[Therapy of ascites with tumor necrosis factor in ovarian cancer].

The biotechnological production of human recombinant tumour necrosis factor (rHuTNF) makes this drug available for clinical application. This endogenous compound exhibits tumouricidal activity and regulatory functions within the immune system. 20 out of 23 (87%) patients with refractory recurrent malignant ascites from ovarian cancer were successfully treated in a phase-I and II-study.

[The extent of radical axillary lymph node excision].

A study on histological findings in 1047 patients who underwent total axillary lymph node dissection (topographical levels I-III), was conducted. A mean of 20.3 lymph nodes (LN) was assessed; LN metastases were detected in 492 cases.

Uterine rupture--an analysis of 81 cases in Conakry/Guinea.

Eighty-one cases of uterine rupture in Conakry/Guinea are analyzed. With an incidence of 0.84%, i.

[A rapid test procedure for the detection of B streptococci in the perinatal period].

At the Hospital of the Department of Gynaecology of the University of Heidelberg, a latex agglutination test (Strep B Patho Dx Test) was applied after extraction of antigens from amniotic fluid and gastric aspirate, parallel to the routine screening programme (vaginal and anal swabs) for maternal colonization with B streptococci. The latex agglutination test was applied in 1336 cases. Maternal vaginal colonization was detected in 14%, anal colonization in 17% of the cases.

[Abruptio placentae].

Neither the frequency nor the clinical pattern of abruptio placentae have changed significantly in the past years. In a retrospective study (1979-1988) we found a frequency of 0.55%, that means one abruptio placentae in every 182 births.

[Urodynamics and the lateral cystogram: value for incontinence diagnosis].

We compared urodynamic findings and results of lateral cystourethrography in 82 patients with incontinence. The aim of the study was to establish a possible correlation between anatomic findings and functional results. Clinically, a significantly higher increase of the posterior urethrovesicular angle was noted in patients with a urodynamic stress incontinence than in patients with urge incontinence or those with normal urodynamic findings.

[Doppler ultrasound flow measurement of fetal and uteroplacental blood vessels. Study of a normal population in the 2d half of pregnancy].

Weekly Dopplersonography measurements were performed on the fetal aorta abdominalis, the umbilical artery, the fetal carotid artery and the uterine arcuate artery from the 20th to the 41st weeks of gestation, mean and maximum blood flow velocities were measured, as well as the resistance index. The mean values calculated from 20 cases per week were translated into standard graphical representations serving as a criterion for the assessment of pathological pregnancies. The vessels were examined as to their value for a screening programme of fetal circulation.

Ifosfamide combination chemotherapy in advanced breast cancer.

The objective of our clinical studies was to develop an effective combination chemotherapy regimen (CHT) with acceptable side effects, consisting of the two most potent drugs used as single agents in breast cancer. We tested the combination of an anthracycline, epirubicin (A) at 70 mg/m2 i.v.

The effect of fibrin glue and peritoneal grafts in the prevention of intraperitoneal adhesions.

We studied the effect of fibrin sealant and peritoneal grafts applied by fibrin glue on adhesion formation in the rat. Sealing and patching of ischaemic lesions of the uterus resulted in a significant increase in adhesion formation. We conclude, that fibrin sealant and peritoneal grafts can not be given general approval for prophylaxis of intraperitoneal adhesions.

[Twin pregnancies with fetofetal transfusion syndrome].

During an observation period of 10 years 30 cases (11%) of twin transfusion syndrome were observed in a collective of 286 twin pregnancies at the University Women's Clinic Heidelberg. Typical symptoms of a twin transfusion syndrome as polyhydramnios, hydrops fetalis, polyserositis, disparity in fetal growth of the twins and pathological CTGs were examined for their diagnostic and prognostic values. A difference in birth weight of more than 25% was noted in only 28% of cases (range 2-58).

Laser surgery in gynecological oncology. Part I: Experimental results. Relapse and metastatic behaviour of the Lewis lung carcinoma subsequent to CO2 laser surgery of the primary tumor. An experimental model to compare the effectiveness of various CO2 laser application techniques.

The influence of various CO2 laser surgical techniques on tumor behaviour was examined in an experimental model on C56BL/6 mice (n = 106) with Lewis Lung carcinomas and compared with that of scalpel excised tumors. Comparisons were made between the healing procedure, the local recurrence rate, metastatic behaviour and the survival rate (n = 86) of mice after laser surgical excision of tumors, using the superpulsed and continuous wave techniques, with and without additional vaporisation of the wound, as well as after general vaporisation only.

Decrease in uterine rupture in Conakry, Guinea by improvements in transfer management.

Lack of an effective transfer system remains a major risk factor for uterine rupture, especially in developing countries. The implementation of a program of consultation, feedback and integration between peripheral delivery units and two hospitals resulted in a decrease in the incidence of uterine rupture from 0.20% to 0.

[Evaluating the cervix in pregnancy using vaginal sonography. Studies of cervix insufficiency].

Transvaginal ultrasound provides important detailed information, which cannot be obtained by routine manual vaginal examination. By measuring the outside-inside distance (from os externum to os internum), we can determine the actual length of the cervix. By depicting the cervical canal, we can identify early dilatation.

[The importance of pulsed Doppler sonography for prenatal diagnosis of placental insufficiency--studies of 198 patients].

Doppler sonographic measurements of the fetal aorta and the carotid artery were performed on 198 pregnant patients having been diagnosed with a placental insufficiency. A relationship between them and fetal as well as non-fetal factors was examined. For the fetal factors minus difference in weight of birth and perinatal morbidity there could be established a definite correlation with corresponding resistance-index (RI) of the examined vessels.

[Application of the neodymium-Yag laser in treating adhesions].

The authors conducted an experimental study on the possibilities of application of the "in touch" technique for microsurgical adhesion resection with a Neodymium-Yag laser. It enables good hemostasis and is an alternative to the CO2 laser, the risk of causing vital organ lesions being reduced.

Human monoclonal antibodies directed against ovarian carcinoma.

In order to obtain human monoclonal antibodies for immunodetection or treatment of ovarian carcinoma, we generated hybridomas by fusing peripheral blood lymphocytes of patients with ovarian carcinoma and the mouse myeloma cell line X63.Ag8.653.

[Marshall-Marchetti-Krantz operation with fibrin gluing. Results after 2 years].

Since broad experience concerning the stability of fibrin sealing is needed, it has become part of the routine program in orthopaedics and in traumatology. Because of these experiences, we decided to modify the standard Marshall-Marchetti-Krantz-Operation replacing all sutures on both sides of the urethra and the bladder neck by fibrin sealing. So far, 76 patients have been operated using to this new method.

[Epithelial growth factor receptors (EGF-R) and DNA flow cytometry in addition to lymph node and hormone receptor status as prognostic factors in primary breast cancer].

The presence of receptors for epidermal growth factor (EGF-R), the percentage of cells in S-phase and DNA-ploidy measured by flow-cytometry are new prognostic factors in breast cancer. In order to investigate the relationship between EGF-R, S-Phase/DNA-ploidy and clinical data, we measured these parameters in 68 tumors from patients with operable breast cancer. 11 Patients had positive EGF-R's (specific binding greater than 10 fmol/mg membrane-protein) and 37 patients had a positive S-Phase (more than 5% of cells in S-Phase).

[The nuclear surface area as a malignancy parameter in breast cancer].

For better characterisation of the degree of malignancy of breast cancers, we have attempted to establish a correlation between nuclear size and prognosis in breast cancer. Karyometric investigations were carried out on biopsies from 200 primary breast cancers. On the basis of the nuclear areas determined, we were able to distinguish three groups of carcinomas: group I: carcinomas with small nuclear areas (n = 33), mean value 97.

[Initial experiences with a monoclonal antibody to the progesterone receptor complex].

Today, the immuncytochemical demonstration of estrogen receptors can be regarded as established. Recently, a monoclonal antibody (mab) against the progesterone receptor-complex became commercially available. The antibody Mi 60-10, developed by Milgrom and co-workers, is murine and principally directed against the progesterone receptor of the rabbit, but it also attacks an "epitop" of the human receptor.

Detrusor and compliance changes of the bladder after radical hysterectomy.

Disturbances of bladder function after radical hysterectomy are caused by the damage done to the pelvic nerves. Reduced radicality in cases of carcinoma cannot be discussed. In a prospective urodynamic study we checked bladder changes in patients with radical hysterectomy and compared them to those with incontinence operations.

Identification of the human papillomavirus type 18 E6 and E6 proteins in nuclear protein fractions from human cervical carcinoma cells grown in the nude mouse or in vitro.

We recently reported the transcription patterns of human papillomavirus (HPV) type 18 sequences in human cervical carcinoma cell lines. The open reading frames (ORFs) E6* and E6 represent the 5'-terminal cistrons in HPV18 mRNAs. ORF E6* was assumed to be specific for HPV types associated with genital carcinomas.

[Tetralogy of Fallot following coumarin administration in early pregnancy--an embryopathy?].

A case report of a 35-year old woman is presented who continued a coumarin therapy unconscious of an early pregnancy up to day 61. At term she delivered a baby with tetralogy of Fallot, up to now not mentioned in the symptom complex of malformations due to a coumarin therapy. In the case presented the typical symptoms of a warfarin embryopathy including a chondrodysplasia punctata and other morphological changes were lacking.