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S Reuter

Publications and source records attributed to S Reuter.

At least 55 records · Page 3Linked to original sources
PubMed1999

Dual provision or duplication? A survey of family planning provision.

BACKGROUND: Family planning has been delivered through dual provision by general practice and community based clinics since its inception. This may be perceived as duplication of services and can be regarded as an area of possible disinvestment in a climate of rising health care costs. AIM: A survey of family planning service provision across a health district was carried out to establish the potential to rationalise current service provision by studying the pattern of service provision in the district and the links between family planning clinics and general practices. METHOD: A postal questionnaire and covering letter were sent to all practices and clinics in May 1997. Following analysis, results were,fed back to clinic staff and general practitioners through accredited meetings. RESULTS: Basic family planning was universally available to the population at all practices and clinics. Clinics offered a wider range of services, especially specialist services for psychosexual counselling and hormonal implants. Very few separate services for young people were identified. Within the primary care sector there was little 'out-of-hours' provision of contraceptive services. Half of the practices responding had used or would use family planning services as referral centres; implants and psychosexual services attracted most referrals. CONCLUSION: An understanding of the complementary nature of the services in primary care and community FP clinics was achieved and agreement was reached that disinvestment in clinics locally was not appropriate. The need to raise public awareness of availability of all contraceptive services was identified. Services in general practice and community clinics are complementary and need to develop a joint strategy to ensure an effective, comprehensive service. Quality of care needs to be examined in future work.

Family Planning Services↗
PubMed1999

Barriers to the use of IUDs as emergency contraception.

The intrauterine contraceptive device (IUD) is a very effective form of emergency contraception (EC). This author hypothesised that IUDs are an underused method and determined to evaluate potential barriers to IUD use. A postal survey of 100 family planning doctors and 100 general practitioners was conducted in Trent Region during March 1998 with a 70 per cent response rate. Lack of time was the most important factor that influenced doctor's decisions not to offer IUDs to the majority of women requesting emergency contraception. Most doctors registered concern about the risk of pelvic inflammatory disease. Misconceptions and a lack of accurate information contributed to participants reluctance to discuss IUDs as emergency contraception. Lack of time in consultations is a well-recognised issue in general practice. The risk of sexually transmitted infections is a nationwide concern, but is difficult to address without accurate data on the prevalence of the most common pathogens. Considerable effort would be required to increase doctors' knowledge and willingness to offer IUDs routinely to women requesting emergency contraception.

Adult↗
PubMed1998

[Chemotherapy of alveolar echinococcosis with benzimidazoles. A prospective long-term study].

BACKGROUND: Mebendazole and albendazole are the drugs of choice for the treatment of alveolar echinococcosis. In this prospective study we present and evaluate the outcome of the long-term treatment with both drugs. PATIENTS AND METHODS: Forty-four patients were treated with either mebendazole or albendazole and they were followed up for an average of 42 months. Success of treatment was defined as non-progression for more than 1 year. RESULTS: The overall success-rate was approximately 80% (35/44). An initial regimen was recurrence-free in 64% of cases under mebendazole and in 73% of cases under albendazole. Half of the cases with recurrent disease could be stabilized after changing the therapeutic regimen. Seven patients received a continuous regimen with albendazole. They were observed over an average of 19 months without signs of progression nor significant side effects. CONCLUSION: This open-labelled prospective study demonstrates the high therapeutic efficacy of both mebendazole and albendazole with similar response rates in the treatment of alveolar echinococcosis. In Germany, serum levels for mebendazole can easily be obtained at numerous institutes, while serum levels for albendazole are rarely available. On the other hand, albendazole reduces costs by over 40%. A simplified mode of intake and a reduced number of side effects argue in favor of the preferred use of albendazole. Albendazole in alveolar echinococcosis is only licensed for intermittent application. Nonetheless, continuous treatment may be considered in inoperable cases or progressive disease.

Adult↗
PubMed1998

APM-1, a novel human gene, identified by aberrant co-transcription with papillomavirus oncogenes in a cervical carcinoma cell line, encodes a BTB/POZ-zinc finger protein with growth inhibitory activity.

Integration of human papillomavirus (HPV) DNA into the host cell genome is an important step in cervical carcinogenesis. In tumour cells with integrated HPV DNA, transcription of viral oncogenes E6 and E7 continues into the flanking cellular sequences thereby producing viral-cellular fusion transcripts. Analysis of cellular sequences flanking the integrated HPV68 DNA in the cervical carcinoma cell line ME180 revealed homozygosity of the mutant allele in ME180 cells. We speculated that this could indicate the existence of a cellular tumour suppressor gene in the integration region. We report here the identification of a novel human gene, named APM-1, which is co-transcribed with the HPV68 E6 and E7 genes and is present in the 3'-cellular part of the ME180 viral-cellular fusion transcripts. The APM-1 gene encodes a protein with a BTB/POZ domain and four zinc fingers, and is located at chromosome 18q21. APM-1 transcripts are detected in normal cervical keratinocytes, but not in the majority of cervical carcinoma cell lines analysed. The APM-1 gene caused a reduction of clonal cell growth in vitro of HeLa and CaSki tumour cells. These characteristics make APM-1, the first novel human gene identified in a HPV integration region, a likely candidate for the postulated tumour suppressor gene.

Alleles↗
PubMed1998

[Leiomyosarcoma and leiomyoma of the vagina].

Sarcomas represent 2-3% of all gynecologic malignancies, only 10% occur outside the uterus. They are often not diagnosed before they reach an advanced stage. We report on a 56 years old women who had an exulcerated leiomyosarcoma of 8 cm in diameter in the posterior wall of the vagina. Initially she was treated by radiation, but the tumor showed a progressive growth. So she underwent a radical hysterectomy, radical colpectomy and vulvectomy, followed by six courses of adriamycinchemotherapy. 15 years later she is free of disease. Additionally we report on two women of 21- and 41-years of age with leiomyomas on the anterior wall of the vagina. These tumors were enucleated with an unconspicious postoperative follow up. In cases of leiomyosarcomas, which in most cases are located at the posterior wall of the vagina, radical surgery shows the best prognosis. Additionally a chemotherapy with adriamycin or ifosphamid can be used. Before surgery a biopsy is recommended to get a definitive diagnosis and to differentiate between benign and malignant lesions and to plan the optimal surgical strategy. In cases of leiomyomas they should be enucleated, because of the possibility of undergoing malignant change.

Adult↗
PubMed1997

Inflammatory pseudotumor of the ureter and the urinary bladder.

Inflammatory pseudotumor (IPS) of the urinary bladder was first described in 1980. We report four cases of IPS which occurred during the last four years. One tumor occurred in the bladder of a 49-year-old woman five months after abdominal hysterectomy of uterine leiomyomas, two tumors in a 35- and 39-year-old woman, respectively, without antecedental surgical intervention (though one with recidive after six months). The fourth occurred in a 64-year-old male in the proximal ureter by pyelonephritis. Two cases were initially diagnosed at frozen section during operative treatment, the others on paraffine section after immunohistochemical examination. Two cases showed an aberrant expression of cytokeratines. There is no evidence of recidive tumor within a mean follow up of 25 months (12-49 months). Features to differentiate benign from malignant spindle cell lesions of the lower urinary tract are the absence of atypical mitoses, significant cytologic atypia, absence of necroses within the tumor (rather on its surface), no destructive growth at the tumor margins and low cellularity. Usually, IPS show a submucosal edematous area with a deeper, highly cellular component. The clinical history of a recent bladder operation or gynecologic surgery is of upmost importance in making the diagnosis of IPS. Complete surgical excision, either by transurethral resection or partial cystectomy appears to be curative for IPS.

Female↗
PubMed1996

Sleep apnoea in treated acromegaly: relative frequency and predisposing factors.

OBJECTIVES: Sleep apnoea is common in active acromegaly. It is associated with increased morbidity and mortality but can be treated effectively. The objective of this study was to determine the largely unknown relative frequency of, and the predictive factors for, sleep apnoea in treated acromegalic patients. DESIGN: Retrospective cohort study. SETTING: Tertiary referral hospital. PATIENTS: Fifty-four of 100 patients with treated acromegaly. If sleep apnoea had been diagnosed before acromegaly, the patient was excluded. MEASUREMENTS: Sleep studies (using the MESAM-4 device measuring oxyhaemoglobin saturation, heart rate, snoring sounds and body position to determine presence and severity of sleep apnoea); GH and IGF-I levels; body mass index, neck and index-finger circumference; daytime symptoms of sleep apnoea, duration of acromegaly before treatment, shoe and neck-size difference since beginning of acromegaly; age, sex and treatment modes of acromegaly. RESULTS: The relative frequency of sleep apnoea was 39% in the 54 patients with sleep studies and at least 21% in the entire study population of 100 patients. In patients with sleep apnoea, statistically significant higher values were observed for GH (P = 0.002), IGF-I (P = 0.029), age (P = 0.014) and neck circumference (P = 0.016). An index-finger circumference of > or = 8.5 cm was associated with a significantly higher desaturation index (P = 0.012, Mann-Whitney U-test). Adenomectomy had been performed significantly less frequently in patients with sleep apnoea (P < 0.001, X2 test). The body mass index was non-significantly higher in the patients with sleep apnoea. CONCLUSIONS: The relative frequency of sleep apnoea in patients with treated acromegaly is at least 21%. Parameters of predictive value for the presence of sleep apnoea in this population are neck and index-finger circumference as measures of soft tissue hypertrophy, age, GH and IGF-I levels, and whether or not operative therapy was applied.

Acromegaly↗
PubMed1995

Transport of dehydroepiandrosterone and dehydroepiandrosterone sulphate into rat hepatocytes.

The purpose of the present study was to characterize the transport of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulphate (DHEAS) into hepatocytes at physiological and pharmacological concentrations. Hepatocytes were isolated from female Sprague-Dawley rats by collagenase perfusion. Uptake of [3H]DHEA and [3H]DHEAS at increasing concentrations (3.5 nM-100 microM) was measured by the rapid filtration technique at 30 s intervals up to 120 s. The uptake of DHEAS by hepatocytes was saturable (Km = 17.0 microM; Vmax = 3.7 nmol/min/mg cell protein). In contrast, a specific saturable transport system for DHEA could not be detected in rat hepatocytes. It is suggested that DHEA enters the cell by diffusion. The uptake of DHEAS could be inhibited by antimycin A, carbonylcyanide-m-chlorophenylhydrazone, and dinitrophenol (inhibitors of the mitochondrial respiratory chain), by dinitrofluorobenzene and p-hydroxymercuribenzoate (NH2- and SH-blockers, respectively), and by monensin (Na(+)-specific ionophore). No inhibition was seen in the presence of ouabain (inhibitor of Na(+)-K(+)-ATPase) and phalloidin (inhibitor of cholate transport and actin-blocker). Interestingly, DHEAS uptake was inhibited by bile acids (cholate, taurocholate and glycocholate). Conversely, [3H]cholate uptake was strongly inhibited by DHEAS, which indicates a competition for the same carrier. Replacement of sodium ion with choline markedly decreased uptake velocity at pharmacological DHEAS concentrations. The results suggest that DHEAS uptake is a saturable, energy-dependent, carrier-mediated, partially Na(+)-dependent process, and that DHEAS may be taken up via the multispecific bile acid transport system.

Animals↗
PubMed1992

[Status of public baths in northwestern Saxony].

This paper characterizes the present situation in public baths in the district of Leipzig from the aspects of civil engineering (building construction and water hygiene). Out of 59 existing baths, 8 are closed mainly for building construction reasons. 29 baths had considerable faults. Only 27 public baths have a work circulation plant. The poor building-technical situation has an important influence on the quality of the water, a fact illustrated by the high rates of contaminated and hence rejected water samples.

Baths↗
PubMed1991

Expression of positional information during cell differentiation of Caulobacter.

The asymmetric targeting of proteins to the Caulobacter predivisional cell poles yields dissimilar progeny. We show that the products of transcriptional reporter gene fusions to a flagellin gene and to the flagellar hook operon are segregated to the progeny swarmer cell. This segregation does not depend on sequences within the mRNA, but on the upstream regulatory region. The subset of developmentally regulated flagellar genes that exhibit mRNA segregation has the same upstream cis-acting elements: an activator-binding site known as the ftr sequence and an IHF-binding site. We propose that these genes are preferentially transcribed from the chromosome in the incipient swarmer cell pole of the predivisional cell.

Bacteria↗
PubMed1989

Effects of chronic treatment with selective and nonselective antagonists on the subtypes of dopamine receptors.

The effects of chronic blockade of D-1, D-2, or both subtypes of dopamine receptors on the densities and properties of the D-1 and D-2 subtypes of dopamine receptors were measured in rat brain. Animals were treated with 14 daily injections (i.p.) of the D-1-selective antagonist SCH-23390, the D-2-selective antagonist sulpiride, the nonselective antagonist fluphenazine, or vehicle. Serial 32-microns horizontal sections that included the caudate putamen were cut and alternately assigned to assays for D-1 or D-2 receptors. D-1 receptors were labeled with 3H-SKF-83566 or 3H-SCH-23390, and D-2 receptors were labeled with 3H-spiroperidol. Scatchard analysis was performed on the saturation data measured in the head of the caudate putamen to obtain estimates of receptor density. As expected, administration of the D-1-selective ligand SCH-23390 resulted in an increase in the density of D-1 receptors by approximately 47% and had no significant effect on the density of D-2 receptors. Similarly, administration of the D-2-selective ligand sulpiride resulted in an increase in the density of D-2 receptors by 25% and had no significant effect on the density of D-1 receptors. Thus the subtypes of dopamine receptors appear to be independently regulated after selective blockade. In contrast to the effects observed with selective antagonists, the results obtained with fluphenazine were more complex. Administration of the relatively nonselective antagonist fluphenazine resulted in an increase in the density of D-2 receptors by 51% but had no significant effect on the density of D-1 receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1977

Comparative characterization of four purified lysine-specific transfer ribonucleic acids from chicken embryos.

Four purified tRNALys species from 13-day-old chick embryo muscle have been characterized with respect to the following properties: qualitative oligoribonucleotide composition (polyacrylamide gel electrophoresis after RNase T1 digestion), anticodon response towards AAG and AAA (equilibrium dialysis and polylysine synthesis), strength of the aminoacyl bond (de-esterification kinetics), sedimentation coefficient, and temperature-dependent double helix-to-coil transition. The results confirm the existence of four molecularly independent lysine-specific tRNA's in this eukaryotic system.

Animals↗
PubMedDate not supplied

Comparison of contrast-enhanced power Doppler ultrasound (Levovist) and computed tomography in alveolar echinococcosis.

BACKGROUND: To date, no study has compared unenhanced and contrast-enhanced (Levovist) power Doppler ultrasound with three-phase helical computed tomography (CT) for the analysis of the vascularization of hepatic lesions in patients who have alveolar echinococcosis. METHODS: Fifteen patients (11 female and four male; average age, 45.8 years) with confirmed Echinococcus multilocularis infection underwent unenhanced and contrast-enhanced (Levovist) power Doppler ultrasound (2- to 5-MHz transducer head) and three-phase helical CT. The largest identified lesion in each patient was studied. RESULTS: CT visualized vascularization peripheral or central to the largest echinococcal lesions in 11 of 15 patients. Vascularization in the area of the echinococcal lesions was not visualized by unenhanced or contrast-enhanced power Doppler ultrasound in any of the 15 patients studied. CONCLUSION: Three-phase helical CT visualizes the vascularization associated with Echinococcus multilocularis lesions in the liver. Neither unenhanced nor contrast-enhanced ultrasound in power mode is suitable for this application.

Adult↗
PubMedDate not supplied

Alveolar liver echinococcosis: a comparative study of three imaging techniques.

BACKGROUND: We compared the imaging findings in patients with alveolar liver echinococcosis using ultrasound (US), computerized tomography (CT) and magnetic resonance imaging (MRI) in a prospective study. PATIENTS AND METHODS: 30 patients with alveolar echinococcosis (AE) were examined with the above imaging techniques. RESULTS: 30 lesions were detected with all three methods and most lesions (n = 55) were detected with CT. Calcifications were seen in 15 lesions with US, in 21 with CT and in 16 with MRI. MRI best detected necrotic areas and multivesicuLar structures. CONCLUSION: US is the screening method of choice and should primarily be complemented by CT due to its ability to detect the greatest number of lesions and clear demarcation of the characteristic calcifications. MRI may facilitate the diagnosis in uncertain cases with noncalcified or partially calcified lesions by showing the characteristic multivesicular structure, necrotic areas and proximity to vascular structures.

Adult↗