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Biomedical subjects

U Köhler

Publications and source records attributed to U Köhler.

At least 55 records · Page 3Linked to original sources
PubMed1996

Management of genital fistulas in patients with cervical cancer.

Among 2096 patients treated for cervical cancer between 1985-1995, genital fistulas developed in 38 cases (1.8%). 16 patients were affected by rectovaginal, 13 patients had rectovesicovaginal and 9 patients had vesicovaginal fistulas. Median age at time of first presentation of the fistulas was 54.8 years. Fistula size ranged from 0.1 to 2.0 cm in diameter. Faecal or urinary leakage through the vagina (44.7%), bleeding (31.5%) and local pain (5.3%) were major clinical symptoms. 10 patients had surgery for the fistula, the remaining patients were managed conservatively.

Adolescent↗
PubMed1996

Relations between various DNA-parameters and degree of malignancy in endometrial carcinoma.

120 imprint-cytology specimens obtained from standardized areas of 20 endometrial carcinomas were investigated by use of a computed-controlled image analysis system to determine special quantitative DNA-parameters. The stem line ploidy, the 2c deviation index (2cDI), the DNA-associated graduation of malignancy (DNA-MG) as well as the 5c exceeding rate (5cER) were calculated for each preparation. 85% of the imprint-cytology preparations had diploid stem lines, and aneuploidy was found in 15%. There were statistically significant correlations between the DNA-MG, the 5cER and the stem line ploidy as well as between the DNA-MG and the 5cER. The sensitivity of the 5cER was 76.6% in our study and so we cannot regard this parameter as prouding accurate information about tumor malignancy in endometrial carcinoma. Special DNA-parameters defined mathematically should be utilized for objective grading of tumor malignancy.

Aneuploidy↗
PubMed1996

Intestinal obstruction in patients with advanced gynecological cancer. A study of 62 cases.

In total, 62 cases with advanced gynecological malignancy were analyzed for the value of interventions for intestinal obstruction. 35 patients had an ileostomy, 7 patients had other palliative surgical intervention and 20 patients were managed conservatively. The median survival after surgical intervention was 7.7 months as against 1.3 months in conservatively treated patients. After surgery, all patients were affected by severe complications due to the primary disease. 22 (52.3%) of surgically treated patients received further therapy. 45 out of 62 patients (77.4%) died of progressive cancer and 14 (22.6%) of ileus. Surgical intervention had a positive effect on survival time, but only a marginal effect on life quality.

Adult↗
PubMed1996

[Primary angiosarcoma of the breast].

We report on a 39 year old woman with a biopsy diagnosed angiosarcoma of the breast. Surgical treatment consisted of a modified radical mastectomy with axillary lymph node dissection (level I and II). The size of the tumor was 4.5 x 3.5 x 2.3 cm with G II grading. In addition the patient was put on postoperative chemotherapy (EC). Soft tissue sarcomas of the breast are very rare tumors (0.04 to < 1 % of all malignant breast tumors). The etiology of most of the vascular neoplasias of the breast is therapy associated such as preexisting surgery and radiotherapy. We found a primary angiosarcoma of the breast and tried to demonstrate aspects of the morphological diagnosis, prognosis and treatment of this disease.

Adult↗
PubMed1996

[Vaginal hemorrhage after hysterectomy as a complication of alcohol-induced liver cirrhosis].

We report on a 50-year-old woman with a decompensated alcoholic liver cirrhosis and Korsakow syndrome since 1991. In July 1992, an abdominal hysterectomy with bilateral salpingoophorectomy was made because of an endometrial carcinoma pT1NOMO. A postoperative abscess of the vaginal stump was evacuated. The patient was admitted three years later with a massive vaginal bleeding. Her general appearance and nutritional status were bad. The vaginal bleeding was caused from ruptured varicose pelvic veins secondary to portal hypertension. Neither conservative (vaginal tamponade, infusions) nor operative (laparotomy with an intraabdominal and transvaginal tamponade) therapy was successful. The patient died as a result of severe bleedings. We discuss differential diagnostics and planning therapy.

Endometrial Neoplasms↗
PubMed1996

Assessment of the nocturnal blood pressure relative to sleep stages in patients with obstructive sleep apnea.

To determine the mean blood pressure relative to sleep stages, two nocturnal cardiorespiratory polysomnographs were recorded in 60 male patients with hypertension and obstructive sleep apnea (OSA). The mean age was 50.2 years, the BMI 32.0 kg/m2, the respiratory disturbance index (RDI) 44, and the blood pressure by the WHO protocol 158/98 mm Hg. A new evaluation program was used to determine the invasively measured mean arterial pressure (mean +/- SEM) and heart rate (mean +/- SEM) during sleep (mean total sleep time 361 +/- 48 min) referred to sleep stages 1 (99.5 +/- 1.5 mm Hg/67.6 +/- 1.1 bpm), 2 (98.7 +/- 1.6 mm Hg/66.6 +/- 1.1 bpm), 3 (97.6 +/- 1.8 mm Hg/67.4 +/- 1.3 bpm), and 4 (97.6 +/- 2.2 mm Hg/66.3 +/- 1.6 bpm) and to REM sleep (103.3 +/- 1.7 mm Hg/68 +/- 1.2 bpm) as 1 s mean values and to compare them with the waking state (98.3 +/- 1.6 mm Hg/83.6 +/- 1.1 bpm). There was no physiological fall in blood pressure in patients with pronounced OSA. Sleep-stage-specific analysis of invasive continuous blood pressure signals is the gold standard. The sleep structure is disturbed less than with other methods.

Adult↗
PubMed1995

The maize GapC4 promoter confers anaerobic reporter gene expression and shows homology to the maize anthocyanin regulatory locus C1.

The cytosolic glyceraldehyde-3-phosphate dehydrogenase (GapC) gene family of maize is differentially expressed in response to anaerobic stress. While GapCl and GapC2 are downregulated, GapC3 and GapC4 are anaerobically induced. We have sequenced and analyzed a 3073 bp promoter fragment of GapC4. The promoter confers anaerobic induction of a reporter gene construct in a transient gene expression system in maize. Deletion analysis of the GapC4 promoter revealed a 270 bp long DNA region required for anaerobic induction. This region contains sequence motifs resembling the cis-acting sequences of the anaerobically induced maize Adh1 and Adh2 genes. Furthermore, the 3073 bp GapC4 promoter fragment displays homology to long terminal repeats of maize retrotransposons and to the 3' region of the maize anthocyanin regulatory locus C1.

Anaerobiosis↗
PubMed1995

CD 44 exon v6 as a predictor of lymphatic metastases in cervical carcinoma--an immunocytochemical study of 94 cases.

The relation between expression of several splicing variants of the CD 44 glycoprotein by tumor cells and the increased risk of metastases was discussed recently. By means of an immunocytochemical study (imprint cytology specimens from 94 invasive cervical carcinomas) we have shown a significant correlation between expression of CD 44 v6 and invasion of lymphatic vessels, lymphangiosis carcinomatosa in the primary tumor and the total number of positive pelvic lymph nodes. Expression of CD 44 v6 was not correlated with staging, grading and histological type. CD 44 v6 could therefore be considered as a predictor of lymphatic metastases in cervical carcinoma.

Adenocarcinoma↗
PubMed1995

Invasive electrophysiological evaluation of patients with sleep apnoea-associated ventricular asystole-methods and preliminary results.

Twelve patients (aged 48 +/- 12 y) with ventricular asystole of >3 s due to complete atrioventricular (AV) block (n = 8), sinoatrial (SA) block or sinus node arrest (n = 3) or both (n = 1) associated with obstructive sleep apnoea underwent invasive electrophysiological evaluation of sinus node function and AV conduction properties before and after administration of atropine (0.02 mg kg-1). Ventricular asystole lasted for 5.9 +/- 2.8 s (range 3.1-13 s). Sinus node function was assessed by measurement of sinus node recovery time, sinoatrial conduction time, and the response of sinus rate to atropine. Parameters of AV-conduction assessment included AH- and HV-intervals, AV- and VA-Wenckebach periods, and effective refractory period of the AV node before and after atropine. Sinus node function was normal in 11 of the 12 study patients and moderately abnormal in 1 patient. AV-nodal function was normal in 8 patients and moderately abnormal in 4 patients. A slightly prolonged HV-interval (59-63 ms) was present in 6 patients. Intra- or infra His block was not observed in any patient. In conclusion, normal or only moderately abnormal electrophysiological findings in patients with sleep apnoea-associated ventricular asystole suggest that a neurally mediated cardioinhibitory reflex may cause ventricular asystole in these patients. This sleep apnoea-triggered 'vasovagal' reflex may unmask pre-existing mild to moderate structural abnormalities of the AV conduction system.

Journal Article↗
PubMed1995

Coronary heart disease and upper airway obstruction.

Coronary heart disease (CHD) is a leading cause of death among middle-aged men. In the same age group the spectrum of upper airway obstruction from habitual snoring to obstructive sleep apnoea syndrome (OSAS) is frequent. In several studies snoring was found to be an important risk factor for ischaemic heart disease. The prevalence of OSAS in patients with CHD, profile of risk factors and ventricular arrhythmias was determined in a prospective manner in 78 patients with stenosis of one or more coronary arteries at coronary arterography. OSAS was found in 27 patients (34.6%). Mean respiratory disturbance index (RDI) was 23.9. RDI increased with higher age. No significant differences in both groups could be found in ventricular arrhythmias, left ventricular ejection fraction and risk factors, except hyperuricaemia and adiposity. OSAS is frequent in patients with CHD and may be an additional risk factor besides the known coronary risk factors. Patients with the combination of CHD and OSAS have to be regarded as a group at particular risk because of several interactions between OSAS and coronary haemodynamics. Furthermore the microstructure of sleep in patients with nocturnal myocardial ischaemia is disturbed.

Journal Article↗
PubMed1995

[Inflammatory pseudotumor the bladder wall after abdominal hysterectomy for uterine myoma].

We report on a 49-year-old woman who underwent an abdominal hysterectomy for uterine myoma. Six months after the primary surgery a 2 x 2 cm tumor was detected in the posterior wall of the urinary bladder. This tumor was associated with pain, dyspareunie and voiding disturbances. A repeat-laparotomy and partial resection of the urinary bladder were carried out. The histological and immunohistochemical examinations revealed an inflammatory pseudotumor of the urinary bladder. Similar lesions after surgery on the genito-urinary system were previously reported mainly in the urinary bladder. Difficulty may arise in differentiation of these lesions from low-grade leiomyosarcomas.

Diagnosis, Differential↗
PubMed1995

[The prognostic value of cathepsin D in endometrial carcinoma].

The concentration of the lysosomal protease Cathepsin D was tested by means of RIA. We used the cytosols of 44 endometrial carcinoma tissue specimens and of the corresponding normal endometrial tissues (n = 42) obtained from the respective uteri after hysterectomy. All patients were in postmenopausal stage. A significant higher level of Cathepsin D expression was found in endometrial carcinoma (median value = 24.2 pmol/mg) compared to normal endometrium (median value = 11.4 pmol/mg). No difference in Cathepsin D concentration was found in relation to grade of histological differentiation (G1 vs. G2/G3), depth of myometrial invasion and tumor stage (stage IA vs. IB/IC vs. > I) as well as state of estrogen receptor (ER) and progesterone receptor (PR). After an average follow-up period of 18 months there was no significant difference in survival rate of operated patients depending on Cathepsin D concentration. However, the prognostic significance of this parameter need to be evaluated after a long-term follow-up. The overexpression of Cathepsin D seems to be important for exact biologic characterization of each endometrial carcinoma with respect to local proteolytic activity. The enhanced activity of cathepsin D may therefore serve as an additional objective malignancy criterion independent of the well-known prognostic factors.

Adenocarcinoma↗
PubMed1995

[Examination by image analysis for determining quantitative DNA parameters of serous papillary adenocarcinoma of the endometrium--a single case analysis].

Serous-papillary adenocarcinoma of the endometrium are rare tumors. We describe DNA-parameters of such a tumor. Imprint-cytologies were taken from 6 different tumor sites (myometrial invasion and 5 additional tumor localizations) and subjected to image-cytophotometry in order to determine their DNA-parameters. All histograms showed an aneuploid DNA-pattern. The DNA-malignancy grade (DNA-MG) was 2.21 +/- 0.11 on median and the 5c exceeding rate (5c ER) was 15.37 +/- 4.17 on median. These results and the slight variability of DNA-pattern at the reported serous-papillary adenocarcinoma support the hypothesis of an own entity of this tumor. Additionally, the high values of DNA-MG and 5c ER confirm the well known aggressive behavior of this tumor entity.

Aged↗
PubMed1994

A new animal model of dopamine supersensitivity using s.c. implantation of haloperidol releasing polymers.

Dopamine supersensitivity was induced by either the continuous daily release of 1.0 mg/kg haloperidol from controlled release polymers implanted subcutaneously in rats or by daily bolus injection. In vitro, these polymers were found to release haloperidol for more than 250 days. After implantation in vivo, supersensitivity was quantified by locomotor activity following apomorphine injection and specific [3H]spiroperidol binding to striatal synaptic membranes. Supersensitivity in rats with haloperidol implants was remarkably similar to that evoked by daily drug applications after 3 weeks without producing the detrimental daily sedations, typically seen after bolus administration. Furthermore, no difference in specific binding between both group was seen. A continuous delivery of haloperidol for 8 weeks also resulted in comparable denervation supersensitivity. Controlled release polymers may thus be a superior tool to induce denervation supersensitivity in a gradual, continuous fashion.

Animals↗
PubMed1994

[Variability of quantitative DNA parameters in endometrial carcinoma].

We performed image analysis examinations of 20 cases of endometrial carcinoma and the compared quantitative DNA parameters within each carcinoma. Specimens were taken from each carcinoma, at standardised, pre-defined sites. Six smear preparations were made from each case and DNA parameters were determined after Feulgen staining. 17 of the 20 cases of endometrial carcinoma (85%) showed in all the examined preparations a uniform diploid or aneuploid (n = 1) DNA distribution. Only 3 carcinomas showed diploid as well as non-diploid DNA distributions. For each carcinoma the mean values of DNA-MG were found to be between 0.37 +/- 0.12 and 2.16 +/- 0.11 and those of the 5cER between 0.91 +/- 0.78 and 15.37 +/- 4.17. Relationships were shown between DNA distribution, DNA-MG, 5cER and morphological prognostic factors while a reliable diagnostic of dignity based on DNA distribution and 5cER as a marker of single cell ploidy seems not possible. With an increase in DNA-MG, the coefficient of variation of this parameter decreased within the individual cases. Concluding, quantitative DNA parameters, owing to their relatively small variability within specific cases of endometrial carcinomas seem to be suitable objective indicators of prognosis to plan a risk-adapted therapy.

Aneuploidy↗