TY - JOUR A1 - Lüthy, Anja T1 - Zeitmanagement für niedergelassene Anästhesisten JF - Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : ains 41(2006)7/8, S. 514-518 Y1 - 2006 ER - TY - JOUR A1 - Beck, Eberhard A1 - Bittl, A. A1 - Koller, S. A1 - Merkle, E. A1 - Katalinic, A. A1 - Jäger, W. A1 - Lang, N. T1 - Erfassung der fetalen Retardierung mittels Ponderal Index und Gewichtsperzentilen Assessment of Fetal Retardation via Ponderal Index and Weight Percentiles JF - In: Geburtsh Frauenheilk 59(1999)2, 62-69 N2 - Zusammenfassung Intrauterin wachstumsretardierte Neugeborene konnten ihr genetisches Wachstumspotential aufgrund einer intrauterinen Mangelversorgung nicht realisieren und werden deshalb zu klein oder zu leicht geboren. Das Merkmal „zu leicht” wird mit Hilfe von Gewichtsperzentilen quantifiziert. Kinder mit einem Gewicht< 10. Perzentile werden als „small for gestational age” (SGA) bezeichnet. Diese Einteilung berücksichtigt jedoch nicht die Proportionen eines Neugeborenen, so daß vor allem asymmetrisch retardierte Neugeborene, deren Gewicht zwar die 10. Perzentile noch überschreitet, die jedoch für ihre Körpergröße untergewichtig sind, nicht erfaßt werden. Der Ponderal Index (PI) dagegen berücksichtigt sowohl Gewicht als auch Länge des Neugeborenen. Kinder mit einem PI < 10. Perzentile werden als „low Ponderal Index” (LPI) klassifiziert. Aus pädiatrischen Studien ist bekannt, daß LPI-Kinder vermehrt durch Hypoglykämien, Hypothermien, Hypokalzämien und Mekoniumaspirationen/Aspirationspneumonien gefährdet sind. Langzeiterhebungen zeigten eine verzögerte körperliche Entwicklung und gehäuft motorische oder neurologische Verhaltensauffälligkeiten sowie schulische Probleme. Fragestellung: Ziel der vorliegenden Arbeit war die Frage, ob Mangelgeborene, insbesondere LPI-Neugeborene, auch intrapartum einer erhöhten Gefährdung ausgesetzt sind. Methoden: Hierzu wurden 3687 Neugeborene retrospektiv erfaßt, die anhand von Perzentilenkurven des betrachteten Kollektivs als SGA, LPI, SGA/LPI oder Vergleichskollektiv klassifiziert wurden. Ergebnisse: Unterschiede im Geburtsmodus zwischen SGA- bzw. LPI-Mangelgeborenen und eutrophen Neugeborenen waren schwach ausgeprägt. Demgegenüber unterschied sich die Indikation, aufgrund deren ein geburtshilflicher Eingriff vorgenommen werden mußte deutlich. Bei 31 % aller operativ entbundenen LPI-Neugeborenen, 47 % der SGA-Neugeborenen und 52 % der SGA/LPI-Kinder erfolgte die operative Entbindung aus fetaler Indikation, im Vergleich zu 16 % des Normalkollektivs. Bezüglich des „fetal outcome”, das die Merkmale neonataler Säure-Basen-Status, Apgar-Wert, Verlegung in die Kinderklinik und perinatale Mortalität einbezog, verhielten sich die Gruppen SGA, LPI und SGA/LPI in gleicher Weise schlechter gegenüber dem Vergleichskollektiv. Die Unterschiede zwischen proportionierten (SGA) und dysproportionierten (LPI) Mangelgeborenen waren weniger deutlich. Schlußfolgerungen: Es zeigte sich, daß das gegenwärtige engmaschige, geburtshilfliche Management mit nahezu permanenter CTG-Überwachung sub partu Probleme rechtzeitig erkennen und beherrschen ließ. Die Erfassung des niedrigen Ponderal Index war zur Erkennung und Vermeidung subpartaler geburtshilflicher Risikofaktoren nicht entscheidend. N2 - Abstract Intrauterine growth retarded fetuses could not realize their genetic potential due to intrauterine malnutrition and could thus not reach an appropriate length or weight according to their gestational age. New born infants below the 10 th percentile are termed „small for gestational age” (SGA). However, this definition does not account for asymmetrically retarded infants who's birth weight is above the 10th percentile, but who are underweight for their length. In contrast the fetal Ponderal Index (PI) regards both fetal length and weight. New born infants with a PI <10th percentile are classified as „low Ponderal Index” (LPI). From pediatric studies it is well known that LPI infants are more likely threatened by hypoglycemia, hypothermia, hypocalcemia and meconium aspiration pneumonitis. Long term follow-up studies showed a retarded physical and mental development of these infants. Purpose: The current study followed the question if intrauterine growth retarded fetuses, esp. LPI infants are also at higher risk during labour. The data of 3687 new born infants were retrospectively analyzed. Study Design: According to their birth weight and length they were characterized as SGA, LPI, SGA/LPI or „appropriate for gestational age” AGA. The AGA infants together with the LGA infants were used as control group. Results: No significant differences in respect to birth modalities (i.e. vaginal delivery, cesarean section, operative vaginal delivery) could be detected between SGA-, LPI- and AGA infants. However, concerning the indication which formed the basis for an operative delivery, we found significant differences. In 31 % of all operatively delivered LPI new born, 47 % of the SGA infants and 52 % of the SGA/LPI group the indication for the operative management was based on fetal problems. This indication accounted for only 16 % of the operatively delivered infants in the control group. Regarding the fetal outcome, specified by the fetal acid base status, Apgar index, frequency of transfer to the neonatal intensive care unit, and perinatal mortality, no differences between LPI, SGA and SGA/LPI infants could be detected. Conclusion: We conclude that the current strategies of monitoring labour, e.g. by continuous CTG scanning, are sufficient to detect and master fetal problems. The detection of a „low Ponderal index” did not add any information concerning the management of labour. Y1 - 1999 SP - 62 EP - 69 ER - TY - JOUR A1 - Beck, Eberhard A1 - Moldenhauer, A. A1 - Merkle, E. A1 - Kiesewetter, F. A1 - Jäger, W. A1 - Wildt, L. A1 - Lang, N. T1 - CA 125 production an release by ovarian cancer cell lines in vitro JF - In: The international journal of biological markers 13(1998), 200 – 206 Y1 - 1998 SP - 200 EP - 206 ER - TY - JOUR A1 - Fehm, T. A1 - Beck, Eberhard A1 - Valerius, T. A1 - Gramatzki, M. A1 - Jäger, W. T1 - CA 125 elevations in patients with malignant lymphomas JF - In: Tumor Biology 19(1998), 283 – 289 Y1 - 1998 SP - 283 EP - 289 ER - TY - JOUR A1 - Beck, Eberhard A1 - Wagner, Maren A1 - Anselmino, Lisa A1 - Xu, Feng-ji A1 - Bast Jr., Robert C. A1 - Jäger, Wolfram T1 - Is OVX1 a suitable marker for endometrial cancer? JF - In: Gynecologic Oncology 65(1997) 2, 291–296 N2 - The single most common cause leading to the diagnosis of endometrial cancer is postmenopausal bleeding. Although most patients with early-stage disease (FIGO stage I and II) can be cured, prognosis worsens considerably with increasing stage. While serum CA 125 levels are elevated only in a significant proportion of patients with advanced disease, recently a new serum marker (OVX1) for the detection of early-stage endometrial cancer was reported. Serum OVX1 levels were measured using an OVX1 radioimmunoassay (RIA) or enzyme immunoassay (EIA) in 192 patients with endometrial cancer. CA 125 levels were measured in 112 patients using the CIS ELSA CA 125 kit. Apparently healthy females had mean serum OVX1 levels measured with the OVX1–EIA of 1.34 ± 0.74 U/ml, while patients with endometriosis had mean OVX1 serum levels of 3.15 ± 2.45 U/ml. The mean OVX1 serum level for endometrial cancer patients was 2.00 ± 1.32 U/ml. These values were 2.76 ± 1.62, 6.10 ± 4.66, and 5.37 ± 3.49, respectively, using the OVX1–RIA assay. Applying a cutoff value of 2.8 U/ml, serum OVX1–EIA levels in endometrial cancer patients were increased in 25 of 127 patients (19.7%) with stage I disease, 5 of 17 patients with stage II (29.4%), 5 of 22 patients (22.7%) with stage III, and 4 of 11 patients (36.4%) with stage IV disease. Using the OVX1–RIA and a cutoff of 7.2 U/ml, serum levels were increased in 22 of 127 (17.3%) stage I, 6 of 17 (35.3%) stage II, 5 of 22 (22.7%) stage III, and 6 of 11 (54.5%) stage IV patients. Serum CA 125 levels, determined in a total of 112 patients, were elevated above 35 U/ml in 12 of 79 patients (15.2%) with stage I, 4 of 12 patients (33.3%) with stage II, 8 of 13 patients (61.5%) with stage III, and all of 8 patients (100%) with stage IV disease. While a good correlation between serum CA 125 levels and the clinical stage of the disease was found, no correlation could be detected for OVX1 and stage. Y1 - 1997 SP - 291 EP - 296 ER - TY - JOUR A1 - Jäger, W. A1 - Sauerbrei, W. A1 - Beck, Eberhard A1 - Maassen, V. A1 - Stumpfe, M. A1 - Meier, W. A1 - Kuhn, W. A1 - Jänicke, F. T1 - Unbound MEDLINE A randomized comparison of triptorelin and tamoxifen as treatment of progressive ovarian cancer JF - In: Anticancer Research 15(1995)6B, 2639-2642 Y1 - 1995 SN - 0250-7005 SP - 2639 EP - 2642 ER - TY - CHAP A1 - Beck, Eberhard A1 - Moldenhauer, A. A1 - Kiesewetter, F. A1 - Jäger, W. A1 - Woldt, L. A1 - Lang, N. T1 - Analysis of CA 125 production and release by ovarian cancer cells in vitro T2 - In: Current tumor diagnosis : applications, clinical relevance, research - trends / 7th Symposium on Tumor Markers, Hamburg 1993 ; Satellite Symposium Cancer of the Lung - State and Trends in Diagnosis and Therapy. Ed. by R. Klapdor. - München [u.a.] : Zuckschwerdt, 1994. - ISBN 3-88603-509-3 Y1 - 1994 SP - 187 EP - 191 ER - TY - JOUR A1 - Beck, Eberhard A1 - Hofmann, M. A1 - Bernhardt, G. A1 - Jäger, W. A1 - Wildt, L. A1 - Lang, N. T1 - In vitro activity of immunoconjugates between cisplatin and an anti CA125 monoclonal antibody on ovarian cancer cell lines JF - In: Cell Biophysics 24/25(1994)1-3, 163-173 N2 - Cis-diammine dichloro platinum (II) (CDDP), is a highly potent antineoplastic agent that is used in the treatment of ovarian cancer. However, the clinical use of CDDP is restricted by its severe side effects. In order to reduce these side effects and to enhance its therapeutic efficacy, we developed specific immunoconjugates consisting of the murine monoclonal antibody OC125 and CDDP, using diethylene triamine pentaacetic acid (DTPA) as a linker. The coupling efficiencies of the different preparations synthesized, varied between 1.10±0.42 and 2.65±1.60 mol of CDDP per mol of antibody protein. Despite the chemical modification of the antibody molecule, specific binding activity of the OC125-CDDP conjugates toward the CA125 antigen was maintained as was demonstrated by means of immunohisto-/cytochemical staining of frozen sections of ovarian cancer tissue, amniotic epithelium, and the CA125 positive ovarian cancer cell line NIH:OVCAR 3. The antiproliferative activity of the immunoconjugates was tested against the human ovarian cancer cell lines NIH:OVCAR3 and SKOV 3, applying a kinetic crystal violet microassay. Despite the promising results obtained with the specific immuno-staining of the target cells, no significant antiproliferative activity of our immunoconjugates against the cell lines tested was observed. One possible explanation for the lack of antitumor activity could be the fact that CA125 is released in large amounts by the NIH:OVCAR 3 cells. This may have prevented an efficient immunotargeting of the cancer cells by the formation of soluble immune complexes. Y1 - 1994 SN - 0163-4992 SP - 163 EP - 173 ER - TY - JOUR A1 - Beck, Eberhard A1 - Russo, Pietro A1 - Gliozzo, Biancamaria A1 - Jäger, Wolfram A1 - Papa, Vincenzo A1 - Wildt, Ludwig A1 - Pezzino, Vincenzo A1 - Lang, Norbert T1 - Identification of insulin and insulin-like growth factor I (IGF I) receptors in ovarian cancer JF - In: Gynecologic Oncology 53(1994)2, 196–201 N2 - Abstract The objective of this study was to test if specific insulin and insulin-like growth factor I (IGF I) receptors are expressed in ovarian cancer tissue. Thirteen tissue specimens from primary ovarian cancers, 1 specimen from a primary peritoneal carcinoma, 10 specimens from metastatic lesions of ovarian carcinomas, and 4 specimens from recurrent ovarian cancers together with 13 normal ovaries were tested for their content of insulin and IGF-I receptors, by the application of specific insulin and IGF-I receptor radioimmunoassays. The insulin receptor (IR) and IGF-I receptor (IGF R) content in the primary tumors varied between 23.8-321.4 and 16.4-554.2 ng/0.1 mg DNA, respectively. Metastatic lesions contained between 12.3 and 226.7 ng IR/0.1 mg DNA and between 7.5 and 459.4 ng IGF R/0.1 mg DNA. In recurrent tumors the receptor concentrations were in the range of 41.5-79.8 and 48.9-160.9 ng/0.1 mg DNA for insulin and IGF-I receptors, respectively. Normal ovarian tissue contained between 12.2 and 150.1 ng IR and between 21.4 and 420.1 ng IGF R per 0.1 mg DNA, respectively. As both insulin and IGF-I receptors are present in ovarian cancer tissue, the effects of insulin and IGF-I as potential growth factors in ovarian cancer should be further investigated. Copyright © 1994 Academic Press. All rights reserved. Y1 - 1994 SN - 0090-8258 SP - 196 EP - 201 ER - TY - JOUR A1 - Beck, Eberhard A1 - Russo, P. A1 - Papa, V. A1 - Jäger, W. A1 - Pezzino, V. A1 - Wildt, L. A1 - Vigneri, R. A1 - Lang, N. T1 - Nachweis von Insulin-Rezeptoren (IR) in Ovarialkarzinomgewebe JF - In: Archives of Gynecology and Obstetrics December 254(1993)Iss. 1-4, 1053-1054 Y1 - 1993 SN - 0932-0067 SP - 1053 EP - 1054 ER -