PubMed Health⌕ Search

Biomedical subjects

H Gremmel

Publications and source records attributed to H Gremmel.

At least 19 recordsLinked to original sources
PubMed1993

High-resolution 1H NMR spectroscopy of cerebrospinal fluid in spinal diseases.

Twenty-nine patients with disk herniations, 7 patients with intraspinal tumors, 4 patients with multiple sclerosis and one patient with infection by borrelia have been studied by CT, myelography and/or MR. To gain information on the metabolism of central nervous system disease (CNS), and thus, to improve diagnosis the cerebrospinal fluid (CSF) was studied in all cases using high-resolution 1H NMR spectroscopy at 360 MHz. Seventeen metabolites could be identified in CSF in addition to the usual clinical chemical parameters. As compared to a control group discrimination of tumors from inflammation was possible by means of different metabolites and/or metabolite concentration. The CSF in disk herniations differed in the concentration of acetate from the control group. In CSF of tumors, multiple sclerosis and of infection by borrelia distinct differences in the concentrations of putrescine, citrate, valine, alpha-alanine, acetate, creatinine, glucose, beta-hydroxy-butyric acid, glutamine and creatine have been observed both as compared directly and in comparison to the control group. Thus, high-resolution 1H NMR spectroscopy of CSF gives speedy information on metabolism, since a variety of metabolites, usually examined only in different tests, can be studied in one single step. Thus, high-resolution 1H NMR spectroscopy supports imaging, especially MR, as morphological changes in diseases may be differentiated by means of different metabolite profiles. This assumption needs further confirmation on a prospective study with a larger patient population.

Borrelia Infections↗
PubMed1991

[Indirect azygos-vein-continuation syndrome with aneurysm of the inferior vena cava].

Nausea and emesis after exercise were leading symptoms in a 28 year old patient with indirect vena azygos continuation syndrome. This anomaly was verified by sonography, abdominal CT and by venography. The CT examination revealed initially structures of malignant appearance low to the renal position by angiography. This appeared to be distended collaterals. Therapeutic intervention aims primarily to the prevention of complications such as thrombosis of the distal venous flow or venous insufficiency of the lower extremities. Prophylactically we suggest low dose heparin and compression stockings.

Adult↗
PubMed1991

[Digital archiving and communication in hospitals].

Different concepts and already available components of a HIS (Hospital Information System) for archiving all data in a hospital are described. Using the example of the Kiel University Hospital, it is shown that a complete HIS-system can be made from already commercially available components.

Germany↗
PubMed1988

Cerebrospinal fluid: detection of tumors and disk herniations with MR spectroscopy.

Cerebrospinal fluid (CSF) samples from 84 patients with confirmed or suspected diseases of the central nervous system were studied with hydrogen-1 magnetic resonance (MR) spectroscopy. In 19 of the patients, clinical chemical tests of the CSF indicated normal protein contents and normal quantities of cells; these samples were used as controls. Preliminary results indicate that tumors may be reflected in the MR spectra of CSF; disk herniations could not be distinguished on the basis of the MR spectral characteristics.

Brain Neoplasms↗
PubMed1986

[Results of the treatment of 197 squamous cell carcinomas of the oropharynx (1964-1982 treatment period)].

197 consecutive patients with squamous cell carcinomas of the oropharynx were treated between 1964 and 1982. The 5 year actuarial survival was 43% (+/- 5%). In patients with stage I and II disease the actuarial survival with combined surgery and radiotherapy was 87% (+/- 16%), but with primary radiotherapy 40% (+/- 28% (p = 0.0250). The results in stage III and IV disease were 59% (+/- 11%) with combined therapy and 29% (+/- 15%) for radiotherapy alone (p = 0.0010). The five year actuarial survival for lymphoepithelial carcinomas (Schmincke) was 71% (+/- 16%) after radiotherapy whilst the patients with undifferentiated carcinomas achieved only 29% (+/- 11%). The survival rate for women (71% +/- 12%) was significantly better than for men (31% +/- 7%), although the proportion of stages was not different in both sexes. Because of these results and because of the minimal chances of controlling recurrent disease we prefer combined treatment not only in stage III and IV disease, but also in stage I and II disease. In these early stages partial mandibulectomy can be avoided. In selected cases transoral surgery can be combined with functional, discontinuous neck dissection. The functional results of surgery are thus minimised in the early stages of oropharyngeal carcinoma.

Adult↗
PubMed1985

[Allogeneic bone marrow transplantation after fractionated whole body irradiation. Results at the Kiel transplantation center].

Allogeneic bone marrow transplantations were carried out between March 1983 and July 1985 in 31 patients aged 7 to 45 years (median 18 years). Acute lymphoblastic leukaemia in 1st to 5th remission was present in 8 patients, acute myeloblastic leukaemia in 1st and 2nd remission in 4 patients, chronic myeloid leukaemia, with various remission status, in 6 patients, 3 patients had severe aplastic anaemia and there were single cases of myelodysplasia and immature cell megakaryocytic myelosis. Transplantation was carried out during relapse in 8 patients with either acute myeloid or lymphoblastic leukaemia. Phenotypic HLA-identical mothers (n = 2) as well as genotypic HLA-identical siblings (n = 27), and in two cases HLA-non-identical mothers, served as bone marrow donors. In leukaemia patients the conditioning treatment consisted of fractionated total body irradiation and high dose cyclophosphamide or etoposide. Patients with severe aplastic anaemia received cyclophosphamide (4 X 50 mg/kg) and fractionated total nodal irradiation (total dose 8 Gy). 19 patients (61%) survived 14 to 605 days after bone marrow transplantation. 15 patients (48%) continue to remain in complete remission with Karnofsky indices of greater than or equal to 90%. Causes for death were infection (n = 3), interstitial pneumonia (n = 3), relapse (n = 3) as well as single cases involving acute graft-versus-host-disease, non-engraftment of donor marrow and veno-occlusive disease of the liver.

Acyclovir↗
PubMed1985

[NMR-diagnosis in radiotherapy?].

The results of NMR tomography obtained hitherto in the imaging of malignant tumors are presented in order to show that this new method is of great importance for radiotherapy. A quantification of radiotherapy and chemotherapy seems possible with the aid of NMR diagnosis, as vital and necrotic tumors zones as well as radiation effects in the tumor and in sound tissue can be visualized.

Humans↗
PubMed1984

[Optimization of dose distribution in whole body irradiation by means of compensators].

In case of whole-body irradiation prior to bone marrow graft, an undesired irregular dose deposition in the median body plane is caused by the irregular body shape and the tissue inhomogeneities of the patient, which can amount up to 50% of the planned focal dose in case of laterally opposing irradiation. A procedure is proposed allowing to modify the dose distribution in the irradiated body systematically by means of compensators. Such compensators are produced with the aid of an adequate number of serial CT scans, a programme system considering these data and the individual irradiation geometry, and a computer-controlled cutter working in three dimensions. First a casting mould is manufactured which is then filled up with an adequate compensation material. The actual compensation data and the planned irradiation geometry are controlled before and during the treatment. Taking into consideration the individual shapes and the different tissue densities, it is not only possible to prevent the dose inhomogeneities mentioned above but also to introduce by means of a special programme part regions with a higher or lower dose deposition at any point of the irradiation field, at the therapeutist 's discretion.

Bone Marrow Transplantation↗
PubMed1982

[Treatment results of Schmincke tumors].

This is a report on the results of a continuous series of 78 previously untreated patients with a lymphoepithelioma (Schmincke-Regaud), who got their diagnosis and therapy in the Medical Center of the University of Kiel between 1951 and 1980. 90% of the patients were treated by radiotherapy alone, which included the primary in the oropharynx (n = 29) or the nasopharynx (n = 48) as well as the regional lymph nodes regardless of whether they were affected (71%) or not; residual lymph nodes of 8 cases were removed afterwards. Thereby a clinically full regression of the tumor disease was achieved in 85%. This group revealed a constant actuarial survival of 39% 7 years later. All therapy failures however, died within two years. The probability to remain free of disease after a primarily successful treatment amount to 86% for the oropharynx tumors (n = 24) and to only 29% for the nasopharynx lesions (n = 31). The analysis of the relapses especially with regard to the nasopharynx tumors showed that in most cases the disease was already very extended at the beginning of the treatment (stage IV according to the UICC-classification). The actuarial survival of this numerous group fell down to a constant rate of 16%, whereas stages I to III finally survive in 59%. The corresponding survival values of the oropharynx tumors were 25% in stage IV and 41% in stages I to III including a lot of age-related deaths. Drawing conclusions out of our retrospective study we recommended to add an appropriate chemotherapy for lymphoepitheliomas of the nasopharynx in stage IV.

Adolescent↗
PubMed1981

[Measurement and calculation of the air activation caused by 15 MeV continuous radiation emitted by a linear accelerator (author's transl)].

The rate of air activation caused by the 15 MeV continuous radiation of a "Clinac 20" can be concluded from activation measurements in urea tablets. In case of the most unfavourable irradiation conditions, a maximum field size of 35 X 35 cm2, and a distance focus-wall of 450 cm, an air activation of 6, 18 X 10(4) Bq per individual irradiation is calculated. The limit of activity concentration prescribed by the Strahlenschutzverordnung (radioprotection directive) is not reached if a sufficient change of air is guaranteed. This method of measuring the air activation is simple, not time-consuming and can be effected with a high degree of accuracy. Measurements and calculations are compared.

Air↗
PubMed1981

[Measurements of the surface dose for the irradiation of cultured cells with a Co-60 source (author's transl)].

In order to exactly determine the irradiation dose for cultured cells in culture containers (Petri dishes and others), it is necessary to have a detailed knowledge of the depth dose curve in water-equivalent layers near the surface. This curve was determined for Co-60 radiation by means of a window-less liquidity dosemeter. The dosemeter liquid was a solution of ammonium-iron (II) sulfate (solution of Fricke), the extinction of which was measured at 304 nm. Petri dishes were used instead of closed irradiation flasks. The distance QOA was 50 cm for all experiments, the field size was 10 X 10 cm. The depth dose maximum was found in a depth of 5,0 mm which corresponds to a mass of 0,50 g cm-2 relating to the surface. The surface dose was determined to be 39,2% and 106,6% of the maximum dose, respectively. This method can also be applied for closed culture containers (flasks).

Cells, Cultured↗