PubMed Health⌕ Search

Biomedical subjects

H J Lehmann

Publications and source records attributed to H J Lehmann.

At least 19 recordsLinked to original sources
PubMed2003

Oral ibandronate: changes in markers of bone turnover during adequately dosed continuous and weekly therapy and during different suboptimally dosed treatment regimens.

The aims of the present study were to investigate how changes in the cumulative dose and the frequency of dosing influence the short-term antiresorptive efficacy of oral ibandronate treatment and whether serial measurements of bone markers could provide a useful diagnostic tool for the revelation of noncompliance to established treatments with antiresorptive drugs. Study participants were 200 healthy women 50-70 years old (mean 63.1 years) with a lumbar spine BMD t-score of -1 to -5. Women were randomly allocated to receive treatment with oral ibandronate according to one of the following eight dosing regimes: (1) 2.5 mg daily for 84 days; (2) 20 mg weekly for 84 days; (3) 2.5 mg daily for 28 days + no treatment for 56 days; (4) 2.5 mg daily for 28 days + 2.5 mg weekly for 56 days; (5) 2.5 mg daily for 28 days + 2.5 mg three times weekly for 56 days; (6) 2.5 mg daily for 14 days + 2.5 mg three times weekly for 56 days; (7) 2.5 mg three times weekly for 84 days; (8) no treatment for 168 days. Study parameters were the serum concentration of the C-terminal telopeptide of collagen type I (s-CTX, resorption marker) and N-MID osteocalcin (formation marker) measured by enzyme-linked immunosorbent assay. Oral treatment with ibandronate 20 mg weekly (cumulative dose 240 mg) resulted in greater final inhibition in s-CTX and area under the curve (AUC) compared to the 2.5 mg daily treatment (cumulative dose 210 mg), indicating that as long as optimal doses are administered the frequency of dosing has secondary importance for overall efficacy. When the cumulative dose was 130 mg or less, the final degree of inhibition was still the function of the cumulative dose, but the overall efficacy estimated by the AUC was also under the influence of the frequency of dosing. These observations suggest that serial measurements of s-CTX may provide a useful diagnostic tool for the early revelation of suboptimal dosing or noncompliance to already optimized therapies with antiresorptive agents.

Administration, Oral↗
PubMed2002

Effect of bisphosphonates on cartilage turnover assessed with a newly developed assay for collagen type II degradation products.

BACKGROUND: Animal studies of arthritis have suggested that bisphosphonates may have chondroprotective abilities. OBJECTIVE: To evaluate the effect of bisphosphonate treatment on cartilage degradation. METHODS: Type II collagen is almost exclusively localised in cartilage, where it is the major structural component of the tissue. Hence fragments derived from this protein should represent a specific index for cartilage degradation. The urinary concentration of collagen type II C-telopeptide degradation products (CTX-II) was measured by a new immunoassay (enzyme linked immunosorbent assay (ELISA)). The serum concentration of collagen type I C-telopeptide degradation products (CTX-I), a marker of bone degradation, was also measured by ELISA. PARTICIPANTS: Two groups were studied. The alendronate group included 63 healthy postmenopausal women aged 45-54 randomly allocated to receive three years' treatment with 1 mg, 5 mg, 10 mg, or 20 mg alendronate daily or placebo. In the third year the women receiving 20 mg were switched to placebo. The ibandronate group included 119 women at least 10 years after the menopause aged <75 randomly allocated to receive 12 months' treatment with 0.25 mg, 0.5 mg, 1.0 mg, 2.5 mg, or 5 mg ibandronate daily or placebo followed by 12 months without treatment. RESULTS: 20 mg of alendronate and 2.5 and 5 mg of ibandronate treatment produced significant decreases in urinary CTX-II to about 50% of baseline. The level reached after three months of treatment remained practically constant during the following 12-36 treatment months. When treatment was withdrawn CTX-II values returned towards baseline. Serum CTX-I also decreased rapidly within three months, but to a level of about 30% of baseline. CONCLUSIONS: The urinary excretion of CTX-II, a new marker of cartilage degradation, decreases significantly in response to bisphosphonate. This suggests that bisphosphonates may have chondroprotective effects in humans. By measurement of CTX-II it should be possible to monitor the effects of drugs that potentially inhibit cartilage destruction.

Alendronate↗
PubMed1989

Autonomic neuropathy in diabetics: comparison of cardiovascular tests, neurography, and cerebral refractory period of somatosensory evoked potentials.

Circulatory regulation tests--postural heart rate response (PHRR), Valsalva ratio, and reaction to sustained muscle exercise--, sural nerve neurography and cerebral refractory period (CRP) of median nerve evoked potentials were measured in 17 diabetic inpatients and correlated with their clinical signs of autonomic neuropathy (AN) and sensorimotor polyneuropathy (SN). Non-diabetic inpatients (without cardiovascular or related nervous disease) served as controls. The data of the diabetics and non-diabetic age- and sex-matched inpatients were significantly different for the PHHR measured by the 30:15 ratio, sural nerve conduction velocity and sural nerve refractory period, and CRP. The results correlated with the corresponding anamnestic signs. The PHRR showed abnormal values much more frequently than the sural nerve neurography or the CRP. No correlation was found between the signs of AN and those of SN or CRP. This stresses the need for a circulatory regulation test (preferably PHRR) in any diabetic when planning narcosis, as only these AN tests can reliably predict an increased cardiovascular risk in individual patients.

Adult↗
PubMed1988

Intrathecal production of HIV antibodies in suspected AIDS encephalopathy.

Thirty-one serum and CSF samples from 21 HIV-antibody-positive patients with neurological deficits were examined to prove or exclude intrathecal production of HIV antibodies. By dilution, sera were adjusted to the IgG concentration of the corresponding CSF samples. Both samples were then serially diluted in log2 steps down to the detection limit and were tested in an anti-HIV ELISA. From the dilution obtained at the cut-off level, a quotient QHIV was derived as an indicator of intrathecal production of HIV antibodies. Six of a total of eight samples with a QHIV value of greater than or equal to 2 were correlated which the clinical diagnosis of AIDS-related dementia complex (ARDC). However, a QHIV less than 1 did not exclude the development of ARDC, as was shown during follow-up in one case. Different methods are compared for the determination of intrathecal production of IgG and anti-HIV. A quotient QHIV greater than or equal to 2 is suggested to be highly indicative of intrathecal production of anti-HIV as well as of the development of ARDC.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Chronic borrelia encephalomyeloradiculitis with severe mental disturbance: immunosuppressive versus antibiotic therapy.

A 57-year-old male was repeatedly admitted to hospital because of complex neurological symptoms, including radicular pain, disturbance of micturition, seizures, and severely impaired mental state. The diagnosis was encephalomyeloradiculitis possibly of viral origin, and treatment with immunosuppressants was initiated. An alternating course with a tendency towards improvement ensued. Two and a half years after the occurrence of the initial symptoms, identification of specific antibodies in the blood and CSF led to the diagnosis of borreliosis with CNS involvement. High-dose therapy with penicillin rapidly reduced the symptoms, beginning with those of radicular pain and followed by an improvement of the mental state. Attention is directed to the wide spectrum of clinical symptoms of chronic borreliosis with CNS involvement. Previous reports that immunosuppression may result in some improvement but with a tendency towards relapse are confirmed. Our encouraging treatment results support those of other reports that penicillin therapy may lead to improvement even at late chronic stages in patients with severe CNS deficits.

Chronic Disease↗
PubMed1988

Di-(2-ethylhexyl)-phthalate as plasticizer in PVC respiratory tubing systems: indications of hazardous effects on pulmonary function in mechanically ventilated, preterm infants.

Several PVC medical devices contain the plasticizer Di-(2-ethylhexyl)-phthalate (DEHP) in high concentration. Taken systematically DEHP only has minor toxic effects in the human organism. In three preterm infants artificially ventilated with PVC respiratory tubes unusual lung disorders resembling those observed in hyaline membrane disease, verified both clinically and radiologically, were observed during the fourth week of life. It was assumed that these lung disorders were causally related to the exposure to high doses of DEHP, which was released from the walls of the respiratory tubes. DEHP was found in the lung tissue of one patient who died of pneumothorax soon after birth after being artificially ventilated. It is strongly recommended that for disposable PVC respiratory devices the plasticizer DEHP should be used with more restrictions.

Diethylhexyl Phthalate↗
PubMed1988

Human immunodeficiency virus antibodies in cerebrospinal fluid.

The relative concentrations of human immunodeficiency virus (HIV) antibodies in relation to equal IgG contents of 46 serum cerebrospinal fluid (CSF) samples from 32 patients were determined by serial dilution in an anti-HIV enzyme-linked immunosorbent assay (ELISA). The ratio of CSF and the serum HIV antibody concentration was expressed as QHIV = CSF dilution/serum dilution. QHIV is regarded as a parameter for specific intrathecal HIV antibody production. The QHIV ranged from 0.7 to 16. Six of seven patients with clinical signs of acquired immunodeficiency syndrome (AIDS)-related dementia (ARD), but only seven of 25 patients without clinical diagnosis of ARD showed a QHIV greater than 2.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Cerebrovascular reserve capacity (CRC) in carotid artery disease: a routine test in selection for surgical treatment?

An increase of arterial carbon dioxide (CO2) partial pressure induces an increase of cerebral blood flow by dilatation of the resistance vessels. By the Transcranial Doppler sonographic technique (TCD) blood flow velocity as a correlate of flow volume can be measured within the great basal intracranial arteries. We investigated 8 patients with an internal carotid artery occlusion or high-grade stenosis and 5 cerebrovascular diseased patients without extracranial stenosis. 12 healthy volunteers and patients without vascular disease served as the control group. Blood flow velocities in the middle cerebral arteries were evaluated before and after 5 minutes of breathing a 5% CO2 gas mixture. In a prestudy the end tidal pCO2 was monitored during this procedure. As a result of the close parallelity of pCO2 increase in the prestudy group we planned to standardize the CO2 reactivity tests without consideration of the individual pCO2 values. The CO2 inhalation provoked a flow velocity increase of at least 20% in the control subjects (47.1 +/- 17.3%). The vascular diseased without extracranial stenosis responded with 34.8 +/- 17.4% (minimum: 23.5%, n. s.). The CO2 reactivity in cases of occlusion or greater than 50% stenosis was significantly decreased (p less than 0.001) both when considering only the affected sides (12.4 +/- 7.5%, maximum: 20%) and when including the non affected sides (22.6 +/- 15.0%). It is concluded that the CO2 reactivity test is a simple and valid method to evaluate the cerebrovascular reserve capacity in any case of uncertainty about the benefits of surgical treatment of a carotid stenosis. In future this technique might become one fundamental argument beside others in selecting adequate treatment.

Arterial Occlusive Diseases↗
PubMed1986

[Atypical facial neuralgia or depressive facial pain. Diagnostic aspects of a well-demarcated form of masked depression].

In three paradigmatical cases the problem of the diagnosis "atypical face pain" is discussed. On clinical inpatients can be demonstrated, that behind an "atypical face pain" a chronic depressive illness can be hidden. The symptom "facial pain" in these cases is part of an oligosymptomatic depressive disorder. A special antidepressant therapy is necessary in the clinical management of these "masked depressions". Therefore it is necessary to be reserved on diagnosing an "atypical face pain". The exact analysis of psychopathological disturbances can prevent these patients who in reality suffer from depressive face pain from therapies in maxillary surgery or in dentistry etc. that are far from useful.

Aged↗
PubMed1985

T lymphocyte populations in multiple sclerosis.

In 36 patients representing different clinical stages of multiple sclerosis (MS) (9 patients with acute exacerbations; 21 patients in remission; 5 patients with chronic progressive MS) determinations of T lymphocyte populations using monoclonal antibodies against surface antigens (OKT3 (pan T cells), OKT4 (helper T cells), OKT8 (cytotoxic/suppressor T cells] were performed. Compared to the control group (40 healthy individuals) a clear elevation of the T4/T8 ratio was found in acute exacerbations and to a lesser degree in patients with inactive phases of MS. Patients with chronic progressive disease did not show increased T4/T8 ratios. Serial determination of lymphocyte populations after corticosteroid therapy in 10 selected patients revealed no significant changes which could be attributed to this therapeutic modality. Pathogenetic and clinical implications of the shifts in surface antigen expression of T lymphocyte populations mirroring the clinical course of MS are discussed.

Adult↗
PubMed1984

[Diagnosis of primary non-Hodgkin lymphomas of the central nervous system].

In literature, primary malignant lymphomas (PML) of the central nervous system (CNS) have been known for many years under different names, although diagnosis was almost exclusively made via autopsy. It is only since the existence of computed tomography (CT) that there is a possibility of identifying or at least presuming intra vitam such malignancy and of securing the diagnosis via brain biopsy. This is most important because it enables an early treatment of patients by means of radiation and chemotherapy. We are documenting a new approach to identify the PML of CNS by four case histories of our own patients. This consists in the specific manner in which these tumours react to high doses of corticosteroid therapy. Under this treatment they diminish in size or even disappear completely. This can even be seen in other diseases, but when such behaviour of an intracerebral lesion is seen in a CT scan it should be of help in the evaluation of differential diagnosis and should be regarded as an important pointer towards achieving early diagnosis of PML of the CNS.

Adult↗
PubMed1983

[Diplopia as an initial symptom of intracranial tumors].

Among 716 patients with intracranial blastomatous changes 74 showed diplopia as a consequence of involvement of the oculomotorius, trochlearis or (and) the abducens nerve. Diplopia as primary symptom of disease was observed in 20 cases. Patients with isolated initial diplopia were on average 10 years younger than patients where diplopia occurred only in the further course of the tumour. There were no preceding other diseases demonstrable in patients with initial diplopia. Papilloedema did not occur significantly more frequently in them than in patients with diplopia as secondary symptom. In rare cases latency between occurrence of diplopia and further symptoms may be months to two years. For this reason exact neurologic and ophthalmologic follow-up controls, particularly in young patients with isolated persistent diplopia, are required.

Abducens Nerve↗