PubMed Health⌕ Search

Biomedical subjects

T Strowitzki

Publications and source records attributed to T Strowitzki.

At least 55 records · Page 3Linked to original sources
PubMed1997

[Radiologic versus ultrasound fallopian tube imaging. Painfulness of the examination and diagnostic reliability of hysterosalpingography and hysterosalpingo-contrast-ultrasonography with echovist 200].

UNLABELLED: Evaluation of tubal patency is usually assessed with hysterosalpingography (HSG) or laparoscopy including chromopertubation. Sonographical visualisation with Echovist 200 (hysterosalpingo-contrast sonography-HyCoSy) provides a new noninvasive tool. Therefore we conducted a prospective controlled study to compare sonographic and radiological evaluation of the fallopian tube. Main test parameters were accuracy of both methods and patient discomfort. PATIENTS AND METHODS: 50 patients were enrolled in this study. All patients were examined by both techniques; the sequence was randomly chosen. The results of HSG and HyCoSy were compared. Patient discomfort was assessed with a standardised questionnaire using a visual analog scale (0-10). RESULTS: Diagnosis of tubal patency identifying proximal or distal blockage was the primary end point using HSG as standard technique. Proximal and distal patency by HSG was sonographically confirmed in 82.9% (63/76) and 82.1% (46/56) tubes respectively. If HSG revealed proximal or distal occlusion, identical results were obtained in 91.7% (22/24) or 60% (12/20) by HyCoSy. No significant differences were found in patient discomfort. However a significant correlation was demonstrated between tubal patency and discomfort. The lowest score was obtained in patients with open tubes (4.6) increased in patients with distal occlusion (6.0) and reached a maximum with proximal pathology (8.7). CONCLUSION: Compared to conventional HSG, HyCoSy provides a highly efficient evaluation of tubal pathology and can be successfully used as a noninvasive screening method.

Contrast Media↗
PubMed1996

Characterization and identification of EGF-receptors as an integral component of membrane structure of human endometrial stromal cells in vitro.

The epidermal growth factor EGF is a well known mitogenic agent, elicits significant biological responses in intact animals, organs and cell cultures, and might be involved in the endometrial receptivity for successful embryo implantation. Although immunohistological and binding studies have detected EGF-binding activity in endometrial tissues, the nature of the EGF- binding site has not been fully investigated. Therefore, this study was performed to characterize and identify the nature of the endometrial stromal cell EGF-binding activity and to demonstrate EGF effects on stromal cell growth under in vitro conditions. Stimulation of cellular proliferation with EGF in various concentrations for 6 days revealed a significant increase of the proliferation rate up to 150% of that found in control subjects in a dose-dependent fashion, reaching a maximum stimulation at 10 nM EGF. Binding studies with labelled 125I-EGF confirmed the localization of the EGF-binding site in the membrane fraction of stromal cells. Furthermore, this binding activity was found to be a ligand-saturable molecular species with a dissociation constant of about 1.75 nM, and with a high specificity to EGF ligands. Affinity cross-linking studies revealed that the stromal cell membrane EGF-binding component is a protein molecule of 170,000 daltons, and has no subunit structure bound with disulphide bridges. The electrophoretic migration pattern of this molecule corresponds to EGF-receptor species already identified in other cells and tissues. This was further documented by specific reactivity with EGF-receptor antibodies and EGF/alpha-TGF peptides as well. In conclusion, the EGF-binding activity of stromal cell membranes has the nature and identity of EGF-receptor species, and is a functionally integral component of the stromal cell membrane structure.

Binding, Competitive↗
PubMed1996

Morphological-cytochemical and molecular genetic analyses of mitochondria in isolated human oocytes in the reproductive age.

Molecular genetic, cytochemical and morphometric analyses have been performed on isolated oocytes from 41 women (27-39 years of age) in order to detect mutations of mitochondrial DNA (mtDNA), defects of the respiratory chain (ubiquinone-cytochrome-c-oxidoreductase = complex III; cytochrome-c-oxidase = complex IV) and alterations of mitochondrial volume during cellular ageing. Morphometric analyses showed an increase in mitochondrial numerical density with age from the mean values of 7.36 per micron2 and 6.97 per micron3 up to 30 years to 10.74 per micron2 and 11.66 per micron3 in the age group 31-40 years (P < 0.001). Similarly, an increase in the mitochondrial profile area from 0.074 per micron2 in the age group < 30 years to 0.101 per micron2 was noted in the fourth decade. The mitochondrial volume fraction was also significantly increased in the elder age group. Neither point mutations of mtDNA (nucleotide pairs 3243, 8344) nor the common deletion (4977 bp, nucleotide pairs 8482-13460) could be detected. In parallel, ultra- and immunocytochemical studies of the complexes III-IV failed to reveal functional defects. In conclusion there is an age-related increase in the volume fraction of the mitochondria which might reflect subtle changes in the oxidative phosphorylation capacity, but is not linked to mutations of mtDNA or functional defects of the respiratory chain enzymes in mature human oocytes from women of reproductive age.

Adult↗
PubMed1996

[Diagnosis and therapy of extrauterine pregnancy].

The combined use of transvaginal ultrasound and serial quantitative determination of the serum human chorionic gonadotropin (HCG) concentration offers an early and exact diagnosis of an ectopic pregnancy before the onset of clinical symptoms. Therefore, a large variety of invasive and noninvasive treatment options can be chosen. In patients without severe clinical symptoms, the trophoblast activity should be determined via the HCG course before invasive treatment methods are performed, because a considerable proportion part of the patients show spontaneous resolution of the ectopic pregnancy without further measures. Recently systemic treatment with methotrexate alone or local injection of different substances like prostaglandins, glucose, and methotrexate, etc. became an alternative to surgical therapy, i.e., endoscopic salpingotomy or salpingectomy. The success rates are generally lower in comparison to surgical therapy. Therefore, medical treatment is useful only in patients with a low trophoblast activity (e.g., < 2,500 mIU/ml HCG). However, in cases with low HCG values, observation alone frequently leads to a resolution. Corresponding to the data being available up to now, the postoperative pregnancy rate does not depend on this decision.

Abortifacient Agents, Nonsteroidal↗
PubMed1996

Characterization of receptors for insulin-like growth factor type I on cultured human endometrial stromal cells: downregulation by progesterone.

Because insulin-like growth factor type I (IGF-I) is reputed to be involved in the endometrial decidualization, we analyzed the expression of IGF-I receptors in an in vitro system of human endometrial stromal cells. Competitive binding studies of both intact stromal cells and membrane preparation indicated the presence of specific components with high affinity for binding IGF-I. Half-maximum displacement was obtained with 2.3 nmol/l native IGF-I, whereas insulin was unable to achieve half-maximum displacement even at higher concentrations. This IGF-I binding component was found to be a saturable protein in respect of the radioligand [125I]IGF-I, with a dissociation constant of 0.16 nmol/l. Affinity cross-linking studies revealed a labelled band of approximate relative molecular mass 135000, corresponding to the known alpha-subunit of IGF-I receptor. This band was significantly inhibited dose-dependently by the IGF-I receptor monoclonal antibody alpha-IR3 or native IGF-I, suggesting that the IGF-I binding component in the membrane of stromal cells has the identity of the alpha-subunit of IGF-I receptor. Cell proliferation in vitro was stimulated by progesterone. Furthermore, progesterone downregulated the [125I]IGF-I binding activity by downregulation of the IGF-I membrane receptor of human endometrial stromal cells. These data show that the IGF-I receptor is a functionally integral component of the stromal cell membrane structure, and its expression might be directly modulated by progesterone and, therefore, might play an important role in the preparation of the stroma for successful embryo implantation.

Autoradiography↗
PubMed1996

Pain intensity following laparoscopy.

The temperature of the gas used for insufflation during laparoscopy has a significant influence on postoperative shoulder and subphrenic pain according to a prospective randomized study of 103 female patients who filled out a standardized pain assessment questionnaire with a visual analogue scale from 0 to 10. Women in group B (n = 53), who had been insufflated with warm CO2 gas during laparoscopy, had significantly less pain than women in the control group (group A; n = 50). The declared value for shoulder pain at the first postoperative day was 3.6 with cold gas versus 2.5 with warm CO2 (p = 0.013). The strongest pain was found following long operations (5.4 vs. 4, respectively) and following high CO2 gas use (5.5 vs. 2.3); in both cases, a significant advantage was noted for the group treated with warmed CO2. Further research is needed regarding the etiology and possible prevention of postoperative pain following laparoscopy. As the use of warm CO2 gas leads to significant reduction of pain, technical and mechanical parameters should be changed accordingly.

Female↗
PubMed1995

Conservative treatment of endometrial cancer permitting subsequent triplet pregnancy.

We report on a 28-year-old woman who received conservative treatment of endometrial carcinoma by curettage and progestins. After regression of endometrial lesions the patient's infertility was treated by gamete intrafallopian transfer (GIFT). Intact triplet pregnancy was diagnosed 3 weeks later. The patient was delivered of three infants by caesarean section following premature rupture of membranes at 30 weeks of gestation. Subsequent standard treatment of endometrial cancer by abdominal hysterectomy and bilateral salpingo-oophorectomy after 4 weeks revealed no clinical or histological evidence of persistent carcinoma. One year after surgery the patient remained without evidence of disease. We believe that individualized cancer therapy may be safely performed in carefully selected cases.

Adult↗
PubMed1995

Ovarian stimulation in women undergoing in-vitro fertilization and embryo transfer using recombinant human follicle stimulating hormone (Gonal-F) in non-down-regulated cycles.

In order to assess the efficacy and safety of recombinant human follicle stimulating hormone (FSH) in routine clinical use, ovarian stimulation with recombinant human FSH was performed in 71 patients prior to in-vitro fertilization (IVF) without gonadotrophin-releasing hormone (GnRH) analogues in a multicentre, non-comparative study. Human chorionic gonadotrophin (HCG) was administered to 58 patients (81.7%), 15 of whom underwent 19 cycles with an initial dosage of three ampoules daily of recombinant FSH and 43 of whom underwent 152 cycles with four ampoules daily from day 3 onwards. No significant differences were detected between these two groups in all test parameters. The mean duration of treatment was 9.06 and 8.86 days respectively with a mean number of 24.06 and 23.25 vials of recombinant human FSH administered. A mean number of 6.26 and 5.88 oocytes respectively was collected. The number of transferred embryos was 2.4 and 2.2. A clinical pregnancy rate of 23.8% (10 out of 42) per transfer was achieved (30.9 and 20.6% respectively). Local tolerance of s.c. administration was excellent. Mild pain at the injection site was the dominant finding in < 20% of patients. Two cases of ovarian hyperstimulation syndrome were noted. Recombinant human FSH is very attractive to patients because it can be self-administered s.c. and the preparation does not come from a human source. In conclusion, these data support the safety and efficacy of recombinant human FSH in routine use for IVF.

Adolescent↗
PubMed1995

Variations of steroid hormone metabolites in serum and urine in polycystic ovary syndrome after nafarelin stimulation: evidence for an altered corticoid excretion.

To evaluate the clinical relevance of testing pituitary-ovarian responses in patients suffering from polycystic ovary syndrome (PCOS) with the GnRH agonist nafarelin, a 1.2-mg dose of nafarelin was given intranasally to 19 women with PCOS and 15 healthy premenopausal women. The subsequent analysis of steroids in both serum and urine during the test was carried out at several time points for up to 24 h. Serum levels of 17 alpha-hydroxyprogesterone were elevated at all time points of the test in PCOS patients vs. controls [at baseline, 3.5 +/- 0.2 vs. 1.8 +/- 0.1 nmol/L (P < 0.001); at 24 h, 9.9 +/- 0.9 vs. 4.9 +/- 0.3 nmol/L (P < 0.001)]. Basal levels of androstenedione were higher in the patient group, but there was no significant change during the test in either group. Serum testosterone levels were also found to differ in PCOS patients compared with the control values at baseline (2.2 +/- 0.2 vs. 1.5 +/- 0.1 nmol/L; P < 0.05) and after nafarelin treatment (at 24 h, 3.2 +/- 0.4 vs. 1.8 +/- 0.2 nmol/L; P < 0.05). Serum estradiol levels rose significantly in both groups during the test; the posttest levels were significantly higher in PCOS than in controls. The PCOS patients displayed a significant increase in androgen and gestagen metabolites as well as in glucocorticoid metabolites excreted in the urine during the 24 h. In the control subjects, except for 17 alpha-hydroxypregnanolone, which rose significantly, none of the urinary steroids investigated showed relevant changes during the nafarelin test. The posttest excretion of allo-tetrahydrocortisol (1.4 +/- 0.2 vs. 0.3 +/- 0.1 mumol/g creatinine; P < 0.001) and the increase in 17 alpha-hydroxypregnanolone excretion (1.4 +/- 0.2 vs. 0.3 +/- 0.1 mumol/g creatinine; P < 0.001) were distinctly higher in PCOS patients than in the controls; the diagnostic sensitivity of the combination of both parameters was 89% at a 93% specificity. Thus, measurements of 17 alpha-hydroxyprogesterone levels in serum and of urinary allo-tetrahydrocortisol and 17 alpha-hydroxypregnanolone after nafarelin treatment make this stimulation test a valuable diagnostic tool for identifying PCOS patients. The significant changes in the excretion of urinary androgen and gestagen metabolites, unmasked by GnRH agonist stimulation, suggest a functional alteration of the pituitary-ovarian axis. The reason for the increased excretion of glucocorticoid metabolites after nafarelin stimulation remains to be clarified.

Administration, Intranasal↗
PubMed1995

[Possibilities and limits of endoscopic fallopian tube surgery].

Treatment of distal tubal occlusion by microsurgical means allows a pregnancy rate of about 30-40% per patient. The success rate directly depends on patient's age and the grade of tubal destruction and increases to 50% in younger patients. Therefore microsurgical repair still represents a sufficient alternative to IVF. The introduction of endoscopical techniques further facilitates distal tubal surgery and offers the opportunity to evaluate the grade of tubal destruction. When performed correctly based on longstanding experience pregnancy rates after endoscopical salpingostomy are similar to microsurgery via laparotomy. In contrast microsurgery by laparotomy is still the method of choice in cases of proximal tubal occlusion or reversal of tubal ligation. Furthermore laparotomy is still indicated in patients presenting with distal tubal pathology, if the endoscopical approach does not lead to a sufficient postsurgical result.

Adult↗
PubMed1994

Low-dose follicle stimulating hormone for ovulation induction in polycystic ovary syndrome.

In 20 patients with clinically, sonographically and endocrinologically proven polycystic ovary syndrome, ovulation induction with low doses of follicle stimulating hormone (FSH) was attempted by administration for 27 menstrual cycles. One ampule FSH was administered from day 3 onwards. If the ovarian response was inadequate after days 10-12, the daily FSH dose was increased by half an ampule until ovulation induction. Of the cycles, 55.5% were monofollicular, whereas 4 cycles had to be cancelled due to a multifollicular response or failure of ovarian stimulation. On average, 14.4 ampules was used, and human chorionic gonadotropin was given on day 16. Seven pregnancies were established, with all of them ongoing at this writing. One twin pregnancy and one triplet pregnancy occurred. Even in polycystic ovary syndrome patients, low-dose administration of FSH allows safe stimulation, with a low incidence of ovarian hyperstimulation, a high pregnancy rate and an acceptably low risk of multiple pregnancies.

Adult↗
PubMed1993

Tyrosine kinase activity of insulin-like growth factor I and insulin receptors in human endometrium during the menstrual cycle: cyclic variation of insulin receptor expression.

OBJECTIVE: To determine whether expression and binding or signaling characteristics of endometrial insulin-like growth factor I (IGF-I) and insulin receptors are modulated throughout the menstrual cycle. SETTING: Research laboratories of a university hospital and of the Institute for Diabetes Research. DESIGN: In vitro receptor binding and phosphorylation studies of human proliferative and secretory endometrial tissue and of cultured endometrial stromal cells. MAIN OUTCOME MEASURES: Binding and tyrosine kinase activation of IGF-I and insulin were studied in wheat germ agglutinin purified receptor protein. Binding data were analyzed by Scatchard plots. Autophosphorylation was measured by 32P incorporation into the 95 kd receptor beta-subunit; substrate phosphorylation was determined with poly(GluNa 4: Tyr 1). RESULTS: Binding studies revealed no differences of the affinities between cycle phases. Half-maximal displacement of both receptors was approximately 1 nM in both phases. Insulin-like growth factor I receptor number appeared to be unaltered in both phases, whereas insulin receptor numbers and tyrosine kinase activity in the secretory phase were significantly increased. The increase of tyrosine kinase activity was entirely because of the increased receptor number as calculated from the binding data. In cultured endometrial stromal cells the increase of expression of insulin receptors could be induced by sexual steroids. CONCLUSIONS: On the receptor level IGF-I signaling to human endometrium is not modulated during the menstrual cycle, whereas insulin binding and signaling are likely to be enhanced in the luteal phase. The increased insulin receptor level may be required for normal luteal function.

Cell Division↗
PubMed1993

'Blind' transvaginal gamete intra-fallopian transfer in distal tubal and peritubal pathology: an evaluation in respect to the laparoscopic approach.

Transvaginal gamete intra-Fallopian transfer (GIFT) is a new treatment modality for patients with proven tubal patency, avoiding invasive laparoscopy. In this study 79 cycles of standard laparoscopic GIFT (group 1) were analysed in comparison to 40 cycles of transvaginal intratubal gamete transfer guided by tactile sensation (group 2). GIFT in group 1 was performed for standard indications; patients with severe intra-abdominal adhesions, distal tubal pathology, peritubal adhesions or extreme obesity were included in group 2. No difference in mean age, duration of infertility, oestradiol level and number of oocytes was found. In group 1 a clinical pregnancy rate of 33% per GIFT cycle (n = 79) was achieved. The clinical pregnancy rate in group 2 was 17.5% per gamete transfer cycle. In conclusion, transvaginal GIFT offers an acceptable chance for in-vivo fertilization to patients who cannot be treated laparoscopically despite having patent tubes and who refuse in-vitro fertilization.

Adult↗
PubMed1993

Combined intra-uterine and extra-uterine pregnancy in the contralateral tube after gamete intra-fallopian transfer.

A case of combined intra-uterine and contralateral tubal pregnancy after gamete intra-Fallopian transfer (GIFT) is presented. Laparotomy with partial tubal resection was performed after tubal rupture. The intra-uterine pregnancy is still ongoing without complications. Heterotopic pregnancies are dangerous conditions for the patient and should be taken into account after transfer of multiple oocytes. To our knowledge this is the first report of a heterotopic pregnancy in the contralateral tube after GIFT.

Adult↗
PubMed1992

[Hormonal and ultrasound monitoring of early pregnancy--differential diagnosis of extrauterine pregnancy and multiple pregnancy].

In this study sonographical and hormonal findings in 63 patients with intrauterine singleton pregnancy were compared with 18 patients with multiple pregnancies and 28 patients with ectopic pregnancy. The earliest detection of the intrauterine gestational sac was obtained with a HCG level of 659 mlU/ml. The sonographical development correlated well with HCG values. There was no statistically significant correlation between gestational age and HCG. In multiple pregnancies with sonographical findings comparable to the development in singletons HCG values were remarkably elevated. A discrimination between multiple and ectopic pregnancies by sonographical and hormonal criteria cannot be performed sufficiently in a HCG zone of 1500 mlU/ml. Close sonographical and hormonal follow-up until diagnosis of the intrauterine pregnancy is necessary.

Chorionic Gonadotropin↗