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Biomedical subjects

H J Fischer

Publications and source records attributed to H J Fischer.

At least 19 recordsLinked to original sources

Identification of the 408 valine to methionine mutation in the low density lipoprotein receptor in a German family with familial hypercholesterolemia.

Familial hypercholesterolemia (FH) is caused by different mutations in the gene encoding the low density lipoprotein receptor (LDLR). In Caucasian patients, at least three single point mutations have been identified causing FH. The asparagine206 to glutamine, and valine408 to methionine mutations were originally described in Afrikaners and recently identified in Dutch FH patients. The proline664 to leucine mutations was previously identified in an FH homozygote of Asian Indian origin and later identified in patients from London. Any of these mutations can be identified using direct amplification of genomic DNA by the polymerase chain reaction (PCR) and restriction enzyme digestion of PCR products. In this study, 100 unrelated German FH patients were screened for these three mutations. The valine408 to methionine mutation was identified in one individual and subsequently in the hypercholesterolemic child of the proband. Haplotype analysis with 7 restriction fragment length polymorphisms (RFLPs) revealed that the mutant allele carried the same haplotype as the previously described patients in South Africa and the Netherlands. Our finding supports the previous assumption of the European origin of the mutation.

Adolescent

MR mammographic localization. Work in progress.

The authors present phantom test results for a stereotaxic device that may permit simple, rapid, and accurate needle biopsy and localization of breast lesions detected at contrast material-enhanced magnetic resonance (MR) mammography. The mechanical accuracy of this prototype MR breast localizer is approximately plus or minus 3.5 mm at 5 cm.

Biopsy, Needle

Identification of a 76-year-old patient with compound heterozygous familial hypercholesterolemia by haplotype analysis of the LDL receptor gene.

In a large family with clinical characteristics of heterozygous familial hypercholesterolemia (FH) seven restriction fragment length polymorphisms (RFLP) were used to determine low-density-lipoprotein receptor (LDLR) gene haplotypes. Following the inheritance of the LDL receptor genes characterized by their seven RFLP haplotypes, two different alleles were found to cosegregate with elevated cholesterol levels within this family. In a 76-year-old man both alleles identified as defective were present, thus classifying this individual as heterozygous compound for FH. In five heterozygous family members one allele was associated with 38% higher cholesterol levels when compared to the other mutant allele in two heterozygous family members. Cosegregation of hypercholesterolemia with the apolipoprotein B (apoB) gene and apolipoprotein E (apoE) gene was excluded by genotyping all individuals for the apoB XbaI RFLP and apoE polymorphisms. These findings are consistent with variable phenotypic expression of the mutant LDLR gene alleles.

Aged

[Meniscus imaging in MR tomography using surface coils. Anatomy, areas of degeneration, laceration formation].

High resolution MR imaging using surface coils and thin-section techniques provides specific information when evaluating meniscal diseases. Extension and localisation of meniscal tears can be demonstrated as well as meniscal attachment areas. Diagnosis of degenerative changes is possible. We examined 7 healthy volunteers and 58 patients with suspected knee injuries. This study was done to discuss the use of MRI in the evaluation of meniscal diseases.

Arthrography

[Computerized tomography in endocrine ophthalmopathy with malignant exophthalmos].

CT scanning was done in 16 patients with deterioration of sight in endocrine ophthalmopathy. The assessment involved muscular changes and density of retrobulbar fat. Evaluation of muscular changes was staged. In addition, exophthalmus was graded and evaluated by staging. More than two thirds of patients showed pronounced muscular thickening whereas the remaining patients showed few or no muscular changes. Likewise, in a number of patients exophthalmus could hardly be demonstrated according to Hertel's values. Thus, clinical presentation in a number of patients is relatively mild. Pathophysiologic considerations as to the development of deterioration of sight mainly involve myogenic compression of the optic nerve at its orbital entry. This does not seem to hold true for patients without muscular thickening. In such patients optic nerve affection could be caused by increase of the volume of the fat body.

Adipose Tissue

Radiology and pathology of malignant fibrous histiocytomas of the soft tissues: a report of ten cases.

Malignant fibrous histiocytomas (MFH) are believed to originate from histiocytes and are composed of malignant cells with spindle or round shapes. We evaluated ten MFH of the soft tissues by plain roentgenograms, computed tomography (CT), and angiography and subdivided them into four grades of anaplasia and five predominant histologic variants. The variants of MFH demonstrated different vascular patterns. The extension of the lesions could be determined by CT and angiography. CT is the method of choice in the assessment of size and extent of MFH of the soft tissues. When intra-arterial chemotherapy is indicated the angiograms obtained at each catheter placement may substitute CT in follow-up studies obviating additional diagnostic procedures.

Adult

Multiple endocrine neoplasia type I. A case report.

A case of multiple endocrine neoplasia (Men) consisting of an unusual combination of an insulin-producing islet cell tumour and an adrenal adenoma is reported. CT clearly demonstrated the adrenal mass whereas the pancreatic lesion remained questionable. Conversely angiography located the pancreatic tumour but the adrenal findings were subtle.

Adenoma

Angiography in soft tissue sarcomas.

Angiography was performed in 41 patients with histologically proven soft tissue sarcomas that included tumors derived from a variety of cell types and locations. The leiomyosarcomas and sarcomas of uncertain or mixed origin showed extensive neovascularity. Liposarcomas, synovial cell sarcomas, and fibrous histiocytic sarcomas were moderately vascularized. Sarcomas originating from vascular, fibrous, neural, and osseous tissues had variable degrees of vascularity. In nearly all of the cases studied, angiography revealed tumor size, extent, source, and degree of vascularity and helped to determine the degree of malignancy. While angiography does not provide a histologic diagnosis, it plays an important role in patient management when a conservative therapy plan that uses several modalities is followed.

Adolescent

[Computer tomography of esthesioneuroblastoma].

Aesthesioneuroblastomas are rare malignant nasal tumours of neural origin. Clinical symptoms depend upon the extent of the lesion. Five cases of tomography visualised the tumours as non-homogeneous soft tissue masses in the nasal cavity and the ethmoid cells with a varying infiltration of the adjacent paranasal sinuses. Radical surgery and radiation therapy are recommended. CT should be an integral part of annual follow-up studies.

Adult

[Radiotherapy in endocrine ophthalmopathy--evaluation of 56 cases].

The authors present the radiotherapeutic results achieved in 56 patients with endocrine ophthalmopathy, 15 out of them with severe, so-called malignant course. All patients were irradiated conventionally with small doses between 3 and 10 Gy at the surface. For this purpose, a deep therapy unit with 250 kV was used. The X-ray irradiation produced an improvement in 62% of the cases; the separate evaluation of cases with malignant course showed an improvement in nine cases. Thus the results produced by this method are as good as those of high doses, the greater possibilities in case of recurrence, however, are to be considered as an advantage. The irradiation should be applied early, and the simultaneous administration of a cortisone preparation is preferred by our team.

Adrenal Cortex Hormones

[Dose distribution during irradiation of the retrobulbar space--results of measurements on a phantom].

The transverse dose distribution in case of X-ray and cobalt irradiation of the retrobulbar space was measured in a water phantom. As expected, the crystalline lens receives a smaller dose by cobalt irradiation with lead shielding in front of the eye than by X-irradiation. In case of cobalt irradiation, the dorsal portions lying within the hypophyseal region can only be sufficiently protected by a special block cast by us in a divergent form and surrounding the irradiation field. If X-ray irradiation is performed with a field size of 2 X 4 cm2, the 50% isodose encloses just the complete retrobulbar space. Taking into consideration a second contralateral field, the crystalline lens is exposed to less than 10% of the maximum dose. Thus the doses applied usually in radiotherapy of endocrine ophthalmopathy, i.e. 15 to 20 Gy, lead to an unproblematic crystalline lens exposure of 150 to 200 rad.

Cobalt Radioisotopes

[Computer tomography in drusen of the optic papilla].

Drusen (astrocytic hamartoma) of the optic nerve are a rare eye disease produced by ocular calcification (inclusions containing calcium) at the optic disc surface. These drusen can lead to eye complaints as they grow bigger; in particular, they can cause loss of vision and can also limit the visual field. Ophthalmologically, they are characterised by an indistinct optic disc and/or ectasia of the optic disc which is sometimes combined with a poorly defined optic disc margin. Differential diagnosis must take into consideration the presence of space-occupying intracranial processes. The final diagnosis can be made via computerised tomography on the basis of a characteristic calcification pattern. Hence, the radiologist must be familiar with the disease pattern and must be able to differentiate this against other types of intraocular calcifications.

Adult

[Radiologic diagnosis of adrenal cyst].

Computed tomography did not lead to the correct diagnosis in a 40-year-old female patient with an adrenal cyst on the right side. Sonography permitted differentiation of the tumour from the surroundings. However, only angiography showed quality and precise localization of the tumour. Thus, in certain cases, angiography cannot be replaced despite the large diagnostic value of the other methods.

Adrenal Gland Diseases