The role of prolactin in the menopause.

Within a study on menopausal discomforts, 2322 women were seen for the first time at the Outpatients Department for Climacteric Disturbances and Prophylaxis of Osteoporosis at our clinic. Amongst routine hormonal examination we measured prolactin levels. We found hyperprolactinemia in 23 women. Furthermore, in 224 women who initially had normal hPRL values, an estrogen-gestagen replacement therapy was administered and within this we found a significant increase of the prolactin levels (P < 0.005). The role of prolactin in the climacteric period as well as the mechanism of the estrogen effect upon prolactin secretion are subjects of discussion.

[Surgical treatment of recurrent stress incontinence: Burch versus lyodura sling operation--a prospective study]. / Zur operativen Behandlung der Rezidivstressinkontinenz: Burch-versus Lyoduraschlingenoperation--eine prospektive Studie.

This prospective randomised study involved 52 female patients suffering from recurrent stress urinary incontinence, objectively confirmed by means of clinical incontinence tests and urodynamic examinations. They alternatively underwent colposuspension according to Burch or suburethral sling procedure surgery. Urodynamic and sonographic examinations were carried out before and 2.5 years (i.e. within a range of 2-3) after surgery according to Burch or suburethral sling procedure. There was no significant difference between the two methods with respect to subjective and objective rate of cure, which amounted to 85% of the cases involving colposuspension and 88% of cases involving the suburethral sling procedure. Both methods resulted in a significant improvement of the depression quotient and a significant elevation of the internal urethral meatus (p < 0.05). Apart from an aggravation of urge symptoms in both groups, the patients with surgery according to Burch tended towards enterocele and rectocele in the medium range, whereas urination disorders had to be accepted in the patients operated on according to the sling procedure in the long term.

[Umbilical blood flow relations in pregnancy complications. Part 2. Pathologic index constellations]. / Umbilikale Strömungsverhältnisse bei Schwangerschaftskomplikationen. 2. Teil: Pathologische Indexkonstellationen.

In a study comprising a total of 700 pregnant women, umbilical resistance was examined. Measurements were taken at both sides of the cord. A decline in resistance was registered from the fetal abdominal wall to the placental insertion of the vessels. According to a collective of 500 patients with a normal development and outcome of their pregnancies a physiological constellation of the resistance indices could be confirmed. It was taken as a basis for the definition of pathological cases. Different pathologies were related quite clearly to a special (unphysiological) constellation of the indices.

[Umbilical blood flow relations in patients with gestosis-- gestosis-specific Doppler phenomenon]. / Umbilikale Strömungsverhältnisse bei Gestosepatientinnen--gestosecharakteristisches Dopplerphänomen.

A collective of 48 pregnant women, whose pregnancies showed signs of a pregnancy-induced hypertension or gestotic tendencies was examined by Doppler ultrasound. The subject of interest was the resistance along the umbilical cord. Measurements were taken both ends of the umbilical cords. Usually, a decline of the indices is seen, which makes the difference between the two ends (Delta F) turn out positive. Pregnancies with any sign of a gestotic development, showed elevated resistances at the placental end of the cord. The indices of the foetal abdominal insertion were just about the same. Delta F changed significantly in our group of patients. Here, the values of both sides either did not differ from one another or the placental indices even exceeded the foetal ones. We called this special constellation of umbilical indices a Doppler phenomenon characterising gestotic pregnancies.

[Umbilical blood flow indices in smoking women]. / Umbilikale Strömungsverhältnisse bei Raucherinnen.

A collective of 154 pregnant women, who smoked at least 5 cigarettes a day was examined by doppler ultrasound. Measurements were taken at the two ends of the umbilical cord. The results had been compared to the physiological constellation of the resistance indices. Elevation of the PI was mainly to be registrated at the fetal abdominal insertion of the umbilical vessels. It seems to be dependent on the duration and amount of smoking. There was no correlation to be found to the fetal outcome.

[Umbilical blood flow relations in different segments of the umbilical cord. Part 1. Physiologic index constellation]. / Umbilikale Strömungsverhältnisse an verschiedenen Abschnitten der Nabelschnur. 1. Teil: Physiologische Indexkonstellation.

Based on a collective of 500 women with normal singleton pregnancies we examined the indices of flow resistance along the umbilical cord. Measurements were taken at the foetal abdominal side of the Aa. umbilicales on the one hand and at the placental insertion of the vessels on the other. According to our results we were able to establish a physiological constellation of the indices for each week of gestation, and - subsequently - for the whole duration of pregnancy. These constellations could be considered physiological. They may serve as a basis for the definition of pathological conditions.

[Human papillomavirus (HPV) DNA infections of the uterine cervix]. / Humane Papillomavirus(HPV)-DNA-Infektionen an der Cervix uteri.

411 women who had dysplasia, selected from an ambulatory group as well as 240 women from a random control group were examined, by using cervical smears, which were initially diagnosed as human papilloma viruses-DNA (HPV-DNA) of the type 6/11, or 16/18, or 31/33/35. This was achieved by the in-situ nucleic acid hybridisation technique. The results of the HPV-DNA typing were tabulated with the cytological diagnosis (Munich Papanicolaou (Pap.) group-classification). The control group corresponding to Pap.Gr. I, and was HPV-DNA positive in 6 (2.5%) of the 240 cases. The group of 180 patients with a Pap.Gr. II showed a HPV-DNA positive result for 75 cases (41.7%); 57 of 99 cases (57.6%) occurred in Pap.Gr. IIID; 42 of 54 cases 77.8% (L) were found in Pap.Gr. IV (a/b), and 72 of 78 cases (92.3%) appeared in Pap.Gr. V. The HPV-DNA mixed infections became evident as the cellular dysplasia increased. The results of the HPV-DNA positive diagnosis clearly indicate a close correlation with the Pap.Gr.-classification. The HPV-DNA type 16/18 was most frequent in cervical carcinomas (Pap.Gr. V). The cyto-histological control of the 57 HPV-DNA positive cases of the untreated Pap.Gr. IIID showed a regression in 31.6% of the 18 cases after a period of 3 to 6 months (post HPV-DNA typing). These were histologically normal. In 33 cases (57.9%), there was a persisting Pap.Gr. IIID (CIN I/II) and in 6 cases (10.5%) a progredient correlation in Pap.Gr. IV a/b. The Pap. group IV (a/b) was histologically a CIN grade III.

[Restricted adenohyphophyseal function after neuroadenolysis for severe pain due to bony metastases.]. / Funktionseinschränkungen der adenohypophyse bei der neuroadenolyse zur behandlung schwerster schmerzzustände bei multiplen Knochenmetastasen.

Neuroadenolysis of the pituitary (NALP) is an efficient measure for treatment of severe pain in patients with bony metastases. It is especially recommended for primary carcinomas of the breast or prostate. The procedure, transsphenoidal puncture of the pituitary under radiographic control and instillation of up to 2 ml 95% alcohol, is simple. The pathomechanism of the analgesic effect is still unknown. Extensive determinations of the anterior pituitary hormones LH, FSH, HPRL, ACTH, and HGH were done before and up to 14 days after NALP in six consecutive patients receiving this treatment. The pituitary was stimulated with releasing hormones LHRH (100 mug) and TRH (200 mug) before and 3 days after NALP. Determinations of hormone parameters were done 25 and 60 min after injection. The results showed that hormone production by the adenohypophysis becomes unevenly suppressed. The following results are significant (P<0.05): (1) LH: poststimulation values are extremely suppressed; (2) FSH: basal values decrease; (3) ACTH: basal values decrease after the 6th day. The antalgic effect of NALP is independent of its hormonal consequences. NALP produces hormonal suppressions of various degrees, and is not a "chemical hypophysectomy".