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Biomedical subjects

H Lampe

Publications and source records attributed to H Lampe.

At least 19 recordsLinked to original sources
PubMed2001

Predictability of hypocalcemia using early postoperative serum calcium levels.

OBJECTIVE: In operations involving the thyroid or parathyroid glands, postoperative serum calcium levels are one contributing factor to patients' length of hospital stay. In this study, we wanted to determine whether early postoperative serum calcium levels could be used to predict hypocalcemia following operations of the thyroid or parathyroid glands. METHODS: A retrospective chart review was performed on 203 patients who had undergone operations involving risk to the parathyroid glands. This included patients who had bilateral thyroid operations or those who had one or more parathyroid glands removed for various disease processes. Postoperative calcium levels were plotted as a function of time, and the slope between the first two levels was examined. Both serum calcium levels were drawn within 12 hours after the operation. RESULTS: A positive slope predicted normocalcemia in 100% of patients undergoing thyroid or parathyroid procedures. A negative slope was predictive in magnitude. Patients who developed hypocalcemia had an average slope two to three times more negative than those remaining normocalcemic. CONCLUSIONS: It appears that early serum calcium levels may be predictive for postoperative hypocalcemia in operations that put the parathyroid glands at risk.

Biomarkers↗
PubMed2001

Laryngectomy clinical pathway: development and review.

OBJECTIVE: The goal of the study is to determine if the implementation of a protocol for the preoperative and postoperative care of patients receiving a laryngectomy for cancer of the larynx or hypopharynx (i.e., laryngectomy clinical pathway) reduced length and cost of hospital stay without increasing complication rates. DESIGN: This study is a comparison of the perioperative course of two groups of laryngectomy patients. Data were collected retrospectively from the records of patients operated on before the implementation of the clinical pathway as the institutional historical control. Comparison was made with data collected prospectively on patients operated on after the implementation of the clinical pathway. SETTING: The study was performed at a mid-sized teaching hospital associated with two regional cancer centres. All surgeries were performed by one of two otolaryngology-head and neck surgeons and residents under their supervision. METHODS: The demographic, patient, tumour, treatment, dietary, and complication data were analyzed. Fisher's exact (two-tailed) statistical test was used for parametric data and Wilcoxon scores for nonparametric data. MAIN OUTCOME MEASURE: The principal outcome measure was the length of postoperative inpatient stay. Secondary outcome measures were readmissions and postoperative complications. RESULTS: There was a statistically significant decrease of 6.7 days in the mean length of hospitalization in the clinical pathway group even when taking postoperative readmissions into account. There was no concomitant increase in surgical complications. The mean reduction in hospital cost per case was calculated to be $3,420 (Can). CONCLUSIONS: Application of a clinical pathway for patients receiving laryngectomy is both feasible and effective.

Case-Control Studies↗
PubMed2001

[Possibilities and limits of ambulatory surgery: demands and reality in plastic surgery].

With the development of office-based operating rooms and improved office anesthesia, the ability to perform more extensive surgery outside the hospital is now given. Experience with the tumescent technique for liposuction and abdominoplasty has demonstrated that extensive plastic surgery can performed with minimal postoperative discomfort. An emergency phone after surgery is necessary, and a call on the operating day evening and the initial postoperative day is a safe strategy with high patient acceptance for most types of plastic surgery. Additionally, the cost savings of office-based plastic surgery makes this surgery much cheaper for the patients and the health insurance organizations.

Ambulatory Surgical Procedures↗
PubMed2000

Maxillary giant cell granuloma, pheochromocytoma, and hyperparathyroidism without medullary thyroid carcinoma.

We examined a young man who had a benign giant cell granuloma of the maxilla, which we subsequently diagnosed as a brown tumor associated with hyperparathyroidism. During surgery for the granuloma, the patient developed severe hypertension and was discovered to have an extra-adrenal pheochromocytoma. Oncogene and calcitonin testing for medullary carcinoma of the thyroid was negative. Therefore, despite the presence of both pheochromocytoma and hyperparathyroidism, we concluded that this patient did not have multiple endocrine neoplasia type 2a.

Adult↗
PubMed1997

Fertility after chemotherapy for testicular germ cell cancers.

PURPOSE: To analyze the probability of recovery of spermatogenesis after orchidectomy and cisplatin-based chemotherapy (CT) for testicular germ cell cancer. PATIENTS AND METHODS: One hundred seventy-eight patients treated between 1979 and 1991 were selected by the requirement of sperm count both pre-CT and post-CT. Counts were classified as normospermic (NS) if more than 10 x 10(6)/mL, oligospermic (OS) if 1 to 9 x 10(6)/mL, and azoospermic (AS) if less than 1 x 10(6)/mL. The median follow-up time after CT before sperm analysis was 30 months. RESULTS: Analysis of 170 patients whose spermatogenesis was reassessed at least 1 year after CT showed that of 89 patients whose pre-CT counts were NS, the post-CT count was NS in 64%, OS in 16%, and AS in 20%. There was clear evidence for continued recovery beyond 1 year; the probability of spermatogenesis increased to 48% by 2 years and 80% by 5 years. There was a significantly higher probability of recovery to OS and NS count levels in the 54 patients treated with carboplatin-rather than cisplatin-based therapy. There was an independent and similar effect of normal pre-CT count. There was a reduced probability to recover to OS in the 26 patients treated with more than four cycles of CT. A prognostic model identified three groups with 25%, 45%, and 82% probabilities of recovering spermatogenesis by 2 years after CT. CONCLUSION: Analysis of pre-CT sperm count together with details of planned treatment can be used to predict recovery of spermatogenesis following germ cell CT.

Adolescent↗
PubMed1995

High-dose carboplatin and etoposide for salvage chemotherapy of germ cell tumours.

We evaluated high-dose carboplatin and etoposide with autologous bone marrow stem cell support in the salvage treatment of patients with metastatic germ cell tumours who had failed previous chemotherapy. The treatment programme comprised initial conventional dose chemotherapy. 23 patients received a first cycle of high-dose treatment, and 12 who showed no evidence of progression had a second cycle 2-3 months later. 8 of the 23 patients treated with high-dose chemotherapy are alive in remission 4-29 months from the start of high-dose treatment. 3 of these 8 required further treatment for recurrence. In the initial part of the study, the dose of carboplatin was escalated in successive patients. Grade 3/4 treatment-related toxicity occurred in 4 of 18 patients (1 fatal) who received carboplatin doses to give a AUC (area under the serum concentration/time curve) of 30 mg.min/ml or less and 3 of 5 patients (2 fatal) who received higher doses. We, therefore, recommend 30 mg.min/ml for further evaluation in chemotherapy sensitive patients.

Adolescent↗
PubMed1994

Forensic odontology: age determination from adult human teeth.

Dentistry has several recognized specialities. Age, race and sex determination together with dental identification and facial reconstruction on skeletal material are procedures that the forensic odontologist has to master. The use of Gustafson's method to determine age in an examination of 350 teeth of living and/or dead males and females from the Heidelberg area, Germany is discussed.

Age Determination by Teeth↗
PubMed1994

Experience with TEM in Germany.

Transanal endoscopic microsurgery (TEM) presents a minimally invasive procedure for local removal of large adenomas as well as early carcinomas of the rectum. 57 surgical departments/clinics, which practice this method in Germany were asked about their experience. 44 questionnaires were evaluated. Indications for the 1,900 recorded operations were 1,411 adenomas, 433 carcinomas (curative intention: 286; palliative intention: 147), and 56 other procedures. The conversion rate to laparotomy was dependent on the experience with this surgical method (1.2%-11.6%). A radical rectal resection as a second step was performed in 5.7% of patients in the case of advanced carcinoma in the histologic examination of the specimen. Complications appeared in 120 patients (6.3%), 77 patients (4.0%) recovered with conservative treatment, and 43 (2.3%) had to undergo surgery. The mortality rate was 0.2% (3/1,900 pts).

Anal Canal↗
PubMed1993

[A three-year aid program for plastic surgery in Peshawar (Pakistan). Ongoing management of severely injured patients of the Afghanistan war: 1,528 large operations, 5,171 smaller interventions, 15,932 patients examined].

Since 1980 Interplast Germany has sent many plastic surgeons to developing countries. In 1989 a new Interplast Germany program for helping Afghan refugees in Pakistan's Peshawar was started. The Federal Republic of Germany financed the first two years; thereafter, the European Community and Help supported the project. Twenty-four teams with 123 nurses, surgeons and anesthesiologists operated on 1,528 patients in two hospitals. In the same period 5,171 smaller operations have been performed and 15,932 patients have been examined. Low expense for the teams, good support by officials, and professional administration have made this project highly effective for 3 years.

Adult↗
PubMed1992

Aminopyrine breath test in the prognostic evaluation of patients with cirrhosis.

This prospective study assessed the role of aminopyrine breath test in the prognosis of patients with cirrhosis, and evaluated whether the test provided useful information not included in the Pugh score. During a period of 36 months, 125 patients with biopsy proven liver cirrhosis were included, and followed for up to 48 months (median 17 months). During follow up 43 patients died (20 of liver failure). Survival was univariately related to aminopyrine breath test (p less than 0.02), Pugh score (p less than 0.01), presence of ascites (p less than 0.01), and sex (p less than 0.05). Using Cox's regression analysis, Pugh score, aminopyrine breath test, and sex, were independent significant predictors of survival. From the Cox's model a prognostic index was computed. According to a receiver operating characteristic curve analysis, the prognostic index predicting death showed an improvement in area under the curve when compared with a prognostic index calculated excluding aminopyrine breath test, but the improvement did not reach statistical significance (p = 0.12). A similar prognostic index was calculated to predict death from liver failure. Cox's regression analysis selected aminopyrine breath test, Pugh score, and aetiology as the best set of predictor covariates. According to a receiver operating characteristic curve analysis, a prognostic index cut off value of 2.6 had a 94% sensitivity and a 88% specificity. The prognostic index significantly improved prognostic accuracy when compared with a prognostic index calculated from Pugh score and aetiology, but excluding aminopyrine breath test (p = 0.05). These data disclose that the aminopyrine breath test offers additional prognostic information to the Pugh score, and the prognosis of patients with cirrhosis.

Adult↗
PubMed1992

Head and neck squamous cell carcinoma cell line-induced suppression of in vitro lymphocyte proliferative responses.

Tumour-infiltrating lymphocytes (TILs) are often difficult to expand in vitro. In some cases this has been attributable to immunosuppression mediated by the elaboration of prostaglandins by either tumor cells or tumor-infiltrating monocytes. In this laboratory, freshly prepared TILs containing single-cell suspensions of head and neck tumors displayed both poor proliferation as well as minimal responsiveness to indomethacin-mediated reversal of immunosuppression. In order to investigate tumor-mediated immunosuppression further, a system was developed whereby a new cell line of head and neck squamous cell carcinoma was used to suppress allogeneic peripheral blood mononuclear cell proliferation in response to phytohemagglutinin (PHA) and Interleukin-2 (IL-2). Tumor cells were able to suppress peripheral blood mononuclear cell (PBMNC) proliferation up to 95%. This suppressive effect was dependent on tumor cell number and was reversible by the use of higher concentrations of PHA, but not by increased concentrations of IL-2. Suppression was immediate when IL-2 was used as the stimulus for proliferation, but required extended lymphocyte/tumor cell contact when PHA was used. Flow cytometric analysis of tumor-exposed and PHA-stimulated PBMNCs revealed a decrease in both the number of cells expressing IL-2 receptors as well as the density of IL-2 receptors per cell. This pattern of suppression, as well as the reversibility of suppression by indomethacin, implicates prostaglandins in the mechanisms by which these tumor cells mediate immunosuppression.

Carcinoma, Squamous Cell↗
PubMed1991

Modulation of glycine-activated membrane current by adamantane derivatives.

Pressure application of the inhibitory neurotransmitters glycine and GABA, respectively, evoked a Cl- current in spinal cord neurons of fetal mice in culture. Memantine, in low concentrations (0.3-5 microM) enhanced the glycine-mediated current at both negative and positive holding potentials. At concentrations of more than 5 microM, memantine increased the glycine-evoked current only when the membrane potential was positive. At negative potentials the current was inhibited. 3-isopropylamantadine and 3,5-diethylamantadine augmented the glycine-activated membrane current irrespective of the concentrations applied, whereas amantadine was ineffective. The GABA-activated Cl- current was not altered by the adamantanes. These data are evidence of a specific glycinergic interaction with putative antispastic agents and can explain some conflicting effects of memantine in experimentally induced seizures.

Adamantane↗
PubMed1991

Blood transfusions and phenotypic immune profile in head and neck cancer patients undergoing surgical resection.

Recent papers in the general surgery and otolaryngology literature have shown a positive correlation between blood transfusion and decreased survival in cancer patients. This is felt to be due to immunosuppression (not yet defined) induced by the transfusion. We prospectively analyzed the peripheral blood immune profiles of patients undergoing surgery for control of their squamous cell carcinoma of the upper aerodigestive tract. Pre- and postoperative profiles were examined. T4, T8, natural killer cells, and interleukin 2 receptor-positive T cell subsets were analyzed by flow cytometry. Statistical analysis indicated a significant difference between the non-transfused and transfused subgroups, with the transfused group having a decrease in their T helper cell and interleukin 2 receptor positive helper cell populations. This supports other literature which shows an increased recurrence rate in the transfused patient population. The patients were analyzed comparing blood transfusions, immune status, initial stage of disease, the nodal status of the disease, tumor differentiation, and patient's age yielding transfusion as the greatest single contributing factor to the observed immunological changes.

Adult↗
PubMed1990

Carbamazepine blocks NMDA-activated currents in cultured spinal cord neurons.

The antiepileptic agents, carbamazepine and phenytoin, suppress seizures in man and convulsant-induced hyperactivity in spinal cord nerve cell cultures. In the present study, we have shown by whole cell recording that carbamazepine, in contrast to phenytoin, blocks N-methyl-D-aspartate (NMDA)-activated membrane currents in cultured neurons in a dose-dependent fashion. The NMDA receptor-activated channel, which is blocked at physiological concentrations of Mg2+ at resting membrane potential, can be activated by glutamate in depolarized neurons and thus be involved in epileptogenesis. Therefore, the block of NMDA-evoked membrane currents in cultured neurons may contribute to the clinical effectiveness of carbamazepine.

2-Amino-5-phosphonovalerate↗