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Biomedical subjects

C Strasser

Publications and source records attributed to C Strasser.

8 recordsLinked to original sources

Inflammatory bowel disease-specific autoantibodies in HLA-B27-associated spondyloarthropathies: increased prevalence of ASCA and pANCA.

AIMS: An association between inflammatory bowel disease (IBD) and spondyloarthropathies (SpA) has repeatedly been reported. The aim of the present study was to investigate whether serologic markers of IBD, e.g. antibodies against Saccharomyces cerevisiae (ASCA), antibodies against exocrine pancreas (PAB) and perinuclear antineutrophil cytoplasmic antibodies (pANCA) are present in HLA-B27-associated SpA. METHODS: 87 patients with HLA-B27-positive SpA and 145 controls were tested for ASCA, PAB and pANCA employing ELISA or indirect immunofluorescence, respectively. Antibody-positive patients were interviewed regarding IBD-related symptoms using a standardized questionnaire. RESULTS/CONCLUSION: When compared to the controls, ASCA IgA but not ASCA IgG levels were significantly increased in patients with SpA, in particular in ankylosing spondylitis (AS) and undifferentiated SpA (uSpA). pANCA were found in increased frequency in patients with SpA whereas PAB were not detected. The existence of autoantibodies was not associated with gastrointestinal symptoms but sustains the presence of a pathophysiological link between bowel inflammation and SpA.

Adolescent↗

Influence of histamine release on postoperative vomiting (POV) following gynaecological laparoscopic surgery.

OBJECTIVE: The mechanisms leading to the high incidence of postoperative vomiting (POV) after gynaecological laparoscopic surgery are still unknown. The effectiveness of POV-prophylaxis using H1 + H2-receptor antagonists has been demonstrated, suggesting a role for histamine in the pathogenesis of POV. However, histamine levels were not measured in these studies. The aim of this study was to investigate the incidence of plasma histamine release and its association with POV after gynaecological laparoscopic surgery. MATERIAL OR SUBJECTS: Twenty-two female patients, aged 20-56 y, classified ASA physical status I or II, undergoing elective gynaecological laparoscopic surgery were enrolled in the study. Blood samples for plasma histamine measurements were drawn at defined time points perioperatively. Emetic symptoms were recorded within the first 24 h after operation. A standardized balanced anaesthesia without any prophylactic antiemetic medication was applied. Formal causality analysis for histamine as a determinant for POV was performed. RESULTS: The overall incidence of POV was 40.9% (9 out of 22 patients). Twelve out of 22 patients (54.5%) demonstrated a histamine release reaction during the whole observation period. Six out of 9 patients with POV (66.7%) had a histamine release. There was no difference in mean plasma histamine levels between POV-positive and POV-negative patients. The conditional probability for POV with histamine release was 6/12 = 0.5, in contrast to 3/10 = 0.3 for POV without histamine release. CONCLUSIONS: A high incidence of plasma histamine release was demonstrated in most but not all patients with POV. The probability of POV with histamine release (0.5) was higher than without histamine release (0.3), thus histamine release was shown to be one of the contributory determinants for POV in this clinical study. Thus, patients at risk for POV may benefit from a H1 + H2-receptor antagonists prophylaxis alone or in combination with other antiemetic strategies.

Adult↗

[Vomiting after gynecologic laparoscopy and under general anesthesia is associated with changes in excretion of serotonin metabolites].

INTRODUCTION: The efficacy of 5-HT(3)-receptor antagonists suggests a role of serotonin in the pathogenesis of postoperative nausea and vomiting (PONV). However, studies investigating the relationship between the turnover of serotonin and PONV were contradictory. Therefore we carried out a pilot study in order to find out whether results can be obtained that would justify further studies on a larger scale. METHODS: A total of 22 patients scheduled for elective gynaecological laparoscopy were enrolled. A balanced anaesthesia using sufentanil, etomidate, cisatracurium, isoflurane and nitrous oxide was administered and 5-hydroxyindoleaceticacid (5-HIAA) concentrations in the urine were measured within the 24 h after surgery. RESULTS: Only the patients that vomited postoperatively had a significant change in the concentrations of 5-HIAA over the time course investigated. However, comparison of urinary 5-HIAA concentrations of the group comprising patients that vomited with those that had no PONV did not reveal a significant difference. CONCLUSIONS: Results of this study support further investigation of the relationship between serotonin and PONV and suggest that there may in fact be an association between PONV and increased serotonin turnover.

Adolescent↗

[Clinical outcome of a cohort of 63 patients with hepatocellular carcinoma treated with octreotide].

Unresectable hepatocellular carcinoma (HCC) are associated with a poor prognosis. Recently, one controlled study reported a strikingly prolonged survival of patients with HCC who were treated with octreotide. Until other randomised controlled trials become available, this multicentric retrospective study therefore assesses the outcome of HCC-patients who received octreotide treatment. 63 patients (53 males, 10 females) who had been treated with octreotide at 13 participating German centres were included in the analysis. In 54 cases liver cirrhosis was present (25 Child-Pugh A, 20 Child-Pugh B, 7 Child-Pugh C, 2 unknown). The liver disease was associated with alcohol abuse in 19 patients, alcohol and viral hepatitis in four patients, while 12 patients had only markers of past or present hepatitis B infection, 11 patients suffered of chronic hepatitis C infection, and four patients were seropositive for both hepatitis B and hepatitis C markers. The Okuda stage was stage I in 23, stage II in 33, and stage III in 7 patients. The patients initially received octreotide as a long-acting release formula (20-30 mg/month) in 43 cases or through subcutaneous injection (dose 3 x 50-3 x 300 ug/day) in the remaining cases. 11 of the patients receiving subcutaneous treatment were later converted to the long-acting release form of the drug. At three months, a partial remission was achieved in two patients, while 22 tumours showed no change and 26 tumours progressed. At six months, 11 tumours showed no change, while 15 tumours progressed. The patients' median survival was 9 months (Okuda stage I 16 months, stage II 9 months, stage III 4 months). In conclusion, octreotide treatment did not result in markedly prolonged survival in this retrospective series of 63 patients.

Adult↗

The visual function of professional baseball players.

PURPOSE: To measure the visual acuity, stereoacuity, and contrast sensitivity of professional baseball players. METHODS: Three hundred eighty-seven professional baseball players underwent several tests of visual function including distance visual acuity. Stereoacuity was evaluated at near by the Randot test and at distance by both contour and random dot targets. Distance stereoacuity was also tested under timed and untimed conditions. Contrast sensitivity was evaluated by the Vision Contrast Test System, Contrast Sensitivity Viewer, and Binocular Visual Acuity Tester. RESULTS: Visual acuity (measured with players' regular distance correction) in 774 eyes ranged from 20/8.89 to 20/100. Near stereoacuity ranged from 23 to 37 seconds of arc, mean untimed distance contour stereoacuity from 55 to 35 seconds of arc, and mean untimed distance random dot stereoacuity from 98 to 76 seconds of arc. The results under timed conditions were 86 to 65 seconds of arc (timed distance contour stereoacuity) and 104 to 83 seconds of arc (timed distance random dot stereoacuity). Statistically significant differences were found between major and minor league players on tests of untimed distance contour and random dot stereopsis, and on contrast sensitivity testing with the 3.0- and 6.0-cpd gratings using the Contrast Sensitivity Viewer. CONCLUSIONS: Professional baseball players have excellent visual skills. Mean visual acuity, distance stereoacuity, and contrast sensitivity are significantly better than those of the general population.

Baseball↗

[Thyroid function after thyroidectomy for benign goiter. 200 cases explored by ultrasensitive TSH].

Based on a retrospective study of a series of 200 thyroidectomies for benign goitre and a mean follow up period of 12 Months, the authors analysed post-operative thyroid function and correlated it with the degree of surgical excision (47 unilateral lobectomies, 91 classical subtotal bilateral lobectomies and 62 extended bilateral subtotal lobectomies). After a presentation of the results in comparison with data from the literature, the timing and threshold for the institution of replacement therapy are examined and the need for prolonged clinical and laboratory monitoring is also stressed. In terms of changes in laboratory criteria only monitoring of spontaneous changes in US TSH allows opotherapy to be avoided or conversely to accurately define the conditions for institution of definitive replacement therapy. The justification of total thyroidectomy in the treatment of multihetoronodular goitres almost totally involving the glandular parenchyma is acknowledged.

Adolescent↗

[Contribution and limitations of peroperative radiotherapy combined with excision-curettage in the treatment of gastric cancers].

Macro- or microscopic residual tumor after surgery is the dominating prognostic factor in the treatment of gastric cancer. The majority of patients die of local recurrence and peritoneal spread. Therefore, in addition to gastrectomy and extended lymphadectomy (compartments 1 & 2) in some centers a adjuvant intraoperative radiotherapy is performed. Recent results of adjuvant intraoperative radiotherapy for gastric cancer revealed a lower local recurrence but there was no improvement in the survival rate for advanced tumor stages. These results are confirmed by our prospective study including 36 patients till now: in the group of 21 survivors there is no sign of a local recurrence. In 15 patients which died meanwhile there was only one case of local recurrence (median follow-up: 9 months, range 1-30 months). Peritoneal spread and liver metastasis were observed as the most frequent cause of death (tumor stage IIIB and IV only).

Combined Modality Therapy↗