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Fehervary P, Busch P, Zieger W, Melchert F. Passagere Hemiparese bei Typ-1-Diabetes im Wochenbett. Geburtshilfe Frauenheilkd 2001. [DOI: 10.1055/s-2001-17391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Förster C, Bechtold I, Melchert F. [Clinical use of the birth simulation program "Anapelvis 2.0" for prediction of feto-maternal disproportion]. ZENTRALBLATT FUR GYNAKOLOGIE 2001; 123:465-8. [PMID: 11562812 DOI: 10.1055/s-2001-17246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
INTRODUCTION The birth simulation program Anapelvis 2.0 was developed to predict feto-maternal disproportion in order to avoid the unfavourable accompanying phenomena of a secondary caesarean section. - PATIENTS AND METHODS The system was used in 71 patients of the Women's Hospital of the University of Mannheim during the period 01. 01. 1999 to 28. 02. 2001. These women were prone to feto-maternal disproportion according to their obstetrical history or to clinical findings. They were informed about the possibility of a computed birth simulation which was carried out in accordance with a standardized scheme. - RESULTS 87.3 % of all patients followed the suggestion of the birth simulation in their decision concerning birth planning. In 76.1 % of the evaluated cases the delivery process was correctly predicted. - DISCUSSION Even though the computed birth simulation has not yet been finally evaluated, it represents a source of important information for birth planning which numerous patients appreciate. It is essential for the acceptance and validity of the procedure to inform the patient comprehensively and to generate exact pelvimetric and fetometric data.
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Römer A, Weigel M, Zieger W, Melchert F. Veränderungen der Zervixreife und Geburtsdauer nach geburtsvorbereitender Akupunkturtherapie. Das Mannheimer Schema - Prenatal Acupuncture: Effects on Cervical Maturation and Duration of Labor -. Geburtshilfe Frauenheilkd 2000. [DOI: 10.1055/s-2000-8028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Volz J, Volz-Köster S, Kanis S, Klee D, Ahlert C, Melchert F. Modulation of tumor-induced lethality after pneumoperitoneum in a mouse model. Cancer 2000; 89:262-6. [PMID: 10918154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND To the authors' knowledge, a generally accepted approach to prevent increased intraabdominal tumor implantation after laparoscopic cancer surgery does not exist. METHODS One week after establishing an ovarian carcinoma cell line in black mice intraabdominally (n = 156), a carbon dioxide pneumoperitoneum (Group 1: n = 78) was administered. The effect of this procedure on tumor-induced lethality and the therapeutic effect of mitoxantrone and taurolidin mixed with heparin and sodium chloride was investigated. The different drugs were added immediately after the release of the pneumoperitoneum and after 48 hours. The 78 control animals received the drugs at the same time without preexisting pneumoperitoneum. Survival time was registered. RESULTS The survival time was reduced significantly in all pneumoperitoneum groups compared with the corresponding control group without pneumoperitoneum. The effect of mitoxantrone on survival time (mean, 62.08 days) was diminished significantly by the application of a pneumoperitoneum (mean, 34.27 days). Taurolidine/heparin appeared to have a positive effect on survival time only in the case of a previous pneumoperitoneum (mean of 21.12 days vs. mean of 16.04 days in the pneumoperitoneum control group; P < 0.001). CONCLUSIONS The induction of a pneumoperitoneum appears to decrease survival time by increasing tumor cell growth and decreases the efficacy of intraperitoneal chemotherapy. The effects of pneumoperitoneum appear to be reduced by the use of heparin/taurolidine, which theoretically blocks extracellular matrix binding domains and inhibits the production of interleukin-1.
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Beichert M, Buchholz B, Weigel M, Martini M, Breitkreutz R, Melchert F. [Prenatal care of a HIV-1-positive pregnancy and birth]. ZENTRALBLATT FUR GYNAKOLOGIE 1999; 121:549-52. [PMID: 10612225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Mother-to-child (vertical) transmission of the human immunodeficiency virus type-1 (HIV-1) is now the main route of infection in HIV-positive children. Without any medical measures and avoiding breastfeeding the rate of vertical HIV-1-transmission is 15-20% in Europe. The rate of vertical HIV-transmission in the German centers is today approximately 2%. This low risk is the result of interdisciplinary prenatal care, antiretroviral therapy according to the individual risk profile as well as cesarean section before onset of labor, and antiretroviral treatment of neonates in the centers.
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Labeit D, Melchert F. P-204. Uterus cDNA gene expression library is able to detect new giant proteins in the ultrastructure of myometrium. Hum Reprod 1999. [DOI: 10.1093/humrep/14.suppl_3.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Weigel M, Obermüller N, Gentili M, Gretz N, Melchert F. P-243. The cell-specific expression of the angiotensin II-receptor type 2 (AT2) and its functional significance in the mature rat ovary. Hum Reprod 1999. [DOI: 10.1093/humrep/14.suppl_3.262-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Melchert F, Rink K, Rinn K, Salzborn E, Grun N. Charge transfer in He+-He+collisions. ACTA ACUST UNITED AC 1999. [DOI: 10.1088/0022-3700/20/7/006] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Rinn K, Melchert F, Rink K, Salzborn E. Ionisation in H+-He+collisions using an improved beam-pulsing technique for measuring the formation of He2+. ACTA ACUST UNITED AC 1999. [DOI: 10.1088/0022-3700/19/22/014] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Schon W, Krudener S, Melchert F, Rinn K, Wagner M, Salzborn E. Mutual neutralisation in H+-H-collisions. ACTA ACUST UNITED AC 1999. [DOI: 10.1088/0022-3700/20/22/006] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hoffmann G, Pollow K, Weikel W, Strittmatter HJ, Bach J, Schaffrath M, Knapstein P, Melchert F, Pollow B. Urokinase and plasminogen activator-inhibitor (PAI-1) status in primary ovarian carcinomas and ovarian metastases compared to benign ovarian tumors as a function of histopathological parameters. Clin Chem Lab Med 1999; 37:47-54. [PMID: 10094378 DOI: 10.1515/cclm.1999.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Ninety-eight patients with histologically confirmed ovarian tumors (77 primary ovarian carcinomas of stages T1 to T3 according to the postoperative histopathological classification pTNM classification, 14 ovarian metastases of various origins and seven benign ovarian tumors) were investigated with regard to the concentration of urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitor (PAI-1) in membrane extracts of tumors. The results were correlated with the clinical course and with histopathological findings. With more advanced stage of primary ovarian carcinomas, there was a highly significant rise in the membrane concentrations of both uPA and PAI-1. However, increasing dedifferentiation of the tumors correlated only with uPA, but not with PAI-1. There was no correlation between the number of steroid receptors for estradiol and progesterone and the content of uPA or PAI-1 in the primary ovarian carcinomas. In the 14 ovarian metastases of different origins incluced in the study, the contents of uPA and PAI-1 were comparable to those of primary ovarian carcinomas. Compared with the malignant ovarian tumors, the median uPA and PAI-1 concentrations in the membrane fraction were 2.5-6 fold lower (highly significant) in the group of seven benign tumors. A cut-off value of 4.8ng/mg pellet protein for a prognostically favorable (< 4.8) or unfavorable course (> 4.8) could be determined for uPA (p = 0.0392) but not for PAI-1 on the basis of the Kaplan and Meier survival curves in the malignant primary ovarian carcinomas.
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Weigel M, Gentili M, Schmidt R, Schleich HG, Melchert F. R-220. Renin synthesis in human granulosa cells. Hum Reprod 1997. [DOI: 10.1093/humrep/12.suppl_2.329-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Köster S, Volz J, Leweling H, Melchert F. Operationstrauma und Postaggressionsstoffwechsel: Laparoskopie versus Laparotomie. Geburtshilfe Frauenheilkd 1997. [DOI: 10.1055/s-2007-1023037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Mueck AO, Melchert F, Deuringer FU, Roemer T, Seeger H, Lippert TH. P304 Transdermal estradiol replacement using chlor-madinone acetate as sequential progestogen. Maturitas 1996. [DOI: 10.1016/s0378-5122(97)81495-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Köster S, Melchert F, Volz J. [Effect of CO2 pneumoperitoneum on intraperitoneal tumor growth in the animal model]. Geburtshilfe Frauenheilkd 1996; 56:458-61. [PMID: 8991842 DOI: 10.1055/s-2007-1022287] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Clinical observations during recent years describe the increased occurrence of rapid intraperitoneal metastases and an impairment of prognosis if a malignant tumour was operated laparoscopically. It is not known whether the observed induction of intraabdominal metastases after laparoscopic surgery in the result of an inadequate surgical procedure with spillage of tumour cells into the abdominal cavity or whether pneumoperitoneum-induced changes of the peritoneal milieu promote tumour growth. An animal model was established to examine the effect of a CO2-pneumoperitoneum on the intraperitoneal growth of tumour cells. Six week old nude mice were divided into 4 groups of 15 animals each. A CO2-pneumoperitoneum was induced by a micro-hysteroflator with an intraperitoneal pressure of 6 mmHg for 90 minutes in groups 2 and 4. Two different tumour cell lines, suspended in 2 ml of Ringer's solution for homogeneous spread of the cells, were injected i.p.. The control groups 1 and 3 received the tumour cells without pneumoperitoneum induction of a CO2-pneumoperitoneum resulted in an increasing seeding rate of tumour cells and provoked a significant increase in the number and size of intraabdominal metastases. Laparoscopic surgery of malignancies is therefore contraindicated.
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Köster S, Volz J, Melchert F. [Indications for 3 D laparoscopy in gynecology]. Geburtshilfe Frauenheilkd 1996; 56:431-3. [PMID: 8974898 DOI: 10.1055/s-2007-1023259] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
In a prospective randomised study we investigated the possibilities of a 3 D-video system in comparison to a 2 D-video system in operative laparoscopy. On 76 patients the following operations were performed: enucleation of fibroids, extirpation of ovarian cysts, fimbrioplasty, tubo-tubal anastomosis and Burch's procedure via preperitoneal access. For microsurgical procedures of the adnexae the new 3 D-technology shows advantages in compared to the standard 2 D-laparoscopy. In these operations the operating area is naturally limited, and hence the disadvantages of the 3 D-technology like limited depth of focus are not important. The 3 D-system allows a very good visualisation even of small structures and safe and exact handling. For surgery of the uterus or larger tumours of the adnexae, the new technology is unsuited.
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Neises M, Soedradjat F, Strittmatter HJ, Wischnik A, Melchert F. [Quality of life of over 60-year-old patients with breast and uterine carcinoma, 5 years after primary operation]. Z Gerontol Geriatr 1996; 29:136-42. [PMID: 8689467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In the 5-year follow-up period, we studied the quality of life of 145 patients who were at least 60 years old at the time of primary operation. Of the patients, 70 women had breast cancer and 75 endometrium cancer. We used the questionnaire "short form health survey: medical outcomes study". The areas which were analyzed were stress due to therapy, body image/femininity and social contacts. The Karnofsky-Index was determined by the physician. In both groups, most stress was felt due to the operation and at the first knowledge of the diagnosis. In the area of emotional stress 1/3 of the patients of both groups declared continuous stress due to feelings of fear, helplessness and passivity. In the area of body image/femininity half the patients with breast cancer and 2/3 with endometrial cancer felt stress. In the area of social contact 2/3 of the patients felt uncertainty in contact with others and this led to social retreat in 1/3 of the women. The Karnofsky-Index of all patients was between 50-100%. Our study supports the view that older patients with cancer should also be offered psychosocial counseling.
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Volz J, Köster S, Weiss M, Schmidt R, Urbaschek R, Melchert F, Albrecht M. Pathophysiologic features of a pneumoperitoneum at laparoscopy: a swine model. Am J Obstet Gynecol 1996; 174:132-40. [PMID: 8571996 DOI: 10.1016/s0002-9378(96)70385-x] [Citation(s) in RCA: 81] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The aim of this study was to examine local and systemic reactions of the body to a pneumoperitoneum to elucidate potential dangers and risks of laparoscopic procedures. STUDY DESIGN Laparoscopy was performed on 25 pigs. The pigs were divided into five groups by level of intraabdominal pressure (14 and 18 mm Hg) and gas used (carbon dioxide and air). The effects of the pneumoperitoneum on cardiopulmonary condition and the peritoneal milieu were observed. These effects should be the result of various changes as the mechanical, ventilatory, cellular, hormonal, and immunologic levels. RESULTS In this animal study marked changes in the peritoneal milieu were observed, and we demonstrated that these changes were dependent on the gas used, intraabdominal pressure, and duration of application. Locally these changes are manifest in the development of severe peritoneal acidosis, hypercapnia, and the release of various mediators. Systemic changes, in particular cardiopulmonary changes, also depend on the intraabdominal pressure and the gas used. CONCLUSION During conventional pneumoperitoneum the peritoneum might change to a large extent so that the development of new risks are possibly encouraged. A reduction in intraabdominal pressure with the use of carbon dioxide as the insufflation gas should result in normal acid-base balance.
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Zieger W, Leveringhaus A, Pilch H, Wischnik A, Melchert F. [Uterine rupture during induced abortion with prostaglandins in the second trimester]. Geburtshilfe Frauenheilkd 1995; 55:592-8. [PMID: 8543135 DOI: 10.1055/s-2007-1023531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Based on our own experiences and on the literature of the past 14 years the variety of the presenting symptoms in patients suffering from ruptured uterus during the second trimenon are discussed. focussing especially on the first symptoms of a so-called "silent" uterus rupture. A 41-year old second gravida, first para--the healthy full-term child was delivered by Caesarean section--suffered a "silent" uterus rupture after termination of pregnancy at 20th/21st weeks' gestation. As more than 50 per cent of patients with "silent" uterus rupture are diagnosed with considerable delay, early and repeated ultrasound examinations should be performed in all patients with unexplained symptoms or if despite abortion induction for several days no progression of birth occurs. In an artificially induced abortion, prostaglandins should be topically applied to enhance cervix ripening, preferably as a biphasic treatment (first for cervix ripening, later induction of contractions). It is not yet clear whether a single or total dose reduction of prostaglandins used in labour induction in the second trimenon may help to prevent uterus rupture in patients at risk. Predisposing risk factors must be taken into account before applying prostaglandins. Uterus rupture should always be considered as differential diagnosis if problems occur in patients after induced abortion in the second trimenon.
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Kaufmann M, von Minckwitz G, Brunnert K, Kreienberg R, Melchert F, Mösch R, Neises M, Schermann J, Schmid H, Seeger F, Seufert R, Staiger H, Stiglmayer R, Stosiek U. 64. Tamoxifen does not promote tumour progression in surgically treated endometrial cancer. Breast 1995. [DOI: 10.1016/0960-9776(95)90156-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Wu W, Cocke CL, Giese JP, Melchert F, Raphaelian ML, Stöckli M. Observation of direct ionization of He by highly charged ions at low velocity. PHYSICAL REVIEW LETTERS 1995; 75:1054-1057. [PMID: 10060194 DOI: 10.1103/physrevlett.75.1054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Weigel M, Friese K, Strittmatter HJ, Melchert F. Measuring the thickness--is that all we have to do for sonographic assessment of endometrium in postmenopausal women? ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 1995; 6:97-102. [PMID: 8535924 DOI: 10.1046/j.1469-0705.1995.06020097.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
For sonographic assessment of the endometrium in postmenopausal women, measurement of the maximum thickness is used in many cases as the sole criterion. The cut-off values stated in the literature, however, vary considerably. This prospective study examined 200 female patients in order to ascertain the value of echomorphology in addition to endometrial biometry. Up to an overall endometrial thickness of 3 mm, we observed only histologies without any pathological findings, whereas from an endometrial thickness of 10 mm upwards, only polyps, hyperplasias and carcinomas were found. In more than a third of our patients, the endometrial thickness was between 3 and 10 mm where the structure of the endometrium could reflect the possible histological finding: homogeneity, low echo and a sonographically depictable central echo between symmetrical endometrial leaves were an indication for absence of pathological findings, whereas heterogeneity and high echogenicity were pointers for pathological changes. In contrast to the sole measurement of endometrial thickness in the postmenopause, the combined metric and morphological parameters improve not only the predictability of pathological findings but, above all, the selectivity of the vaginosonographic assessment of the endometrium in postmenopausal women.
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Weigel M, Friese K, Melchert F. [The sonographic assessment of the female genitalia. Abdominal and vaginal sonography compared]. Dtsch Med Wochenschr 1995; 120:1047-50. [PMID: 7628317 DOI: 10.1055/s-2008-1055443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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