[Intraocular pressure and corneal thickness. A comparison between non-contact tonometry and applanation tonometry]. / Augeninnendruck und Hornhautdicke. Ein Vergleich zwischen Non-Contact-Tonometrie und Applanationstonometrie.

OBJECTIVE: Corneal thickness and deformation seem to have a considerable influence on intraocular pressure measurement. Due to differences in the corneal deformation in either non-contact tonometry or applanation tonometry, both methods should be compared in the same patient group depending on central corneal thickness. METHODS: In 106 eyes of 55 patients (18 males, 37 females, age 17-89 years, mean 63.3 years) with glaucoma and central corneal thickness between 409 and 644 microm (Orbscan II pachymetry) intraocular pressure was measured in each eye with non-contact tonometry (Reichert AT550) and 30 min later with Goldman applanation tonometry. RESULT: Non-contact tonometry as well as applanation tonometry showed a positive correlation between measured intraocular pressure and corneal thickness. The steepness of the line of regression was 0.33 mmHg per 10 microm of corneal thickness in non-contact tonometry and 0.17 mmHg per 10 microm of corneal thickness in applanation tonometry. CONCLUSION: Independently of the large differences in individual pressure measurements between non-contact tonometry and applanation tonometry, we found higher IOP values with non-contact tonometry in thicker corneas as compared with applanation tonometry. In thinner corneas there was a better correspondence between both methods. Thus, it seems very likely that corneal rigidity increases with corneal thickness.

Immunogenetic and serological investigations in nonpregnant and in pregnant women with a history of recurrent spontaneous abortions. German RSA/IVIG Study Group.

In the context of a controlled multicenter study on intravenous immunoglobulin (IVIG) treatment of patients with a history of unexplained recurrent spontaneous abortions (RSA), a number of controversial immunological parameters were evaluated prior to and during pregnancy with respect to their diagnostic and/or prognostic significance. A total of 390 serum samples from 52 patients were investigated. Sharing of 2 or more HLA (A, B, DR, DQ) antigens was significantly more frequent in RSA couples than in controls. The rate of cytotoxic or Fc-receptor (FcR)-blocking antibodies was not significantly lower in RSA patients than in individuals with normal pregnancies. Both tumor necrosis factor-alpha (TNF-alpha) levels and IgG anticardiolipin antibodies (IgG-ACA) were significantly increased in the patient group. While the occurrence of HLA sharing, cytotoxic/FcR-blocking antibodies and IgG-ACA did not correlate with the outcome of pregnancy, TNF-alpha levels were found to be significantly higher in patients with subsequent miscarriage than in those with successful pregnancy. IgG-ACA, if present, significantly decreased during the course of successful pregnancy but remained high in patients with subsequent abortion. It is concluded that the diagnostic and/or prognostic value of HLA sharing and cytotoxic/FcR-blocking antibodies has been overestimated while TNF-alpha and ACA levels are potential diagnostic markers and/or exhibit prognostic significance in subgroups of RSA patients.

[Fetal ascites in the ultrasound B image]. / Fetaler Aszites im Ultraschall-B-Bild.

Fetal ascites is a rare ultrasonic diagnosis. The prognostic consequence is not clear. The course of pregnancy with fetal ascites in three cases is represented and compared with literature. The reason of fetal ascites often cannot be determined in spite of extensive diagnostic action. Problems of abortion are discussed.

[Use of small neuroleptanalgesia sub partu]. / Zur Anwendung der kleinen Neuroleptanalgesie sub partu.

Application of 0.1 mg Fentanyl and 5 mg Droperidol iv. (obstetric neurolept-analgesia) causes an enduring pain relief. Labor is not influenced. The obstetric neuroleptanalgesia appears to accelerate labor indirectly. The condition of the fetus will be not affected by obstetric neuroleptanalgesia. In respect of this obstetric neuroleptanalgesia can be recommended as a method of analgesia during parturition.

[Pregnancy course, labor and puerperium in nephrectomized pregnant patients]. / Schwangerschaftsverlauf, Geburt und Wochenbett bei nephrektomierten Graviden.

The coincidence of pregnancy and situation after nephrectomy is rare. Pregnancy, delivery and puerperium of 28 patients with nephrectomy were analysed and compared statistically with a control group from 200 healthy pregnant women. Abortion rate, incidence of gestosis, perinatal mortality and frequency of premature deliveries are not increased. The pregnancy of women after nephrectomy should be controlled in a special prenatal care service. Delivery and puerperium do not need any increased medical expense.

[Anti-phospholipid antibodies in gynecology and obstetrics]. / Anti-Phospholipid-Antikörper in der Gynäkologie und Geburtshilfe.

Anti-phospholipid-antibodies are connected with many diseases. In gynecology and obstetrics they are related to habitual abortion, preeclampsia, intrauterine retardiation and thrombembolic events. Pathogenetic conceptions, the diagnosis, problems in contraceptions, pregnancies and puerperium are explained. Their search and an individual trial of therapy should be done in spite of unknown mechanism of effectiveness.

[Thanatophoric dwarfism]. / Thanatophorer Zwergwuchs.

The thanatophoric dwarfism is a relatively rare disease. The course of a pregnancy with this in every case lethal syndrome is demonstrated in one case. The possible ultrasonographic suspected diagnosis is discussed. If the diagnosis is certain termination of pregnancy is indicated.

[Sonographic studies of physiologic involution of the uterus in the puerperium]. / Sonographische Untersuchungen der physiologischen Involution des Uterus im Wochenbett.

141 sonographic investigations were performed in a group of 52 patients between the first and eighth day after normal delivery for supervision of physiologic involution of the uterus. There were examined position of the uterus, size of cervix and corpus and thickness of anterior and posterior uterine wall. The results were examined statistically concerning correlations to birth weight of the newborn.

[Cytogenetic study of peripheral lymphocyte culture in couples with habitual abortion]. / Zygogenetische Untersuchung von peripheren Lymphozytenkulturen bei Paaren mit habituellen Aborten.

We report on a cytogenetic investigation of lymphocytes in 241 couples and six women with at least three abortions. We found a balanced reciprocal translocation three times (1.2% of couples) and a balanced Robertsonian translocation twice (0.8% of couples). Four numerical aberrations of the gonosomes were detected (three of them as a mosaic), and one deletion Xq- as a mosaic. The heterochromatic region of the chromosomes 1, 9 or 16 was enlarged in 12 couples (4.9%). There was no couple with a pericentric inversion of the chromosomes 1 or 9. The enlarged Y-chromosome (five males) according to our results does not play any important role for the reproduction. Five translocations and one supernumerary chromosome each in one cell only indicate an enlarged frequency of breakage events in couples with habitual abortion.

[Immunologic aspects of habitual abortion and intrauterine fetal death]. / Immunologische Aspekte von habitueller Abortneigung und intrauterinem Fruchttod.

Habitual abortions and intrauterine death represent diagnostic and therapeutic problems in spite of application of near all diagnostic possibilities. The appearance of autoantibodies to nuclear and extractable nuclear antigens as well as occurrence of phospholipid-antibodies may be associated with negative course of pregnancy. Furthermore problems of autoantibodies to DNA, the role of HLA-system trophoblast antigens and other reasons will be explained. Treatment facilities are referred, too.

[Immunologic aspects of pregnancy]. / Immunologische Aspekte der Schwangerschaft.

Immunological studies of normal pregnancies as well as of recurrent spontaneous abortions serve as indicators that certain immune responses are linked to reproductive success or failure. Some of the observed often contradictory phenomena concerning intraspecies mammalian pregnancies will be discussed in this review.

[Diagnostic difficulties in immunologically-induced infertility]. / Diagnostische Schwierigkeiten bei immunologisch bedingter Infertilität.

This is a report on diagnostics in a patient who anamnestically had three abortions in her history. To look for in search of the cause we found a little submucosal uterine myoma which could not to be removed by curettement. Thus, a gynaecological laparotomy had to be carried out. Paraclinical examinations finally proved the lupus-anticoagulant-factor.

[Sonographically detectable changes in placental structures in pregnancy. 4. Statistical comparison of the frequency distribution of placental stages 0-3 in newborn infants in a pregnancy of 37-42 weeks duration]. / Sonographisch nachweisbare Veränderungen plazentarer Strukturen während der Schwangerschaft. 4. Mitteilung: Statistischer Vergleich der Häufigkeitsverteilung der Plazentastadien 0-3 bei Neugeborenen mit einer Schwangerschaftsdauer von 37-42 Wochen.

Among women with a duration of pregnancy between 37 and 42 gestational weeks procentual frequency, confidence intervals of O. Bunke, pounts of separability and areas of unsharpners were analysed. 1412 sonographical examinations were done in 645 pregnant women. Stage 0 was found statistically significant more frequent with error of probability alpha = 0.05 until the 30. week of pregnancy, stage 1 between the 21. and 36. week of pregnancy, stage 2 between the 33. and 36. gestational week and stage 3 in 37. and 38. week. Transformation (areas of unsharpness) from stage 0 to stage 1 occurs between the 24. and 32. gestational week, from stage 1 to stage 2 between the 31. and 34. week, from stage 2 to stage 3 between the 36. and 42. gestational week.

[Sonographically detectable changes in placental structures in pregnancy. 5. Statistical comparison of the frequency distribution of placental stages 0-3 in newborn infants in a pregnancy of less than 37 weeks duration]. / Sonographisch nachweisbare Veränderungen plazentarer Strukturen während der Schwangerschaft. 5. Mitteilung: Statistischer Vergleich der Häufigkeitsverteilung der Plazentastadien 0-3 bei Neugeborenen mit einer Schwangerschaftsdauer von weniger als 37 vollendeten Wochen.

The analysis of sonographically provable changes of placental structures in 97 pregnant women (202 examination) shows in cases with a duration of pregnancy less than 37 gestational weeks that stage 0 could be found statistically significant more frequent until the 32nd week of pregnancy, stage 1 in the whole pregnancy, stage 2 and 3 between the 29. and 36. gestational week. Stage 0 and 1 don't effect prematurity; however stages 2 and 3 could be proved before the 32nd or 34th week of pregnancy in 41 or 100% of examination respectively and effect a premature birth. Stage 2 could be proved 2,8 times more frequent and stage 3 4 times more frequent in premature babies than in newborns with a normal duration of pregnancy.

[Sonographically detectable changes in placental structures in pregnancy. 6. Effect of sonographic placental morphology on premature labor and intrauterine growth retardation]. / Sonographisch nachweisbare Veränderungen plazentarer Strukturen während der Schwangerschaft. 6. Mitteilung: Der Einfluss der sonographischen Plazentamorphologie auf Frühgeburtlichkeit und intrauterine Retardierung.

Influence of sonographically demonstrable changes of placental structure on prematurity and intrauterine retardation was analysed and concerning its statistical rehability in 807 gravids. While the stages 0 and 1 don't effect prematurity and intrauterine retardation, the stage 2 is accompanied premature infant of normal birthweight if proved before the 32nd week of pregnancy. If stage 3 appears before the 34. week of pregnancy we found in 30.6% a small for date newborn, in 64% a normal weight and in 80% a small for date premature newborn. In comparison with the normal weight newborn the difference is statistically significant with an error probability of alpha = 0.05.

[Sonographically detectable changes in placental structures in pregnancy. 2. Statistical comparison of the frequency distribution of placenta stages 0-3 newborn infants with a birth weight of 2,500-3,999 grams]. / Sonographisch nachweisbare Veränderungen plazentarer Strukturen während der Schwangerschaft. 2. Mitteilung: Statistischer Vergleich der Häufigkeitsverteilung der Plazentastadien 0-3 bei Neugeborenen mit einem Geburtsgewicht von 2 500-3 999 Gramm.

1200 examinations of sonographical demonstrable placental ripeness were done in 552 pregnant women. The frequency of stages 0 to 3 as compared with aid of O. Bunke's confidence intervals. Stage 0 were found frequently until the 30. week of pregnancy, stage 1 between the 21. and 36. gestational week, stage 2 between the 33. and 38. week of pregnancy and stage 3 between the 35. and 40. week. The comparison of the areas of unsharpness several stages possibly may give informations about the period of pregnancy when the stages coincide.

[Sonographically detectable changes in placental structures in pregnancy. 3. Statistical, comparison of the frequency distribution of placenta stages 0-3 in newborn infants with a birth weight of less than 2,500 grams]. / Sonographisch nachweisbare Veränderungen plazentarer Strukturen während der Schwangerschaft. 3. Mitteilung: Statistischer Vergleich der Häufigkeitsverteilung der Plazentastadien 0-3 bei Neugeborenen mit einem Geburtsgewicht von weniger als 2 500 Gramm.

The utilisation of sonographically provable changes of placental structures in 131 pregnant woman (277 examinations) shows in cases with newborn infants with a weight of birth under 2500 gram than the stage 0 is found significant frequent to the 32. week of pregnancy, the stage 1 to the 40. week of pregnancy, the stage 2 between the 29. and 40. week of pregnancy and the stage 3 between the 31. and 40. week of pregnancy. The stages 0, 1 and 2 influence in comparison with the newborn infants with a weight of birth between 2500 gram and 3999 gram not the weight in newborn infants under 2500 gram. The stage 3 will prove frequent in 13,5 times before the 34. week of pregnancy as in the comparison group with normal weight of birth.

[Retrospective immunohistologic search for metastases using monoclonal anti-cytokeratin antibodies in lymph nodes of patients with stage Ib-IIb cervix cancer dying within 5 years]. / Retrospektive immunohistologische Metastasensuche mittels monoklonalem Anti-Zytokeratin-Antikörper an Lymphknoten von Zervixkarzinompatientinnen der Stadien Ib-IIb, die innerhalb von 5 Jahren verstarben.

With immunohistological methods using monoclonal antibodies more metastases were detected in carcinomas today. We examined 10 women, where the carcinoma of the cervix was removed today in healthy and where the lymph nodes were free of metastases. With use of the monoclonal cytokeratin-antibody lu-5 it was not possible to improve the diagnostic. In a histomorphological differentiation of grade 2 or 3 a radiation should be considered.

[Prospective immunohistologic search for metastases using monoclonal anti-cytokeratin antibodies in gynecologic malignancies]. / Prospektive immunohistologische Metastasensuche mittels monoklonalem Antizytokeratin-Antikörper bei gynäkologischen Malignomen.

A higher prevalence of positive lymph node metastases can be found with immunohistological methods in comparison with conventional technique. We examined the lymph nodes from 20 patients with gynecological malignant tumors. We found in 304 lymph nodes with conventional technique 3.3% metastases. With immunohistological methods we showed in 9.9% of the lymph nodes metastases.

Elevated temperature differentially affects virulence, VirB protein accumulation, and T-pilus formation in different Agrobacterium tumefaciens and Agrobacterium vitis strains.

That gene transfer to plant cells is a temperature-sensitive process has been known for more than 50 years. Previous work indicated that this sensitivity results from the inability to assemble a functional T pilus required for T-DNA and protein transfer to recipient cells. The studies reported here extend these observations and more clearly define the molecular basis of this assembly and transfer defect. T-pilus assembly and virulence protein accumulation were monitored in Agrobacterium tumefaciens strain C58 at different temperatures ranging from 20 degrees C to growth-inhibitory 37 degrees C. Incubation at 28 degrees C but not at 26 degrees C strongly inhibited extracellular assembly of the major T-pilus component VirB2 as well as of pilus-associated protein VirB5, and the highest amounts of T pili were detected at 20 degrees C. Analysis of temperature effects on the cell-bound virulence machinery revealed three classes of virulence proteins. Whereas class I proteins (VirB2, VirB7, VirB9, and VirB10) were readily detected at 28 degrees C, class II proteins (VirB1, VirB4, VirB5, VirB6, VirB8, VirB11, VirD2, and VirE2) were only detected after cell growth below 26 degrees C. Significant levels of class III proteins (VirB3 and VirD4) were only detected at 20 degrees C and not at higher temperatures. Shift of virulence-induced agrobacteria from 20 to 28 or 37 degrees C had no immediate effect on cell-bound T pili or on stability of most virulence proteins. However, the temperature shift caused a rapid decrease in the amount of cell-bound VirB3 and VirD4, and VirB4 and VirB11 levels decreased next. To assess whether destabilization of virulence proteins constitutes a general phenomenon, levels of virulence proteins and of extracellular T pili were monitored in different A. tumefaciens and Agrobacterium vitis strains grown at 20 and 28 degrees C. Levels of many virulence proteins were strongly reduced at 28 degrees C compared to 20 degrees C, and T-pilus assembly did not occur in all strains except "temperature-resistant" Ach5 and Chry5. Virulence protein levels correlated well with bacterial virulence at elevated temperature, suggesting that degradation of a limited set of virulence proteins accounts for the temperature sensitivity of gene transfer to plants.