PubMed Health⌕ Search

Biomedical subjects

R Osmers

Publications and source records attributed to R Osmers.

70 records · Page 4Linked to original sources
PubMed1989

[The value of leukocytes, C-reactive protein and granulocyte elastase in patients with premature rupture of fetal membranes and amniotic infection].

Serum concentrations of leucocytes, C-reactive protein (CRP) and elastase-alpha 1-proteinase inhibitor (E alpha 1 PI) have been determined in 85 women during pregnancy and after birth to assess their diagnostic value in case of amniotic infections (AI). In ten patients clinically diagnosed AI could be confirmed by histopathological examination, three patients who fulfilled the clinical criteria showed no histological signs of infection. E alpha 1 PI-levels were found to be elevated to over 200 meg/l in six patients with clinical and histological infection and remained below this value in all other cases whereas leucocyte- and CRP concentrations raised in five out of these eight women but also showed false positive values in patients without AI. The application of betamethasone led to a marked elevation of leucocyte concentration. CRP levels were raised substantially after birth, whereas E alpha 1 PI remained unchanged. It is suggested that all three parameters should be taken into consideration to increase diagnostic reliability in case of suspected amniotic infections.

C-Reactive Protein↗
PubMed1989

Vaginal sonographic visualisation of a cervical carcinoma.

In the present case, the vaginal sonographic picture of a cervical (collum) carcinoma, which was clinically non-apparent, but was histologically established through a fractionated curettage, led to a change in the surgical procedure in the sense that a primary operation according to Wertheim--Meigs instead of a knife conisation was performed. The postoperative histology showed a good correlation between sonographic tumor boundaries and the actual expansion of the carcinoma.

Adult↗
PubMed1989

Enzymatic collagen degradation in the pregnant guinea pig cervix during physiological maturation of the cervix and after local application of prostaglandins.

The role of enzymatic collagen degradation in prostaglandin-induced and physiological cervical ripening was studied in guinea pigs. The cervices were removed from (a) 8 non-pregnant guinea pigs, (b) 8 animals at day 45 of pregnancy, (c) 14 pregnant animals of comparable gestational age which had either an intracervical application of 0.2 ml 5% tylose or 10 micrograms sulprostone gel, and (d) 8 guinea pigs at day 63 to 65 of pregnancy. Collagenase activity was assayed in a highly specific and sensitive system using native collagen type I as substrate. Protease activity was measured by the method of Green and Shaw. Collagen fragments were identified by SDS-polyacrylamide electrophoresis (SDS-PAGE) of acetic-soluble fractions. Collagenase and protease activities were found in all extracts from the different groups. However, there were no differences in enzymatic activities between the non-pregnant, early-pregnant and late-pregnant cervical specimens. Prostaglandin pre-treatment of the cervix led to no significant increase in either collagenase or protease activity as compared to the control groups. The absence of typical collagen degradation products in the SDS-PAGE suggested that no significant collagen breakdown had taken place. In contrast to previously published literature, we conclude that enzymatic collagen degradation is unlikely to be a key factor in prostaglandin-induced and physiological cervical ripening.

Animals↗
PubMed1989

[Vaginosonographic measurement of the postmenopausal endometrium in the early detection of endometrial cancer].

Vaginosonographic measurements of the endometrium were performed in 155 postmenopausal women without abnormal gynecological findings and free of any clinical symptoms. An endometrial thickness of greater than or equal to 4 mm was clarified histologically by means of a curettage. We found endometrial carcinomas in seven cases, cervical carcinomas in one, endometrial polyps in ten and glandular-cystic hyperplasia in three cases. One patient showed an atrophic endometrium associated with a submucous myoma. In total, endometrial carcinomas were detected by sonography in 4.5% of our patients. On the basis of our preliminary results, we conclude that vaginosonographic examination of the endometrium is a highly sensitive (81%) and specific (89%) method, with good acceptance by the patients, in the detection of asymptomatic benign and malignant neoplasms of the postmenopausal woman.

Aged↗
PubMed1988

Sonographic detection of an asymptomatic rupture of the uterus due to necrosis during the third trimester.

This is a report on the first sonographic detection of a silent rupture of the uterus in the 33rd week of pregnancy of a 35-year-old patient. On the basis of the clear sonographic picture immediate cesarean section was (considered) indicated in spite of lack of clinical symptoms. The intraoperative situs confirmed the sonographic diagnosis of a ruptured uterus related to an old cesarean section, combined with partial necrosis of the lower uterine segment.

Adult↗
PubMed1988

Collagenase activity in cervical tissue of the non-pregnant and pregnant human cervix.

Collagen degradation has been suggested to play an important role in the process of cervical ripening at term. After giving informed consent tissue samples were taken from the posterior lip of 10 non-pregnant women of child-bearing age, 10 women having a termination of pregnancy at 9-12 weeks' gestation and 12 women who had had normal spontaneous deliveries at term. Collagenase activity was measured by a specific technique using native, triple helical collagen. Proteolytic activity was determined with commercially available 14C-methaemoglobin as substrate. For identification of collagen fragments SDS-polyacrylamid-gel-electrophoresis was performed using a modified Laemmli-technique. Collagenase and protease activity were found in all extracts of the different groups. There was a marked increase in enzymatic activities in the postpartum tissue samples suggesting that significant collagen breakdown had taken place. The absence of typical collagen fragments in the SDS-electrophoresis seemed to be due to a very rapid further degradation of the fragments by proteases into small peptides which then readily left the cervix. The present findings confirm the essential role of proteolytic enzymes in cervical dilatation at term.

Adult↗
PubMed1988

[Changes in the 13,14-dihydro-15-ketoprostaglandin F2alpha and oxytocin level in the 1st trimester following beta-sympathomimetic and intracervical prostaglandin E2 gel administration].

3 ml tylose gel containing 500 micrograms PGE2 was injected into the cervical canal of 23 patients prior to first trimester abortion. 11 patients received 5 mg fenoterol orally before the PGE2-gel application and 12 patients a placebo tablet. The PGFM and oxytocin concentrations in plasma were determined radioimmunologically. The results showed the dominant role of elevated PGFM levels in the clinical prevalence of pain during induced abortion.

Abortion, Induced↗
PubMed1987

Identification of endogenous sugar-binding proteins (lectins) in human placenta by histochemical localization and biochemical characterization.

Human placentas of different stages of development were histochemically analyzed for expression of endogenous sugar-binding proteins using a panel of biotin-conjugated, chemically glycosylated probes with specificity for beta-galactosides, alpha-galactosides, alpha-mannosides, alpha-fucosides and alpha-glucosides. Temporal differences in the expression of sugar-binding proteins and different patterns of staining of the component cell types of human placenta were discerned, especially pronounced for alpha-fucoside-specific binding in the trophoblast and alpha-glucoside-specific binding in fetal and maternal macrophages. Fractionation of salt and detergent extracts from human placentas by affinity chromatography on columns with immobilized carbohydrates or glycoproteins substantiated the histochemically detectable temporal changes on the basis of alterations in the pattern of individual sugar-binding proteins, as determined by gel electrophoresis under denaturing conditions. Analysis of the trophoblastic layer primarily disclosed the presence of several additional sugar-binding proteins (lectins) in comparison to full-term placenta. The presence and developmental changes of such endogenous sugar receptors may lead to specific carbohydrate-protein interactions of physiological significance with similarly developmentally regulated carbohydrated portions of glyco-conjugates, already detected in human placenta by plant lectins.

Carbohydrate Metabolism↗
PubMedDate not supplied

Evaluation of tubal patency by hysterocontrast sonography (HyCoSy, Echovist) and its correlation with laparoscopic findings.

In 20 patients with suspected infertility, fallopian tube patency was assessed using Doppler-supplemented hysterocontrast sonography (HyCoSy). All patients underwent transvaginal HyCoSy with the contrast agent SHU 454/Echovist prior to laparoscopy with chromopertubation (chromolaparoscopy). Following application of the Echovist contrast medium, the fallopian tubes were visualized with B-mode scanning and tubal flow was evaluated by means of Doppler sonography. None of the patients received anesthesia. We found corresponding results with regard to the tube patency between HyCoSy and conventional chromolaparoscopy in 82.5% of cases. These results make transvaginal HyCoSy a suitable first-line diagnostic procedure in patients with infertility disorders.

Adult↗
PubMedDate not supplied

[Measuring subcutaneous fatty tissue as a sonographic parameter for detection of fetal growth retardation and fetal hypertrophy in pregnancy].

This investigation contains a statistical evaluation of sonographic results concerning fetal subcutaneous adipose tissue aiming to examine and assess the relevance of this new sonographic parameter for the detection of fetal growth retardation, resp. fetal hypertrophy during pregnancy. The diagrammatic presentation of the growth of the subcutaneous adipose tissue of eutrophic fetuses shows low validity for the differentiation of hyper- and hypotrophic fetuses. To enable the differentiation between "asymmetric" and "symmetric" types of retardation, the different degrees of growth of the subcutaneous adipose tissue of hypertrophic fetuses have to be taken into consideration. The relation between birthweight and growth of the subcutaneous adipose tissue shows no distinct differentiation of the birthweight, however, presents overlapping categories of the birthweight for diagnostic orientation.

Adipose Tissue↗
PubMedDate not supplied

[Biochemical principles of cervix ripening and dilatation].

The central function of the cervix to maintain pregnancy is biochemically characterized by an increased synthesis of collagen, proteins, glycosaminoglycans (GAG) and fibronectin within the extracellular matrix, thus leading to an increase of cervical volume without significant changes of cervical consistency. During the time of cervical ripening we found a marked reduction of collagen concentration, a 2.5-fold increase in GAG content, a significant fall in dermatan sulfate concentrations from 41% to 15% of total GAG content, a 12-fold increase in hyaluronate concentrations, and a marked reduction in fibronectin, demonstrated by immunhistochemical methods. Thus, the loss of collagen and sulfated GAGs may facilitate distensibility in the ripened cervix, while the significant gain in hyaluronate associated with hydratation may explain the soft and swollen consistency. In this connection increased hyaluronate concentrations and degradation of fibronectin may play a trigger role for subsequent cervical dilatation. The dramatic changes of the cervix during parturition occurring within a few hours require the rapid activation and action of catabolic enzyme systems. Our studies showed a significant increase of sialidase-, collagenase- and elastase activities during cervical dilatation. These proteinases originate from polymorphonuclear leucocytes (pml), which accumulate in cervical capillaries at the onset of labor; this is followed by a massive leucocyte infiltration of the cervical stroma at the beginning of cervical dilatation and a degranulation of the pml at further dilatation, thus releasing collagenase and other proteinases. This process is limited by the immediate post partum insudation of the cervix by plasma containing highly potent proteinase inhibitors. The clinical aim of our basic biochemical studies is to develop new concepts in the causal treatment of cervical pathology during pregnancy.

Animals↗
PubMedDate not supplied

[Labor contraction-dependent changes in magnesium and calcium in the myometrium].

Magnesium is commonly used in the therapy and prevention of preterm labor. Therefore the differences of the concentrations of magnesium and its antagonist calcium were measured in the human myometrium to examine the interaction of labour and ionic changes. The ionic concentration in the myometrium of 37 patients without labour are determined and the values are compared to the data of 26 patients in active labour. Women of the first group without labour had a magnesium concentration of mean = 4.1 mmol/kg wet weight and a calcium concentration of mean = 2.9 mmol/kg wet weight. Women of the second group with active labour have a significantly lower (p < 0.01) magnesium concentration (mean = 3.5 mmol/kg wet weight). However, the calcium level (mean = 2.7 mmol/kg wet weight) does not show significant differences. These results indicate that the decrease of magnesium plays an important role in the physiology of parturition. A low magnesium concentration in the myometrium might have a considerable influence on premature labour in the third trimester of pregnancy. Therefore a prophylactic application of magnesium seems to be useful.

Adult↗
PubMedDate not supplied

[Normal pregnancy duration after maternal Fontan operation of univentricular heart].

Up to now pregnancy in patients with a previous Fontan operation for definitive palliation of a univentricular heart has been regarded as contraindicated. Two cases of a pregnancy after Fontan operation and univentricular heart were published in the literature. In a single case a successful delivery of the fetus could be achieved. The presented case is the third published pregnancy after Fontal operation and the second with a successful fetal outcome. The 30 years old patient was born with a univentricular heart of right ventricular type with tricuspid and pulmonary atresia and persisting arterial duct. After bilateral Blalock Taussig anastomoses (1966) and modified Waterston-Cooley-anastomosis (1974) a primary existing cyanosis could be improved. The cyanosis was completely abolished after definitive repair with the Fontan operation at the age of 17 (1980). The course of pregnancy and its surveillance is reported. In the 32nd week of gestation cesarean section had to be performed because of threatening cava compression. A healthy female fetus of 1275 g was delivered. The mother's postoperative recovery was uneventful. Meanwhile the neonate and the mother have been discharged and are in good clinical condition.

Adult↗
PubMedDate not supplied

[Meaning of assimilation pelvis according to Kirchhoff in modern obstetrics].

OBJECTIVE: To what extent is the cesarean section indication "arrest of labour" due to pathological forms of the pelvis and what is the meaning of the assimilation pelvis in modern obstetrics. PATIENTS: NMR-pelvimetries were performed in 166 post partum women from June 1993 to August 1995. The patients were divided into 4 groups. Group 1: patients who had had cesarean section owing to arrest of labour (n = 56), group 2: patients who had had cesarean section due to breech presentation (n = 20), group 3: patients who had had cesarean section owing to another indication (threatening fetal asphyxia, multiple pregnancy, premature delivery, placental abruption, gestosis, n = 40), group 4: patients who had a spontaneous delivery (control group, n = 50). After analysing the NMR pictures all the pelves were alloted to one of the case studies according to their pelvic form. The diagnosis "assimilation pelvis" was made according to the criteria of Kirchhoff (1949). The four groups were compared and analysed. RESULTS: In group 1 an assimilation pelvis was found in 61%. The obstetrically most unfavourable canal pelvis occurred most frequently, amounting to 29%. In only 9% we found a contracted pelvis. In group 2 the proportion of the assimilation pelvis was even higher, rising to 65%. Only 35% of all pelves had a normal shape. In group 3 we found an assimilation pelvis in 50% of all cases. 66% of all patients with spontaneous delivery had a normal pelvis. An assimilation pelvis was found in 34%. In these cases duration of labour was prolonged by 4 hours on average (mean value: 9.5 hours). CONCLUSIONS: Due to its frequency in our days the assimilation pelvis plays a major obstetrical role. This is true in particular when there is a pathological course of labour. From this results that pelvic parameters other than the conjugata vera will be of diagnostic importance, especially those parameters which are able to characterise the assimilation pelvis with its high promontory, the steepness of the pelvic inlet, the lengthening of the birth canal and the decrease of the hollow of the sacrum. We take the view that the angle of the pelvic inlet, the pelvic inclination and the direct length of the pelvis are of outstanding importance.

Breech Presentation↗
PubMedDate not supplied

Wertheim's hysterectomy after neoadjuvant carboplatin-based chemotherapy in patients with cervical cancer stage IIB and IIIB.

BACKGROUND: To improve local response and survival, a prospective study was designed to determine the effects of neoadjuvant chemotherapy in the management of cervical carcinoma stage IIB and IIIB. PATIENTS AND METHODS: Fourteen patients were treated with preoperative neoadjuvant chemotherapy. Three courses of carboplatin were administered in combination with ifosfamide in 11/14 patients, whereas 3 patients received three courses of carboplatin and paclitaxel. RESULTS: After neoadjuvant chemotherapy, there were 8/14 clinical responses while 6/14 patients had no change. In 8 cases, Wertheim's hysterectomy was possible after neoadjuvant chemotherapy. Six of these 8 patients are still alive after a duration of 32 months median follow-up, 2 patients died of metastatic disease. In 6 cases with no change after chemotherapy, Wertheim's hysterectomy was impossible. In this subgroup, the median survival time was 15.5 months, and 4/6 patients died of metastatic disease. CONCLUSIONS: Neoadjuvant chemotherapy with carboplatin/ifosfamide or carboplatin/paclitaxel is safe, well-tolerated, effective and useful to enable Wertheim's hysterectomy.

Adult↗