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Biomedical subjects

B Glodny

Publications and source records attributed to B Glodny.

16 recordsLinked to original sources
PubMed2006

Placement of endovascular stent-grafts for emergency repair of acute traumatic aortic rupture: a single-centre experience.

The aim of this retrospective study was to evaluate mid- and long-term results of endovascular stent-graft placement for emergency repair of acute traumatic thoracic aortic rupture. From 1996 through 2005, 22 consecutive patients (mean age: 38.7 years) underwent endovascular repair of acute traumatic thoracic aortic rupture located at the aortic isthmus in most cases. All patients were at high surgical risk due to severe associated injuries. The endografts were inserted via femoral or iliac artery access under fluoroscopic guidance. Follow-up was performed postinterventionally, at 6 and 12 months and yearly thereafter, and included clinical examination and computed tomography (CT) scans. Technical and clinical success rates were 86.3%. Mean follow-up was 31.7 months. Three patients developed early type I endoleak due to the inability of the rigid graft to adapt to the curved aortic contour. In two of them conversion to open surgery was necessary. One patient had late type I endoleak and died. No other complications were observed. The outcome was successful in most patients. The mid- and long-term results of our current study are promising. However, early type I endoleak represents a problem, especially in adolescent patients with a marked curvature of the aortic arch.

Adolescent↗
PubMed2006

The vasodepressor function of the kidney: prostaglandin E2 is not the principal vasodepressor lipid of the renal medulla.

AIM: Whereas prostaglandin E2 has been characterized as the principal vasodepressor lipid, medullipin remains a hypothetical vasodepressor principle of the renal medulla. Representing the first step towards the isolation of medullipin as a pure compound, the aim of the present study was to determine whether or not the known vasodilator and antihypertensive action of prostaglandins play a role in the antihypertensive activity of renal medulla. METHODS: A chloroform extract of porcine kidney medulla was fractionated by gradient vacuum liquid chromatography (VLC) and analysed by capillary GC-MS for the presence of prostaglandins (detection limit: 2.2 ppm). The biological activity was determined in spontaneously hypertensive Wistar rats. The particle size of injectable colloids prepared from extract and fractions was controlled by photon correlation spectroscopy. RESULTS: The extract caused a pronounced blood pressure decline (29.6 +/- 6.3/24.9+/- 5.5 mmHg; P = 0.0078; 10 mg kg(-1) body weight; particle size of 143 +/- 18 nm; n = 7) lasting for more than 1 h. The heart rate remained stable, showing only a slightly decrease. All fractions were shown to be devoid of vasodilator prostanoid substances. The VLC procedure allowed the successful separation of endogenous emulsifiers from the active principle. An extract from the renal cortex did not exhibit a similar vasodepressor effect. CONCLUSION: Prostaglandins are excluded as the blood pressure-lowering active principle of a total lipid kidney medulla extract. The vasodepressor principle is contained in the kidney medulla, but not in the cortex. It can be separated from endogenous emulsifying substances, is chromatographically stable, and is amenable to purification and chemical characterization.

Animals↗
PubMed2001

Conn's syndrome and bilateral renal artery stenosis in the presence of multiple renal arteries.

We report the case of a 42-year-old male who was admitted to our hospital after an acute hypertensive crisis despite four-way anti-hypertensive therapy. The renal scintigraphy, the excretory urogram and the biochemical profile performed two years before were unremarkable, except for slightly elevated serum creatinine and plasma aldosterone, in presence of normal aldosterone/renin ratio. The renal arterial angiography that was performed despite a second unremarkable scintigraphy revealed high-grade bilateral arterial stenosis in the presence of multiple renal arteries. Following dilatation of the left stenosis, the aldosterone/renin ratio was pathologic. Recumbent and orthostatic aldosterone values were 830 pg/ml and 1824 pg/ml, respectively, and recumbent and orthostatic renin values were 0.82 and 1.21 ng angiotensin I/ml/h, respectively. The abdominal computed tomography performed to investigate a possible concomitant Conn's syndrome resulted in the detection of a left adrenal tumor. After resection of the lesion, plasma-aldosterone levels normalized and a pronounced rise in serum potassium levels was observed. Following angioplasty of the right renal artery stenosis, blood pressure could easily be managed with combined beta and calcium channel blocker therapy. Particularly in cases of bilateral (but also in the presence of unilateral) renal artery stenosis in association with Conn's syndrome, all the available screening methods for these disorders can fail. In cases of poor response to combination hypertensive therapies, renal arteriography and a fludrocortisone-suppression test should be performed in order to rule out both renal arterial stenosis and Conn's syndrome, even in the absence of clinical and biochemical findings suspicious for either disorder.

Adult↗
PubMed2001

A possible explanation for the frequent concomitance of arterial hypertension and multiple renal arteries.

In more than 20% of subjects, at least one kidney is found to be supplied by more than one artery arising from the aorta. This aberrant renovascular anatomy has been reported in the literature to occur in up to 80% of patients who suffer from essential hypertension. Predominant numbers of the so-called 'accessory' vessels are longer and narrower than the segmental arteries arising in the main renal artery. As a result (in accordance with Poiseuille's law of fluid flow), the renal segments supplied by these 'accessory' vessels may have lower levels of blood pressure than the remainder of the parenchyma, thereby increasing the renin secretion. This hypothesis could be significant in terms of finding a causal treatment for a disorder induced by such a mechanism. We first review the literature in which the frequency of these vascular anomalies in normotensive and hypertensive patients is described, and then advance a hypothesis explaining the frequent incidence of essential hypertension in these subjects, as well as the ramifications of this phenomenon.

Adult↗
PubMed2001

Clinical differences between benign and malignant pheochromocytomas.

Most pheochromocytomas can be cured by resection. In view of the unfavourable prognosis for surgical therapy in cases of late tumour detection and malignant tumours, the aim of the present study is to differentiate between typical signs and symptoms of malignant versus benign pheochromocytomas. We investigated the records of 133 patients retrospectively (1967-1998). In cases of benign tumours (104 of 133, mean age 42+/-15.8 years) tumour size was 5.9+/-3.4 cm, and history was 47.4+/-75.4 months. 7.7% of the tumours were extraadrenal, and 77% had paroxysmal manifestations. The other 29 patients (mean age: 39.2+/-21.9 years) had malignant lesions (tumour size: 9.4+/-5.9 cm (p=0.0022); history: 7.4+/-5.6 months (p=0.0137); extraadrenal: 24.1% (p=0.0219); paroxysmal: 37.9% (p=0.0012)). Symptoms of patients with benign tumours were hypertension (80%), headaches (42.3%), sweating (30.8%), tachycardia (26%) and pallor (24%) (Malignant: Hypertension 46%, p=0.0873; headaches 11%, p=0.0008; sweating 11%, p=0.0196; tachycardia 14%, p=0.1961 and pallor 0%, p=0.0010). Abdominal pain and dorsalgia occurred more frequently in malignant pheochromocytomas (26% versus 7%, p=0.0014). Unusually short histories and extraadrenal localization appear to be suspicious for malignancy. The "typical" clinical signs and symptoms occur more frequently in patients with benign tumours and can therefore be regarded as typical signs of benign pheochromocytomas.

Abdominal Pain↗
PubMed2000

Hypertension associated with multiple renal arteries may be renin-dependent.

OBJECTIVE: Subjects with multiple renal arteries have been shown to suffer more frequently from hypertension and to have higher blood pressures than subjects whose kidneys are supplied by single renal arteries. This study was carried out to determine whether subjects with multiple renal arteries also have higher renin activity. METHODS: We studied 62 consecutive patients who had undergone angiography for various reasons. They were divided into two groups. Group A comprised 29 patients whose kidneys were supplied by single arteries (male :female ratio 1.63, mean age 51.8 +/- 1.9 years) while Group B comprised 33 patients with multiple renal arteries (male:female ratio 2, mean age 47.3 +/- 2.3 years). RESULTS: Before stimulation with frusemide, the plasma renin in Group A was 0.79 +/- 0.13 ng angiotensin l/ml per h, while in Group B the corresponding figure was 1.73 +/- 0.38 ng angiotensin l/ml per h. This difference was statistically significant (P= 0.0127). Thirty minutes later the plasma renin level in Group A was 2.43 +/- 0.37 ng angiotensin l/ml per h versus a level of 3.86 +/- 0.53 ng angiotensin l/ml per h in Group B (P= 0.0169). Again, 30 minutes later the level was 2.59 +/- 0.4 ng angiotensin l/ ml per h in Group A, versus 3.79 +/- 0.59 ng angiotensin l/ ml per h in Group B (P= 0.0495). CONCLUSIONS: We conclude that patients with multiple renal arteries constitute a group who have high plasma renin activity and may therefore be prone to develop arterial hypertension.

Adult↗
PubMed2000

An assessment of diagnostic procedures preparatory to retroperitoneoscopic removal of adenoma in cases of primary hyperaldosteronism.

The goal of this study was to improve assessment of diagnostic measures for lateral localization of aldosterone-producing adrenal adenomas preparatory to retroperitoneoscopic removal, in view of the fact that this technique allows for only unilateral access. A retrospective study was carried out of the medical records of 64 patients (38 women, 26 men, average age 46.8+/-11.2) who underwent surgery at University Hospital, Münster, between 1969 and 1998. Seventeen of the 64 patients presented with hyperplasia and 47 had adrenal adenoma. In cases of hyperplasia, computerized tomography imaged a false-positive unilateral tumor 10 times, a false-negative 3 times, and a unilateral hyperplasia 1 time (ultrasonography: tumor 2 times, false-negative 3 times; 131I-Iodomethylnorcholesterol scintigraphy: tumor 5 times, false-negative 1 time, correct 1 time). In cases of adenoma, computerized tomography yielded accurate results 40 times, imaged a false-negative 2 times, and indicated the incorrect side 1 time (Ultrasonography: false-negative 12 times, correct side 9 times, incorrect side 1 time; 131I-Iodomethylnorcholesterol scintigraphy: correct side 19 times, false-positive (both sides) 5 times, negative 3 times, incorrect side 2 times). Venous sampling, which was carried out seven times, yielded accurate results six times, and failed technically one time. Venous sampling appears to be the method of choice for preoperative lateral localization. Thus, retroperitoneoscopic treatment of Conn's syndrome should not be carried out unless venous sampling is carried out first.

Adenoma↗
PubMed2000

CYFRA 21-1 serum analysis in patients with esophageal cancer.

This study was conducted to determine a potential use of CYFRA 21-1 in patients suffering from carcinoma of the esophagus. CYFRA 21-1 serum concentrations of 50 patients with histologically proven malignant lesion of the esophagus were compared with 50 healthy persons, 50 patients with benign esophageal disease, and 50 patients with benign lung disease. Additional analysis of serum carcinoembryonic antigen, CA 72-4, and squamous cell carcinoma-antigen serum concentrations were performed. The patients with esophageal carcinoma underwent follow-up tumor marker examinations every three months for 1 year. Analysis to detect statistically significant differences was conducted to estimate a cutoff and to evaluate tumor entity, tumor stage, survival, and tumor-free survival. CYFRA 21-1 at a cutoff of 1.40 ng/ml showed an overall sensitivity to esophageal carcinoma of 36% (45.5% to squamous cell carcinoma, 17.6% to adenocarcinoma) at a specificity of 97.3%. CYFRA 21-1 concentrations showed a tendency to higher serum levels depending on local tumor burden. A correlation of CYFRA 21-1 with various N- or M-stage disease was not observed. Postoperative development in terms of survival and tumor-free survival showed significant correlation to preoperative CYFRA 21-1 concentrations. Clinical tumor recurrence was preceded by CY-FRA 21-1 elevation by 3.4 months. For prognosis and follow-up, this marker is justified for additional analysis in a larger series of patients suffering from carcinoma of the esophagus.

Adult↗
PubMed1998

Decreased HER-2 tyrosine kinase expression in rectal mucosa of FAP patients following low-dose sulindac chemoprevention.

As a part of the mechanisms of action in reversing FAP adenomas by the low-dose sulindac maintenance therapy (2 x 25 mg/patient per day), the extent of HER-2 proto-oncogene expression in the rectal mucosa seems to be of interest. Immunocytochemical analyses were performed in plasma and in rectal tissue of sulindac-treated FAP patients during an 18 months follow-up and compared with rectal tissue of patients with FAP, Crohn's disease, or rectal cancer or with healthy volunteers. HER-2 was significantly reduced and maintained in tissue under sulindac chemoprevention below base line levels of healthy individuals, but not in plasma. Therefore, a direct or indirect effect of sulindac as a tyrosine kinase inhibitor may be implicated. During NSAID treatment HER-2 protein expression as a prognostic tool seems to be of little clinical relevance.

Adenomatous Polyposis Coli↗
PubMed1998

[Prognostic differences in primary malignancies of the small intestine].

Malignant small bowel tumours are rare, with about 320 deaths every year due to metastases. Tumours of differing histologic entitites (adenocarcinomas, leimyosarcomas, non-Hodgkin, lymphomas, carcinoids) are detected at late stages of the disease because of non-specific symptoms. Valuable diagnostic means are small bowel enema, intestinoscopy and abdominal CT/ultrasound. Five-year survival rates are poor for carcinomas (21%), for sarcomas (37%), lymphomas (44%) and best for carcinoids (100%). Surgical options are poor for carcinomas with a high number of R2 resections and bypass operations. Multivisceral surgery is beneficial for sarcomas and lymphomas, followed by local radiation therapy or chemotherapy.

Adolescent↗
PubMed1997

Angiotensin type-1 (AT1) receptor gene expression in primarily cultured human arterial umbilical endothelial cells.

The aim of this study was to investigate the interaction of angiotensin II (Ang II) and human umbilical arterial endothelial cells (HUAEC). Specific binding of 125I-ANG II to primarily cultured HUAEC showed a K(D) of 1.98 +/- 0.53 x 10(-9) M (n = 5) with a maximum binding site of 2.84 +/- 1.07 x 10(-13) mol/mg protein (n = 5). In later passages (third and fifth subculture), this binding site was no longer detectable. Gene expression analysis revealed a strong expression of the angiotensin type-I receptor (AT1-R) in the primarily cultured HUAEC, with a decrease in additional passages. In primarily cultured HUAEC, Ang II (10(-10)-10(-6) M) induced a concentration-dependent increase in intracellular free calcium ([Ca2+]i) that could be blocked by a preincubation with candesartan (TCV-112) but not by PD123319. These data show the expression of the AT1-R in primary cultures of HUAEC. The Ang II-induced increase in [Ca2+]i seems to be mediated by this receptor.

Angiotensin II↗
PubMed1997

Cell-cycle arrest in G0/G1 phase of growth factor-induced endothelial cell proliferation by various calcium channel blockers.

Calcium channel blockers cause antiproliferative effects on various cells in culture. Since angioneogenesis is a crucial step in the development of tumor growth, we examined the influence of different calcium channel blockers on human umbilical arterial endothelial cell (HUAEC) growth. Cell growth was measured by cell count, by [3H]thymidine incorporation, and by a 5-bromo-2-deoxyuridine (BrdU-incorporation immunofluorescence assay. Cell-cycle analysis was performed by flow cytometric analysis. Nifedipine, isradipine, diltiazem, and verapamil dose-dependently inhibited the basic fibroblast growth factor (bFGF)-induced [3H]thymidine incorporation. Fifty micromolars of nifedipine, isradipine, diltiazem, and verapamil completely inhibited bFGF-induced proliferation of HUAEC. Ten micromolars of each calcium channel blocker abolished the bFGF-induced increase in cell count. Five micromolars of isradipine completely blocked the bFGF-induced BrdU incorporation. Stimulation of HUAEC with bFGF (50 ng/ml) for 24 h caused a 2-fold increase in cells that entered S and G2+M phase in comparison with control cells. Five micromolars of isradipine abolished this effect completely. We conclude that calcium channel blockers are able to inhibit cell proliferation by a cell-cycle arrest in G0/G1 phase.

Calcium Channel Blockers↗
PubMedDate not supplied

Gallbladder bile tumor marker quantification for detection of pancreato-biliary malignancies.

BACKGROUND: The pre-operative differentiation of tumors of the pancreas, Papilla of Vater and the biliary tract is still unsatisfactory. Tumor marker analysis of the pancreatic juice did not improve the pre-operative diagnosis by a great deal. METHODS: Bile from resected gallbladders of patients suffering from carcinomas of the pancreato-biliary system was analysed for CA 19-9, CEA, CA 72-4, CA 125 and AFP concentrations. The results were compared to patients suffering from acute cholecystitis, cholecystolithiasis as well as those suffering from benign tumors of the pancreato-biliary region. RESULTS: Extreme high CA 19-9 concentrations were found in bile. Evaluations of the tumor-antigens CA 19-9, CA 72-4 and CEA in gallbladder bile were superior to any serum and pancreatic juice examination with respect to sensitivity and specificity. Observed sensitivities amounted to 100% for patients suffering from bile duct carcinoma (CA 19-9) and papillary carcinoma (CEA) at a specificity of 100%. CA 19-9 showed a sensitivity of 76.5% for pancreatic carcinomas at a specificity of 96.4%. CA 19-9 showed significant differences for the local tumor burden and for the degree of lymph node metastasis. Examination of tumor antigens in the gallbladder results in a high degree of discrimination for malignant and benign lesions of the subhepatic pancreato-biliary system. CONCLUSIONS: CA 19-9 must follow a entero-hepatic circulation, since it showed raised bile concentrations (factor: 10(4)) compared to serum analysis. Analysis of CA 19-9, CEA and CA 72-4 gives an opportunity for improvement in the detection of cancers of the pancreato-biliary system. Since the clinical important differentiation of tumors of the head of the pancreas (carcinoma vs. pancreatitis) remains unclear, an improvement by bile analyses must be assumed.

Antigens, Tumor-Associated, Carbohydrate↗
PubMedDate not supplied

Analysis of serum CYFRA 21-1 concentrations in patients with esophageal cancer.

BACKGROUND: This study was conducted to determine the use of CYFRA 21-1 for patients suffering from esophageal carcinoma. MATERIALS AND METHODS: 50 patients with malignant, 50 patients with benign esophageal lesions, 50 healthy persons and 50 patients with benign lung disease were tested for CYFRA 21-1, CEA, CA 72-4 and SCC-antigen serum concentrations. The patients with esophageal carcinoma underwent follow-up analysis for one year. RESULTS: CYFRA 21-1 (cut-off: 1.40 ng/ml) showed a sensitivity for esophageal carcinoma of 46% at a specificity of 89.3%. There was a tendency for higher serum CYFRA 21-1 concentrations in advanced T-stages. Correlations of CYFRA 21-1 with N or M stages could not be observed. The postoperative course, in terms of survival and tumor free survival showed significant correlation to pre-operative CYFRA 21-1 concentrations. Adjuvant therapy could be monitored by CYFRA 21-1 as well. Clinical tumor recurrence was preceded by CYFRA 21-1 elevation by 3.4 months. CONCLUSIONS: We recommend the use of CYFRA 21-1 in cases of esophageal carcinoma, especially in cases of squamous cell carcinoma.

Antigens, Neoplasm↗