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Biomedical subjects

H Albrecht

Publications and source records attributed to H Albrecht.

At least 19 recordsLinked to original sources
PubMed2007

Impact of patient- and disease-specific factors on SLNB in breast cancer patients. Are current guidelines justified?

BACKGROUND: The evidence on which to base guidelines for sentinel lymph node biopsy (SLNB) in breast cancer is still limited. In order to facilitate the further implementation of renewed guidelines, we evaluated patient- and disease-specific factors for their impact on the results of SLNB. MATERIALS AND METHODS: Prospective data acquisition from patients undergoing surgery for primary invasive breast cancer was performed. All patients underwent SLNB using the radiocolloid or the combined technique. The association of patient- and disease-specific factors to detection rate and false-negative rate was calculated using univariate and multivariate analyses (P < 0.05 considered as significant). Calculation of the false-negative rate was based on patients who underwent a backup axillary dissection. RESULTS: Among 455 consecutively enrolled patients, a significant inverse association to the detection rate was found for extracapsular extension of non-SLN metastases, body mass index (BMI), number of involved lymph nodes, pT category, tumor size, and age. A significant association to the false-negative rate to identify macrometastases was found for pT category, tumor size, and grading. Other factors, such as prior surgery, multicentric tumor growth, or vascular invasion, showed no influence. A cut-point analysis revealed that a tumor size of 2 cm separated the collective of patients with the highest significance in regard to the false-negative rate (9% vs. 25%). CONCLUSION: Our results indicate that SLNB can be safely used in elderly and obese patients with multicentric tumors and those having undergone prior surgery for benign breast disease. However, the method should be applied with caution in patients with tumors larger than 2 cm.

Adult↗
PubMed2006

Real time 3D (4D) ultrasound-guided percutaneous biopsy of solid tumours.

PURPOSE: The aim of the current study was to investigate the feasibility of real-time 3D (4D) ultrasound-guided biopsy. MATERIALS AND METHODS: Between 2003 and 2005, 53 patients with suspicious lymph nodes or solid tumours underwent 4D ultrasound-guided core needle biopsy using a 4D US-System (Voluson 730, GE/Kretztechnik, Austria). The results were documented prospectively and compared to a matched series of 53 conventional 2D ultrasound-guided core biopsies. RESULTS: 4D ultrasound-guided biopsy can be performed using multiplanar views or a combination of cross-sectional and rendered images. Assessment of additional 3D images during the biopsy procedure was helpful in 34 % of the cases. In the differentiation of malignant and benign lesions, 4D ultrasound guided biopsy yielded 35 true-positive results, 12 true-negative results and 5 false-negative results. The sensitivity and specificity for the diagnosis of malignancy was 87.5 % and 94.4 %, respectively (control group: 89.5 % and 94.4 %). There was one case of insufficient tissue sampling in the 4D targeting group and 2 cases in the control group. No complications were observed related to the biopsy procedure. CONCLUSIONS: 4D ultrasound-guided biopsy is feasible and can improve visualisation of biopsy procedures by multiplanar display or 3D rendering. Although the accuracy is comparable to that of conventional 2D biopsy, this technique may be helpful for biopsy of lesions with close relation to relevant anatomical structures.

Adult↗
PubMed2006

[Severe colitis due to Histoplasma capsulatum in an AIDS patient].

The case of a thirty-two-year-old female HIV-positive patient from Ghana admitted with a septic illness, diarrhoea, anaemia, and severe weight loss is presented. During an extensive diagnostic work-up Mycobacterium tuberculosis infection and typhoid fever were detected. Specific treatment led to marked improvement in the patient's condition. However, five weeks later high fever and diarrhoea recurred. Histological examination of biopsies from coloscopy and blood cultures revealed Histoplasma capsulatum. The patient recovered completely following antifungal therapy with amphotericin B and itraconazole. The case presented emphasises the need for medical staff dealing with immunocompromised patients from endemic areas to be aware of symptoms, diagnostic features, and therapeutic measures of this rare fungal infection.

AIDS-Related Opportunistic Infections↗
PubMed2005

Effects of peripheral cooling on intention tremor in multiple sclerosis.

OBJECTIVE: To investigate the effect of peripheral sustained cooling on intention tremor in patients with multiple sclerosis (MS). MS induced upper limb intention tremor affects many functional activities and is extremely difficult to treat.Materials/ METHODS: Deep (18 degrees C) and moderate (25 degrees C) cooling interventions were applied for 15 minutes to 23 and 11 tremor arms of patients with MS, respectively. Deep and moderate cooling reduced skin temperature at the elbow by 13.5 degrees C and 7 degrees C, respectively. Evaluations of physiological variables, the finger tapping test, and a wrist step tracking task were performed before and up to 30 minutes after cooling. RESULTS: The heart rate and the central body temperature remained unchanged throughout. Both cooling interventions reduced overall tremor amplitude and frequency proportional to cooling intensity. Tremor reduction persisted during the 30 minute post cooling evaluation period. Nerve conduction velocity was decreased after deep cooling, but this does not fully explain the reduction in tremor amplitude or the effects of moderate cooling. Cooling did not substantially hamper voluntary movement control required for accurate performance of the step tracking task. However, changes in the mechanical properties of muscles may have contributed to the tremor amplitude reduction. CONCLUSIONS: Cooling induced tremor reduction is probably caused by a combination of decreased nerve conduction velocity, changed muscle properties, and reduced muscle spindle activity. Tremor reduction is thought to relate to decreased long loop stretch reflexes, because muscle spindle discharge is temperature dependent. These findings are clinically important because applying peripheral cooling might enable patients to perform functional activities more efficiently.

Activities of Daily Living↗
PubMed2005

Evaluation of a digital store-and-forward colposcopic system--a pilot study to assess usability for telemedicine.

We evaluated the diagnostic reliability of cervical examination using digital colposcopy compared with conventional binocular colposcopy. A total of 315 patients were examined and diagnosed by a colposcopist on-site. During the colposcopic examination, digital camera images were stored on a PC (median five pictures per patient). A second physician, experienced in colposcopy, re-evaluated the initial diagnostic findings using the stored digital images. The primary and secondary findings in each patient were categorized according to the Rome classification system. There was agreement between the primary and secondary examiners in 69% of cases (kappa=0.60). There was no systematic bias in terms of under- or over-rating. The proportion of non-assessable colposcopic examinations was 9%. Digital colposcopy was reliable and provided advantages in terms of a better follow-up examination and internal quality control of the diagnosis. The pilot study suggests that telecolposcopy may provide better training and further education for physicians and students, and may also improve the diagnostic possibilities in gynaecology.

Adult↗
PubMed2004

Limits for the central production of Theta+ and Xi(--)pentaquarks in 920-GeV pA collisions.

We have searched for Theta+(1540) and Xi(--)(1862) pentaquark candidates in proton-induced reactions on C, Ti, and W targets at midrapidity and square root of s = 41.6 GeV. In 2 x 10(8) inelastic events we find no evidence for narrow (sigma approximately 5 MeV) signals in the Theta+ --> pK0(S) and Xi(--) --> Xi- pi- channels; our 95% C.L. upper limits (UL) for the inclusive production cross section times branching fraction B dsigma/dy/(y approximately 0) are (4-16) mub/N for a Theta+ mass between 1521 and 1555 MeV, and 2.5 mub/N for the Xi(--). The UL of the yield ratio of Theta+/Lambda(1520) < (3-12)% is significantly lower than model predictions. Our UL of B Xi(--)/Xi(1530)0 < 4% is at variance with the results that have provided the first evidence for the Xi(--).

Journal Article↗
PubMed2004

[Strychnine poisoning].

HISTORY AND ADMISSION FINDINGS: A 46-year-old man presented two hours after ingestion of about 250 mg strychnine with severe violent, generalized convulsions, triggered by external stimuli. During the convulsion-free periods there were no abnormal signs in the physical examination. INVESTIGATION: The presence of strychnine was confirmed by urine analysis with gas chromatography-mass spectrometry. TREATMENT AND COURSE: Because diazepam as anticonvulsant of choice was not effective in abating the convulsions the patient was intubated. A combination with midazolam, fentanyl and pancuronium was effective in controlling the convulsions. The patient was discharged from ICU on day three. CONCLUSION: Fatal outcome of strychnine poisoning demands an aggressive management with early intubation, control of muscle tremors and prevention of rhabdomyolisis and renal failure.

Analgesics, Opioid↗
PubMed2004

[The suitability of digital colposcopy for telematic applications].

Since carcinoma of the cervix is one of the most common cancers in women, screening of the cervix has acquired considerable importance. Colposcopy is a simple diagnostic method of detecting suspicious changes at an early stage. Shortcomings of this method are its low specificity and high inter- and intra-observer variability. A clinical pilot study was therefore carried out to investigate the advantages of a digital colposcopic system comprising a binocular colposcope coupled to a CCD camera and a computer. The aim of the study was to evaluate the reliability of diagnostic findings of the cervix obtained with digital colposcopy in comparison with standard binocular colposcopy, and to assess its suitability for telematic applications (teleconsultation, telediagnostics, treaching). A total of 315 patients were examined and statistically analysed. The patients were first submitted to a conventional colposcopic examination and a diagnosis was established. During the colposcopic examination camera images were stored on a computer, on the basis of which a second physician experienced in colposcopy reviewed the initial diagnosis. The primary and secondary findings of each patient were classified into 4 categories and compared following the Rome classification system. Agreement between the primary and secondary diagnosis was established in 69% of the cases (kappa = 0.60 +/- 0.03). No bias was observed in terms of under- or overrating. The percentage of non-assessable colposcopic examinations was 9.2%. Digital colposcopy is therefore suitable for reproducing diagnostic findings on the computer, given adequate digital image quality and a suitable classification model. The method has clear advantages with regard to follow-up, internal quality control of the diagnosis, and the training and further education of physicians and students. In the future, telecolposcopy may open up new opportunities in gynaecology.

Adult↗
PubMed2003

Progressive multifocal leucoencephalopathy with unusual inflammatory response during antiretroviral treatment.

A case of biopsy verified progressive multifocal leucoencephalopathy (PML) in an HIV patient is presented. Imaging and histological examination confirmed remarkable inflammatory activity accompanied by an unusually benign clinical course despite no clear evidence of immune reconstitution after the start of antiretroviral treatment. This case not only raises several questions regarding the pathophysiology of PML, but gives also evidence that AIDS associated inflammatory PML must be considered another clinical entity in the expanding range of diseases now commonly referred to as the immune reconstitution syndrome.

AIDS Dementia Complex↗
PubMed2003

Making sense of AIDSVAX.

Preliminary data from the manufacturer of AIDSVAX presented in a February press conference indicate overall disappointing results from their large vaccine trial, but some intriguing results among the small numbers of non-white volunteers.

AIDS Vaccines↗
PubMed2002

Effectiveness of twice-weekly pyrimethamine-sulfadoxine as primary prophylaxis of Pneumocystis carinii pneumonia and toxoplasmic encephalitis in patients with advanced HIV infection.

The safety and efficacy of a fixed 25 mg pyrimethamine-500 mg sulfadoxine combination supplemented with 15 mg folinic acid twice a week as primary prophylaxis of Pneumocystis carinii pneumonia (PCP) and toxoplasmic encephalitis was evaluated in 106 patients infected with the human immunodeficiency virus. All patients had a CD4+ T-lymphocyte count of less than 100 cells/microl at study entry. Efficacy in this single-arm open-label prospective study was analyzed on an as-treated basis. No patient received highly active antiretroviral treatment, including protease inhibitors or non-nucleoside reverse transcriptase inhibitors, while on study medication. PCP developed in four patients, one of whom had been noncompliant. No PCP episode occurred in the first year. Probabilities of freedom from PCP were 0.97 (95%CI, 0.92-1) after 24 months and 0.93 (95%CI, 0.84-1) after 36 months. Of 74 (69.8%) patients positive for anti-toxoplasma IgG antibodies, one noncompliant patient developed toxoplasmic encephalitis after 24 months. Allergic reactions were observed in 18 (17%) patients and resulted in permanent discontinuation in 7 (6.6%) patients. One (0.9%) patient who had continued prophylaxis despite progressive hypersensitivity reactions developed a serious adverse reaction (Stevens-Johnson syndrome). The median survival of study participants was 29 months, with relentless progression of AIDS accounting for most deaths. The prophylaxis regimen studied appeared safe and effective for primary prophylaxis of PCP and toxoplasmic encephalitis. Severe adverse events can likely be prevented by discontinuation of prophylaxis at the time allergic reactions are noted. Rechallenge frequently results in tolerance. Efficacy and safety compare favorably with previously studied regimens. This simple prophylactic regimen may provide a convenient alternative for patients failing or intolerant to approved regimens.

AIDS-Related Opportunistic Infections↗
PubMed2002

A new database on basic research in homeopathy.

A new database on 'Basic Research on Homeopathy' has been established. It contains research on biological systems and physico-chemical effects of the succussion process. It is aimed at the elucidation of the working mechanism of the homeopathic similia principle following application of low doses and potencies of substances. By the end of 2000, this database included 829 experiments in 782 primary publications. The publications are classified according to organism and field of interest. Several reasons for the relatively high number of experiments and publications are presented. It is concluded that the research community would benefit from a European research agenda with a priority on the translation of relevant publications from the different European languages into English.

Databases, Bibliographic↗
PubMed2001

Measurement of ataxic symptoms with a graphic tablet: standard values in controls and validity in Multiple Sclerosis patients.

Aim of our study was to find a specific measure for the intensity of upper limb tremor and other ataxic symptoms in Multiple Sclerosis (MS) patients, and to establish standard values and test quality parameters. Three hundred and forty-two consecutive patients with different symptoms in the upper limbs (upper motor neuron symptoms, cerebellar upper limb ataxia, and/or sensory deficits in the upper limbs) and 140 healthy controls took part in the study. All patients and controls had to trace over a 25 cm high figure '8' on a graphic tablet, to tap with the stylus on the tablet and to perform the nine-hole-peg test (9HPT). Patients were additionally examined using clinical standard scales to classify motor dysfunctions of the upper limbs. One hundred and eighty-nine patients and 27 controls were tested twice to investigate the test reliability. Kinematic analysis of the tablet data was performed by kernel estimators, oscillatory activity by spectral analysis. Total power in the 2--10 Hz band was very specific for ataxia versus other motor symptoms. Tapping and 9HPT could well distinguish patients from controls, and patients with predominant motor neuron or cerebellar symptoms from patients with predominant sensory dysfunctions. Mean drawing error did not differ between motor and sensory dysfunctions. The test--retest reliability was similarly high for both spectral analysis and 9HPT.

Adult↗
PubMed2001

The phosphatidylethanolamine-binding protein is the prototype of a novel family of serine protease inhibitors.

Serine proteases are involved in many processes in the nervous system and specific inhibitors tightly control their proteolytic activity. Thrombin is thought to play a role in tissue development and homeostasis. To date, protease nexin-1 is the only known endogenous protease inhibitor that specifically interferes with thrombotic activity and is expressed in the brain. In this study, we report the detection of a novel thrombin inhibitory activity in the brain of protease nexin-1(-/-) mice. Purification and subsequent analysis by tandem mass spectrometry identified this protein as the phosphatidylethanolamine-binding protein (PEBP). We demonstrate that PEBP exerts inhibitory activity against several serine proteases including thrombin, neuropsin, and chymotrypsin, whereas trypsin, tissue type plasminogen activator, and elastase are not affected. Since PEBP does not share significant homology with other serine protease inhibitors, our results define it as the prototype of a novel class of serine protease inhibitors. PEBP immunoreactivity is found on the surface of Rat-1 fibroblast cells and although its sequence contains no secretion signal, PEBP-H(6) can be purified from the conditioned medium upon recombinant expression.

Amino Acid Sequence↗