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Biomedical subjects

H Becker

Publications and source records attributed to H Becker.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Additional intra-abdominal injuries in multiple-traumatized patients with pelvic fractures. Difficulties in diagnosis and therapy].

Between 1.1. 1987 to 31.12. 1988 178 polytraumatized patients were treated with 62 patients demonstrating pelvic fractures. In 58% of patients injured by rapid falls pelvic fractures were diagnosed compared to only 25% of all patients with traffic accidents. 22% of all polytraumatized patients suffered from intraabdominal injuries, with raise to 47% in patients with pelvic fractures. To avoid unnecessary laparotomies caused by questionable positive lavage ultrasonography is recommended because of its high accuracy and lack of any diagnostic morbidity. 27 of 29 patients with intraabdominal injuries underwent laparotomy. One patient with an isolated kidney rupture was treated conservatively and one patient died before operation. The most common intraabdominal lesion was rupture of liver in 52% and splenic injury in 10 patients. Lesions of the intestine were diagnosed in 11 patients mostly in combination with parenchymal injuries. Concerning the therapeutical approach a conservative treatment is recommended in order to shorten time of operation in concern of the progressively increasing retroperitoneal hematoma. The overall mortality rate was 36%. Most common cause was direct injury of CNS in 14 patients of whom 6 patients suffocated during the first 24 hours. Unstable dislocated pelvic fractures were primary stabilized by external fixator which may help to avoid further progressive retroperitoneal hematoma.

Abdominal Injuries↗
PubMed1990

Immunohistochemical markers in (ganglio)neuroblastomas.

17 commercially available antibodies were applied on formalin fixed and paraffin embedded tissues of neuroblastomas (NBLs, n = 20), ganglioneuroblastomas (GNBLs, n = 7) and ganglioneuromas (GNs, n = 7), to assess their reliability as markers for neuroendocrine differentiation and the degree of tumor cell maturation. Our results indicate, that antibodies directed to neuron specific enolase, HISL 19, dopamine beta-hydroxylase, neurofilament, EGC, LK2H10 and leucocyte common antigen may be useful in discrimination of neuroblastomas from non-neuroendocrine round and small cell tumors in routinely processed tissue. Antibodies to neuron specific enolase, EGC, PGP 9.5, VIP, and S 100 protein may contribute to the determination of the maturation grade of (ganglio)neuroblastomas.

Biomarkers, Tumor↗
PubMed1990

[A successful lytic treatment of a perioperative pulmonary embolism necessitating resuscitation using recombinant tissue-type plasminogen activator].

We report a patient with massive perioperative pulmonary embolism (stage IV) and cardiac arrest who was successfully treated with recombinant tissue plasminogen activator (rt-PA). Thrombolytic therapy was started with 25 mg rt-Pa over 15 min followed by another 25 mg over 45 min. During the next 5 h 50 mg were infused, and thereafter an additional 50 mg over 24 h. No major alterations in the plasmatic coagulation profile were noted. With the exception of moderate blood loss from one puncture site, no further bleeding complications occurred. The relevance of this new thrombolytic agent in the perioperative management of acute, life-threatening pulmonary embolism is discussed.

Humans↗
PubMed1990

[Occurrence of antigen-antibody complexes in the clinic].

We have analyzed 3,671 out of 16,000 immune-complex determination for this I.U.I.S.-Symposium in St. Georgen/Längsee, Carinthia, Austria. Patients came from various parts of Austria suffering from various inflammatory, regressive, autoimmune diseases or immunodeficiency. After extended trials of standardization with various complement tests and biological assays we have studied systematically PEG-precipitation and correlated with the clinic and biopsy in representative cases. Our experience showed, that complement assays may be sensitive to storage, shipping and sampling errors and have to be considered with this respect. Physical methods give additional informations to the diagnosis, prognosis and course of some diseases and are very useful for the clinical routine laboratory with the reservation, that the precipitated material consists of inflammatory and other denatured proteins but immunecomplexes. Precipitated materials is easily accessible to further biochemical identification.

Antigen-Antibody Complex↗
PubMed1990

[Survey of the attitude of specialists faced with bronchial small cell carcinoma].

The practice of therapeutic trials is indispensable in the management of bronchial carcinoma if one hopes to improve the results. We have questioned 134 doctors in the Alsace region who are involved in the diagnosis and treatment of bronchial cancer. We asked how they would wish to be treated if they had a small cell cancer, and if they would agree to participate in a therapeutic trial should the occasion arise. Four different clinical situations of small cell carcinoma localised to the hemithorax were presented, illustrating current controversy on the best treatment or treatments to apply. The 4 proposed protocols were refused by 50% to 84% of the doctors questioned in different cases. The greater the level of consensus on a therapeutic treatment in a given clinical situation the greater the level of refusal to participate in a randomised protocol was. The fact that at least half of the specialist doctors questioned would refuse to be included in a current therapeutic protocol which is underway for patients in Europe leads to the suggestion that before the application for new protocols experts surrogates should give their opinion in association with ethical committee.

Adult↗
PubMed1990

[Primary therapy of polytraumatized patients and reasons for early transfer to a specialty hospital].

200 polytraumatized patients were treated at our institution between 1.1.1987 to 28.2.1989. 58 patients had been submitted from other hospitals. Reasons for submissions were complex cranio-facial-trauma in 27 patients, thoracic trauma in 9 patients and complex abdominal injury in 8. In 13 of 44 patients (29.5%), submitted in between the first 24 h after trauma, severe and partially life threatening injuries had not been diagnosed at the first hospital. Failures in decision making burden especially patients with cranio-facial injuries, in whom intraabdominal and thoracical injuries are often overseen. Patients with abdominal trauma were often submitted after an operative attempt demonstrating complex traumatisation which was underestimated at primary diagnosis. Polytraumatized patients need to have a multidisciplinary management performed by a specified crew with all diagnostic facilities available to avoid overestimation or neglection of additive injuries. Direct submission into a specified medical center is therefore recommended and seems preferable to submission after failed or insufficient primary therapy in inadequately equipped smaller hospitals.

Adult↗
PubMed1990

[Prognosis and therapy of liver injury in patients with multiple injuries].

Between 1.7. 1986 and 31.10. 1989 abdominal trauma was seen in 108 (35.8%) of 300 polytraumatized patients, 44 of these showed rupture of the liver. 23 patients belonged to grade I-III (Moore-classification) and 11 patients to grade IV. Extensive bilobar parenchymal destruction (grade V) was found in 10 patients including 6 patients with retrohepatic vena cava injury. 80% of all patients with liver trauma had intraabdominally associated injuries. In Grade I-II (n = 4) patients were treated conservatively and continuously observed by ultrasound. Injuries graded to III (n = 19) and IV (n = 11) were mostly treated by simple suture or segmental resection. In grade V hemihepatectomy was done in 4 cases, in 2 cases combined by packing and in 1 patient packing only. In 3 patients no adequate therapy was possible. The mortality rate being 36% (n = 16), hemorrhagic complications were the most common cause of death (7 of 16 patients). This was due only to the patients graded to V. In comparison the prognostic factor in grade I-IV ruptures were the associated injuries. In all these cases hemorrhage was stopped by a conservative, organ-retaining therapy. No further hemorrhage occurred. Liver packing was mainly used as additional treatment in cases of coagulopathy after resection. Further indications are extensive bilobar parenchymal destruction without the possibility of primary reconstruction and temporary hemostasis to allow transport to a specialized hospital.

Abdominal Injuries↗
PubMed1990

[Misinterpretation of the adhesio interthalamica and the commissura epithalamica (posterior) in occlusive hydrocephalus in the computed tomogram].

As a cause of an occlusive hydrocephalus, sometimes by CT a cystic malformation of the third ventricle is falsely assumed. This misinterpretation is based on the enlargement of the ventricular system, which leads to an unusual visualization of the interthalamic adhesion and the epithalamic (posterior) commissure. We show these structures to be the reason for the misleading diagnosis by comparing anatomical sections, ventriculography and magnetic resonance imaging (MR) with each other. Finally we discuss the clinical significance by presenting cases, in which an operative treatment of the so called "cyst" already had been planned. For the definite diagnosis we favor MR.

Cerebral Ventriculography↗
PubMed1990

[Onset of Wegener's granulomatosis with skin and joint symptoms].

A 54-year-old female presenting with arthralgias, weight loss, and anemia developed Raynaud's phenomenon and subcutaneous nodules at her hands. Granulomatous inflammation was observed in biopsies taken from her hands and sinuses, and later on the patient suffered from glomerulonephritis. The diagnosis Wegener's granulomatosis was further supported by detection of anticytoplasmic antibodies.

Female↗
PubMed1989

Aberrant fatty acyl alpha-hydroxylation in human neuroblastoma tumor gangliosides.

Abnormalities of ganglioside structure characterize the neoplastic state, and aberrant glycosylation has been implicated as underlying many new tumor ganglioside structures. However, variations in ceramide structure can also result in novel tumor gangliosides. To address systematically this aspect of ganglioside metabolism, we have initiated a study of the structures of the ceramide species of an oligosaccharide-homogeneous human tumor-derived ganglioside, GM2. The ganglioside was isolated from neuroblastoma tissue and purified by normal-phase high pressure liquid chromatography. Marked ceramide heterogeneity was observed; 18 individual ceramide species of neuroblastoma GM2 were separated by reversed-phase high pressure liquid chromatography and collected. Their structures were determined by a combination of negative- and positive-ion fast atom bombardment mass spectrometry and collisionally activated dissociation tandem mass spectrometry of the underivatized gangliosides. The striking finding was the detection of alpha-hydroxylation of a significant fraction of each of the major fatty acid species (16:0, 18:0, 20:0, 22:0, and 24:1); alpha-hydroxylated species quantitatively represented almost one-fifth of the total tumor GM2 species. Fatty acyl hydroxylation was also detected in the ceramide of several other human tumor gangliosides. In contrast, as previously known, fatty acyl hydroxylation was not detected in the normal human brain gangliosides GM3, GM2, and GM1. We propose that aberrant fatty acid alpha-hydroxylation is a novel and sometimes quantitatively significant characteristic of human tumor ganglioside metabolism.

Ceramides↗
PubMed1989

Immunomodulating therapy of rheumatoid arthritis by high-dose intravenous immunoglobulin.

11 patients with rheumatoid arthritis were treated with intravenous immunoglobulin (IVGG). In 6 patients clinical results were impressive, although lasting responses could be achieved in 3 patients only. This treatment was immunomodulating, since the immunoregulatory T-cell ratio (CD4/CD8) decreased following therapy by reducing CD4-positive cells in-vivo. By use of anti-mu-antibodies as a B-cell specific mitogen, IVGG-treatment was seen to suppress early processes of B cell activation. In parallel to these cellular effects, IVGG led to a reduction in the levels of polyethyleneglycol-precipitated circulating immune complexes as measured by lasernephelometry.

Adult↗
PubMed1989

Potent leukocidal action of Escherichia coli hemolysin mediated by permeabilization of target cell membranes.

The contribution of Escherichia coli hemolysin (ECH) to bacterial virulence has been considered mainly in context with its hemolytic properties. We here report that this prevalent bacterial cytolysin is the most potent leukocidin known to date. Very low concentrations (approximately 1 ng/ml) of ECH evoke membrane permeability defects in PMN (2-10 x 10(6) cells/ml) leading to an efflux of cellular ATP and influx of propidium iodide. The attacked cells do not appear to repair the membrane lesions. Human serum albumin, high density and low density lipoprotein, and IgG together protect erythrocytes and platelets against attack by even high doses (5-25 micrograms/ml) of ECH. In contrast, PMN are still permeabilized by ECH at low doses (50-250 ng/ml) in the presence of these plasma inactivators. Thus, PMN become preferred targets for attack by ECH in human blood and protein-rich body fluids. Kinetic studies demonstrate that membrane permeabilization is a rapid process, ATP-release commencing within seconds after application of toxin to leukocytes. It is estimated that membrane permeabilization ensues upon binding of approximately 300 molecules ECH/PMN. This process is paralleled by granule exocytosis, and by loss of phagocytic killing capacity of the cells. The recognition that ECH directly counteracts a major immune defence mechanism of the human organism through its attack on granulocytes under physiological conditions sheds new light on its possible role and potential importance as a virulence factor of E. coli.

Adenosine Triphosphate↗
PubMed1989

Monoclonal antibody that defines the prostate specific antigen.

A monoclonal antibody to a protein with a single band in the 30-kD region was obtained from fusion of Balb/C mouse spleen cells immunized with epithelial fractions of BPH, with the myeloma cell line P3 x 63 Ag8 6.5.3 by standard procedures. This antigen was characterized in immunobinding studies with various cellular and target antigens and in immunoperoxidase staining.

Animals↗
PubMed1989

Sneddon's syndrome: clinical course and outcome.

Fifteen patients with Sneddon's syndrome presenting since 1979 were re-examined. After a neurological examination, an orienting test of mental ability as well as an electroencephalogram were performed in all patients. In 10 of the 15 patients computed tomography of the brain was performed, too. Preceding reports and the results of the present study have been used to discuss the characteristics and prognosis of Sneddon's syndrome.

Adult↗