatic. A diagnostic curettage was carried out in cases where the endometrium had a depth of at least 4 mm. The authors identified a 6% incidence of cases of adenomatous hyperplasia, 21% of endometrial cancer in women with hemorrhages and a 20% cancer rate in the asymptomatic women. Where the thickness of the endometrium was less than 4 mm, there were no cases of cancer. The infiltration depth examined microscopically was twice as great in the patients with hemorrhages (10 mm vs 4 mm).

Aged↗
PubMed1991

Collagenase activity in the human cervix uteri after prostaglandin E2 application during the first trimester.

Cervix biopsies were obtained during the first trimester from plurigravidae and primigravidae at various times after intracervical application of prostaglandin E2. The tissues were extracted with Ca(2+)-containing buffer, and collagenase activity was determined in these extracts using a solid phase assay in which triple helical 125I-labelled collagen was cleaved. Collagenase was detected in all samples but elevated activity was present only during a short temporal window after prostaglandin application. Maximal activity was observed 1 and 2 h after application of prostaglandin in multigravidae and 4 h in primigravidae. These data can explain why collagenase activity in cervical tissues after prostaglandin application had previously not been found. They indicate somewhat different mechanisms of cervical ripening in primigravide compared to multigravidae.

Cervix Uteri↗
PubMed1991

Incidence of abortion after genetic amniocentesis in twin pregnancies.

Fetal outcome after genetic amniocentesis (AC) in viable twin pregnancies was analysed in a retrospective study at three centres in order to estimate the rate of fetal loss after AC. The maternal age ranged from 33 to 45 years (mean 36.7 years). The gestational age varied between 15 and 20 weeks of gestation (mean 17.1). In 98 viable twin pregnancies with complete follow-up, spontaneous abortion of both fetuses occurred within 28 completed weeks of gestation in eight pregnancies and six women aborted within 20 completed weeks of gestation after AC, corresponding to a rate of fetal loss of 8.1 and 6.1 per cent, respectively (excluding the loss of five twins with viable outcome of the co-twin in five pregnancies).

Abortion, Spontaneous↗
PubMed1991

[Diagnosis of early extrauterine pregnancy by serum and Douglas pouch fluid hCG level].

In 44 patients with assumed ectopic pregnancy culdocentesis were carried out under transvaginosonographic control. In 23 cases, the clinical diagnosis ectopic pregnancy and in 16 cases, an early intact intrauterine pregnancy could be verified. Five patients had an early abortion. In all patients with an intact intrauterine pregnancy, the cul-de-sac liquid was serious. In 16 of the 23 cases of ectopic pregnancies, the fluid was bloody, 6 aspirates were bloody/serous and one serous. The findings in patients with an early abortion were as follows: three serous, one bloody/serous, one bloody. Further information could be gathered from the comparison of hCG-levels in simultaneously obtained serum samples and cul-de-sac liquid. All intact intrauterine pregnancies were associated with lower hCG-levels in the cul-de-sac liquid than in the serum (ratio: serum/cul-de-sac liquid greater than 1.3). In all ectopic pregnancies but one, we found an inverse constellation (ratio: serum/cul-de-sac liquid less than 0.7). In the described exceptional case the ratio was nearly 1 and when culdocentesis was repeated 5 days later, a ratio of 0.17 proved the clinically suspected ectopic pregnancy. In 3 cases of histologically confirmed intrauterine abortions, the hCG-level in the cul-de-sac liquid was lower than in the serum, in 2 cases of early abortions without histologically proved localisation the hCG-level was slightly above the level in the serum.

Abortion, Spontaneous↗
PubMed1991

[Pregnancy termination in the 2d and 3d trimester with prostaglandins depending on the cervix status].

Termination of pregnancy was performed in a standardized, on the cervical state depending manner in 48 patients with abortion between the 16th and 27th week of gestation and in 20 women with intrauterine fetal death (IUFD) between the 28th and 41st week of gestation. At a Bishop-Score (B.S.) less than 7 cervical ripening was induced by intracervical application of 0.1 mg sulprostone gel. In patients with a very unripe cervix (B.S. less than or equal to 3) local applications of prostaglandin gel were repeated at 6 hours intervals until a B.S. greater than or equal to 5 had been achieved. For induction of labour 0.5 mg sulproston was injected intramuscularly after at least one sulproston gel application in a range between B.S. greater than or equal to 5 to 7. At a B.S. 7 intravenous infusion of oxytocin was administered, if necessary, for augmentation of labour. Most of the patients received epidural anaesthesia before induction of labour. The time interval between the beginning of the procedure and expulsion of the fetus ranged from 6.5 to 49.5 hours (mean = 26.3 h) in the abortion group and from 2.0 to 46.0 hours (mean = 20.0 h) in the IUFD group. The median interval between induction of labour and abortion/delivery was 4.3 hours (range: 0.5-27.0), and 5.5 hours (range: 0.7-9.3 h) respectively. No surgical interventions were necessary in any of the patients, and no cervical lesions occurred. Undesired systemic side effects to prostaglandins were observed in only 4 out of the 68 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortifacient Agents, Nonsteroidal↗
PubMed1990

Vaginosonography for early detection of endometrial carcinoma?

In 103 women with postmenopausal bleeding and 283 postmenopausal women without bleeding maximum endometrial thickness was measured by vaginosonography. All patients with postmenopausal bleeding and all women without atypical bleeding but with an endometrium thicker than 4 mm or with some other indication for further investigation underwent curettage. The curettings were examined histologically. All histologically classified endometrial carcinomas were associated with an endometrial thickness of at least 4 mm. Endometrial cancer was found in 12.6% in the postmenopausal bleeding group (n = 103) and in 3.5% in the symptom-free group (n = 283). Vaginosonography is thus a good method of screening for uterine neoplasms in presymptomatic women--those with endometrial thickness of 4 mm or greater should undergo curettage and histological examination.

Aged↗
PubMed1990

Collagenase activity in the cervix of non-pregnant and pregnant women.

Cervical biopsies were obtained from non pregnant patients and from pregnant at various stages of gestation and during labour. The tissues were extract with a Ca(++)-containing buffer, and collagenase activity was determined in these extracts using a solid phase assay in which triple helical 125I-labelled collagen was cleaved. Collagenase was detected in all samples but significantly elevated activity was only present in labour at 6-8 cm cervical dilatation. This provides direct evidence for the crucial role of specific collagen degradation during cervical ripening and dilatation.

Abortion, Induced↗
PubMed1990

Vaginosonographic detection of endometrial cancer in postmenopausal women.

In a prospective study 155 postmenopausal women not on hormone treatment underwent a vaginal ultrasound investigation. All women were routine patients of the regular ambulance. In addition to uterus biometry, the endometrial thickness was also measured. An endometrium of greater than or equal to 4 mm thickness was clarified histologically by means of a curettage. In total we found 7 endometrial cancers and 1 cervical cancer. Vaginal sonography proved to be a very sensitive (81%) and specific (89%) method for the detection of endometrial neoplasia.

Aged↗
PubMed1990

[Clinical management of cystic ovarian tumors].

In a prospective study at the University of Göttingen 206 cystic ovarian tumours were examined vaginosonographically. Basing on a graduated schedule, the individual therapy of each ovarian tumour was determined. By use of this clinical management, all blastomas could be detected correctly and in 6.8% of all cases a follicle or corpus luteum cyst was operated per laparotomiam. Basing on the created data, the authors suggest a simple and effective clinical management of cystic ovarian tumours.

Adolescent↗
PubMed1990

[Principles of physiologic and drug-induced cervix ripening--recent morphologic and biochemical findings].

Maturation of the cervix during pregnancy is an essential pre-requisite for an uncomplicated delivery at term. Physiological cervical ripening is characterised by a diffuse loosening of the collagenous connective tissue with widely scattered collagen fibrils and an increased amount of extracellular ground substance. These morphological changes are similar to those after prostaglandin (PG)-pre-treatment of the cervix. The local application of PG leads to a marked mulifocal loosening of the collagen fibre bundles with "activated" fibroblasts, characterised by a fine granular loosening of the cytoplasm, vacuolised enlarged mitochondria and an increased number of cytoplasmatic vesicles close to the cell surface. In the course of pregnancy the volume of the cervix increases by a significant rise in synthesis of collagen, protein, glycosaminoglycan and fibronectin. The change in consistency during late pregnancy corresponds to a significant decrease in dermatan sulphate coninciding with a marked increase in hyaluronic acid concentration associated with increased water uptake. Contrary to the already published literature, enzymatic collagen degradation does not play an important role in physiological cervical maturation. The action of catabolic enzymes (collagenases, glycosidases), liberated from polymorphonuclear leukocytes invading the extracellular matrix, is responsible for the rapid dilatation of the cervix at parturition. This process is limited by the immediate postpartum insudation of the cervix by plasma containing highly potent proteinase inhibitors (e.g. alpha 2-macroglobulin). PG-induced cervical ripening is associated with a time-limited enzymatic collagen degradation, an increased synthesis of non-collagenous proteins and a significant increase in hyaluronic acid concentration. Our basic biochemical findings in cervical ripening and dilatation during parturition may greatly contribute to the development of new concepts in the causal treatment of cervical pathology during pregnancy.

Cervix Uteri↗
PubMed1990

[Risk of abortion following genetic amniocentesis in the 2d trimester in twin pregnancies].

Though the risk of abortion after amniocentesis in singleton pregnancies is well known, that for twin pregnancies is still unclear. A retrospective study was performed during December 1985 to May 1989 on all twin pregnancies that had undergone an amniocentesis, because of advanced maternal age. Out of the 33 patients aged greater than or equal to 35 years with viable and sonographically normal foetuses at the time of amniocentesis, three aborted spontaneously within 28 weeks of gestation, representing a risk of abortion after amniocentesis of 9.1%; using a cut-off at 20 weeks of gestation, only two patients aborted, giving a risk figure of 6.1%. This is 3.6 times higher than in singleton pregnancies (1.7%). However, to evaluate the procedure-related risk of amniocentesis, the age-dependent spontaneous abortion risk in twin pregnancies has to be considered. Accepting a spontaneous abortion risk of 4.5% after 16 weeks of gestation we have to calculate an amniocentesis-dependent risk of 1.6% up to the 20th week of gestation. It is essential, that the obviously higher genetic risk in twin pregnancies and the risk of procedure should be discussed carefully, before a patient with a twin pregnancy is advised to undergo genetic amniocentesis.

Abortion, Spontaneous↗
PubMed1990

[Vaginal ultrasound as a screening method for detection of adnexa tumors in postmenopause?].

424 ovaries of 212 postmenopausal women not on hormone treatment were examined by vaginal ultrasound. 155 patients had no clinical complaints, 57 patients showed atypical uterine bleeding. 48 pathological findings could be detected sonographically (11.3%). Among the histologically clarified cases were 2 asymptomatic ovarian cancers. Altogether, the vaginosonography proved to be a very simple and effective method to detect ovarian tumors in postmenopausal women.

Aged↗
PubMed1990

Cytogenetic analysis of 750 spontaneous abortions with the direct-preparation method of chorionic villi and its implications for studying genetic causes of pregnancy wastage.

Altogether, 750 cases of spontaneous abortion between the fifth and 25th week of gestation were analyzed cytogenetically by the direct-preparation method using chorionic villi. The majority of cases (68%) were derived from early abortions before the 12th week of gestation. The frequency of abnormal karyotypes was 50.1%; trisomy was predominant (62.1%), followed by triploidy (12.4%), monosomy X (10.5%), tetraploidy (9.2%), and structural chromosome anomalies (4.7%). Among trisomies, chromosomes 16 (21.8%), 22 (17.9%), and 21 (10.0%) were prevalent. The frequency of chromosomally abnormal abortions increased with maternal age but only because of an increase of trisomy. Polyploidy and monosomy X, however, decreased. Mean maternal age was significantly increased for trisomies 16, 21, and 22 and was highest for trisomies 18 and 20. The results obtained are within the range of variability reported earlier from tissue culture-type studies. A consistent feature during our study is the excess of females in chromosomally normal abortions (male:female sex ratio 0.71). According to the methodology applied, maternal cell contamination and undetected 46,XX molar samples cannot have influenced the sex ratio. However, a bias introduced by social status or maternal age cannot be excluded. With the more rapid and convenient direct preparation of chorionic villi, reliable cytogenetic data on causes of spontaneous abortions can be obtained.

Abortion, Spontaneous↗
PubMed1990

A randomized double blind study of a new ready-for use prostaglandin gel (Org 2436) for cervical ripening prior to first trimester pregnancy termination.

In a placebo-controlled double-blind randomized study involving 50 primigravidae scheduled for termination of first trimester pregnancy 500 micrograms PGE2 gel or placebo gel were applied intracervically 6 hours before curettage. The priming effect was verified in all patients by means of comparative examinations with a special tonometer before application of the gel and immediately before the surgical procedure. No abortion or vaginal bleeding occurred in any of the patients. After 500 micrograms PGE2 gel the mean free passability (i.e. force less than or equal to 1 Newton) was 7.8 (+/- 2.0) mm, the corresponding value for the placebo group 5.2 (+/- 1.2) mm (p less than 0.0001). The prostaglandin pretreatment led to a significant increase in dilation of 5.9 +/- 2.3 mm versus 2.0 +/- 1.2 mm in the placebo group (p less than 0.0001). 17 of the 25 PGE2-treated patients complained of lower abdominal pain, gastrointestinal side effects were observed in one of these patients. In the placebo group there were no undesired concomitant symptoms. No intra- or postoperative complications occurred in the PGE2 gel-treated group. After application of the placebo gel cervical lesions and incomplete curettages were demonstrated in 4 cases. According to this preliminary experience, the intracervical application of the new ready-for-use-PGE2 gel represents a practicable and efficient method for preoperative cervical priming. In view of the intraoperative complications in the placebo group the frequency of side effects after PG application are within tolerable limits.

Abortion, Induced↗
PubMed1989

[Vaginal sonography: a screening method for early detection of ovarian tumors and endometrial cancers?].

In total we performed a vaginosonographic measurement of 212 patients with or without a postmenopausal bleeding. Altogether 424 ovaries were sonographically examined. An endometrial thickness greater than 4 mm was histologically clarified by means of a curettage and all detectable ovarian tumors by means of a laparotomia. In total we found seven asymptomatic endometrial carcinomas, one cervical carcinoma and two ovarian cancers. The vaginosonography showed to be a very sensitive and acceptable method for the early detection of postmenopausal ovarian and endometrial tumors.

Female↗