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Biomedical subjects

J Hoffmann

Publications and source records attributed to J Hoffmann.

At least 19 recordsLinked to original sources
PubMed1992

[Surgical interventions in ulcer diseases in Denmark. A questionnaire study].

Surgical practice in the treatment of peptic ulceration in Denmark is illustrated by means of a questionnaire. The percentage of replies was 96. The investigation reveals that the predominant method of elective surgery for duodenal ulceration is still proximal gastric vagotomy rather than vagotomy+antrectomy. In elective surgery for prepyloric ulcer, vagotomy+antrectomy is employed most frequently and for elective operation for gastric ulcer partial gastric resection. In operative interventions for complications of ulceration such as haemorrhage and perforation, the operative strategy appears to be determined by the difficult current possibilities for training in ulcer surgery to a not inconsiderable extent, rather than to be based on a rational scientific basis as the definitive intervention here is replaced to a great extent by minor interventions such as simple undersewing of a bleeding gastric ulcer followed by H2-blocker treatment and simple closure of a perforated duodenal ulcer.

Denmark↗
PubMed1992

[Axillary band contractures after axillary lymph node excision].

Three patients are described who developed painful bands across the axilla which severely restricted shoulder abduction after breast surgery and axillary lymph-node dissection. They were treated by transection of the bands with excellent results in two of the three patients. The underlying pathology is apparently thrombosis, obstruction and inflammation of lymphatic channels. Treatment should be conservative in most cases, with surgery reserved for patients with intolerable symptoms.

Adult↗
PubMed1992

The 'absent' appendix.

During an operation for suspected appendicitis, the surgeon concluded that the appendix was absent. The causes of this situation are presented and a guide to its management is suggested.

Abdominal Pain↗
PubMed1992

Surgical complications of intraoperative radiation therapy: the Radiation Therapy Oncology Group experience.

Intraoperative radiotherapy (IORT) is being used with increasing frequency in many institutions in the United States but little is known about the surgical complication rates. The Radiation Therapy Oncology Group initiated three prospective studies in IORT in 1986 and we report here the experience in advanced malignancies of the stomach, pancreas, and rectum. The incidence and nature of major surgical complications were reviewed and presented with their implications in regard to future IORT trials. Two hundred twenty-seven patients were entered on three studies by 20 participating institutions between 1985 and 1989. One hundred twenty-nine patients received IORT while 98 patients were found to have too advanced disease to be benefited by IORT and underwent palliative surgical procedures only. IORT doses ranged from 12-22 Gy and bowel anastomoses were not irradiated. Wound infection in the IORT group was 6% vs. 2% in the non-IORT patients but this was not significant at the P = 0.05 level. Other complications included anastomotic leak (n = 5), operative bleeding (n = 10), pancreatitis (n = 2), and were not statistically different in the IORT and non-IORT groups. The mortality rate for the IORT and non-IORT groups combined was 1.8%. This large multi-institutional experience in patients with advanced malignancy demonstrates that patients receiving IORT do not have a higher surgical complication rate than those not receiving IORT. Long-term survival data await the implementation of Phase III trials in advanced intra-abdominal malignancy.

Combined Modality Therapy↗
PubMed1992

Regression of left ventricular hypertrophy during long-term antihypertensive treatment--a comparison between felodipine and the combination of felodipine and metoprolol.

Seventy-six hypertensive patients with left ventricular hypertrophy (LVH) were randomized to receive felodipine or felodipine plus metoprolol in a double-blind parallel-group study. The doses of each treatment regimen were titrated to obtain a diastolic blood pressure (BP) of less than 95 mmHg. The duration of the treatment was 9 months. At the end of the study, BP was significantly reduced in both groups, and the reduction did not differ between the groups. Left ventricular posterior wall and septum thickness were significantly and similarly reduced in both groups. Left ventricular systolic and diastolic end diameters were not significantly changed. Left ventricular mass (LVM) was significantly and similarly reduced in both treatment groups, as was the ratio of LVM and left ventricular end diastolic volume. In conclusion, felodipine and the combination of felodipine and metoprolol reduced left ventricular hypertrophy to the same extent when BP was similarly reduced.

Adult↗
PubMed1992

Clinical studies of Ukrain in terminal cancer patients (phase II).

Phase II of clinical studies was performed on 70 patients, ranging in age from 14 to 80 years, (27 male, 43 female) to determine the appropriate dose range for Ukrain and the clarification of dose/response relationships, in order to provide an optimal background for wider therapeutic trials. The following parameters were studied: physiological (pulse, blood pressure, temperature); biochemical, haematological and immunological. Electrolytes and trace elements were investigated, as well as neopterin, tumour markers, immune complexes, non specific blocking factors, development of tumours and metastases in quantitative respects (by X-ray, CT, scintigrams and US). The patients' general conditions were also assessed. Ukrain was given intramuscularly or intravenously every one, two, three, four or five days, or according to other schemata, in the dose range of 2.5, 5, 10, 15, 20 or 25 mg increasing (2.5 to 25 mg per injection), decreasing (25 to 2.5 mg per injection) and stable (5, 10, 15, 20 or 25 mg per injection). Duration of one course of therapy was between 10 days and 90 days. Intervals between courses ranged from 7 days to 3 months. In order to find dose/duration/interval/response-relationships, some cases were treated after chemoradiotherapy, some as adjuvant therapy to chemo-radiotherapy and alternatives such as iscador, and some as monotherapy. All patients were at terminal stages of their disease.

Adolescent↗
PubMed1991

Relationship between a subunit of NADH dehydrogenase (complex I) and a protein family including subunits of cytochrome reductase and processing protease of mitochondria.

The primary structure of a 40 kDa subunit of the respiratory chain NADH:ubiquinone reductase from Neurospora crassa was determined by sequencing cDNA, genomic DNA and the N-terminus of the mature protein. The gene which is interrupted by 7 introns encodes a preprotein consisting of 375 amino acids with a 26 amino acid long presequence typical for a mitochondrial targeting signal. The sequence of the mature subunit shows conspicuous similarities to the recently [(1989) Nature 339, 147-149] discovered protein family which includes subunits I and II of the ubiquinol:cytochrome c reductase, and the processing proteins, matrix processing peptidase and processing enhancing protein, of mitochondria. The possible role of the subunit is discussed.

Amino Acid Sequence↗
PubMed1991

Assessment of the reliability of the symptoms and signs of acute appendicitis.

The reliability of the signs and symptoms of acute appendicitis are reviewed. The wide variation in clinical findings when the different studies are compared can probably be explained by the huge quantity of retrospective studies. Migration of pain to the right iliac fossa and/or guarding/rigidity support the diagnosis of appendicitis. The diagnosis of appendicitis should be doubted when anorexia, nausea and vomiting are absent, when symptoms have persisted for more than 72 h without apparent perforation, or when tenderness in the right iliac fossa is absent. Presentation in proximity to menstruation, cervical dislocation tenderness and bilateral adnexal tenderness indicates pelvic inflammatory disease. Small children have high perforation rates because of their uniform response to many illnesses and relative inability to express themselves and cooperate. The clinical findings in young and old patients are similar, except for a higher rate of abdominal distension in old patients. With a more thorough knowledge of the signs and symptoms of acute appendicitis and a constant awareness of its possible presence, it should be possible to increase the diagnostic accuracy.

Abdominal Pain↗
PubMed1991

Ultraconservative management of appendiceal abscess.

An appendiceal abscess is usually treated conservatively. Drainage of the abscess is instituted if this treatment is unsuccessful. Some surgeons practise immediate appendectomy and abscess drainage. An alternative ultraconservative approach whereby abscess drainage is avoided has been reviewed retrospectively. Twenty-eight patients were treated by observation only. They remained in hospital for between 1 and 36 days (median 10 days) until their signs and symptoms disappeared. No patient required surgery or developed complications in hospital. One patient developed acute appendicitis 10 days after discharge. One developed a recurrent abscess. Another group of 19 patients were treated over the same period of time by immediate operation. Ten developed postoperative complications. Hospitalization ranged from 4 to 36 days (median 8 days). Ultraconservative management of appendiceal abscess is a safe and effective alternative to immediate surgery, or ultrasound- or computed tomographic-guided drainage.

Abscess↗
PubMed1990

Enhanced expression of the proto-oncogenes fos and raf in the rhabdomyosarcoma cell line BA-HAN-1C after differentiation induction with retinoic acid and N-methylformamide.

BA-HAN-IC is a clonal rat rhabdomyosarcoma cell line consisting of proliferating mononuclear tumor cells, some of which spontaneously fuse to form terminally differentiated post-mitotic myotubes. Exposure of BA-HAN-IC cells to retinoic acid (RA) or N-methylformamide (NMF) resulted in a significant inhibition of proliferation (p less than 0.001) and in cellular differentiation, as evidenced by a significant increase in the creatine kinase (CK) activity (p less than 0.05) and the number of terminally differentiated post-mitotic myotubes (p less than 0.001). Furthermore, between 5% (NMF) and 30% (RA) of the mononuclear tumor cells exhibited ultrastructural features of rhabdomyogenic differentiation, not observed in their mononuclear counterparts under standard growth conditions. Although BA-HAN-IC cells responded to both inducers of differentiation, differences in time course and magnitude of both increase of differentiation and growth inhibition were observed. These effects of RA and NMF were preceded by a marked enhancement of c-raf expression which became evident 6 and 12 hr after exposure to RA and NMF, respectively, and which persisted throughout the observation period of 5 days. Furthermore, a transient expression of c-fos could be observed 15 and 30 min after exposure to RA. Our results suggest that c-raf expression might be implicated in the differentiation process of BA-HAN-IC tumor cells.

Animals↗
PubMed1990

Interaction of Triton X-100 and octyl glucoside with liposomal membranes at sublytic and lytic concentrations. Spectroscopic studies.

The molecular mechanism of the solubilisation of phospholipid bilayers by nonionic detergents was studied by turbidity changes, carboxyfluorescein fluorescence dequenching, steady-state and time-resolved fluorescence anisotropy of DPH, lifetime measurements, ANS binding and 31P-NMR. Particular attention has been paid to the effective detergent-to-lipid ratio in the lipid phase. The disturbance of the bilayer arrangement varies considerably for various detergents depending on the hydrophilic and lipophilic parts of the molecule. Small amounts of detergents with low CMC (e.g. Triton X-100) can even induce an optimisation of packing of the lipid molecules.

1,2-Dipalmitoylphosphatidylcholine↗
PubMed1990

Isolation and structure elucidation of a novel 5-kDa peptide from neurohaemal lobes of the corpora cardiaca of Locusta migratoria (Insecta, Orthoptera).

Two predominant peptides have been isolated from neurohaemal lobes of corpora cardiaca of 8000 adults of Locusta migratoria. Both peptides have been unambiguously characterized by automated peptide microsequencing and liquid secondary-ion mass spectrometry as a 50-residue peptide (5K peptide) and a 48-residue isologue (5K' peptide). Computer search of sequence data banks did not reveal any significant similarity with other identified proteins. The 5K peptides are remarkably rich in alanine residues (25%) and contain a stretch of five consecutive alanines. This structure suggests that these molecules could correspond to spacer peptides. This assumption is corroborated in the accompanying paper [Lagueux et al. (1990) Eur. J. Biochem. 187, 249-254] on the molecular cloning of the precursor protein which attributes to the 5K peptides a role analogous to that of the C peptides of insulins.

Amino Acid Sequence↗
PubMed1990

Diurnal salivary cortisol patterns during pregnancy and after delivery: relationship to plasma corticotrophin-releasing-hormone.

The circadian rhythm of salivary cortisol was studied in 10 healthy women every 4 weeks throughout pregnancy. In addition, in 12 women the diurnal patterns of salivary cortisol, serum cortisol, plasma ACTH, plasma CRH and serum progesterone were analysed in late third trimester pregnancy and again 3-5 days after delivery. Salivary cortisol profiles exhibited a clear circadian rhythm during pregnancy with an increase in mean salivary cortisol from the 25th to 28th week onwards reaching concentrations in late pregnancy more than twice as high as in non-pregnant controls, rapidly returning to normal concentrations after delivery. The coefficient of variation of salivary cortisol profiles decreased in third trimester pregnancy due to a parallel upward shift of cortisol concentrations (40.2 +/- 3.4% vs 77.6 +/- 6.6% after delivery, P less than 0.01). A diurnal pattern was also found for plasma ACTH and serum cortisol before and after delivery with lower concentrations post-partum (P less than 0.01). In late pregnancy, progesterone concentrations were significantly higher in the evening (930 +/- 85 nmol/l vs 813 +/- 74 nmol/l at 0900 h, P less than 0.01) but showed no diurnal variation post-partum. Plasma CRH was significantly elevated in late third trimester pregnancy (1.22 +/- 0.23 micrograms/l at 0900 h) but showed no diurnal change (1.30 +/- 0.28 micrograms/l at 1900 h). Moreover, no correlation between the free cortisol increase in late pregnancy and plasma CRH was noted despite a wide range of CRH levels (0.13-3.60 micrograms/l). In contrast, a significant correlation was observed between the serum progesterone increase and the salivary cortisol increase in late pregnancy (r = 0.70, P less than 0.05). These findings demonstrate that placental CRH is not the only regulator of maternal ACTH and cortisol release. Instead, our study suggests that placental CRH has little influence on baseline maternal adrenocortical function in pregnancy. The elevated salivary cortisol levels in pregnancy may be explained by glucocorticoid resistance owing to the antiglucocorticoid action of high progesterone concentrations.

Adult↗