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Biomedical subjects

A Huber

Publications and source records attributed to A Huber.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Value of the elastase-alpha 1-proteinase inhibitor complex in pediatric oncologic patients with fever].

The elastase-alpha1-proteinase inhibitor complex (E-alpha 1-PI) is a well known, sensitive indicator of infection. The significance of this parameter was investigated in 12 febrile paediatric-oncological patients. With neutrophil counts greater than 500/microliters infections caused a definitive increase in E-alpha 1-PI serving as an additional diagnostic parameter. E-alpha 1-PI provided no additional information in situations of sepsis with leukopenia and simultaneous agranulocytosis. In patients with metastatic tumours, the assay of E-alpha 1-PI may differentiate between infection-related and tumour-related serological disturbances.

Child↗
PubMed1989

[Lung function following irradiation in pediatric cancer patients].

Lung function tests were performed in 22 children and juveniles who had received radiotherapy to the lungs, an average of 9.5 years previously, for tumour (14 with Hodgkin's disease [aged 7-22 years], 4 with malignant non-Hodgkin lymphoma [aged 6-14 years], 3 with Wilms tumour [4-6 years], and one with Ewing's sarcoma [aged 16 years]). All three patients who, as young children, had had radiotherapy to both lungs because of a Wilms tumour with multiple lung metastases had restrictive disorders of lung function. Four of 12 after treatment of Hodgkin's disease and one of two after malignant non-Hodgkin lymphoma and extensive thoracic irradiation developed a restrictive disorder of pulmonary function. But all four patients who had irradiation restricted to the mediastinum had normal lung functions.

Adolescent↗
PubMed1989

[Surgery of bronchus carcinoma].

UNLABELLED: Indications for surgical treatment of lung cancer are based on histology and staging of the tumour and on the general condition of the patient. HISTOLOGY: The current therapy for non-small cell cancer of the lung is operative excision. Small cell cancer however is best treated by chemotherapy or radiotherapy or by both in combination. Small or peripheral small cell cancer should also be removed surgically, but only in combination with chemotherapy or radiotherapy. Stage: Non-small cell tumours, which are assessed to be limited to the thorax and locally resectable have to be removed surgically. If the tumour involves the chest wall, pre- and postoperative radio-therapy is advisable. If lymph nodes in the upper mediastinum or in the contralateral hilus are involved, or if distant metastases are proven, surgical intervention is indicated only in exceptional cases. PATIENT: The patient's general condition should allow tolerance of thoracotomy and extensive resection of lung parenchyma and adjacent tissue. Adequate ventilatory reserve is mandatory. In this regard it is important to realize that part of the lung may already be excluded from ventilation by obstruction, and resection of such parenchyma does not further impede ventilation. Indeed, resection of non-ventilated segments of lung parenchyma will even improve cardio-pulmonary reserve since the procedure might eliminate pulmonary av-shunting.

Carcinoma, Bronchogenic↗
PubMed1989

Four DNA polymorphisms in the LDL-receptor gene and their use in diagnosis of familial hypercholesterolemia.

To examine the potential usefulness of restriction fragment length polymorphisms (RFLPs) for diagnosis of familial hypercholesterolemia (FH), we determined the genotype of FH patients and their relatives for the Apa1I, NcoI, PvuII and StuI RFLP of the LDL-receptor gene in a sample of German patients attending the Lipid Clinic in Munich. There was no significant difference in the relative allele frequency between the group of FH patients and controls for any of the four polymorphisms. Using linkage analysis, we could determine the four-RFLP haplotypes of 39 defective and 90 normal LDL-receptor genes in 38 FH families. In our sample, defective LDL-receptor genes occur on 6 different chromosomes determined by the four RFLPs. This suggests that at least 6 different genetic defects may cause FH in this sample. RFLPs of the LDL-receptor gene cannot be used to detect FH in individuals; however, appropriate diagnosis can be carried out in more than 90% of families using linkage analysis and these RFLPs.

Gene Frequency↗
PubMed1989

Does stimulant medication improve the peer status of hyperactive children?

Although stimulants improve the social behaviors of hyperactive children, analogous changes in peer status have not been previously demonstrated. We compared peer appraisals of hyperactive boys (N = 25) after placebo, 0.3 mg/kg, and 0.6 mg/kg methylphenidate (Ritalin). With the higher dose generally producing stronger effects, methylphenidate enhanced social standing, increasing nominations of hyperactive boys as best friends, cooperative, and fun to be with. These medication-related improvements, although important, did not normalize peer appraisals, and there was marked interindividual variability in medication response.

Attention Deficit Disorder with Hyperactivity↗
PubMed1989

[Follow-up after surgery of the bile ducts].

The main emphasis of aftercare after surgery of the biliary tract is on monitoring the bile flow as a means of assessing the underlying disease and the patient's postoperative condition. If there is evidence of a bile flow disturbance, the cause must be discovered and eliminated in order to prevent secondary lesions from occurring in the liver.

Bile Duct Diseases↗
PubMed1989

[After-care following surgery of the pancreas].

Postoperative treatment after pancreas surgery is concentrated on the function of the exocrine and endocrine part of the gland. While functional disturbances of the endocrine pancreas may give rise to serious problems associated with diabetes, functional disturbances of the exocrine pancreas are less important. On the other hand, flow disorders of the exocrine pancreas may lead to pancreatitis, fistulas, cysts, and abdominal sepsis. Pancreatic tumours are not infrequently apudomas whose biology has an important bearing on the after-treatment. Thrombophlebitic splenomegaly may lead to portal and possibly to segmental portal hypertension. In this event, a careful follow-up examination will be needed to decide whether further surgery is necessary.

Humans↗
PubMed1989

[Diagnosis and therapy of liver injuries in the polytraumatized patient].

We examined 120 patients with liver trauma, 100 retrospectively (1973-1986 group I) and 20 prospectively (1986-1987 group II). The severity of the liver injury was categorized in 5 grades (modified after Moore) and the degree of multiple trauma was assessed by the injury severity score (ISS). Patients in the liver injury groups were equally distributed among grades I to IV; there was one patient with a grade V injury in both the retrospective and prospective group. The overall mortality was 14%, 15% for the retrospective and 10% for the prospective group. Mortality was mainly due to concomitant injuries (head injuries, ARDS, multiple organ failure, pneumonia) and only 3 patients in the whole group died as a result of continuous bleeding or because of prolonged hemorrhagic shock due to the liver injury. The defined protocol for the prospective group included early efficient resuscitation and blood/fresh frozen plasma transfusion, systematic and rapid assessment of injuries and determination of priorities of treatment. Immediate ultrasonography or peritoneal lavage was used for assessment and diagnosis of a liver injury and early selection of treatment according to the grade of the liver injury: Conservative management for stable cases consisted of close supervision and repeated investigations (CT, angiography). Immediate operation was undertaken for continuing hemorrhage. Postoperative care in an intensive care unit with a low threshold for reoperation in cases of suspected sepsis, ongoing hemorrhage or necrosis of liver tissue was an important part of the treatment. Our results suggest that death in multiple trauma patients should almost never be due to liver injury alone. Conservative treatment may be justified in some patients, but early resuscitation and operation directed at definitive or provisional control of hemorrhage with removal of all devitalized tissue and liberal use of early reoperation are essential in the management of severe liver injury.

Adolescent↗
PubMed1989

[Mediastinal neuroblastoma in Wiedemann-Beckwith syndrome].

A mediastinal neuroblastoma developed in a female infant with Wiedemann-Beckwith syndrome. Careful and close examinations in children with Wiedemann-Beckwith syndrome should therefore not only include screening for Wilms tumour but also for neuroblastoma.

Abnormalities, Multiple↗
PubMed1989

[After-care in liver transplantation].

Liver transplantation is assuming an increasingly important role in present-day hepatology; it is the preferred treatment in many cases of acute or chronic liver disease. The results have shown constant improvement thanks to the introduction of standardized techniques for removal and implantation of the liver, improved immunosuppression and postoperative care. Good long-term results--a five-year survival rate in up to 70% of the cases--can only be achieved by strict self-discipline on the part of the patient and careful postoperative follow-up, with close collaboration between the general practitioner, the hepatologist and the transplant surgeon.

Combined Modality Therapy↗
PubMed1988

Inflammation of the hind limb as a model of unilateral, localized pain: influence on multiple opioid systems in the spinal cord of the rat.

Inoculation of the right hind paw with Mycobacterium butyricum rapidly led to swelling and inflammation. The afflicted limb showed an enhanced sensitivity to noxious pressure (hyperalgesia) and a reduced sensitivity to noxious heat 24 h following treatment. Both naloxone and MR 2266 (which has greater activity at kappa-opioid receptors) further increased the sensitivity to pressure (that is, potentiated the hyperalgesia) but did not affect the response to heat. They did not affect the response of the uninflamed paw. At 1 week, only MR 2266 was effective. At both 24 h and 1 week, the inflamed paw showed pronounced supersensitivity to the antinociceptive action of morphine against noxious pressure. At both 24 h and (to a greater extent) 1 week, a rise in levels of immunoreactive (ir)-dynorphin (DYN) was seen in the ipsilateral dorsal horn of the lumbar spinal cord. There was no alteration in the contralateral dorsal horn or in either ventral horn. Furthermore, levels of ir-met-enkephalin (ME) and ir-leu-enkephalin (LE) were unaffected. There was no difference in the density of mu-, delta- or kappa-binding sites in any part of the lumbar cord, at either 24 h or 1 week, between ipsilateral and contralateral tissue. By 3 and 5 weeks postinoculation, the symptoms had spread to the contralateral hind limb and ir-DYN was elevated in the contralateral dorsal horn and the ipsilateral ventral horn. At 5 weeks, levels of ir-ME and ir-LE also were increased in the ipsilateral and contralateral dorsal horns, but not in the contralateral ventral horn. Furthermore, levels of ir-DYN were increased in the cervico-thoracic spinal cord, and rats displayed adrenal hypertrophy and a rise in plasma levels of ir-beta-endorphin (beta-EP). These data indicate: (1) Peripheral inflammation localized to a single limb selectively modifies levels of ir-DYN in ipsilateral dorsal horn. The effect is specific to DYN as compared to ME and LE. The density of mu-, delta-, or kappa-receptors in the lumbar spinal cord is unmodified. (2) The altered response to opioid agonists and antagonists shown by rats with an inflamed limb may be selective to the injured tissue. (3) Alterations in opioid systems associated with unilateral hind limb inflammation may not be exclusively chronic in nature: they appear very rapidly (within 24 h) of the induction of pain. With time, the contralateral limb becomes affected and, eventually, the effects resemble those seen with generalized polyarthritis.

Animals↗
PubMed1988

Motivational effects of opioids in an animal model of prolonged inflammatory pain: alteration in the effects of kappa- but not of mu-receptor agonists.

An unbiased preference conditioning procedure was used to characterize and compare the motivational effects of opioids in naive rats and those suffering from the prolonged pain associated with Freund's adjuvant (FA)-induced inflammation of one hind limb. The mu-opioid agonist morphine functioned as a reinforcer in naive animals, producing marked preferences for the drug-paired place. Similarly, rats injected with FA 7 days prior to conditioning exhibited a preference for the morphine place, and the magnitude of this effect did not differ between groups. Administration of the kappa-opioid receptor agonist U-69593 to naive rats produced dose-related place aversions. The aversive effect of this kappa-agonist was, however, abolished in FA-treated rats. Thus, regardless of the dose administered, U-69593 produced conditioning similar to that observed in response to saline. These data suggest that kappa-agonists may lack aversive effects in subjects experiencing prolonged noxious stimulation, and as such may be effective therapeutic agents in the management of chronic pain states.

Animals↗
PubMed1988

[Homonymous hemianopsia in brain tumors].

Homonymous hemianopsia may be caused by tumors in the region of the optic tract, the lateral geniculate body, the optic radiation, and the visual cortex. Tumors are responsible for about two-thirds of the temporal lesions and about one-half to one-third of the parietal and occipital lesions. With brain tumors a chronological sequence of two groups of signs and symptoms is the rule: first the focal symptoms corresponding to the tumor lesion in a defined cerebral area, later the distant effects of the increasing volume of the tumor, which lead to the general signs of increased intracranial pressure. The different types of homonymous hemianopia in tumor lesions along the suprachiasmatic pathway (optic tract, lateral geniculate body, temporal lobe, parietal lobe, occipital lobe) are described and discussed. The general neurological signs and symptoms are briefly reviewed. Demonstration of important cerebral diagnostic examination methods (plain X-ray, electroencephalogram, computer tomogram, nuclear magnetic resonance, angiography). Differential diagnosis of brain tumors (hematomas, abscesses, granulomas, parasites etc.).

Brain Mapping↗
PubMed1988

Macrophage size determinations in the diagnosis of tuberculous effusions.

This study investigated the usefulness of macrophage size determinations in lymphocyte-rich pleural effusions to improve the cytologic diagnosis of tuberculous pleurisy. The size of pleural macrophages was analyzed by quantitative morphometric planimetry in 18 effusions due to tuberculosis, 21 effusions following radiotherapy for malignant disease and 10 effusions due to congestive heart failure. Macrophages were identified and clearly separated from mesothelial cells by latex phagocytosis and immunostaining with the monoclonal antibody My4 (CD14). The mean macrophage area (+/- standard deviation) in tuberculous effusions (92 +/- 14 sq micron) was significantly smaller than in postradiation (141 +/- 28 sq micron) and heart-failure effusions (154 +/- 22 sq micron) (P less than .0001). There was also a smaller ratio of mesothelial cells in tuberculous effusions (0.5 +/- 0.9%) in comparison with effusions following radiotherapy (4 +/- 5%) or congestive heart failure (10 +/- 12%). In summary, this study demonstrated some cytomorphologic parameters that may be helpful in the differential diagnosis of tuberculous effusions.

Adolescent↗