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Rechtsmedizin.90090230.eng.abstr
|
Rechtsmedizin.90090230.eng.abstr
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"We report the case of a 58-year-old man in whom the diagnosis of an aortopulmonary window was not made until the age of 39 and present clinical and pathomorphogical findings of this rare congenital malformation . Due to fixed pulmonary hypertension and right-to-left shunting ( Eisenmengers reaction ) , surgical treatment was no longer possible . The lungs of the deceased showed secondary sclerosis of the pulmonary arteries in an extreme form and thrombosed aneurysms in both main trunks of the pulmonary artery . The other findings - bronchial carcinoma in association with asbestos-associated hyaline plaques of the pleura - indicate an occupational disease ( number 4104 ) . Due to the occupational disease the occurrence of death was presumably accelerated by at least 1 year ."
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Rechtsmedizin.90090234.eng.abstr
|
Rechtsmedizin.90090234.eng.abstr
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"type": "abstract",
"text": [
"Some interesting data from the last annual report of the Medical Examiner's Office ( San Francisco , California ) are presented : annual budget US $ 3.57 million , 1733 cases examined ( including 58% complete autopsies ) , 75 cases of homicide ( primarily by shooting ) , 111 suicides ( primarily by hanging ) . An interesting fact is that seven of the homicides were caused by a traffic accident . In the cases proven to have been caused by poisoning , the majority were committed by administration of morphine or cocaine ."
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[] |
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Rechtsmedizin.90100001.eng.abstr
|
Rechtsmedizin.90100001.eng.abstr
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"Malaria is one of the most common infectious diseases worldwide . Characteristic signs of malaria are special macroscopic and microscopic organ changes , which may also be seen in postmortem examinations . Modern diagnostic tools allow a fast and reliable diagnosis . The symptoms of malaria are rather unspecific , so the correct diagnosis may be difficult , especially if the doctor is not informed about the patient having been abroad . The cases presented also point out possible legal consequences of a missed diagnosis ."
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[] |
[] |
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Rechtsmedizin.90100007.eng.abstr
|
Rechtsmedizin.90100007.eng.abstr
|
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"id": "Rechtsmedizin.90100007.eng.abstr-passage-0",
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"The present study investigated the frequency and influencing factors of petechial bleeding ( PET ) in the conjunctivae and eyelids in different causes of death except strangulation . In a series of 473 autopsies the over all occurrence of PET was 13.3% . The highest frequencies were found in fire victims ( 31% ) , persons who had died after intensive care ( 24% ) , cardiac death ( 22% ) , drowning and intoxication ( 16% each ) . The frequency of PET decreased with increasing age and increased with the body mass . At first sight cardiopulmonary resuscitation ( CPR ) seemed to influence the occurrence of PET , because the rate was 11% without and 19% with CPR ( x2: p 0.05 ) ; an aspect which has been mentioned in the literature . However , further analysis showed that a higher rate of PET could only be observed in causes of death where PET are often fround irrespective of CPR , whereas in the other groups PET ( with or without CPR ) are uncommon . Furthermore , a case-by-case analysis showed that in several cases with PET after CPR the causes could clearly be attributed to conditions other than CPR . In a second series of autopsy cases with only cardiac deaths ( 181 cases ) , the influence of age and body mass on the rate of PET was statistically significant and there was a tendency for more frequent PET with increasing heart weight . On the other hand , no statistically significant influence of CPR on the rate of PET could be found in this relatively homogeneous group ."
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Rechtsmedizin.90100021.eng.abstr
|
Rechtsmedizin.90100021.eng.abstr
|
[
{
"id": "Rechtsmedizin.90100021.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Urine specimens were collected from 49 persons up to 10 days after abstaining from cannabis use . Urine samples ( n = 135 ) were investigated for free and conjugated 9-carboxy-11-nor tetrahydrocannabinol ( THCCOOH ) by LC/MS/MS and for free and glucuronidated tetrahydrocannabinol ( THC ) and 11-hydroxy-THC ( 11-OH-THC) by GC/MS prior to and after enzyme hydrolysis . Concentrations for free and conjugated THCCOOH were measured with reference to 100 mg creatinine/dL urine . Cannabis use was classified as light , moderate and heavy according to the current literature . In all groups chosen free and bound THCCOOH was present in urine samples on the day of the last use and on the next day . Urine samples from occasional and frequent users generally differed in the amount of THCCOOH and THCCOOH glucuronide . Within 4-6 days the concentrations of free and glucuronidated THCCOOH in urine samples of heavy users decreased to those ranges present in urine samples of moderate and light users . In frequent users , THC glucuronide and 11-OH-THC glucuronide could be found up to 1 and 3 days after abstinence , respectively . In light users , neither THC glucuronide nor 11-OH-THC glucuronide was detectable . The determination of conjugated THC and 11-OH-THC in addition to free and bound THCCOOH is suggested as an aid in assessing the frequency of cannabis use , but is limited to samples obtained within a few days after the last consumption ."
],
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[] |
[] |
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Rechtsmedizin.90100032.eng.abstr
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"The forensically relevant aspects of mummification were investigated in six fatalities from the years 1996-1998 . The deceased ( 6 males between 22 and 77 years ) had lived socially isolated . The postmortem interval was between 8 months and 5 years . On external examination the bodies showed - mostly combined - putrefaction , postmortem insect artifacts and different stages of decomposition , especially mummification ( so-called secondary mummification ) . The differentiation of certain organs by inspection with the naked eye was a problem to some extent . Histopathological examinations presented relevant findings for further elucidation of the cause of death . Immunhistochemical staining with myeloperoxidase revealed confluent bronchopneumonia in one case of 19 months postmortem interval . In a case of known chronic heroin consumption morphine was detected after a postmortem interval of 31 months . Apart from forensic pathology and toxicology aspects and criminal investigations , these fatalities are also noteworthy from the point of view of social medicine ."
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Rechtsmedizin.90100039.eng.abstr
|
Rechtsmedizin.90100039.eng.abstr
|
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"As a rare complication during and after transurethral resection of the prostate ( TURP ) , large quantities of irrigating fluid can be absorbed through periprostatic venous sinuses into the vascular compartment , causing cardiovascular and central nervous symptoms designated as the TUR-syndrome . Two cases with lethal outcome are reported with special emphasis on medicolegal aspects : 1 ) establishment of the causal relationship of postoperative complication and the occurrence of death and 2 ) consequences concerning the extent of explanation ."
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Reproduktionsmedizin.00160003.eng.abstr
|
Reproduktionsmedizin.00160003.eng.abstr
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"Sperm-autoantibodies in the male result mainly from violation of the epididymis or the ductus deferens . Our knowledge on the corresponding antigens is incomplete , but sperm antibodies may interfere with different sperm functions . The MAR test ( mixed-antiglobulin-reaction ) is the most suitable method of demonstrating the presence of sperm antibodies . Treatment with corticosteroids is questionable , as the aim of treatment should not be to treat sperm antibodies , but to treat the fertility problem . In order to achieve fertilization , the same techniques of reproductive medicine are applied as in any other cause of infertility . Today mainly in vitro fertilization ( IVF ) or intracytoplasmatic sperm injection ( ICSI ) is performed ."
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[] |
[] |
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Reproduktionsmedizin.00160008.eng.abstr
|
Reproduktionsmedizin.00160008.eng.abstr
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"Postmenopausal estrogen-replacement therapy maintains bone density as assessed by densitometry of skeletal sites relevant for future fracture . Optimal doses are 2 mg oral estradiol , 0.625 mg conjugated equine estrogens , 1.25 mg estrone and 50 µg transdermal estradiol . There is a role for calcium supplementation in individuals with non-optimal dietary intake of calcium . Observational studies suggest that estrogen replacement reduces the future risk for hip fracture by 25 % . Discontinuation of replacements is associated with an increase of fracture risk few years later . It is noteworthy that there is a lack of formal fracture studies providing data on the efficacy of estrogen replacement for primary prevention of osteoporosis and for secondary prevention in terms of treatment of women with established osteoporosis , with a diagnosis based on WHO criteria . Raloxifene , a selective estrogen receptor modulator , and tibolone , a synthetic steroid with weak estrogenic , progestogenic and androgenic properties , may constitute alternatives to estrogen-replacement therapy . Raloxifenen maintains bone density in and reduces vetebral fractures by some 50 % in women with prevalent osteoporosis ."
],
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Reproduktionsmedizin.00160020.eng.abstr
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Reproduktionsmedizin.00160028.eng.abstr
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Reproduktionsmedizin.00160028.eng.abstr
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Reproduktionsmedizin.00160037.eng.abstr
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"Technological advances in the last two years in mammalian nuclear transfer techniques and the establishment of human embryonic stem cell lines formed the background of the International Workshop on \" Embryonic Stem Cells and Nuclear Transfer Strategies \" organized at the Gene Center , Munich , September 1999. The aim of the meeting was to bring together scientists working in the stem cell field and those working on somatic nuclear transfer techniques to discuss the present status and prospects of both technologies for basic and applied research and future use in medicine and livestock breeding . \" Biology of Embryonic Stem Cells \" , \" Nuclear Transfer Strategies \" , and \" Stem Cell Differentiation - Cell Therapy \" were the main topics of the meeting . It became clear that we are far from understanding the processes involved in stem cell self-renewal and differentiation and the mechanisms resulting in reprogramming of nuclei from somatic cells after transfer into enucleated oocytes . However , data were presented that showed the enormous potential of the embryonic stem cell technology for tissue transplantation in the future . Before any use of this technology in combination with any cloning technology for human cell therapy will be possible , further research including animal models and stem cell differentiation approaches in culture ( i . e . , identification of differentiation factors , selective differentiation strategies , reporter gene assays ) is necessary to understand the basic principles of pluripotent stem cell differentiation and the mechanisms involved in reprogramming somatic cell nuclei ."
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Reproduktionsmedizin.00160043.eng.abstr
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Reproduktionsmedizin.00160043.eng.abstr
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"Until a few years ago an estimation of the genetic risk of mutagenic action on human germ cells had to be based on data obtained by practically performed mutagen research over decades . Detailed knowledge about the differing levels of mutagen sensitivity of the various stages of germ-cell development was also obtained based on experimental mammal studies . New technical developments in the last 10 years have allowed the first direct insights into mutagenic action on human germ cells . Moreover , the number of reports on the offspring of individuals exposed to strong mutagens has also increased , which is even more important for estimation of the genetic risks of mutagen exposure . They document in a highly convincing way the evident and efficient activity of modifying factors that drastically reduce the number and spectrum of the originally induced mutations . Because of these findings the risk estimation of genetic counseling of mutagen-exposed individuals can now have a more solid basis ."
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Reproduktionsmedizin.00160090.eng.abstr
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Reproduktionsmedizin.00160090.eng.abstr
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[
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"In the industrial Western world , 8 % of the population suffer from urogenital discomfort . Epidemiologic studies show that the incidence rises with age . In light of the steadily increasing longevity in the female population , clinically manifested irregularities such as urogenital atrophy , recurrent urinary tract infections , irritable bladder , and incontinence pose a challenge to the attending physician . To this day , urinary incontinence in later life is considered \" normal \" and \" caused by old age . \" However , among other age-related reasons , the main cause of this disorder is postmenopausal hormone deficiency . Thus , following thorough diagnostics , pathological changes in the urogenital tract can often be reduced or altogether eliminated by simple conservative measures such as topical hormone administration , which rapidly enhance patients ' quality of life . The present study gives an overview of the physiology of urogenital aging and the diagnostic and therapeutic means available to physicians to alleviate patients ' discomfort ."
],
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0,
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}
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[] |
[] |
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Reproduktionsmedizin.00160103.eng.abstr
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Reproduktionsmedizin.00160103.eng.abstr
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"Many new methods have been introduced in reproductive medicine in recent years , and some have already found their way into clinical routine . Cryopreservation of oocytes and in vitro maturation and culture of primordial follicles do not play a significant role in patient treatment . However , the short-term culture of oocytes before metaphase II does seem relevant . Blastocyst culture has mostly replaced coculture techniques and , given appropriate laws , provides adequate possibility of selecting embryos with high developmental and implantation potential . An exact pronuclear diagnosis also has a high ability to predict the probability of implantation . Viewing the latest data , assisted hatching seems to bring no improvements for most patients . Preimplantation diagnosis is being discussed in Germany due to new statements from ethical committees . Cytoplasma transfer , nuclear transfer , or the transplantation of spermatogenic cells into donors are currently only experimental ."
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[] |
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Reproduktionsmedizin.00160116.eng.abstr
|
Reproduktionsmedizin.00160116.eng.abstr
|
[
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"text": [
"Because of the permanency and finality of sterilization surgery , women or couples who are considering sterilization as a means of contraception should receive counseling before the operation . They should be informed individually and in detail about the psychosocial prerequisites for coping positively with the situation and they should receive sufficient time for making a balanced , free , and responsible decision ."
],
"offsets": [
[
0,
420
]
]
}
] |
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{
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}
] |
[] |
[] |
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Reproduktionsmedizin.00160129.eng.abstr
|
Reproduktionsmedizin.00160129.eng.abstr
|
[
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"text": [
"There is a need for improved infertility treatment modalities today . In vitro maturation with meiosis-activating sterols ( MAS ) , which were recently detected in the follicular fluid and in testis , represents such an opportunity . The data presented in this review may be summarised as follows : ..."
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[] |
[] |
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Reproduktionsmedizin.00160140.eng.abstr
|
Reproduktionsmedizin.00160140.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.00160140.eng.abstr-passage-0",
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"Besides an exponential growth in possibilities for diagnosis , treatment , and prevention in reproductive medicine and genetics , the synergistic effects of modern health technologies have led to the necessity of fast transfer of knowledge into the public domain in order to develop a common social consensus . Thus , physicians and scientists have enormous obligations not only for the development of medical technology but also of medical and societal ethics . Very early , i . e . in 1984 , the German Medical Association developed professional laws for reproductive medicine . In addition , the German government saw the need in 1990 for an \" Embryo Protection Law \" ( Embryonenschutzgesetz ) . Today , in the light of European integration , the medical profession's and state's obligations are challenged in different ways . Whereas the German Medical Association continuously works on professional guidelines for reproductive medicine and genetics - currently the case with preimplantation genetic diagnosis - the government must develop the sociolegal framework for ethically sound reproductive medicine , i . e . , in the areas of inheritance law , adoption law , family law , and law of succession , the latter especially in the case of discrepancies between genetic vs. social paternity in heterologous insemination ."
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Reproduktionsmedizin.00160147.eng.abstr
|
Reproduktionsmedizin.00160147.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.00160147.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In approximately 1 % of males with severe spermatogenesis disorders , the fertility problem can be understood as one of several aspects of a syndrome . It is important to diagnose such a constitutional disorder correctly , both for the practical clinical management of the patient and for genetic risk counseling . A syndrome should be suspected if an infertile or hypogonadal man presents with seemingly unrelated extragonadal malformations or dysmorphisms . A short description is given of those syndromes most likely to come to andrologists ' clinical attention : Aarskog syndrome , Bardet-Biedl syndrome , Boucher-Neuhaeuser syndrome , Kallmann syndrome , Kartagener syndrome , Noonan syndrome , myotonic dystrophy , MURCS in the male , X-linked spinobulbar muscular atrophy , polycystic kidney disease plus male infertility , and various disorders that cofeature limb and male genital system defects ."
],
"offsets": [
[
0,
906
]
]
}
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Reproduktionsmedizin.00160155.eng.abstr
|
Reproduktionsmedizin.00160155.eng.abstr
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[] |
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Reproduktionsmedizin.00160183.eng.abstr
|
Reproduktionsmedizin.00160183.eng.abstr
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[
{
"id": "Reproduktionsmedizin.00160183.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Human seminal plasma anaphylaxis has to be differentiated from allergic reactions to latex , spermicidal substances , local anesthetics or components of lubricants . In this review article , IgE-mediated ( type I ) allergic reactions against seminal plasma antigens are discussed . Corresponding symptoms have rarely been reported . However , it is likely that a significant number of cases remain unpublished or undiagnosed . Most patients are younger than 40 years . Human seminal plasma anaphylaxis is not always associated with female infertility . Symptoms start immediately or within 1 h after exposure to the ejaculate . Local reactions include itching , burning , erythema and edema of the perivaginal region or other areas that have been exposed to seminal plasma . Systemic reactions are dyspnea , dysphagia , rhinitis , conjunctivitis , urticaria , angioedema , gastrointestinal symptoms , anaphylaxic shock or exacerbation of atopic eczema . These complaints may become manifest during the first sexual intercourse . Available data imply that seminal plasma allergens are of prostatic origin and that prostate specific antigen is one of the clinically relevant components . The diagnostic procedure is based on medical history , evaluation of specific IgE antibodies in the serum of patients and skin tests . Patients are advised to avoid allergen contact by proper use of condoms . In occasional cases specific hyposensitization has been performed successfully ."
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Reproduktionsmedizin.00160208.eng.abstr
|
Reproduktionsmedizin.00160208.eng.abstr
|
[
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"The peptide hormone relaxin has long been associated with changes in the uterus and cervix related to the suppression of spontaneous contractions and the softening and widening of the birth canal . However , most of these results were obtained in animals such as the pig or the rat which have a pronounced systemic relaxin physiology with a maximum serum level in the third trimester of pregnancy . In women and monkeys circulating relaxin levels barely ever exceed a few percent of those in other species and have a maximum in early pregnancy . This early peak probably reflects a paracrine physiology in the ovary and uterus which is associated with ovulation and decidual changes in the endometrium preparatory to implantation . Relaxin also supports other local functions related to osmoregulation , heart rhythm and tonus , and angiogenesis . Furthermore , recent studies show that relaxin can remodel connective tissue in the skin and thus offers a potential therapy for scleroderma patients . Finally , recent gene cloning studies have revealed that there are other relaxin-related peptides which may also be involved in similar relaxin-like functions , for example in the male . Thus relaxin should be regarded less as a specific hormone of late pregnancy than as a broad-range growth factor specializing in tissue remodelling and reproduction ."
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Reproduktionsmedizin.00160265.eng.abstr
|
Reproduktionsmedizin.00160265.eng.abstr
|
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726
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[] |
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Reproduktionsmedizin.00160274.eng.abstr
|
Reproduktionsmedizin.00160274.eng.abstr
|
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"\" MicroSort \" promises to become a reliable method for preselecting the sex of our children . As so many innovations in the field of assisted reproductive technology , however , sex selection raises difficult moral and legal issues . In this paper , we focus on the question whether or not sex selection calls for a legal ban . Since it does not seem to imply any serious harm to others , we argue in favour of the legalization of sex selection ."
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446
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[] |
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Reproduktionsmedizin.00160279.eng.abstr
|
Reproduktionsmedizin.00160279.eng.abstr
|
[
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"Erectile failure after radical prostatectomy is a common postoperative disorder . However , nerve-sparing technique provides in about 50-60 % erections sufficient for sexual intercourse . Damage to the cavernous nerves or vascular injuries are responsible for erectile dysfunction . Alprostadil is most commonly used for self-injection monotherapy or in combination with other vasoactive drugs . Intraurethral administration of alprostadil failed to reproduce promising early results . The oral drug Sildenafil showed to be effective in patients with partial erections , however , it failed to work after non nerve-sparing radical prostatectomy . Negative pressure devices and penile prosthesis can be considered as alternative therpeutic options . Autologous N. suralis transplantation during radical prostatectomy might further improve erection rates in the near future ."
],
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[] |
[] |
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Reproduktionsmedizin.00160299.eng.abstr
|
Reproduktionsmedizin.00160299.eng.abstr
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[
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"All of the major features and functions that are required for sperm to fertilise an egg ( good motility , uniform morphology , ability to bind to the zona pellucida , capacity to undergo the acrosome reaction , capability of fusing with the vitellus , condensed chromatin , the ability to fertilise eggs in vivo and in vitro and the ability to support normal embryo development ) are acquired within the human epididymal canal . Many secreted epididymal glycoproteins have been identified that bind to particular sperm membrane domains and appear to be involved in facilitating sperm-ovum interaction . The ability of \" immature \" sperm from the proximal epididymis or germ cells from the testis to initiate embryo development as a result of artificial reproductive technologies depends on these procedures ' bypassing the major role of the epididymis , that of permitting survival and transport to and through the egg investments ."
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Reproduktionsmedizin.00160310.eng.abstr
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Reproduktionsmedizin.00160310.eng.abstr
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[
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"Estrogens induce a pleiotropy of relevant neuroprotective effects . They occur via actions on vascular factors , on the metabolism of toxic free radicals , on the cholinergic system and on growth factor systems . Beside this , estrogens affect neurocellular phosphorylation , antiapoptotic proteins and the metabolism of Alzheimer's disease-related proteins , partly mediated by their \" classical genomic receptors \" and partly by other mechanisms . The available clinical and epidemiological database however , reveals no relevant effects ( except for some verbal functions ) in already demented patients and on normal neuropsychological symptoms of ageing . Whether estrogen treatment in earlier periods ( e . g . perimenopause ) or the endogenous hormone production reduce the risk of dementia in later life , is not clear yet . Pathophysiological interactions of a variety of biological , psychological and social factors must be taken into account . The article defines questions to be solved ."
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"id": "Reproduktionsmedizin.00160310.eng.abstr-s7-r11-t2.1-t5.1",
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}
] |
Reproduktionsmedizin.00160319.eng.abstr
|
Reproduktionsmedizin.00160319.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.00160319.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In Germany about 1 million people are chronically infected with the hepatitis B or C virus and most of them are in the reproductive age . If a child is desired , liver function and moreover sexual and materno-fetal risk of transmission should be taken into consideration . Active vaccination can prevent sexual transmission of HBV and simultaneous passive vaccination strategies are able to inhibit consecutive infection of the newborn . Perinatal aquired chronic hepatitis B is typically asymptomatic and shows good short term prognosis . In men with chronic HBV infection transmission of the virus to the fetus by the infected sperm cannot fully be excluded . In HCV infection no successful vaccination strategies are available yet and preventing sexual transmission is based on condom use . Assisted reproduction techniques can reduce the risk of male to female transmission . HCV transmission to the newborn depends on maternal viral load . Perinatal aquired chronic hepatitis C shows a good prognosis . Prior to assisted reproduction antiviral treatment should be considered ."
],
"offsets": [
[
0,
1081
]
]
}
] |
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Reproduktionsmedizin.00160332.eng.abstr
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Reproduktionsmedizin.00160332.eng.abstr
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"The Federal Ministry of Health had organized a symposium on \" Reproductive Medicine in Germany \" which convened more than 600 participants in Berlin , from May 24th to 26th , 2000. The background for this conference is the unsolved political problem , whether it would be more suitable to reform the German Embryo Protection Act from January 1991 , or to create a new \" Reproductive Medicine Act \" covering the whole field of human reproductive biology research and therapy . The first of seven key questions of this symposium dealt with the fundamental problem of the biological , ethical , and legal status of the early human embryo before implantation . New developments in reproductive and embryonic sciences suggest discussions also in Germany , whether early embryos should be used for research and therapeutic purposes . Interestingly , since 1990 Great Britain has decided on a legal commission to control high ranking research and therapy use of human embryos , however , this committee always is governed by highly responsible laymen . Such committee decisions essentially need the definition of the status of a human embryo before implantation , as well in vivo as also in vitro . If the German society wants to discuss the definition of the status of a non-implanted embryo , it would be necessary to include all aspects of such status , embryonic life and developmental potency in vivo and in vitro . By all means , one must not avoid to refer to the German Abortion Law ( StGB § 218 ) , the definition of which , scientificly false , uses implantation as the beginning of pregnancy . The German constitution , however , asks to protect human dignity from the point of time when fertilization is finished . Consequently , we should demand equal criteria for assessment and legal protection of early human embryonic life in vivo as in vitro before implantation ."
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Reproduktionsmedizin.00160343.eng.abstr
|
Reproduktionsmedizin.00160343.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.00160343.eng.abstr-passage-0",
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"Polar body analysis is a perfect tool to exclude genetically altered oocytes prior to fertilisation . This helps to improve pregnancy rates and baby take home rates in assisted reproduction , primarily in advanced maternal age patients . This might reduce the need of invasive prenatal diagnosis for those patients . Polar body analysis offers treatment in reproductive medicine for female patients carrying a chromosomal aberration or a mutation before they become pregnant . However , it does not assess the genetic status of the embryo resulting from the oocyte tested and selected . The paternal contribution to the embryo is left unattended . Ethical considerations do not play a role , since no manipulation or selection is performed on embryos ."
],
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752
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]
}
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] |
[] |
[] |
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Reproduktionsmedizin.90150009.eng.abstr
|
Reproduktionsmedizin.90150009.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150009.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Causal treatment regimens of proven effectiveness in controlled studies are only available for cases of male infertility resulting from hypogonadotropic hypogonadism . Drug treatment of retrograde ejaculation is also effective but has so far not been tested in double-blind , placebo-controlled randomized studies . On the other hand , inconsistent results have been obtained with empirical therapy , e . g . with kallikrein , tamoxifen , clomiphene , pentoxifylline , mast cell blockers , testolactone , vitamin E , captopril , alpha receptor blockers , glutathione , indomethacin , interferon alpha , growth hormone , zinc salts , ketoprofen , mesterdone or testosterone undecanoate , are inconsistent , or the studies performed are not sufficient to allow a final judgement . Recent studies have indicated a possible impairment of sperm function by pure FSH , while GnrH and FSH have no influence on spermatogenesis in normogonadotropic men ."
],
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[
0,
945
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}
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Reproduktionsmedizin.90150029.eng.abstr
|
Reproduktionsmedizin.90150029.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150029.eng.abstr-passage-0",
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"text": [
"In the case of infertility the macroscopically and/or histologically confirmed diagnosis of endometriosis alone is not an indication for surgical or medical treatment of endometriosis . Treatment is necessary only when additional clinical symptoms of pain caused by the disease , active proliferative implants , severe mechanical disturbances of Fallopian tubes and ovaries , or deep infiltration endometriosis is judged as a relevant cause of sterility . The presence of implants alone - especially in mild or minimal stages - is probably an accidental finding with no correlation to the infertility problems . The therapeutic options are surgical - mainly endoscopic surgery - medical or a combination of both . Regression of the implants and shrinkage of the cysts can be achieved with medically induced ovarian suppression . Clinical trials have demonstrated that high doses of progestins , Danazol and GnRH agonists are effective . Because low differentiated types of endometriosis and deep infiltration nodules can only be influenced with permanent estrogen deprivation , an endoscopic surgical procedure - resection , coagulation or vaporisation of endometriotic tissue , plus resection of adhesions and fibrosis - is the main therapeutic principle . Because microscopic implants and deep infiltration foci surrounded by fibrosis can not be treated sufficiently with endoscopic surgery alone , an individual therapeutic strategy must be adopted in each case of endometriosis and infertility . Taking in account the age of the patient , the duration of infertility , and other factors we have to consider medical and/or surgical treatment of endometriosis ."
],
"offsets": [
[
0,
1663
]
]
}
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Reproduktionsmedizin.90150037.eng.abstr
|
Reproduktionsmedizin.90150037.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150037.eng.abstr-passage-0",
"type": "abstract",
"text": [
"First a survey is given about current research regarding psychosocial factors in infertility . The need for psychological counselling for infertile couples will be discussed as well as the available concepts of psychological counselling . The two-step counselling concept of the \" Heidelberg Fertility Consultation Service \" is presented . The main results of the counselling study are reported as well as the effects of infertility counselling from the patient's point of view . Psychological counselling in infertile couples should help the couple to cope with this critical life event and with the medical treatment ."
],
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}
] |
[] |
[] |
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Reproduktionsmedizin.90150045.eng.abstr
|
Reproduktionsmedizin.90150045.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150045.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The recent introduction of a 1.48-µm diode laser system has brought a new stimulus to the field of laser-assisted reproduction . This objective-delivered laser can be applied in a noncontact working mode with extreme precision using conventional microscope and culture systems . A major application is the fast and efficient opening of the zona pellucida . In the field of assisted hatching , the use of this laser has enhanced the pregnancy rates for certain patient groups . Further , laser-assisted opening of the zona pellucida facilitates the removal of polar bodies or blastomeres for preimplantation genetic diagnosis . The precise openings allow for the use of blunt-ended , flame-polished aspiration needles , which greatly reduces the risk of damage to the embryo or the biopsied cells . Further modes of application of the diode laser system are the immobilisation of spermatozoa and the cryopreservation of spermazoa in empty , cell-free zona pellucida . This makes the laser technique and especially the diode laser system a versatile tool , which will be soon an essential part of assisted reproduction techniques ."
],
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0,
1129
]
]
}
] |
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Reproduktionsmedizin.90150055.eng.abstr
|
Reproduktionsmedizin.90150055.eng.abstr
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"The genetic reasons for male infertility are still poorly understood . In approximately 30 % of infertile men no reason for their defect in spermatogenesis can be found ( idiopathic infertility ) . In a high percentage of these patients single gene defects are assumed to be responsible for the infertility . Well-known reasons for infertility are microdeletions on the long arm of the Y chromosome . In approximately 3-18 % of patients with azoospermia or severe oligospermia these deletions can be detected by using molecular techniques . In 4-6 % of infertile men chromosomal abnormalities are responsible for their andrological disorder . While numeric aberrations are widely observed in patients with azoospermia , alterations in chromosomal structure are prominent in patients with oligozoospermia . Chromosomal anomalies can be found only in rare cases of patients with structural or functional sperm defects . Up to now the genetic basis has only be described for a few functional or structural sperm defects ( immotile cilia syndrome , globozoospermia ) . More recently , it became possible to identify genes involved in spermatogenesis and to investigate their functions in male germ cell differentiation by using new tools of molecular biology , e . g . gene replacement techniques in the mouse . For the majority of these genes homologous human genes are known . However , the role of these genes in human spermatogenesis and their relevance for male fertility have still to be elucidated ."
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] |
Reproduktionsmedizin.90150065.eng.abstr
|
Reproduktionsmedizin.90150065.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150065.eng.abstr-passage-0",
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"text": [
"Preimplantation genetic diagnosis ( PGD ) helps to diagnose severe genetic diseases in vitro . Prenatal diagnosis can be done as early as the early cleavage stages . Only those diseases that mean a severe condition for the newborn child should be indications to perform a PGD cycle . The routine techniques of PGD , especially biopsy techniques , polymerase chain reaction , fluorescence in situ hybridization and modifications of these techniques are discussed in this article ."
],
"offsets": [
[
0,
479
]
]
}
] |
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] |
[] |
[] |
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Reproduktionsmedizin.90150087.eng.abstr
|
Reproduktionsmedizin.90150087.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150087.eng.abstr-passage-0",
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"text": [
"Potential environmental hazards should be carefully evaluated during clinical assessment of male fertility disorders . Apart from drugs or factors related to lifestyle such as alcohol and tobacco smoke , various environmental and occupational agents , both chemical and physical , may impair male reproductive functions . With regard to the complex development and regulation of the male reproductive system , different compartments and cell types have to be considered as possible targets . Disturbances of spermatogenesis can be routinely identified by detailed semen analysis . However , our knowledge of single exogenous factors and their mechanisms of action in humans is very limited , as extrapolation of results from experimental animal studies remains difficult . For the clinical andrologist , the assessment of relevant exposures to reproductive toxicants by taking detailed histories is still most important . In conjunction with epidemiological studies in occupational and environmental medicine , more data from both exposed and unexposed men have to be collected according to standardized protocols in order to identify or confirm potential reproductive hazards ."
],
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[
0,
1178
]
]
}
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Reproduktionsmedizin.90150096.eng.abstr
|
Reproduktionsmedizin.90150096.eng.abstr
|
[
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"Today , estrogen therapy of postmenopausal women is clinical routine . Hormone substitution in aging men , however , has only recently become a research topic . As a result , guidelines for general androgen substitution of aging men are still lacking and androgen substitution should be restricted to patients with documented testosterone deficiency , i . e . hypogonadism . The incidence of hypogonadism increases with advancing age . For substitution testosterone , as produced by the testes , should be the preferred molecule . Of the available injectable , oral and transdermal preparations transdermal systems have the advantage of mimicking the physiological serum testosterone levels . Prostate carcinoma is the most important reason not to start or to interrupt testosterone therapy . There is no scientific evidence to justify the use of testosterone precursors , e . g . dehydroepiandrosterone ( DHEA ) or metabolites , e . g . dihydrotestosterone or estrogens , for substitution in aging men ."
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1004
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[] |
[] |
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] |
Reproduktionsmedizin.90150108.eng.abstr
|
Reproduktionsmedizin.90150108.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150108.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In this review , empirical findings on the influence of stress on sperm parameter are presented . Although stress is not associated per se with an abnormal semen analysis , personal and situational factors may cause a decrease in sperm quality . The patient's subjective perception of stress represents an essential personal factor , whereas chronicity of stress represents a situational factor . At present , little is known about the endocrine mechanisms mediating the influence of stress on spermatogenesis . Additionally , it is not yet clear to what extent fertility is actually affected by stress-induced decrease of sperm quality . Irrespective of the effects of stress on the sperm parameters , there are other relevant behavioral effects of stress on fertility : patients infrequently seek professional help ; chances to conceive may be reduced due to sexual difficulties . Patients feeling highly distressed should be offered proven interventions to reduce stress ."
],
"offsets": [
[
0,
975
]
]
}
] |
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{
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[] |
[] |
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Reproduktionsmedizin.90150115.eng.abstr
|
Reproduktionsmedizin.90150115.eng.abstr
|
[
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"The cryopreservation of human ovarian tissue is essentially intended to maintain fertility and endocrinological function in female cancer patients and female patients at increased risk of early menopause . After having been frozen and subsequently thawed , the tissue can , ideally , be transplanted to its original site , where it leads to spontaneous fertilisation . Heterotopic transplantations are also discussed as autografts or xenotransplants in SCID mice . In addition to the use of whole tissue , the isolation of individual follicles and their in vitro maturation ( IVM ) are discussed . As in the case of heterotopic transplantation of ovarian tissue , pregnancy can only be achieved in these cases by in vitro fertilisation of the matured oocytes . Although considerable progress has already been made in both directions , these are still , at the present time , experimental processes that require further in-depth investigation prior to widespread clinical application . In addition to its use following the cryopreservation of ovarian tissue , IVM of immature oocytes also plays a significant role in promoting current methods of assisted reproduction . The successful maturation of immature oocytes could lead to improved assessment of the oocytes obtained by follicular puncture and to a reduction in the incidence and risk of ovarian stimulation . IVM is therefore expected to broaden the spectrum of individual treatment regimens as in the case of PCOS patients , for instance , increasing treatment efficacy by the additional acquisition of immature oocytes or by \" rescuing \" IVF cycles with unintentionally immature oocytes ."
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Reproduktionsmedizin.90150133.eng.abstr
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Reproduktionsmedizin.90150133.eng.abstr
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"During the past 15 years urologists have acquired a widespread knowledge on physiology and pathophysiology of male erectile dysfunction and consequent etiology-based therapies . The same period was characterized by a profound change of sexual behavior and public appearance of sexual issues . On the other hand the socio-demographic effects of prolonged life-span and reduced socio-economic resources for reimbursement of medical therapies become visible . Sexology of aging men is an interdisciplinary research field ; its scientific results should be included into therapeutic decisions in impotent patients . Especially in recognition of our new treatment options such as oral sildenafil , a partner- and libido-oriented sexual counseling should accompany somatic therapy in most of our elderly patients . There exists no general \" sexology of the aging male \" but rather an individual sexual behavior and self-understanding that is transported into senescence . \" Zeitgeist \" -phenomena , partner problems and age-dependent physiologic changes can coincide and potentiate the resulting sexual dysfunction . Modern therapeutic plans should recognize these facts and create behaviour- and partner-oriented counseling strategies combined with minimally invasive somatic approaches ."
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Reproduktionsmedizin.90150159.eng.abstr
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Reproduktionsmedizin.90150159.eng.abstr
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"The German embryo protection law prohibits any research on and with embryos if the embryo is not the immediate beneficiary . Accordingly , removal of pluripotent cells from an embryo is prohibited in Germany . The preparation of embryonic stem cells ( ES cells ) from blastocysts is carried out for reasons other than those aimed at preserving the embryo . Thus it is not compatible with the provisions of the embryo protection law . This is true also if the development of the embryo will not be impaired by the removal of some cells . Nuclear transfer into enucleated oocytes aimed at generating pluripotent stem cells is prohibited also because this technique might be employed to clone human beings . Preparation of pluripotent stem cells from tissues of prematurely aborted dead foetuses or aborted foetuses can be carried out legitimately in Germany . This type of cell or tissue preparation is subject to regulation by the General Medical Council Guidelines ( Richtlinien der Bundesaerztekammer ) for Usage of Foetal Cells and Foetal Tissues . The DFG ( Deutsche Forschungsgemeinschaft ) concludes that currently there is no need to alter the German legal status concerning research with human pluripotent stem cells . It is the view of the DFG that the process of shaping opinions concerning ethical and embryological questions in relationship with research on stem cells has only just begun in Germany and abroad . The DFG suggests that this opinion-shaping process should take place on a broad basis and will take part in it . At the same time the DFG will make efforts to work towards the development of uniform European standards in this matter which will include also a due assessment of existential values such as human dignity and health which are fundamental and guaranteed by the constitutional law . With respect to future research on and with human stem cells the DFG believes that under all circumstances measures must be taken to rule out that embryos , sperm cells or oocytes will be allowed to develop from human pluripotent stem cells . In addition , effective measures will have to be taken to prevent cloning of human beings or generation of human beings with artificially altered genetic information . As an appropriate way the DFG suggests the establishment of a central commission assessing research projects with stem cells on the basis of ethical , legal , and scientific point of views , and fulfilling the role also of a supervisory attendant body ."
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] |
[] |
[] |
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Reproduktionsmedizin.90150165.eng.abstr
|
Reproduktionsmedizin.90150165.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150165.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Artificial insemination from donor ( heterologous insemination ) is a rationally based treatment in complete male infertility . In this overview the enlarged knowledge on semen donors , the receiving couples and the development of the offspring will be summarized . Although motivation of men towards semen donation is predominantly based on financial expectancy , most of the donors agree to offer the offspring not-identifiable information on biological and social characteristics . Semen donation does not enhance the risk of consanguinity and of genetic diseases in the population . The decision to undergo heterologous insemination is a burden for the couples . Retrospectively , however , the majority state positive influences of the insemination on their partnership . The most important question is whether they should disclose the insemination to the children . The course of the pregnancy and the postnatal development of the children do not differ from those of children of natural procreation . They receive more love and care than \" usual \" children . Their rights concerning the insemination , however , are poorly considered . If we agree that the knowledge of genetic descent is part of human rights , non-disclosure of the donor insemination to the children raises severe ethical problems ."
],
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[
0,
1308
]
]
}
] |
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Reproduktionsmedizin.90150173.eng.abstr
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Reproduktionsmedizin.90150173.eng.abstr
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"The definition of endocrine disrupters is not very sharp . At present all non-physiologic substances which bind to steroid receptors , are defined as endocrine disrupters of which the best studied are estrogenic in nature . Many pesticides or insecticides or their metabolites have estrogenic activity and pollute our surface water . Here they may cause severe estrogenization of aquatic life . Only traces of these substances are demonstrable in drinking water . On the other hand , weak estrogens present in plastic ware may be ingested by men and therefore be potentially harmful for human health . On the other hand , many plants produce socalled'hyto-estrogens' , particularly soy products are rich in phyto-estrogens but their high consumption in Asian populations are most likely the reason for reduced occurrence of breast cancer . Many plant extracts used for human medication also contain phyto-estrogens and are beneficial in the treatment of climacteric complaints . Hence , not all endocrine disruptors must be harmful to human health , in fact , some of them ( clearly phyto-estrogens ) may have beneficial effects ."
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Reproduktionsmedizin.90150179.eng.abstr
|
Reproduktionsmedizin.90150179.eng.abstr
|
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],
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612
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}
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[] |
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Reproduktionsmedizin.90150186.eng.abstr
|
Reproduktionsmedizin.90150186.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150186.eng.abstr-passage-0",
"type": "abstract",
"text": [
"This is a report on a patient who was treated for years for sterility and eventually became pregnant although she did not want to have a child . Tracing the striking psychodynamics of this case , a strong plea is made for fertility treatment which takes the reasons behind the woman's wish to become pregnant into account rather than just blindly consenting to treat everyone who seeks medical help to conceive a child . Help is offered in identifying those patients who are especially at risk amongst the totality of patients labelled as \" longing for a child \" ."
],
"offsets": [
[
0,
564
]
]
}
] |
[
{
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29
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{
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],
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60,
69
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{
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"child"
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},
{
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"text": [
"fertility"
],
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222,
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{
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{
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{
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466
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{
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},
{
"id": "Reproduktionsmedizin.90150186.eng.abstr-s3-t2",
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"risk"
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{
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{
"id": "Reproduktionsmedizin.90150186.eng.abstr-s3-t4",
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[
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560
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0008059"
}
]
}
] |
[] |
[] |
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Reproduktionsmedizin.90150200.eng.abstr
|
Reproduktionsmedizin.90150200.eng.abstr
|
[
{
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"text": [
"Recurrent miscarriages are , like sporadically occurring miscarriage , often ( approx . 50 % ) due to chromosomal aberrations . An undefined proportion of the other half may be due to immunological incompliances . The basis for this assumption is the fact that the maternal immune system recognizes paternal antigens and rejects them . The initial hypothesis that such immune reaction is due to a high similarity between the maternal and paternal HLA systems ( HLA sharing ) is most likely incorrect . Nevertheless , the incomplete recognition of the fetus by the maternal immune system and the resulting insufficient protection is basis for the active immune therapy with partner or donor lymphocytes . Several placebo-controlled studies have been performed . Due to the small number of cases , results were not significant . A metaanalysis of all studies , however , proves significant effects of the active immune therapy . The risks of active immune therapy led to the development of passive immune therapy with immune globulins ( IVIG ) . This therapy , however , is relatively expensive and obviously no more successful than the active immune therapy . In a metaanalysis of all published results , IVIG was not significantly more effective than treatment with placebo . The indication for both forms of immune therapy is given after 3 or more consecutive abortions , after exclusion of other reasons for these abortions . It appears that only primary aborting patients are suitable for active immune therapy . Athough the concept of immune therapy is still under debate , alternative concepts are not available . Hence , new therapeutic approaches are also not available ."
],
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0,
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}
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[] |
[] |
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Reproduktionsmedizin.90150212.eng.abstr
|
Reproduktionsmedizin.90150212.eng.abstr
|
[
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"The medical treatment of erectile dysfunction includes the systemic ( oral , epidermal , intramuscular ) as well as the local ( intracavernosal , intraurethral ) application of pharma cological agents . Up to now only yohimbine , a well-known alpha-receptor blocking agent , and sildenafil , a newly introduced phosphodiesterase V inhibitor with predominant peripheral action , have been approved and listed in Germany . Other oral agents under investigation are trazodone and apomorphine ( central action ) as well as phentolamine ( peripheral action ) . For the small group of patients with an established testosterone deficit , the epidermal or intramuscular substitution of testosterone seems to be a reasonable alternative to other therapeutic options . For the local application of pharmacological agents , intracavernosal injection therapy and intraurethral application ( \" medicated urethral system for erection \" , MUSE ) are available . Currently , several promising pharmacological agents with different modes of action and routes of administration are under investigation . The ultimate goal of these basic and clinical research efforts is to develop a specific and \" tailored \" therapy for each individual patient . While the pharmacological therapy of erectile dysfunction will most likely continue to be the therapeutic standard for most patients , it will certainly be augmented by devices ( i . e . vacuum erection devices , \" functional electromyostimulation of the corpus cavernosum \" , FEMCC ) and surgical treatment options ( vascular and prosthetic surgery ) ."
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] |
Reproduktionsmedizin.90150231.eng.abstr
|
Reproduktionsmedizin.90150231.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150231.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Ejaculated spermatozoa and spermatogenic cells express - and -chains of 1- , 3- and 4-integrins as well as their ligands laminin and fibronectin . These adhesion molecules ( AM ) showed an extended intra- and interindividual variation and different patterns of location . The mRNA transcripts of the AM were detectable by nested polymerase chain reaction in the spermatozoa . The conclusion of a functional competence of the AM was supported by the correlation of the AM-expression on the spermatozoal surface after the acrosome reaction with three function tests : ( i ) the zona-free hamster oocyte penetration ( HOP ) test , ( ii ) the in vitro fertilization of human oocytes and ( iii ) the cell attachment assays . AM labelling was modified by progesterone , human follicular fluid , disintegration of the sperm plasma membrane in seminal plasma , and micro organisms . In contrast , the sperm cryopreservation did barely influence the labelling of spermatozoal AM ."
],
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[
0,
971
]
]
}
] |
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}
] |
[] |
[] |
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Reproduktionsmedizin.90150249.eng.abstr
|
Reproduktionsmedizin.90150249.eng.abstr
|
[
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"id": "Reproduktionsmedizin.90150249.eng.abstr-passage-0",
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"text": [
"German in vitro fertilisation ( IVF ) groups have been voluntarily participating in a national IVF register since 1982 and in 1997 seventy five centres sent their results to this register . Since 1998 participation has become mandatory . Prior to 1997 results could be forwarded as a written compilation or as D-base file , but since 1997 only computerised files have been used . The catalogue of items covers all aspects of IVF treatment which could be completed in a retrospective or prospective manner . Overall , 37 962 treatment cycles were reported to the German IVF register , 8387 of them being collected prospectively . While in the retrospective analysis pregnancy rate per transfer was calculated to be 24.4 % for IVF and 23.3 % for IVF with ICSI , these rates dropped to 18.5 % per transfer for both treatment modalities in the prospective data . Although a retrospective database of over 30.000 treatment cycles may provide interesting information , such as the fact that over 70 % of these treatments were performed according to the socalled long agonistic protocol , retrospective compilation of data will never lead to a reliable register , whether national or international . As with scientific studies , prospective database , capturing information from the beginning of egg stimulation is preferable . This should allow the register to become a reliable instrument for measurement of quality control ."
],
"offsets": [
[
0,
1420
]
]
}
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Reproduktionsmedizin.90150254.eng.abstr
|
Reproduktionsmedizin.90150254.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150254.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The simultaneous occurrence of a pregnancy after in-vitro-fertilisation ( IVF-ET ) and an active tuberculosis can have massive and life-threatening consequences . We are showing in our case-report the symptoms , diagnostic investigations and the therapy of a patient with exacerbated tuberculosis after an IVF-pregnancy . As a conclusion preventive measures should be taken ; varios options will be discussed ."
],
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[
0,
410
]
]
}
] |
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[] |
[] |
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Reproduktionsmedizin.90150258.eng.abstr
|
Reproduktionsmedizin.90150258.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150258.eng.abstr-passage-0",
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"It involves an understanding of the structure as well as of the philosophy of reproductive technologies . First , the experiences which people unwillingly childless make when undergoing technological interventions have to be taken into consideration . Second , the implications which reproductive technologies have on people concerned as well as on society are further important points to be considered by moral reasoning . It is essential to clarify the perspectives which we have on reproductive technologies as well as on \" natural \" reproduction . Points to consider in ethical debates should be : The constructed polarity and assumed contradiction between natural and artificial , our concepts of ( human ) nature and our anthropological assumptions which influence the reasoning about reproductive medicine , the technological imperative ( in terms of persuasiveness by the perfection of technologies ) by which is meant that we should do what we can do , the shifting in value-orientation with concentration on an intensive desire for a child influencing further decisions at the cost of considerations about the future wellbeing of the child to be . The possible splitting of parenthood as well as the tendencies of postponing parenthood to older ages are examples which require value research and moral examination of consequences of blind application of technologies without moral reasoning implications . Ethical counselling for people concerned and open debate in society about shared values and technologically implied problems should lead to transparency and responsible decision-making sometimes implying the setting of moral limitations ."
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Reproduktionsmedizin.90150268.eng.abstr
|
Reproduktionsmedizin.90150268.eng.abstr
|
[
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"The zona pellucida is surrounding the oocyte and the early developing embryo . It serves several functions , from ovulation until shortly before implantation . Initially it induces sperm-oocyte interaction , acrosom-reaction and prevents polyspermy . Later , it prevents disaggregation of the non-compacted blastomeres and the premature attachment to the oviductal and endometrial surface . Additional , it protects the embryo against toxins and antibiotics , as well as bacteria , viruses and phagocytes . As the embryo is covered by the zona pellucida until immediately before implantation , all signals of the embryo-maternal signalling have to pass the zona and are detectable within it . Logically we may define the zona pellucida as a mailbox of the embryo-maternal signalling . Oviductal , uterine and embryonic proteins are incorporated into the zona pellucida as embryonic development goes on and change the zona's morphological and biochemical properties . Whether a protein is able to penetrate the zona , whether it accumulates within the zona or whether it is rejected by the zona depends on its biochemical properties and can be predicted by its Van der Waals attraction and by either the hydro- or lipophily . New cognitions in the physiology of the zona pellucida might lead to new achievements of the in-vitro culture of embryos , and present new aspects how to prevent zona hardening . Furthermore , the knowledge of the zona proteins enables the development of immunocontraceptive-vaccines . Consequently , the zona pellucida is not only significant with regard to fertilisation , but also during early embryonic development . Investigations of the zona pellucida will yield new insights into early embryo-maternal signalling which in turn may lead to improvements of classic IVF and new approaches of in-vitro culture ."
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Reproduktionsmedizin.90150276.eng.abstr
|
Reproduktionsmedizin.90150276.eng.abstr
|
[
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"Risk assessment for fetal chromosomal disorders and open neural tube and ventral wall defects was carried out at the Institute of Human Genetics , University of Goettingen , between autumn 1989 and spring 1999. A total of 33 774 pregnancies were routinely examined . Individual risk calculation was based on maternal age related risks and on changes of the concentration of three serum markers ( human chorionic gonadotropin , alpha-fetoprotein , and unconjugated estriol ) . Our results confirm the findings of other prospective and retrospective studies concerning the effectiveness of such a biochemical screening . In the examined cohort 54 chromosomal disorders and 27 neural tube or ventral wall defects have been detected by the use of cut-offs that are generally accepted in Germany . In addition , many other fetal disorders and gestational anomalies , for instance intrauterine fetal death , hydrops fetalis and x-linked ichthyosis , have been detected because of atypical changes in serum-marker concentrations . We present our results and furthermore report on experiences that have led to reduction of systematic errors and to improvement of specificity ."
],
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0,
1168
]
]
}
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Reproduktionsmedizin.90150313.eng.abstr
|
Reproduktionsmedizin.90150313.eng.abstr
|
[
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"id": "Reproduktionsmedizin.90150313.eng.abstr-passage-0",
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"text": [
"Inhibin B , a dimeric glycoprotein , is formed in the Sertoli cells , which interact closely with the gonadal cells . Serum inhibin B concentrations are negatively correlated with the serum FSH concentrations and positively with sperm concentrations , testicular biopsy scores and testicular volumes . Inhibin B is the best known endocrine marker for spermatogenesis . This opens new perspectives for the diagnosis of fertility disturbances and especially for treatment modalities for male infertility ."
],
"offsets": [
[
0,
503
]
]
}
] |
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Reproduktionsmedizin.90150318.eng.abstr
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Reproduktionsmedizin.90150318.eng.abstr
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[
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"id": "Reproduktionsmedizin.90150318.eng.abstr-passage-0",
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"Progesterone antagonists ( antiprogestions ) can completely or partially inhibit progesterone effects at the receptor level . Accordingly , two types of antiprogestins , type I ( pure antagonists and type II ( partial agonists ) have been proposed . Compounds with absent or much reduced represent a special subgroup of type II antiprogestins . Their abortifacient activity is drastically reduced because of high partial progestagenic activity . Antiprogestins can modulate the function of progesterone receptors in a tissue-specific manner . Type II antiprogestins interact with co-repressors of transcription and can , therefore , exert inhibitory effects even in the presence of strong DNA binding of the PR-antiprogestin complex . On the other hand , type I antiprogestins prevent the binding of the PR-antiprogestin complex to DNA . The \" pure \" antiprogestins can be particularly useful for obstetrical indications such as cervical ripening and labor induction at term . Surprisingly pure antiprogestins induce high myometrial responsiveness to oxytocic stimuli but inhibit uterine PGF2 secretion . This may be the reason why a combination with prostaglandins for induction of labor is essential . \" Pure \" Type II antiprogestins and the mesoprogestins exhibit antiovulatory activities and inhibit endometrial proliferation in primates . Some compounds can even induce a complete atrophy of the endometrium in the presence of circulating estrogens . This effect , which mechanism remains unclear , is surprising . There are ongoing studies aimed to determine which antiprogestin type is particularly suitable for a bleeding-free estrogen replacement therapy or endometriosis treatment ."
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[] |
[] |
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},
{
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},
{
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},
{
"id": "Reproduktionsmedizin.90150318.eng.abstr-s10-r1-t1.1-t2.1",
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},
{
"id": "Reproduktionsmedizin.90150318.eng.abstr-s12-r1-t2.2-t1.1",
"type": "diagnoses",
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},
{
"id": "Reproduktionsmedizin.90150318.eng.abstr-s12-r2-t2.2-t1.1",
"type": "degree_of",
"arg1_id": "Reproduktionsmedizin.90150318.eng.abstr-s14-t2",
"arg2_id": "Reproduktionsmedizin.90150318.eng.abstr-s14-t1",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150318.eng.abstr-s12-r3-t2.1-t1.1",
"type": "location_of",
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"arg2_id": "Reproduktionsmedizin.90150318.eng.abstr-s14-t1",
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},
{
"id": "Reproduktionsmedizin.90150318.eng.abstr-s12-r6-t1.1-t2.2",
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},
{
"id": "Reproduktionsmedizin.90150318.eng.abstr-s12-r7-t1.1-t2.2",
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"arg2_id": "Reproduktionsmedizin.90150318.eng.abstr-s14-t2",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150318.eng.abstr-s12-r9-t2.2-t1.1",
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},
{
"id": "Reproduktionsmedizin.90150318.eng.abstr-s14-r1-t1.1-t2.1",
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},
{
"id": "Reproduktionsmedizin.90150318.eng.abstr-s14-r2-t1.1-t2.1",
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},
{
"id": "Reproduktionsmedizin.90150318.eng.abstr-s14-r3-t2.1-t1.1",
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"arg2_id": "Reproduktionsmedizin.90150318.eng.abstr-s14-t1",
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},
{
"id": "Reproduktionsmedizin.90150318.eng.abstr-s14-r4-t2.1-t4.1",
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"arg2_id": "Reproduktionsmedizin.90150318.eng.abstr-s14-t4",
"normalized": []
}
] |
Reproduktionsmedizin.90150336.eng.abstr
|
Reproduktionsmedizin.90150336.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Legal and moral considerations hinder the introduction of preimplantation genetic diagnosis ( PGD ) in Germany . This article presents and discusses the ethical arguments for and against PGD . In the autor's view neither the fact that PGD is not a well established technique nor the danger that single-cell-analysis may lead to misdiagnosis convincingly demonstrates that PGD is morally inacceptable . Inconsistencies in ethical positions which defend abortions but do not accept PGD are highlighted . The use of arguments dealing with the prediction of negative social consequences after establishing PGD is criticised . Extensive counselling prior to PGD should be implemented in order to help couples which want to use the new technique to make an autonomous decision ."
],
"offsets": [
[
0,
772
]
]
}
] |
[
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s1-t1",
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"text": [
"diagnosis"
],
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[
82,
91
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0011900"
},
{
"db_name": "UMLS",
"db_id": "C0348026"
}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"PGD"
],
"offsets": [
[
94,
97
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0033558"
}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"Germany"
],
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[
103,
110
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0017480"
}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"preimplantation genetic diagnosis"
],
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[
58,
91
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0086142"
}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"PGD"
],
"offsets": [
[
187,
190
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0033558"
}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"PGD"
],
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235,
238
]
],
"normalized": [
{
"db_name": "UMLS",
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]
},
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"type": "umlsterm",
"text": [
"technique"
],
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265,
274
]
],
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"db_name": "UMLS",
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}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"single-cell-analysis"
],
"offsets": [
[
295,
315
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0087136"
}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"single-cell-analysis"
],
"offsets": [
[
295,
315
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0007634"
}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"single-cell-analysis"
],
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[
295,
315
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002778"
}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s3-t6",
"type": "umlsterm",
"text": [
"PGD"
],
"offsets": [
[
372,
375
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0033558"
}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"abortions"
],
"offsets": [
[
452,
461
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0000786"
},
{
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]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"PGD"
],
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480,
483
]
],
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{
"db_name": "UMLS",
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}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"use"
],
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[
506,
509
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042153"
}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"PGD"
],
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[
602,
605
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0033558"
}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"PGD"
],
"offsets": [
[
653,
656
]
],
"normalized": [
{
"db_name": "UMLS",
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}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t2",
"type": "umlsterm",
"text": [
"couples"
],
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[
696,
703
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0010222"
}
]
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t3",
"type": "umlsterm",
"text": [
"technique"
],
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[
730,
739
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0025664"
}
]
}
] |
[] |
[] |
[
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s1-r1-t1.1-t1.2",
"type": "analyzes",
"arg1_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t1",
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},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s1-r2-t4.1-t1.2",
"type": "analyzes",
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"arg2_id": "Reproduktionsmedizin.90150336.eng.abstr-s4-t1",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s3-r1-t3.1-t5.1",
"type": "performs",
"arg1_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t3",
"arg2_id": "Reproduktionsmedizin.90150336.eng.abstr-s3-t5",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s3-r2-t2.1-t1.1",
"type": "produces",
"arg1_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t2",
"arg2_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s3-r3-t5.1-t1.1",
"type": "analyzes",
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"arg2_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s3-r4-t2.1-t5.1",
"type": "performs",
"arg1_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t2",
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"normalized": []
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s3-r5-t2.1-t5.1",
"type": "produces",
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},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s3-r6-t3.1-t2.1",
"type": "uses",
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"arg2_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t2",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s3-r7-t5.1-t1.1",
"type": "measures",
"arg1_id": "Reproduktionsmedizin.90150336.eng.abstr-s3-t5",
"arg2_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s4-r1-t1.2-t1.1",
"type": "associated_with",
"arg1_id": "Reproduktionsmedizin.90150336.eng.abstr-s4-t1",
"arg2_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s4-r2-t1.1-t1.2",
"type": "associated_with",
"arg1_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t1",
"arg2_id": "Reproduktionsmedizin.90150336.eng.abstr-s4-t1",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s4-r3-t2.1-t1.1",
"type": "affects",
"arg1_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t2",
"arg2_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150336.eng.abstr-s6-r1-t2.1-t3.1",
"type": "uses",
"arg1_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t2",
"arg2_id": "Reproduktionsmedizin.90150336.eng.abstr-s6-t3",
"normalized": []
}
] |
Reproduktionsmedizin.90150343.eng.abstr
|
Reproduktionsmedizin.90150343.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The prevalence of a premature ovarian failure ( POF ) is about 1 % of all fertile women . The etiology of the disease is heterogenic and in most cases unknown . Patients history and determination of serum FSH ( continously above 40 IE/l ) is important . Concomitant diseases such as autoimmune diseases or a galactosemia must be excluded . Fertility cannot be improved by suppression of serum FSH by means of GnRH-analogues or Danazol followed by a high dose stimulation with gonadotropins or a pretreatment with estrogens . The prognosis in view to a pregnancy is unfavourable and in the individual case not predictable . A long term hormone replacement therapy is absolutely required in view to the health of the women with POF . In patients treated with biphasic HRT regimen a spontanous pregnancy cannot be excluded ."
],
"offsets": [
[
0,
821
]
]
}
] |
[
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"prevalence"
],
"offsets": [
[
4,
14
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],
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"db_id": "C0220900"
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"db_name": "UMLS",
"db_id": "C0033105"
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]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"women"
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82,
87
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],
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"db_id": "C0043210"
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]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"premature ovarian failure"
],
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[
20,
45
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],
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"db_name": "UMLS",
"db_id": "C0085215"
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]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"etiology"
],
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94,
102
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"db_id": "C0015127"
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]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"disease"
],
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110,
117
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],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0012634"
}
]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"Patients"
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161,
169
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],
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"db_id": "C0030705"
}
]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"history"
],
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170,
177
]
],
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"db_name": "UMLS",
"db_id": "C0019664"
},
{
"db_name": "UMLS",
"db_id": "C0019665"
}
]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"determination"
],
"offsets": [
[
182,
195
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002778"
}
]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"FSH"
],
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[
205,
208
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],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0733758"
}
]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"diseases"
],
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266,
274
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],
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]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"diseases"
],
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294,
302
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],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0012634"
}
]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"galactosemia"
],
"offsets": [
[
308,
320
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0016952"
}
]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"Concomitant diseases"
],
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[
254,
274
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0243087"
}
]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"autoimmune diseases"
],
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[
283,
302
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0004364"
}
]
},
{
"id": "Reproduktionsmedizin.90150343.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"Fertility"
],
"offsets": [
[
340,
349
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[] |
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Reproduktionsmedizin.90150356.eng.abstr
|
Reproduktionsmedizin.90150356.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150356.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The human uterus is composed of the paramesonephric archimetra and the non-paramesonephric neometra . The archimetra consists of the glandular as well as stromal part of the endometrium and the subendometrial myometrium and meets several fundamental functions in the early process of reproduction such as providing the site of implantation , uterine directed sperm transport and high fundal implantation of the embryo by uterine peristalsis as well as inflammatory defence . The neometra is composed of the stratum vasculare and stratum supravasculare . Its main function is to provide the forces for expulsion of the fetus . Endometriosis is considered a disease of the archimetra in that it constitutes a non-obilgatory consequence of uterine adenomyosis or its early manuifestations . This view is supported by several lines of evidence . First : The eutopic endometrium shows alterations similar to those seen in endometriotic lesions that are not found in the endometrium of women free of disease . Second : Uteri of women with endometriosis display hyper- and dysperistalsis of which the extent does not correlate with the severity of the disease . This dysfunction results in a break down of rapid and sustained directed sperm transport and may explain sterility and subfertility in women with mild-to-moderate endometriosis . Third : In women with endometriosis there is a proliferative and infiltrative expansion of all elements of the archimetra into the outer myometrial layers . There is no correlation of the extent of the infiltrative expansion with the grade of endometriosis but with the age of the patients . In MR imaging these findings are similar or identical with those found in adenomyosis ."
],
"offsets": [
[
0,
1713
]
]
}
] |
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{
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"sperm"
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{
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"type": "umlsterm",
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{
"id": "Reproduktionsmedizin.90150356.eng.abstr-s2-t10",
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{
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Reproduktionsmedizin.90150372.eng.abstr
|
Reproduktionsmedizin.90150372.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150372.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Fluorescence-in-situ-hybridisation ( FISH ) on uncultured amniocytes could be established in routine prenatal diagnostics successfully . Frequently occurring numeric aberrations ( trisomies 13 , 18 , 21 and numeric gonosomal aneuploidies ) can now be detected within 24 h . More than 3300 amniotic fluid samples could be analysed with this method . Because the complete karyotype is not analysable by FISH it can not be considered as a stand alone test . It can only be performed in combination with conventional karyotyping ."
],
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0,
526
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}
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[] |
[] |
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Reproduktionsmedizin.90150378.eng.abstr
|
Reproduktionsmedizin.90150378.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150378.eng.abstr-passage-0",
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"Disorders of sexual function are a frequent sequel to the surgical treatment of tumors in men . Operations involving the abdominal cavity , the retroperitoneal space and the true pelvis can damage the nerve and blood supply of the sexual organs , and this may cause dysfunction of the mechanisms of erection and ejaculation . Since it is often a matter of sexually active patients at the reproductive stage of their lives , the prevention of these secondary effects of tumor therapy takes on a special significance . Impairment of the erection mechanism or disturbances of ejaculation may follow the operative , radiological or medical treatment of a variety of tumors . They are a frequent consequence of the treatment of carcinoma of the bladder , prostate , testes , colon or rectum , and are particularly to be feared after radical operations that can damage the integrity of the nerves and vessels of the pelvis and lumbar region , since these are necessary for the physiological function of the sex organs . Today , with a thorough understanding of the neuroanatomy and with modern surgical techniques , these effects are avoidable in a high percentage of cases . If , however , effective treatment of the neoplasm requires such a radical operation that damage to these nerve pathways cannot be avoided , the consequent reduction of the sexual activity and fertility of patients in this age group can seriously impair the quality of their lives . Even so , there are many therapeutic procedures available which make it possible to treat disturbances both of the erection mechanism and of ejaculation in almost all cases ."
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Reproduktionsmedizin.90150393.eng.abstr
|
Reproduktionsmedizin.90150393.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150393.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Reactive oxygen species ( ROS ) are produced physiologically in mitochondria during aerobic respiration while oxygen is reduced to water . In the ejaculate ROS are mainly generated by leukocytes , but can also be produced by the spermatozoa themselves . ROS are physiological signaling molecules and are involved in the regulation of spermatozoan functions such as capacitation and acrosome reaction . However , very high ROS levels , occurring for example during the \" oxidative burst \" of leukocytes , can impair these functions . Additionally high ROS concentrations can oxidize the lipids of the spermatozoa plasma membranes , which are prone to oxidation due to their high concentration of polyunsaturated fatty acids , thus impairing spermatozoan functions . Increased generation of ROS in the ejaculate could be associated with an increased DNA-oxidation rate , motility loss , decreased capacity for spermatozoa-oocyte fusion and infertility . The main source of ROS in the ejaculate is leukocytes . Several antioxidants protect against these damaging effects . They are located both within the cells and in the seminal plasma . Without seminal plasma spermatozoa are exposed to the ROS generated by leukocytes without adequate protection . This situation occurs in the context of inflammation of the testes or the epididymidis as well as during spermatozoa preparation in assisted reproduction programs . To prevent the damage of spermatozoa preparation procedures should be used where leukocytes are separated from spermatozoa while seminal plasma is still present , such as swim-up from semen , gradient centrifugation or glass-wool filtration . Some controlled studies have shown beneficial effects of systemic antioxidative therapy of male infertility . It remains open , however , as to which diagnostic test is best suited to detect patients with ROS-associated infertility and the optimal medicament and its dosage ."
],
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0,
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Reproduktionsmedizin.90150410.eng.abstr
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Reproduktionsmedizin.90150410.eng.abstr
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[
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"There are around 28,000 people of reproductive age and infected with HIV living in Germany at present . In recent years , modern antiretrovirus therapy has not only extended their life expectancy , but also restored to them aspects of life that were thought to be already lost . The desire for a child of one's own as the expression of a fulfilling relationship with one's partner can be one of these aspects , but the danger of infecting the healthy partner stands in the way of its realization . Procedures devised for assisted conception do offer a way out of this dilemma , but are sometimes not applied because practitioners have ethical or medical reservations or are worried about legal liability . While in the case of HIV-positive women this hesitation still seems justified , particularly as there is a real risk that a mother can transmit the virus to the fetus , HIV infection in the man has now become an indication for assisted reproduction techniques . Motile sperm can be separated from any HIV viruses contained in the ejaculate by a special preparation method . After testing by a highly sensitive detection technique they can be used for insemination , IVF or ICSI , so helping the healthy spouse to bear a healthy child ."
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},
{
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},
{
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},
{
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},
{
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},
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"id": "Reproduktionsmedizin.90150410.eng.abstr-s7-r5-t7.1-t1.1",
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"arg2_id": "Reproduktionsmedizin.90150410.eng.abstr-s7-t6",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150410.eng.abstr-s7-r7-t4.1-t1.1",
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"arg2_id": "Reproduktionsmedizin.90150410.eng.abstr-s7-t1",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150410.eng.abstr-s7-r8-t5.1-t1.1",
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{
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{
"id": "Reproduktionsmedizin.90150410.eng.abstr-s7-r13-t7.1-t4.1",
"type": "performs",
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"arg2_id": "Reproduktionsmedizin.90150410.eng.abstr-s7-t4",
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},
{
"id": "Reproduktionsmedizin.90150410.eng.abstr-s7-r14-t6.1-t1.1",
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"arg2_id": "Reproduktionsmedizin.90150410.eng.abstr-s7-t1",
"normalized": []
}
] |
Reproduktionsmedizin.90150419.eng.abstr
|
Reproduktionsmedizin.90150419.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In reproductive therapy , the quality of experience of involuntarily childless women and their partners takes second place . In the following article , the experiences in various areas of life ( partnership , family , profession , friends and acquaintances ) are described from the subjective view of the persons affected . Issues are the peculiarities of the female position in life and the reproductive function . Conflicts in different areas of life are described from the point of view of the persons affected . The diverse aspects of the unfulfilled wish for a child become clear and , above all , the emotional isolation of the persons affected . The permanent feeling of failure and insufficiency emerges ."
],
"offsets": [
[
0,
713
]
]
}
] |
[
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s1-t1",
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"therapy"
],
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[
16,
23
]
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},
{
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"db_id": "C0039798"
}
]
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s1-t2",
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"women"
],
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[
79,
84
]
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}
]
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"life"
],
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[
188,
192
]
],
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{
"db_name": "UMLS",
"db_id": "C0376558"
}
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{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"family"
],
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[
209,
215
]
],
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{
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"db_id": "C0015576"
}
]
},
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"id": "Reproduktionsmedizin.90150419.eng.abstr-s2-t3",
"type": "umlsterm",
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"profession"
],
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218,
228
]
],
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}
]
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"friends"
],
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[
231,
238
]
],
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{
"db_name": "UMLS",
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}
]
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{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s2-t5",
"type": "umlsterm",
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"persons"
],
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[
305,
312
]
],
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{
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}
]
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{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s3-t1",
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"text": [
"female"
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[
360,
366
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"db_id": "C0086287"
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}
]
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"life"
],
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[
379,
383
]
],
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{
"db_name": "UMLS",
"db_id": "C0376558"
}
]
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"function"
],
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[
405,
413
]
],
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{
"db_name": "UMLS",
"db_id": "C0031843"
}
]
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"Conflicts"
],
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[
416,
425
]
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"db_id": "C0009671"
}
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},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s4-t2",
"type": "umlsterm",
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"life"
],
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[
448,
452
]
],
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"db_name": "UMLS",
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}
]
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{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s4-t3",
"type": "umlsterm",
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"persons"
],
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[
497,
504
]
],
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}
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},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"child"
],
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[
566,
571
]
],
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{
"db_name": "UMLS",
"db_id": "C0008059"
}
]
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"isolation"
],
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[
617,
626
]
],
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{
"db_name": "UMLS",
"db_id": "C0220862"
}
]
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"persons"
],
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[
634,
641
]
],
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{
"db_name": "UMLS",
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}
]
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"feeling"
],
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[
667,
674
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0015749"
}
]
}
] |
[] |
[] |
[
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s2-r1-t4.1-t2.1",
"type": "interacts_with",
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"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s2-r2-t1.1-t3.1",
"type": "issue_in",
"arg1_id": "Reproduktionsmedizin.90150419.eng.abstr-s6-t1",
"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t3",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s2-r3-t2.1-t3.1",
"type": "issue_in",
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"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s2-r4-t4.1-t3.1",
"type": "issue_in",
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"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t3",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s2-r5-t2.1-t4.1",
"type": "interacts_with",
"arg1_id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t2",
"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s2-t4",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s3-r1-t1.1-t3.1",
"type": "measurement_of",
"arg1_id": "Reproduktionsmedizin.90150419.eng.abstr-s6-t1",
"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t3",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s3-r2-t3.1-t1.1",
"type": "affects",
"arg1_id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t3",
"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s3-r3-t1.2-t3.1",
"type": "measurement_of",
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"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t3",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s3-r4-t3.1-t1.2",
"type": "affects",
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"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s4-r1-t2.1-t1.1",
"type": "conceptually_related_to",
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"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s4-r2-t1.1-t2.1",
"type": "conceptually_related_to",
"arg1_id": "Reproduktionsmedizin.90150419.eng.abstr-s6-t1",
"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s4-r3-t3.1-t1.1",
"type": "performs",
"arg1_id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t3",
"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s6-t1",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s4-r4-t1.1-t3.1",
"type": "associated_with",
"arg1_id": "Reproduktionsmedizin.90150419.eng.abstr-s6-t1",
"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t3",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s5-r1-t1.1-t2.1",
"type": "interacts_with",
"arg1_id": "Reproduktionsmedizin.90150419.eng.abstr-s6-t1",
"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t2",
"normalized": []
},
{
"id": "Reproduktionsmedizin.90150419.eng.abstr-s5-r2-t2.1-t1.1",
"type": "interacts_with",
"arg1_id": "Reproduktionsmedizin.90150419.eng.abstr-s5-t2",
"arg2_id": "Reproduktionsmedizin.90150419.eng.abstr-s6-t1",
"normalized": []
}
] |
Reproduktionsmedizin.90150424.eng.abstr
|
Reproduktionsmedizin.90150424.eng.abstr
|
[
{
"id": "Reproduktionsmedizin.90150424.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Knowledge of the biology of progesterone and progesterone receptors has increased tremendously over the past decade . The range of progesterone receptor modulators , including agonists and full antagonists , has been extended . Thus , the great potential of medical uses , ranging from the treatment of specific diseases such as hormone-dependent cancer and endometriosis to post-menopausal hormone replacement therapy and to new methods in fertility regulation , has been made possible . Early research on progesterone receptor modulators focused on abortion , and this application received much attention by the media and pressure groups . This obscured the non-abortion uses , and both real and perceived barriers have slowed down the development of these agents . Given continuing research and development , it is very likely that progesterone receptor modulators will contribute significantly to improvements in the health of both women and men . Because of these beneficial effects on health , it is unethical not to continue to conduct scientifically sound medical research in this area . Physicians and scientists , including representatives of academia , organizations involved in medical research and the pharmaceutical industry , who attended the Symposium on Progesterone , Progestins and Antiprogestins in the Next Millennium held in Jerusalem , Israel , on 31 August to 3 September 1999 , are calling for continuing intensive research and development in the field of progesterone receptor modulators ."
],
"offsets": [
[
0,
1515
]
]
}
] |
[
{
"id": "Reproduktionsmedizin.90150424.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"Knowledge"
],
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[
0,
9
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0376554"
}
]
},
{
"id": "Reproduktionsmedizin.90150424.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"biology"
],
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[
17,
24
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0005532"
}
]
},
{
"id": "Reproduktionsmedizin.90150424.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"progesterone"
],
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[
28,
40
]
],
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{
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"db_id": "C0033308"
}
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},
{
"id": "Reproduktionsmedizin.90150424.eng.abstr-s1-t4",
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"progesterone"
],
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[
45,
57
]
],
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{
"db_name": "UMLS",
"db_id": "C0033308"
}
]
},
{
"id": "Reproduktionsmedizin.90150424.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"progesterone receptors"
],
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[
45,
67
]
],
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{
"db_name": "UMLS",
"db_id": "C0034833"
}
]
},
{
"id": "Reproduktionsmedizin.90150424.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"progesterone"
],
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[
131,
143
]
],
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{
"db_name": "UMLS",
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}
]
},
{
"id": "Reproduktionsmedizin.90150424.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"agonists"
],
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[
176,
184
]
],
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{
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}
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},
{
"id": "Reproduktionsmedizin.90150424.eng.abstr-s2-t3",
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"antagonists"
],
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194,
205
]
],
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{
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}
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},
{
"id": "Reproduktionsmedizin.90150424.eng.abstr-s2-t4",
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"progesterone receptor"
],
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131,
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Reproduktionsmedizin.90150428.eng.abstr
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Reproduktionsmedizin.90150428.eng.abstr
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"There is hardly any other discipline that illustrates the conflict between the freedom of science and research , that is to say , ultimately , what is medically possible , and human dignity and the protection of life or , in other words , what can be justified in ethical or legal terms , so clearly as reproduction medicine . The topics involved in this conflict cover a broad spectrum , ranging from in vitro fertilization with subsequent implantation of the embryo through the problems of multiple pregnancy and selective feticide , the many questions raised by assisted fertilization , and especially by anonymous sperm donation , and the controversial techniques of preimplantation diagnosis and cryopreservation , to the legal aspects of prenatal diagnosis , some of which have already been the subjects of cases decided in the supreme courts . In a good many of these sectors it is difficult to reconcile what doctors can do and what it is admissible for them to do , so that it is hardly surprising that there is often no general consensus . Against this backdrop objective discussion is all the more important , and the notes in this paper , which necessarily touch on only some of the matters at issue , are intended to stimulate such discussion ."
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Reproduktionsmedizin.90150435.eng.abstr
|
Reproduktionsmedizin.90150435.eng.abstr
|
[
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"Nowadays operative sperm retrieval in connection with assisted reproduction is a well-established procedure in urological-gynecological cooperative groups . Microsurgical epididymal sperm aspiration ( MESA ) and testicular sperm extraction ( TESE ) are the fundamental procedures in cases of non-reconstructable obstructive azoospermia or testicular azoospermia . As they are often favored percutaneous techniques such as percutaneous epididymal sperm aspiration ( PESA ) or percutaneous testicular sperm extraction ( PTESE ) , need to be in Anglo-American countries and the countries of northern Europe , discussed regarding their efficacy ( number of retrieved spermatozoa ) and possible testicular injury due to blind or ultrasound-guided puncture ."
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Strahlentherapie+Onkologie.01760009.eng.abstr
|
Strahlentherapie+Onkologie.01760009.eng.abstr
|
[
{
"id": "Strahlentherapie+Onkologie.01760009.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The treatment of persistent postoperative lymphatic fistulas or lymphoceles is often a problem . Approximately 2% of patients will develop lymphatic fistula after vascular surgery . This can require a long lasting conservative therapy . If spontaneous cure fails , a second operation with wound revision becomes necessary . We studied low-dose percutaneous radiotherapy to be used as an alternative treatment in addition to conservative or surgical therapy . Between 1989 and 1998 29 patients ( 25 with lymphatic fistulas , 4 with lymphoceles ) received radiation therapy . Depending on the depth of the fistula 27 patients were treated with electrons ( 7 to 18 MeV ) . Two other patients suffering of retroperitoneal lymphoceles received a treatment with photons ( 15 MV ) . In all patients the fractionation was 4- to 5 x 1.0 Gy/week and the dose ranged from 3 to 12 Gy depending upon the onset of the radiation therapy effect . In 27 of 28 evaluable patients a complete disappearance of the fistula or lymphocele was achieved by radiation during therapy or shortly afterwards . In 1 case no benefit was observed after a dose of 11 Gy . This patient required further surgery with wound exploration . Low dose percutaneous radiotherapy ( up to 10 to 12 Gy ) is effective to heal lymphatic fistulas and lymphoceles without complications . Individual dosage is required because doses even lower than 10 Gy may be effective . Radiation can be effective even after a failed conservative therapy or instead of surgery ."
],
"offsets": [
[
0,
1515
]
]
}
] |
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Strahlentherapie+Onkologie.01760016.eng.abstr
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Strahlentherapie+Onkologie.01760016.eng.abstr
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"How important and predicative are clinical parameters and locoregional failure after radical radiotherapy of oropharyngeal carcinomas for the probability of the occurrence of distant metastases ? From 1 August 1990 to 1 October 1998 , 139 patients with carcinomas of the oropharynx were treated in a prospective study by radical radiotherapy and evaluated in regard to the clinical parameters reflex-otalgia , predominant structure of tumor growth , T-category , presence of involved lymph nodes , and smoking and drinking habits . Twenty-nine patients received a concomitant chemotherapy . Twenty-five out of 139 patients had a planned neck dissection after completion of radiotherapy . Ten patients received a salvage operation . The median follow-up time was 24 months ( range , 4 to 74 ) . Two- and 5-year overall survival rates according to Kaplan Meier were 56.1 and 49.6% . The tumors were controlled in 77/139 patients ( 55% ) . The therapy failed in 62/139 patients ( 45% ) . Both groups , 62 patients with locoregional therapy failure and 77 patients with locoregionally controlled tumors , were comparable in regard to performance status ( Karnofsky index ) , age , gender , TNM-categories , histological differentiation , drinking habits , pretherapeutic diagnostics , total dose ( Gy ) , and number of simultaneous chemotherapy cycles . Locoregional tumor control was significantly determined by the parameters reflex-otalgia ( p 0.0078 ) , predominant growth pattern ( p 0.012 ) , T-category ( p 0.03 ) , and smoking ( p 0.0285 ) . The median survival time of patients with locoregional failure is 17 months . At this moment 81% of locoregionally controlled patients are still alive . In 14/62 patients ( 23% ) with locoregional failure , distant metastases were detectable against 4/77 ( 5% ) of locally controlled patients , p 0.0026. Probability of local control and distant metastases , predominantly pulmonary , reached a plateau after 24 months . Locoregional tumor control , determined by several clinical parameters , is an important parameter for the probability of the development of distant metastases . Failure of local therapy is caused by the biologic aggressiveness of the tumor ."
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Strahlentherapie+Onkologie.01760022.eng.abstr
|
Strahlentherapie+Onkologie.01760022.eng.abstr
|
[
{
"id": "Strahlentherapie+Onkologie.01760022.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In a retrospective study the role of radiation therapy for the treatment of primary tracheal carcinoma was investigated . Between 1984 and 1997 , 25 patients with primary tracheal carcinoma were treated with external beam radiotherapy ( 17 squamous-cell carcinoma [ SCC ] , 8 adenoid cystic carcinoma [ ACC ] , median dose SCC 60 Gy , ACC 55 Gy ) . An additional brachytherapy boost was carried out in 10/25 patients ( median dose SCC 18 Gy , ACC 15 Gy ) . Ten patients underwent operative treatment . The median survival ( Kaplan-Meier ) for patients with SCC was 33 months ( ACC 94.2 ) . The 1- , 2- and 5-year survival rates ( Kaplan-Meier ) for patients with SCC were 64.7% ( ACC 85.7% ) , 64.7% ( ACC 85.7% ) , and 26% ( ACC 85.7% ) . Patients with ACC and patients with a complete remission after treatment had a significantly better survival probability ( log rank test , p 0.05 ) . An excellent or good relief of clinical symptoms was achieved in 88% of the patients with SCC ( ACC 88% ) . Eleven patients were locally controlled at last follow-up ( SCC : 5/17 ; ACC : 6/8 ) . Grade 1 to 2 toxicity ( RTOG/EORTC ) occurred in 12% ( SCC : 2/17 , ACC : 1/8 ) and Grade 3 to 4 toxicity in 8% ( SCC : 0/17 , ACC : 2/8 ) of the patients . Persistent or progressive local disease caused complications in 5 patients ( fatal hemorrhage n = 2 , esophagotracheal fistula n = 2 , tracheal necrosis n = 1 ) . Radiation therapy is an effective treatment for primary tracheal neoplasms . Surgery followed by adjuvant radiotherapy and primary radiotherapy in inoperable cases represent potentially curative treatment options . Prospective multicenter studies are needed to determine the optimal radiotherapeutic approach ."
],
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Strahlentherapie+Onkologie.01760032.eng.abstr
|
Strahlentherapie+Onkologie.01760032.eng.abstr
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[
{
"id": "Strahlentherapie+Onkologie.01760032.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The effect of 3D radiotherapy planning ( 3D RTP ) in comparison to 2D radiotherapy planning ( 2D RTP ) was evaluated in an usually practiced treatment schedule ( starting by v. /d. opposing portals , continued with computer-planned portals ) for non-small-cell lung cancer . In 20 patients with locally advanced non-small-cell lung cancer the computer-planned part of the treatment schedule was calculated 2- and 3-dimensionally . Target volume were the primary tumor , the involved and the electively irradiated mediastinal lymph nodes . The results of the 2D RTP were recalculated 3-dimensionally and the mean doses to target volume and organs at risk were defined . Further the normal tissue complications were calculated . Under the prerequisite of 44 Gy maximally allowed to the spinal cord and a dose to the reference point of 50 Gy a small , but significant advantage with 2.1 gy to the target ( p = 0.004 ) and a reduction of 3.6 Gy to the heart ( p = 0.05 ) was achievable for 3D RTP . The dose to the lungs did not differ significantly ( 19.7 Gy for 2D RTP , 20.3 Gy for 3D RTP ) . The dose to the heart was not estimated critical by NTCP ( normal tissue complication probability ) . The NTCP for the ipsilateral lung was 16.1 and 18.7% for 2D RTP and 3D RTP , respectively . Regarding the simulator-planned ap/pa fields at the start of the radiotherapy the advantage of 3D RTP was further reduced but remained significant . Favorable with respect to the mean lung dose and the NTCP ( 18.7% ipsilateral lung for early onset of 3D planned radiotherapy vs 31.7% for late onset of 3D planned radiotherapy ) but not significantly measurable is the early start of the treatment by computerized RTP . The main advantage of 3D RTP in treatment of advanced lung cancer is the better coverage of the target volume . A reduction of the mean lung dose cannot be expected . A dose escalation by 3D RTP to target volumes as described here seems not to be possible because of unchanged high lung exposure ."
],
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0,
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Strahlentherapie+Onkologie.01760040.eng.abstr
|
Strahlentherapie+Onkologie.01760040.eng.abstr
|
[
{
"id": "Strahlentherapie+Onkologie.01760040.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The polymorphous low-grade adenocarcinoma of the nasopharynx is a rare disease . Polymorphous low-grade adenocarcinoma is a minor salivary gland neoplasm which occurs frequently in the mucosa of the soft and hard palates , in the buccal mucosa and in the upper lip . To date this entity has been identified within the oral cavity and only one case within the nasopharynx and some cases in the parotid gland . It has a slow infiltrating growing pattern with frequent perineural invasion and low metastatic potential . We report on a patient with non-papillary polymorphous low-grade adenocarcinoma in the nasopharynx which extended intracranially . The patient underwent primary radiotherapy . The CT showed partial response to radiotherapy and the patients is alive 51 months after the diagnosis his state being unchanged . The treatment for minor salivary gland tumor is primarily surgical . It is reported that the polymorphous low-grade adenocarcinoma has been known to have poor response to radiotherapy . However , we believe that in addition to its favorable biological behavior , the radiotherapy in this localization may result in longer survival ."
],
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0,
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}
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Strahlentherapie+Onkologie.01760105.eng.abstr
|
Strahlentherapie+Onkologie.01760105.eng.abstr
|
[
{
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"A prospective study was undertaken to evaluate the influence of pelvic irradiation techniques on the dose-volume histograms of organs at risk and to analyze its possible clinical relevance using radiobiological models . For 20 patients receiving postoperative pelvic irradiation because of rectal cancer a 3-field technique ( 3-FT ) , a 4-field technique ( 4-FT ) and an opposing field technique ( OFT ) were designed by a 3-D planning system ( Helax , TMS ) . Dose-volume histograms ( DVH ) of small bowel , urinary bladder and planning target volume ( PTV ) were analyzed . The normal tissue complication probability ( NTCP ) was determined by the radiobiological model of Lyman and Kutcher using the tolerance data of Emami . Median dose to the PTV did not differ between the 3 techniques ( 3-FT/4-FT/OFT: 99.2%/98.6%/98.1% of the prescribed dose ; p > 0.05 ) . Although the median dose to the urinary bladder was lower for the 3-FT than for the 4-FT ( 44.7% vs 60.3% ; p 0.001 ) , there was no difference in the calculated NTCP ( 0.0% vs 0.0% ; p > 0.05 ) . Using multiple field techniques both the dose to and the treated volume of the urinary bladder were significantly lower than using the OFT . As a consequence of this the late NTCP of the bladder was higher for the OFT ( 5.46% ) . Although the median dose of the small bowel was lower for the 3-FT than for the 4-FT ( 30.8% vs 54.4% ; p 0.005 ) , the fractional part of small bowel within the high-dose region ( 90% isodose ) was higher for the 3-FT ( 10.6% vs 8.2% ; p > 0.05 ) . Thus the calculated NTCP was higher for the 3-FT ( 0.79 vs 0.44 ) than for 4-FT . For the OFT the median dose to small bowel was 69.9% and the small bowel volume within the high-dose region was 57.8% resulting in a late NTCP of 9.36% ( OFT vs 3-FT/4-FT; p 0.05 ) . Using multiple field techniques both the dose to the organs of risk and the fractional part of risk organs within the high-dose region can be reduced significantly . As a consequence of this a lower NTCP was calculated for the 3-FT and the 4-FT than for the OFT . Using the biological model a small , but significant difference between a 3-FT and a 4-FT was demonstrated in favor to the 4-FT ."
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Strahlentherapie+Onkologie.01760112.eng.abstr
|
Strahlentherapie+Onkologie.01760112.eng.abstr
|
[
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"text": [
"This analysis was undertaken to review the outcome and toxicity of postoperative adjuvant therapy for Stage II and III rectal cancer . We reviewed 112 patients treated with radiotherapy ( 44 patients ) and radiochemotherapy ( 68 patients ) after potentially curative ( R0) surgery for rectal cancer ( UICC Stages II and III ) , between 1983 and 1994 at the University Clinic of Wuerzburg . Median radiation dose was 56 Gy ( range : 45 to 66 Gy ) . Chemotherapy consisted of 4 to 6 courses of 5-fluorouracil ( 5-FU ) ( 420 mg/m2/d) and leucovorin ( 200 mg/m2/d). Median follow-up was 37 months . The overall survival was 84% for patients with UICC Stage II and 45% for patients with UICC Stage III disease ( p = 0.0045 ) . There were no statistically significant differences between patients treated with radiochemotherapy vs radiotherapy in terms of 5-year survival ( 63% after radiochemotherapy vs 53% after radiotherapy , p = 0.16 ) , relapse-free survival ( 52% vs 50% ) and locoregional control ( 69% vs 67% ) . UICC Stage III disease was associated with high failure rates ( 40% pelvic recurrences and 53% distant metastases ) . There was a statistically significant difference in terms of the incidence of distant metastases between the 2 treatment modalities for patients with Stage III disease ( 49% 5-year probability for developing distant metastases after radiochemotherapy vs 66% after radiotherapy , p = 0.047 ) . In a multivariate analysis , the addition of chemotherapy , lymph node stage and grading were independent prognostic factors for survival . Severe late toxicity was documented in 5% of treated patients . Prognosis of patients with UICC Stage III rectal cancer remains poor after \" standard \" surgery followed by postoperative adjuvant treatment ( pelvic radiotherapy and bolus intravenous injection of 5-FU and leucovorin ) . Major efforts should be made in order to improve prognosis for these patients , including optimization of surgical treatment and systemic treatment . More effective multimodality treatment strategies should be investigated in prospective randomized trials ."
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[
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"To compare the conventional 2-D , the simulator-guided semi-3-D and the recently developed CT-guided 3-D brachytherapy treatment planning in the interstitial radiotherapy of breast cancer . In 103 patients with T1-2, N0-1 breast cancer the tumor bed was clipped during breast conserving surgery . Fifty-two of them received boost brachytherapy after 46 to 50 Gy teletherapy and 51 patients were treated with brachytherapy alone via flexible implant tubes . Single , double and triple plane implant was used in 6 , 89 and 8 cases , respectively . The dose of boost brachytherapy and sole brachytherapy prescribed to dose reference points was 3 times , 4.75 Gy and 7 times 5.2 Gy , respectively . The positions of dose reference points varied according to the level ( 2-D , semi-3-D and 3-D ) of treatment planning performed . The treatment planning was based on the 3-D reconstruction of the surgical clips , implant tubes and skin points . In all cases the implantations were planned with a semi-3-D technique aided by simulator . In 10 cases a recently developed CT-guided 3-D planning system was used . The semi-3-D and 3-D treatment plans were compared to hypothetical 2-D plans using dose-volume histograms and dose non-uniformity ratios . The values of mean central dose , mean skin dose , minimal clip dose , proportion of underdosaged clips and mean target surface dose were evaluated . The accuracy of tumor bed localization and the conformity of planning target volume and treated volume were also analyzed in each technique . With the help of conformal semi-3-D and 3-D brachytherapy planing we could define reference dose points , active source positions and dwell times individually . This technique decreased the mean skin dose with 22.2% and reduced the possibility of geographical miss . We could achieve the best conformity between the planning target volume and the treated volume with the CT-image based 3-D treatment planning , at the cost of worse dose homogeneity . The mean treated volume was reduced by 25.1% with semi-3-D planning , however , it was increased by 16.2% with 3-D planning , compared to the 2-D planning . The application of clips into the tumor bed and the conformal ( semi-3-D and 3-d ) planning help to avoid geographical miss . CT is suitable for 3-D brachytherapy planning . Better local control with less side effects might be achieved with these new techniques . Conformal 3-D brachytherapy calls for new treatment planning concepts , taking the irregular 3-D shape of the target volume into account . The routine clinical application of image-based 3-D brachytherapy is a real aim in the very close future ."
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Strahlentherapie+Onkologie.01760125.eng.abstr
|
Strahlentherapie+Onkologie.01760125.eng.abstr
|
[
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"Aim of our work was to evaluate the standards of treatment in elder women with breast cancer and their results of radiation therapy . In our hospital 218 breast cancer patients were treated in the years 1990 and 1991. Forty-three women were younger than 50 years of age ( group I ) , 92 between 50 and 64 years ( group II ) , 83 elder than 64 years ( group III ) . One hundred and forty-nine patients underwent mastectomy , 65 patients had conservative treatment ( Table 5 ) . Four patients were not operable . All of the patients were irradiated uniformly locoregionally with 50 Gy Co-60-photons, followed by a boost to the tumor bed with 10 Gy with 6- to 12-MeV electrons . Forty-four patients had an additional chemotherapy . The 5-year survival rate was 79.8% ( n = 174 ) , the disease free survival was 59.1% ( n = 129 ) ( Table 6 ) . The mean rate of local recurrence was 3.6% ( n = 8 ) , 4% after mastectomy ( n = 6 ) and 3% ( n = 2 ) with breast conservation . Age group specific 5-year survival rates were 72% ( I ) , 85.6% ( II ) and 77.1% ( III ) , respectively , disease free survival rates were 48.8% ( I ) , 65.2% ( II ) and 57.8% ( III ) , respectively . The rates of local recurrence were 9.3% ( I ) , 3.2% ( II ) and 1.2% ( III ) , respectively . Significant age group specific differences in surgical and radiotherapeutical treatment could not be found . The curative chance of treatment has to be used in every age . A treatment of elder patients below the actual valid standards of treatment is not justified ."
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Strahlentherapie+Onkologie.01760135.eng.abstr
|
Strahlentherapie+Onkologie.01760135.eng.abstr
|
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"Differential radiomodification induced by 2-deoxy-D-glucose ( 2-DG ) is proving to be a feasible modality for optimizing tumor radiotherapy . Our earlier work on Ehrlich ascites tumor cells has shown that pretreatment with hematoporphyrin derivatives increases the uptake and phosphorylation of 2-DG . Moreover , the alteration induced in bioenergetic profile was more drastic and less reversible . The promising combination of hematoporphyrin derivatives and 2-DG has been further evaluated in the Ehrlich ascites tumor bearing mice for determining the effects on radiotherapeutic response . Solid tumors ( average volume = 0.9 +/- 0.1 cm3) implanted in Swiss-albino strain \" A \" mice were focally irradiated ( 10 Gy ) using 60Co teletherapy . Drugs were administered intravenously . Tumor bioenergetics was assessed by 31P MR spectroscopy . The uptake and phosphorylation of 2-DG was observed to be increased following pretreatment with hematoporphyrin derivatives . Upon hematoporphyrin derivatives + 2-DG treatment followed by irridiation , the intracellular pH reduced and a remarkable increase in glycerophosphorylcholine and inorganic phosphate levels was observed . The present study demonstrates the potential of hematoporphyrin derivative pretreatment in increasing the bioavailability of 2-DG in a mice Ehrlich ascites tumor model . The finding may have interesting clinical implications in the form of increased manifestation of the radiation-induced damage in the case of use of these drugs as a potential adjuvant in radiotherapy of tumors ."
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Strahlentherapie+Onkologie.01760144.eng.abstr
|
Strahlentherapie+Onkologie.01760144.eng.abstr
|
[
{
"id": "Strahlentherapie+Onkologie.01760144.eng.abstr-passage-0",
"type": "abstract",
"text": [
"By means of 3 cases with infield soft tissue carcinomas after radiotherapy for breast cancer , symptoms and therapy are described . Consequences for treatment planning and patient's information before radiotherapy for breast cancer are discussed . Three of 1,025 patients with breast cancer irradiated from 1984 to 1997 suffered from infield secondary soft tissue sarcomas . The latency periods were 61 , 49 and 59 months . Two patients had been treated with breast-conserving therapy ( computerized planning , 50 Gy to reference point , 5 times 2 Gy/week , 5-MV photons ) , 1 patient received a local boost dose of 15 Gy ( 10-MeV electrons ( thoracic wall ) and 5-MV photons ( lymph node areas ) to 50 Gy , 5 times 2 Gy/week . No adjuvant chemotherapy was given . All sarcomas were very extensive , all patients died from local progression and/or distant failure after 17 , 13 and 12 months . The incidence of spontaneous sarcomas of the breast is about 0.06% , after operation and radiotherapy 0.09 to 0.45% . No correlations to radiotherapy technique and no risk factors were found . Radiation dose could play a role , but there are very sparse data about this . Secondary soft tissue sarcomas are very rare , but familiar complications of radiotherapy . Only early diagnosis leads to a chance for cure . Because of unclear correlations to the treatment parameters and rareness of this event , in our opinion no regular information to the patient receiving radiotherapy for breast cancer is mandatory ."
],
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[
0,
1505
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]
}
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"Radiobiological and physical examinations suggest clinical advantages of heavy ion irradiation . We report the result of 23 women and 22 men ( median age 48 years ) with skull base tumors irradiated with carbon ion beams at the Gesellschaft fuer Schwerionenforschung ( GSI ) , Darmstadt , from December 1997 until September 1999. The study included patients with chordomas ( 17 ) , chondrosarcomas ( 10 ) and other skull base tumors ( Table 1 ) . It is the first time that the intensity-controlled rasterscan-technique and the application of positron-emission tomography ( PET ) for quality assurance was used . All patients had computed tomography for three-dimensional-treatment planning ( Figure 1 ) . Patients with chordomas and chondrosarcomas underwent fractionated carbon ion irradiation in 20 consecutive days ( median total dose 60 GyE ) . Other histologies were treated with carbon ion boost of 15 to 18 GyE delivered to the macroscopeic tumor after fractionated stereotatic radiotherapy ( median total dose 63 GyE ) . Mean follow-up was 9 months . Irradiation was well tolerated by all patients . Partial tumor remission was seen in 7 patients ( 15,5% ) ( Figure 2 ) . One-year local control rate was 94% . One patient ( 2,2% ) deceased . No severe toxicity and no local recurrence within the treated volume were observed . Clinical effectiveness and technical feasibility of this modality could clearly be demonstrated in our study . To evaluate the clinical relevance of the different beam modalities studies with larger patient numbers are necessary . To continue our project a new heavy ion acclerator exclusively for clinical use is planed to be constructed in Heidelberg ."
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Strahlentherapie+Onkologie.01760217.eng.abstr
|
Strahlentherapie+Onkologie.01760217.eng.abstr
|
[
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"Highly conformal radiotherapy techniques require precise patient positioning . We report our first experience with a new cast system for fixation of the pelvis during stereotactically guided intensity modulated radiotherapy ( IMRT ) of the prostate with respect to positioning accuracy of the prostate . The immobilization device consists of a custom-made wrap-around body cast that extends from the abdomen to the thighs and a seperate head mask , both made from Scotchcast , and attaches to a frame for extracranial stereotaxy . Sixteen CT-studies ( > = 25 slices , thickness : 3 mm ) of 2 patients who were immobilized for IMRT of prostate tumors were evaluated with respect to set-up accuracy of bony structures and the prostate itself . CT-studies were performed immediately before or after a treatment fraction . Deviations of bony landmarks and anatomical landmarks inside the planning target volume were measured in all 3 dimensions . Mean patient movements of 0.15 +/- 0,3 mm ( latero-lateral ) , 0,9 +/- 1mm ( anterior-posterior ) , 1 +/- 1 mm ( transversal vectorial error ) and 3 mm slice thickness ( craniacaudal ) were recorded using bony landmarks and 0,9 +/- 0,9 mm ( latero-lateral ) , 1,8 +/- 1,5 mm ( anterior-posterior ) , 2,2 +/- 1,5 mm ( transversal vectorial error ) and 3 mm ( craniocaudal ) using the confines of , or landmarks within the prostate . Standard deviations of absolute positioning error as an often used metric for positioning accuracy ranged between 0,3 and 1,7 mm in the transversal plane . The worst case transversal vectorial deviation for the prostate was 4,4 mm . Figure 4 summarizes the set-up accuracy of bony landmarks and the prostate . The presented combination of a body cast and head mask system in a rigid stereotictic body frame ensures reliable noninvasive patient fixation for fractionated extrcranial stereotactic radiotherapy . It provides precise and reliable positioning of the prostate and meets the requirements for highly conformal radiotherapy such as IMRT . No further improvement of reprositioning can be achieved with external immobilization devices since the positioning error of the target relative to the skeleton exceeds the accuracy of the positioning of the skeleton itself ."
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Strahlentherapie+Onkologie.01760223.eng.abstr
|
Strahlentherapie+Onkologie.01760223.eng.abstr
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[
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"type": "abstract",
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"Since the skin dose becomes the limiting factor while deciding the tumorcidal dose , the detailed analysis of dose distribution in the build-up region is necessary for high-energy photon beams . In this study the beam characteriwstics affecting the build-up and skin dose for 6- and 18-MV photons are analyzed . Measurements were made with 6- and 18-MV photons using a PTW parallel-plate ionization chamber ( B23344-036) and a RDM-1F electrometer . Build-up ionization measurements were made with the chamber fitted into a 25 x 25 x 25 cm polystyrene phantom with a fixed SSD of 100 cm . The entrance and buildup dose measurements were made with a polycarbonate and a mesh type metallic shielding tray and a 45 ° wedge . Exit dose measurements were carried out for the graphite patient supporting assembly table top , 1.0 cm thick piece of wood and the 1.0 cm thick patient supporting perspex base frame for head and neck treatments . It was observed that the dmax decreased slightly with field size as with other accelerators . For both photon energies the surface dose was observed to increase with increase in field size . It was also noticed that the dose in the build-up region increases slightly when the polycarbonate secondary blocking tray is introduced with the increase in surface dose . The data show that the tray pertubation factor ( TPF ) at surface decreases steadily with tray-surface distance for both photon beams for all field sizes . It was noted that the TPF was more when the polycarbonate tray was introduced at shorter tray-surface distances for both energies . At tray-surface distances above 60 cm the TPF almost remained close to unity for 6-MV photons for all field sizes , whereas the continuous decrease in TPF could be noted for 18-MV photon beams even after the TPF rewached unity . The increase in surface dose with field size for both photon energies is due to the electron scattering from the intervening materials . The use of wedge filters absorbs low-energy scattered electrons siginificantly and hence , the relative surface dose ( RSD ) is always less than unity . The increase in dose enhancement percentage with graphite compared to perspex supporting assembly indicates that the electron backscatter is proportional to the atomic number of the medium ."
],
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[
0,
2296
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}
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] |
[] |
[] |
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Strahlentherapie+Onkologie.01760229.eng.abstr
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Strahlentherapie+Onkologie.01760229.eng.abstr
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"This paper briefly summarizes the research on this topic , undertaken in the Department of Cancer genetics , Paterson Institute for Cancer Research , Manchester , England , over the previous 6 years . Patients with the recessively-inherited disease , ataxia-telangiectasia ( A-T ) , who are cancer-prone and suffer severe reactions after radiotherapy , also have highly radiosensitive cells , particularly when chromosome damage is used as the measure of radiosensitivity . Enhanced chromosomal radiosensitivity is also a feature of many other cancer-prone disorders . We have investigated the possible role of such radiosensitivity as a marker of cancer predisposition and response to radiotherapy in the general population . We found that 42% ( 57/135 ) of breast cancer patients exhibit chromosomal radiosensitivity when lymphocytes are irradiated in the G2 phase of the cell cycle , compared with 6% ( 6/105 ) of healthy controls ( Figure 1 ) . These figures are much higher than the estimated frequencies of carriers of the ataxia-telangiectasia gene ( heterozygotes ) amongst breast cancer patients ( 5% ) and controls ( 0.5% ) . We have also obtained evidence of heritability of G2 sensitivity by studying relatives of breast cancer cases ( Figures 2 and 3 ) . The pattern of inheritance is relatively simple and attributable to 1 or 2 genes segregating in each family ( Figure 4 ) . In a prospective study of 123 breast cancer patients , 9 ( 7% ) had severe acute reactions to radiotherapy and their mean G2 sensitivity was significantly greater ( p = 0.001 ) than that of the remaining patients ( Figure 5 ) . In 16 patients with adverse acute reactions we found no mutations of the ataxia-telangiectasia gene ( ATM ) . Using another chromosomal assay ( micronucleus induction in G0 lymphocytes ) we found that the mean radiosensitivity of patients with severe late reactions was higher than that of normal reactors . For example , 8 patients with severe fibrosis were more sensitive ( p = 0.055 ) than 39 patients with a normal response ( Figure 6 ) . However , the discriminatory power of these chromosomal assays is too low for them to be used alone in a clinical setting . Our results provide good evidence that genes other than ATM , that confer chromosomal radiosensitivity , are involved in low penetrance predisposition to breast cancer in a high proportion of cases and contribute to adverse reactions after radiotherapy ."
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Strahlentherapie+Onkologie.01760251.eng.abstr
|
Strahlentherapie+Onkologie.01760251.eng.abstr
|
[
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"text": [
"For more than 20 years , after establishing the role of postoperative radiotherapy for malignant astrocytomas , no definitive improvement in survival rates could be observed , despite advances in established treatment modalities such as radiotherapy and chemotherapy . This review discusses available laboratory and clinical data as well as recent advances in our knowledge about prognostic factors ( Table 1 ) and their implications for the design of future clinical trials . Elucidation of the biology of malignant astrocytomas allowed for development of rational new approaches , such as gene therapy and immunotherapy , which could interfere with established treatment regimens or being used independently . Possible strategies include the restoration of defective cancer-inhibitory genes , cell transduction or transfection with antisense DNA corresponding to genes coding for growth factors and their receptors , or with the so-called suicide genes . Several antiangiogenic approaches such as administration of thalidomide , protamine , or monoclonal antibodies against vascular endothelial growth factor have been developed , too . Further treatment possibilities include modulation of drug resistance , e.g. by P-glycoprotein antagonists or O6-alkyl-guanine-DNA-transferase inhibitors , inhibition of matrix metalloproteinases , inhibition of protein kinase C , and administration of agents such as phenylbutyrate or valproic acid that showed promising antiproliferative effects in vitro . Several rational new approaches are now entering clinical trials ( Table 2 ) . In the light of limited survival after standard treatment it is recommended that patients should be offered participation in such trials ."
],
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0,
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}
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Strahlentherapie+Onkologie.01760259.eng.abstr
|
Strahlentherapie+Onkologie.01760259.eng.abstr
|
[
{
"id": "Strahlentherapie+Onkologie.01760259.eng.abstr-passage-0",
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"text": [
"To assess treatment outcome and prognostic factors following postoperative external radiotherapy in 77 patients with low-grade glioma . Between 1977 and 1996 , 45 patients with astrocytoma , 14 with oligodendroglioma and 18 with mixed glioma received postoperative radiotherapy with a median total dose of 52 Gy ( range , 45 to 61 Gy ) . Sixty-seven patients were treated immediately following surgery , 10 patients with tumor progression . The influence of various factors including histology , gender , age , seizures , duration of symptoms ( = 6 weeks vs > 6 weeks ) , CT pattern ( enhancement vs no enhancement ) , type of surgery , total radiotherapy dose and timing of radiotherapy on relapse-free survival and overall survival was investigated . The median overall survival time was 81 month , the 5- and 10-year survival rates were 54% and 31% , respectively . The median time to progression was 56 months , while the 5- and 10-year progression-free survival rates were 45% and 24% . Univariate analyses identified the total radiotherapy dose ( p = 0.01 ) , duration of symptoms ( p = 0.05 ) , the presence of seizures ( p = 0.04 ) , and the CT pattern following intravenous contrast ( p = 0.005 ) as significant prognostic factors for overall survival . Progression-free survival rates were influenced by the total dose ( p = 0.04 ) , the duration of symptoms ( p = 0.01 ) and CT pattern ( p = 0.006 ) . On multivariate analysis , only the CT pattern ( enhancement vs no enhancement ) remained as independent prognostic factors for both progression-free survival and overall survival . A minimum total dose of 52 Gy is recommended for the postoperative radiotherapy in low-grade glioma . Tumors with CT enhancement seem to need further intensification of treatment ."
],
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[
0,
1775
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]
}
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Strahlentherapie+Onkologie.01760265.eng.abstr
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Strahlentherapie+Onkologie.01760265.eng.abstr
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[
{
"id": "Strahlentherapie+Onkologie.01760265.eng.abstr-passage-0",
"type": "abstract",
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"Ductal pancreatic carcinoma ranks third among malignancies of the gastrointestinal tract and its incidence is rising . Today , patients with this disease still have fatal prognosis necessitating efforts towards more effective treatment . This report provides a review of adjuvant and neoadjuvant radiotherapy in pancreatic carcinoma without distant metastasis . Particular respect is given to prospective , randomized trials . They are analyzed according to clinical staging : 1. In resectable tumors adjuvant , neoadjuvant or intraoperative radiotherapy is performed . 2. Radiotherapy in neoadjuvant intention is an approach for downstaging to achieve resectability in initially irresectable tumors . The widespread use of new techniques such as supervoltage irradiation , computer based 3-D-planning, interventional therapy and combination of different therapeutic modalities induced a great number of studies . When concomitant chemotherapy was added to radiotherapy , results became significantly better compared to exclusive radiotherapy . It is shown that patients with operable tumors will have better survival rates and lower risk of relapse , if radiochemotherapy is added to surgery . Patients with irresectable tumors possibly can be downstaged and be brought to resection nevertheless . Simultaneous radiochemotherapy with 5-FU and mitomycin C can be performed without elevated risk of acute side effects of higher degree . This approach may be indicated in the case of adjuvant situations in patients free of distant metastases . Neoadjuvant simultaneous radiochemotherapy should only be performed as a part of a clinical trial ."
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[] |
[] |
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"p53 is the most commonly mutated gene in human tumors with large impact on cellular biology and response to radiation . Many excellent reviews are available on various aspects but for several years none about the role of p53 for radiosensitivity . The latter is the aim of the present paper . Review of the literature . p53 is a regulator of apoptosis mainly in hematopoetic tissue . In normal tissue and solid tumors presumably other functions have more impact on the cellular response . p53 controls cell-cycle progression after irradiation and also DNA-repair , namely homologous and non-homologous recombination . Mutations of p53 alter these functions which may be responsible for an enhanced cellular and tumor radioresistance . At present only few reports were able to show that under tightly controlled conditions loss of p53 wild-type function leads to enhanced radioresistance . A general proof is still lacking . The emerging picture in the year 2000 shows p53 as a central protein in a multi-enzyme multi-function network which is far from being fully understood . Although p53 appears to be a major regulator it is certainly not the unreplacable component the loss of which uniformly determines radioresistance . Only further understanding of modifiers and cooperators in the cell and in the specific tissue context will elucidate p53's role for radiosensitivity and radiotherapy ."
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Strahlentherapie+Onkologie.01760307.eng.abstr
|
Strahlentherapie+Onkologie.01760307.eng.abstr
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"It seems that there exists a specific lymph node center called sentinel node ( SN ) which appears to be the primary site of metastases . The sentinel node concept ( SNC ) is fundamentally based on the orderly progression of tumor cells within the lymphatic system . It is the most important new concept in surgical and radiation oncology . The purpose is to present the biological significance , the diagnostic and clinical basis of the sentinel node concept in breast cancer patients . Lymphoscintigraphy and gamma probe biopsy is necessary to show predictable lymph flow to the regional sentinel node , to multiple sentinel nodes or unpredictable lymph flow to extra-regional sentinel nodes and for performing sentinel node procedure . The standard protocol for the evaluation of the sentinel node metastases consists of extensive histopathological investigation including step Hematoxylin & Eosin ( H&E ) stained sections and immunohistochemistry . A high rate of success of the identification of the sentinel node for breast cancer was reported . The presence or absence of metastasis in this node is a very accurate predictor of overall node status . The temptation to examine the sentinel node with the greatest possible degree of accuracy highlights one of the major problems related to sentinel node biopsy . The success of the sentinel node procedure depends primarily on the adequate functional capacity necessary for sufficient uptake to ensure the accurate identification . In negative sentinel-node patients a complete axillary lymph node dissection is avoidable . In sentinel-node positive patients and clinically negative patients a postoperative radiotherapy would permit an adequate tumor control . The last 2 procedures permit a low morbidity . In the actual TNM classification it was recently introduced a definition of a \" pNo \" patient based on sentinel node biopsy . New target volumes are defined for adjuvant radiotherapy or lymphatic basins could be spared from unnecessary irradiation . The sentinel node concept seems to revolutionize the treatment of early breast cancer . Biopsy of the sentinel node is a highly accurate , minimally invasive method of staging patients and can substantially reduce the morbidity and costs of treatment by avoiding unnecessary complete axillary lymph node dissection . The procedure may lead to a more justifiable approach to adjuvant therapy strategies with low complication rates . The identification of the individual lymphatic flow pattern would permit the irradiation of the individual locoregional lymphatic basin ."
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Strahlentherapie+Onkologie.01760315.eng.abstr
|
Strahlentherapie+Onkologie.01760315.eng.abstr
|
[
{
"id": "Strahlentherapie+Onkologie.01760315.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The so-called \" supraclavicular \" region bears the confluence of deep jugular , upper mediastinal and axillary lymph node groups and therefore it is often part of the target volume in common malignancies like lung cancer , breast cancer and head and neck cancer . For treating this area , several authors recommend an anterior portal with the dose prescribed to a tissue depth of 3 cm , which does not fit our institution's experience . In 119 consecutive patients a computed tomography for planning purposes was performed . We used the subclavian blood vessels between clavicula and first rib as an estimate of the confluence of the mentioned lymph node regions and determined their tissue depth ( which does not describe the deepest part of the lymph vessels ) . Mean and median of the tissue depth were 5 cm in a range from 2 to 9 cm . Only in less than 20% of the measurements we found the vessels located 3 cm or less under the surface which would correspond to a depth of the lymph node target volume 4 to 5 cm . Increasing body mass resulted in deeper location of the vessels . The position of the patient's arms influenced the tissue depth even more . Arms risen above the head resulted in 55% of the measurements in tissue depths of 6 cm or deeper compared to 6% in patients treated with arms beside the body . Standardized treatment prescriptions do not cope adequately with individual anatomy . Treatment position especially of the arms influences location of the \" supraclavicular \" lymph node region in thoracic treatment . Target volume delineation by computed tomography seems the most accurate solution , although it is the most expensive one . Patient immobilization is crucial for accuracy of treatment delivery ."
],
"offsets": [
[
0,
1731
]
]
}
] |
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Strahlentherapie+Onkologie.01760319.eng.abstr
|
Strahlentherapie+Onkologie.01760319.eng.abstr
|
[
{
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"text": [
"The aim of this study was to quantify the combined effect of cisplatin and radiation on chromosomal damage with emphasis on the time interval between cisplatin and radiation . Bone marrow of female NMRI-nu ( + ) mice was taken as a model system for a highly proliferative tissue irradiated with cobalt-60 ( 1 to 4 Gy ) . Cisplatin was injected intraperitoneally ( ip ) at 1.1 to 36 mg/kg . Cisplatin was given at various time intervals before and after radiation . Bone marrow and metaphases were prepared according to standard procedures . The percentage of aberrant metaphases after radiation or cisplatin alone increased in a dose-dependent manner ( sigmoidal dose-response curve ) . Combining both modalities led to additive values at all time points for the percentage of aberrant metaphases . Borderline significant ( p 0.05 ) supraadditive effects were found 2 hours before or 1 hour after irradiation . However , a supraadditive percentage of aberrant chromosomes was found only at 2 or 1.5 hours with cisplatin before irradiation indicating the dependence of supraadditivity on the chosen parameter . It is doubtful to expect a true supraadditive or \" radiosensitizing \" effect , e . g . in the clinical setting from combined treatment with cisplatin and radiation . Rather , cisplatin might act as an independent cytotoxic agent ."
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0,
1340
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[] |
[] |
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Strahlentherapie+Onkologie.01760324.eng.abstr
|
Strahlentherapie+Onkologie.01760324.eng.abstr
|
[
{
"id": "Strahlentherapie+Onkologie.01760324.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Aggressive angiomyxoma ( AAM ) is a tumor of the soft tissues predominantely occurring in the genital and pelvic area with a strong propensity to local recurrences . The entity was first described in 1983. The tumor is regarded as low-grade sarcoma by some authors ; its cause and pathogenesis are presently unknown . This is a case report on a 27-year-old man who underwent 4 surgical procedures of the left lower extremity because of a recurrent soft tissue neoplasm , initially ( August 1993 ) diagnosed as a myxolipoma . The patient suffered from recurrences in February 1995 , September 1996 and February 1998. The diagnosis was revised at the time of the latest recurrence . A palliative resection with macroscopic residuals left was performed in February 1998 , followed by a radiation therapy with 56 Gy total dose and a concomitant administration of the radiosensitizer razoxane per os . The single radiation doses were 200 cGy 5 times a week . The small residuals of the tumor obviously regressed although an objective response could not be shown because the lesion was not clearly measurable . A follow-up 2 years after the radiation treatment revealed no recurrence . The time of the local control achieved as yet is already longer than any former time to regrowth between the surgical procedures . This is , to our knowledge , the first description of a therapeutic irradiation of a recurrent aggressive angiomyxoma . Radiation therapy combined with the sensitizer razoxane is able to control a recurrent AAM for an unknown time . It remains open whether a radiation treatment alone would have had a similar effect ."
],
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}
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"A treatment technique favorable for linacs with asymmetric jaws , which combined cranio-caudal matching fields with fields enclosing the whole target volume , is investigated with respect to field matching and sparing of normal tissue and organs at risk . For a pelvic target volume rapidly varying in cranio-caudal direction a 5-field technique was planned with individually weighted and blocked fields . Three fields adjoining in cranio-caudal direction were completed by 2 fields enclosing the whole target volume . The matching line was measured and calculated with Helax TMS©. Furthermore a 4-field box and opposing fields were planned . The dose-volume histograms for target , bladder , intestine and soft tissue were exported . Normal tissue complication probability and tumor control probability , respectively , were calculated for all techniques . In the region of the matching line the summation of the measured normalized curves resulted in relative dose maxima of 6.0% ( caudal ) and 4.5% ( cranial ) , respectively . For fields enclosing the whole target volume the dose maxima in the region of the matching line decreased to 2.0% ( caudal ) and 1.8% ( cranial ) , respectively . For the dose profiles calculated with Helax TMS© no overdose was found . The 5-field technique with adjoining fields results in a better sparing of the organs at risk compared to the other techniques , whereas the tumor control remains the same . In specific cases a technique with cranio-caudal adjoining fields can be recommended with respect to sparing of normal tissue and organs at risk ."
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[] |
[] |
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Strahlentherapie+Onkologie.01760388.eng.abstr
|
Strahlentherapie+Onkologie.01760388.eng.abstr
|
[
{
"id": "Strahlentherapie+Onkologie.01760388.eng.abstr-passage-0",
"type": "abstract",
"text": [
"An \" Interdisciplinary Consensus Statement on the Diagnosis and Therapy of Testicular Tumors \" was prepared in 1996 by the \" Interdisciplinary Testicular Tumor Working Group \" ( IAH ) with input from representatives from diagnostic and therapeutic disciplines of various working groups of the German Cancer Society ( Strahlenther Onkol 1997 ; 173:397-406). In 1998 the IAH met again together with the \" Testicular Tumor Working Party \" of the Urooncology Working Group ( AUO ) and formed the \" German Testicular Cancer Study Group ( GTCSG ) . Defined and accepted interdisciplinary standards from the initial meeting were revised based on current scientific developments and clinical results . This cooperating effort increases the quality of the initial recommendations and helped to put the recommendations for diagnosing and treating testicular on a broader scientific basis . According to the principles of \" evidence-based medicine \" ( EBM ) , the Consensus from 1996 was modified , based on the current level of evidence from the published literature . The methodological process and evaluation criteria used were that of the \" Cochrane Collaboration \" . An \" Interdisciplinary Update Consensus Statement \" summarizes and defines the diagnostic and therapeutic standards according to the current scientific practices in testicular cancer . For 21 separate areas scientifically based decision criteria are suggested . For treatment areas where more than one option exist without a consensus being reached for a preferred strategy , such as in seminoma in clinical Stage I or in non-seminoma Stages CS I or CS IIA/B , all acceptable alternative strategies with their respective advantages and disadvantages are presented . This \" Interdisciplinary Update Consensus \" was presented at the 24th National Congress of the German Cancer Society on March 21st and subsequently evaluated and approved by the various German scientific medical societies ."
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Strahlentherapie+Onkologie.01760406.eng.abstr
|
Strahlentherapie+Onkologie.01760406.eng.abstr
|
[
{
"id": "Strahlentherapie+Onkologie.01760406.eng.abstr-passage-0",
"type": "abstract",
"text": [
"To retrospectively evaluate the effectiveness of radiotherapy with or without transarterial embolization ( TAE ) and/or percutaneous ethanol injection ( PEI ) in patients with hepatocellular carcinoma who were ineligible for surgery . From October 1984 to November 1997 , 62 patients underwent radiotherapy receiving 50 to 70 Gy in 25 to 35 treatments with or without transarterial embolization and/or percutaneous ethanol injection and were followed for a median period of 8.6 months ( 1.5 to 92 months ) . Overall median survival rates were 9.5 months . Significant prognostic factors were the extent of pretreatment liver function impairment , radiation field size and the existence of tumor thrombosis . Six-month and 1-year local control rates were 67 and 54% , respectively . Seven of the 8 patients who suffered from hepatic failure had poor pretreatment liver functions . Radiotherapy with or without transarterial embolization and/or percutaneous ethanol injection appears effective in controlling hepatocellular carcinoma and prolonged survival . Individualized treatment strategies are presented depending on the tumor presentation and the degree of liver function impairment ."
],
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0,
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}
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Strahlentherapie+Onkologie.01760411.eng.abstr
|
Strahlentherapie+Onkologie.01760411.eng.abstr
|
[
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"To evaluate remission and breast-conservation rates after preoperative chemotherapy or chemo-radiotherapy ( CT-RT ) . Seventy-three patients with 74 biopsy-proven invasive breast cancer prospectively entered the protocol . Eighteen patients were treated by neoadjuvant chemotherapy followed by surgery and adjuvant irradiation ( chemotherapy group ) . Fifty-five patients with 56 tumors were treated with combined neoadjuvant chemo-radiotherapy , followed by surgery ( chemo-radiotherapy group ) . Most patients of both treatment groups received 4 cycles of EC chemotherapy . In some patients with large tumors 3 cycles of CMF were added . Chemotherapy was followed by hormonal treatment with tamoxifen or LHRH agonists in case of positive hormone-receptor status . Preoperative radiotherapy was administered using 2 Gy fractions up to a total dose of 50 Gy , followed by a tumor boost of 6 to 11 Gy . The median overall treatment time was 41 days ( range : 35 to 55 days ) . The median time interval between end of neoadjuvant therapy and surgery was 11 weeks ( range : 10 to 22 weeks ) and 27 weeks ( range : 11 to 41 weeks ) for the chemotherapy- and chemo-radiotherapy group . The median time interval between end of chemotherapy and the beginning of irradiation ranged between 2 and 8 weeks ( median 4 weeks ) in the chemo-radiotherapy group . Side-effects due to chemo- or radiotherapy were moderate and reversible . In the chemotherapy group 17/18 patients ( 94% ) achieved a partial ( pPR ) and 1/18 patients ( 6% ) a complete histopathological response ( pCR ) . In the chemo-radiotherapy group 32/56 ( 57% ) showed a pPR and 24/56 ( 43% ) a pCR . The difference in complete remission is significant ( Fisher's Exact Test : p = 0.004 ) . In 45/74 cases ( 61% ) the breast was preserved , immediate breast reconstructions with rectus myocutaneous flaps ( TRAM ) after mastectomy were performed in 8/74 cases ( 11% ) and modified radical mastectomies without reconstruction were required in 21/74 cases ( 28% ) . The breast conversation rates were similar in both treatment groups . Even though the small number of patients in the present protocol does not permit definite conclusions , the results of combined modality treatment seem promising with regard to tumor remission within the treated breast and as a tool for breast conservation in advanced stage disease . On the basis of these encouraging data a prospective Phase-III study has been initiated ."
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Strahlentherapie+Onkologie.01760429.eng.abstr
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Strahlentherapie+Onkologie.01760429.eng.abstr
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"In the irradiation of prostate cancer internal organ movement leads to uncertainties in the daily localization of the clinical target volume . Therefore more or less large safety margins are added when designing the treatment portals . With daily CT planning internal organ movement can be compensated to some extent , safety margins can be reduced and irradiated normal tissue can be spared . The feasibility of daily CT-based 3D treatment planning is studied in a patients with localized prostate carcinoma using a new patients positioning system . Daily CT planning was applied during boost irradiation of a patient with prostate cancer : After patient immobilization the pelvis was scanned in 3 mm CT slices . Planning was done with the BrainSCAN planning system for stereotactc body irradiation . The prostate was contoured in all slices and the safety margins of the micromultileafs were automatically set to the distance chosen by the physician ( 0.8 cm ) . Patient positioning was done with the BrainLAB ExacTrac positioning system on the basis of skin attached stereotactic body markers . Before each treatment verification images of the isocenter were taken . The total time requirement for planning and irradiation was about 1 hour 15 minutes . Patient positioning on the treatment couch took about 10 minutes . The accuracy of the positioning system was good ( 75% of the deviations were smaller than 3 mm ) . The shift of the single markers from CT scan to CT scan was more extensive than those of the center of all 7 markers combined ( 47% of the deviations were smaller than 3 mm ) . The location of the markers seems to influence the magnitude of their dislocation . Daily CT planning is feasible but time consuming . The new patient positioning system ExacTrac is an interesting tool especially for daily CT planning since conventional simulation can be obmitted ."
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Strahlentherapie+Onkologie.01760443.eng.abstr
|
Strahlentherapie+Onkologie.01760443.eng.abstr
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[
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"Experimental studies and prospective randomized clinical trial have demonstrated a detrimental effect of prolongation of overall treatment time on local tumor control . In a brief review of the literature , possible mechanisms of the time factor are discussed . The mechanisms of the time factor in cancer treatment are complex and , at present , not fully understood . In experimental tumors , rapid proliferation of clonogenic cells during fractionated irradiation and treatment gaps has been determined as a major cause of the time factor in radiotherapy . Also , chemotherapy can stimulate repopulation of experimental tumors by clonogenic cells . Besides repopulation of clonogenic tumor cells , other factors such as the deterioration of the tumor vasculature with increasing tumor hypoxia might contribute to the time factor ."
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[] |
[] |
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Strahlentherapie+Onkologie.01760448.eng.abstr
|
Strahlentherapie+Onkologie.01760448.eng.abstr
|
[
{
"id": "Strahlentherapie+Onkologie.01760448.eng.abstr-passage-0",
"type": "abstract",
"text": [
"With the intention to achieve tumor reduction and thereby increase R0-resection rate , preoperative radiochemotherapy is increasingly applied in locally advanced rectum cancer . Along with the advantages of prior therapy , a delay of surgical treatment occurs which might despite continuing therapy give way to local tumor progression or metastatic disease . Since 1993 we have treated locally advanced rectum carcinomas by preoperative radiotherapy according to a preoperative study protocol . We analyzed the incidence of local tumor progression or metastases during the 12 weeks of preoperative treatment . Hundred and fifteen patients with histologically proven primary rectum carcinoma without evidence of regional or distant metastases and endosonographically determined infiltration depth of stage T3 or more underwent preoperative radiochemotherapy between 3/1993 and 10/1999 . Hundred and eight patients ( 88 times uT3 and ( 20 times uT4) have been operated and examined afterwards with respect to response to prior treatment . Before and after preoperative therapy , endorectal ultrasound was performed to evaluate local response . Distant metastatic manifestations were excluded by radiography and ultrasound scanning . A reduction of the infiltration depth was observed in 55 patients ( 51% ) . Tumor size remained unchanged in 50 patients ( 46% ) . Only 3 patients ( 3% ) showed tumor growth in histological assessment . Fifty-seven patients ( 53% ) showed no change in lymphonodal status after preoperative therapy , whereas lymphonode metastases were detected in 11 patients ( 10% ) who were judged uN0 preoperatively . We discovered metastases in 6 patients ( 6% ) after preoperative therapy . During preoperative therapy , tumor progress is not entirely evitable . Considering the lack of precision in pretherapeutic staging diagnostics , we conclude that delays due to therapeutic regimen are responsible for prognostic disadvantage in only a small number of patients ."
],
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[
0,
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}
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Strahlentherapie+Onkologie.01760452.eng.abstr
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Strahlentherapie+Onkologie.01760452.eng.abstr
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[
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"The timing of surgery and postoperative radiotherapy - especially if combined with chemotherapy - has been a subject of interest over the past years . This analysis was based on a literature review of mostly retrospective publications . Data concerning the interval between surgery and radiotherapy were correlated with the locoregional control , incidence of distant metastases and prognosis of breast cancer , lung carcinoma , and head and neck carcinomas . The reviewed data did not show a clear relationship of the time interval between surgery and start of radiotherapy and locoregional control . However , evaluation of the data was difficult , because in most publications , retrospective analyses were performed and other prognostically more relevant parameters may influence locoregional control stronger than the time interval . In patients with head and neck carcinomas , there is a negative effect of time interval between surgery and radiotherapy on local control if unfavorable factors exist , i . e . , close surgical margins , unfavorable pathohistological parameters and low radiation dose . In patients with breast cancer who do not receive chemotherapy , there are inconsistent reports in the literature . If additional chemotherapy is necessary , the sequence surgery , chemotherapy and radiotherapy seems adequate . Although some data suggest that delaying the initiation of radiotherapy due to chemotherapy may increase the risk or local recurrences , there may , on the other hand , be an increased likelihood of systemic metastases , if radiotherapy is applied before chemotherapy . Concerning lung cancer , only one retrospective analysis exists suggesting a better survival of patients with an interval of more than 36 days between surgery and radiotherapy as compared to patients with a shorter interval ."
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Strahlentherapie+Onkologie.01760458.eng.abstr
|
Strahlentherapie+Onkologie.01760458.eng.abstr
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[] |
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