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Biomedical subjects

W Hardt

Publications and source records attributed to W Hardt.

At least 19 recordsLinked to original sources
PubMed1999

[Hepatocellular carcinoma as a rare cause of excessive rise in alpha-fetoprotein in pregnancy].

OBJECTIVE: Elevation of alphafetoprotein in pregnancy warrants a thorough diagnostic workup. In most cases, no pathologic result in the fetus will be obtained. CASE REPORT: A case report is presented on a hepatocellular carcinoma (HCC) during pregnancy, in which a massive increase of alpha-fetoprotein (AFP) was found during a routine screening for neural tube defects in the 17th week of gestation. The amniocentesis revealed a normal AFP value in the amniotic fluid. Liver sonography in the 21st week of gestation showed a 5 cm tumor, which was interpreted as nodular focal hyperplasia. In the control sonography in the 32nd week of gestation, there was a growth to 12 cm. The subsequently performed magnetic resonance imaging (MRI) and fine needle aspiration led to the diagnosis of a HCC. Delivery was performed in the 34th week of gestation by cesarean section followed by surgical therapy of the HCC. CONCLUSIONS: Unexplained cases of alphafetoproteinelevation in pregnancy can be caused by maternal disease and should prompt a directed amnamnestic and diagnostic search for maternal causes. Nuclear magnetic resonance beyond the first trimester of gestation can help to clarify the diagnosis in liver tumors.

Adult↗
PubMed1993

Keratin expression reveals mosaic differentiation in vaginal epithelium.

OBJECTIVE: Analyzing the expression of keratins has proved to be valuable for identifying of pathways of epithelial differentiation. In stratified epithelia K10 and K13 are representative for either the keratinizing (epidermal-type) or the nonkeratinizing pathway. STUDY DESIGN: We have investigated keratin expression in "normal" vaginal epithelium from 30 women, applying two-color immunofluorescence with monoclonal antibodies to K10 and K13 on cryostat sections and cell smears. RESULTS: A differential expression pattern of vaginal cells dependent on their localization within the epithelium was found. In cells of the first suprabasal layers differentiation began and became identifiable by a weak expression of K13. The adjacent layers displayed cells that concurrently expressed K10 and K13. In contrast, cells within the superficial strata expressed exclusively either one of the two keratins. CONCLUSION: Thus vaginal epithelium appears to be mosaic in differentiation, showing simultaneous expression of keratins K10 and K13, thought to be representative for distinct routes of differentiation.

Adult↗
PubMed1989

[Atmocausis vaporization. Most severe internal burns following intrauterine use of steam].

The article gives a brief historical review of the now obsolete method of atmocausis and reports on two cases of very deep internal burns after direct intrauterine application of superheated steam; one of the patients died as a result of this procedure. In the thirties this method was used especially to arrest intrauterine perimenopausal bleeding, but has since been abandoned.

Adult↗
PubMed1988

[Clinical experiences in the treatment of endometriosis with the LH-RH analog buserelin with special reference to the post-therapy course].

The current therapy study with 50 patients showed that a reversible down regulation of the ovaries is possible. Particularly in cases with severe endometriosis a rapid release of pain can usually be achieved. Further development of the disease could be prevented and in two third of the cases even a partial reduction of tumor size. Within 12 weeks after the therapy the cycle is normally stabilized. But in about 70% of the patients the typical complaints of endometriosis were recurrent. The advantage of this treatment is the high acceptance of the patients in comparison to steroid medication. In long term administration it is mandatory to control bone and lipid metabolism.

Adult↗
PubMed1986

[Initial results in the treatment of endometriosis with the LH-RH analog buserelin].

Twenty-six women, most of them with advanced endometriosis (Stage III according to Acosta), were treated for six months with the LH-RH agonist Buserelin. After initially increased liberation both of the gonadotropins as well as of the sexual steroids there was consecutive inhibition of gonadal function, especially after inhibition of FSH secretion. Within two to four weeks estradiol production was completely and lastingly suppressed in 21 of the 26 women. In three women it lasted for three months and in two women estradiol again rose up to three times during the period of observation. Correspondingly, 22 of the women suffered from hot flushes as early as within the first two months. Twenty of the 26 women became completely free of symptoms within four to six weeks, and a clear regression of the pain was recorded in another four. In two women the complaints persisted without change. Withdrawal bleeding of short duration occurred simultaneously with the intermittent increases in estradiol levels; however, this bleeding usually caused little or no pain. Eleven of the 19 endometrium biopsies performed during therapy revealed a dormant endometrium, and only in one case was proliferated endomedium found, in the third month of treatment, in a stage of transition to hyperplasia. The remaining seven biopsies were insufficient for assessment. In seven women with advanced endometriosis, laparotomies were performed after drug treatment. Histologic study of the endometriosis tissue thus obtained revealed, except in the two nonresponders, cicatrized tissue with atrophic glands and severely reduced stroma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Sustained gonadal suppression in fertile women with the LHRH agonist buserelin.

Nine fertile women were treated with the luteinizing- hormone-releasing hormone agonist buserelin (seven women received 800 micrograms, two women 1200 micrograms intranasally for up to 24 weeks). Both doses produced sustained suppression of ovarian function, accompanied by hot flushes. In five women chemical castration was established within 1 to 5 weeks, whereas in the other four volunteers transient peaks of serum oestradiol occurred between the 6th and 19th weeks. Thereafter low postmenopausal oestradiol levels persisted. Chemical castration was confirmed by hormonal parameters and endometrial biopsies (inactive endometrium). After cessation of treatment normal cyclical function occurred immediately. This reversible chemical castration may be useful for new therapeutical approaches in sexual hormone dependent diseases (endometriosis, precocious puberty, metastatic breast cancer).

Buserelin↗
PubMed1982

Sustained suppression of testosterone production by the luteinising-hormone releasing-hormone agonist buserelin in patients with advanced prostate carcinoma. A new therapeutic approach?

Nine patients with advanced carcinoma of the prostate were treated with the luteinising-hormone-releasing-hormone agonist buserelin (2 mg/day subcutaneously for 3 days then 0.4-1.2 mg/day intranasally for up to 24 weeks). There was a rise in luteinising-hormone levels during the first few days of treatment, but levels fell after 3 weeks and remained lower than normal after 24 weeks' treatment. In patients receiving 0.6-1.2 mg buserelin per day testosterone levels fell to less than 1 ng/ml within 3 weeks and were still as low as those found in surgically castrated men after 24 weeks. Histology showed regressive changes in some tumours after 3-6 months' buserelin treatment similar to those seen in surgically castrated men. Buserelin treatment may be an alternative to surgery in patients with advanced carcinoma of the prostate.

Administration, Intranasal↗
PubMed1981

Influence of the LH-RH analogue buserelin on cyclic ovarian function and on endometrium. A new approach to fertility control?

The long-acting stimulatory luteinizing hormone - releasing hormone analogue D-Ser(TBU)6-EA10-LH-RH (buserelin) was administered intranasally once daily in a dose of 400 mcg to 24 normally ovulating women and to 4 women with pre-existing endocrine dysregulation. Ovulation was inhibited in 136 out of 156 treatment months. In 20 treatment months, progesterone values temporarily increased indicating luteinization of follicles or ovulation with defective corpus luteum function. Estradiol secretion showed a tendency to lower values as treatment progressed but individually indicated follicle maturation until the end of the observed medication period. Bleeding pattern ranged from menses-like bleeding in regular as well as irregular intervals to amenorrhea. The morphological findings of 31 endometrial biopsies of 20 volunteers ranged from atrophy (n = 4) to proliferation (n = 25) with early signs of hyperplasia as well as early secretory transformation (n = 2). The morphological alterations indicate that unopposed estrogen stimulation of the endometrium is the main problem of long-term contraception with the dose schedule of buserelin used.

Adolescent↗
PubMed1981

[The influence of long-term medication with the LH-RH analogue buserelin on the regulation of the menstrual cycle (author's transl)].

We investigated in 70 women over a period of 6 months the influence of different dose regimen of the potent LH-RH analogue Buserelin (HOE 766: 400, 200, 100 micrograms per day) on pituitary and ovarian function. The histological findings of the endometrial biopsy specimen (n = 109) were correlated with the hormonal profiles and the bleeding pattern. There was an evident dose-related inhibition of ovulation or corpus luteum integrity. A regular bleeding pattern was found more often in the lower dose groups. Unopposed estrogen effects recognized by prolonged endometrial stimulation were mainly registered in women with amenorrhea induced by 400 micrograms buserelin. Regression of endometrial stimulation could be observed during the six months period of medication. If higher dose regimen will lead to a more consistent inhibition of ovarian function, remains to be investigated.

Adolescent↗
PubMed1981

Induction of abortion with sulprostone, a uteroselective prostaglandin E2 derivative: intramuscular route of application.

Sulprostone, a new prostaglandin E2-derivative, with high selectivity for the uterine muscle, was tested in 180 women (62 primigravidae) for induction of abortion in the first trimester of pregnancy by intramuscular administration. Total dosages from 500 to 1,500 mcg in single injections of 500 mcg were tested. The injections were given at intervals of 4 to 8 hours. Adequate cervical dilatation was achieved in nearly 94% of the patients with complete abortion in more than 50%. No sulprostone-related complications such as shock or cramps were registered. Side effects were at a tolerable level with concomitant medication being necessary for about one-third of the patients. Optimal effectiveness and acceptability were recorded, at an injection interval of 6 to 8 h and a total dose of 1,000 mcg sulprostone. The application of sulprostone as abortifacient in first trimester pregnancy is discussed.

Abortifacient Agents↗
PubMed1980

[The influence of lithium salts and antidepressive medication on the serum prolactin level (author's transl)].

The prolactin (hPRL) level in the serum of 17 patients (10 females, 7 males) with primary depression (manic-depressive disease) was determined before and after prophylactic treatment with lithium salts. All patients were free of acute psychotic-depressive symptomes. However, 9 of 17 patients received moderate doses of additional antidepressive medication continuously for 4 weeks. No significant changes of the serum hPRL were observed in the group as a whole, the lithium serum levels being within the normal therapeutic range. The mean hPRL level in patients with concomitant antidepressive medication was significantly higher as compared to the "only lithium" group, but never exceeded the normal range in both groups. Considering similar results of other authors, it is suggested that lithium does not influence the hPRL serum level, at least if no special methods of hPRL stimulation are used. However, with regard to recent communications suggesting that besides dopaminergic influences also serotonergic mechanisms play an important part in hPRL regulation, it is held that the prolactin response in lithium-treated patients warrants further investigations using serotonergic stimulation methods.

Adult↗
PubMed1980

[Pregnancies after ineffective interruption or intrauterine procedure in early pregnancy (author's transl)].

We report about 13 pregnancies after intra-uterine procedure in early pregnancy. In 12 cases infant and placenta were without any lesions. One infant had a traumatic loss of the left arm and shoulder caused by the ineffective interruption of pregnancy. Into discussion come the conditions in which we can support the wish to carry on pregnancy after an early intra-uterine procedure.

Abortion, Spontaneous↗
PubMed1980

[The diagnosis of androgen producing tumours in women (author's transl)].

The problems of the diagnosis of an androgen producing tumour are described within the review of a case of a 37 year old woman with marked virilization. Functional endocrine tests, laparoscopy, retroperitoneal pneumography and angiography did not estabion of the ovarian and adrena veins established the pre-operative diagnostic of an androgen producing tumor of the left ovary. This permitted to limit the operative procedure to the minimum procedure necessary.

Adult↗