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Biomedical subjects

K de Heer

Publications and source records attributed to K de Heer.

At least 19 recordsLinked to original sources
PubMed2004

Quality of life after brachytherapy in patients with glioblastoma multiforme.

As quality of life (QoL) is perhaps the most important outcome for patients treated for glioblastoma multiforme (GBM), we measured QoL in GBM patients after brachytherapy. QoL was assessed by questionnaires for both patients and partners before brachytherapy and at various times during follow-up in 21 GBM patients by an extension of the Rotterdam Symptom Checklist (e-RSCL), consisting of four subscales. The Karnofsky Performance Scale (KPS) was also measured. Analysis of variance was done to evaluate the direct effect of brachytherapy (visit 1-2, short-term) and during follow up (visit 1-4, longer-term). Significant short-term effects were found for two subscales of the e-RSCL. Longer-term effects were found for all four subscales and for the KPS. A high correlation between partner and patient's QoL assessment was found. QoL in GBM patients after brachytherapy can therefore be carefully monitored with a subjective instrument such as the e-RSCL. Patients and partners experience QoL equally.

Activities of Daily Living↗
PubMed1999

Inflammatory bowel disease and the genes for the natural resistance-associated macrophage protein-1 and the interferon-gamma receptor 1.

The genes for the interferon-gamma receptor 1 and the natural resistance-associated macrophage protein 1 (NRAMP1) control the immune response to intracellular microbial pathogens. Such pathogens, in particular Mycobacterium paratuberculosis, have been implicated in the pathogenesis of Crohn's disease. We studied markers in the genes for NRAMP1 and two mutations in the interferon-gamma receptor in relation to inflammatory bowel disease (IBD) in the following groups: 270 healthy individuals, 74 patients with Crohn's disease, 72 patients with ulcerative colitis, and 40 patients with primary sclerosing cholangitis. We studied the allele frequencies of two restriction fragment length polymorphisms in the gene for NRAMP1 and the prevalence of two mutations in the interferon-gamma receptor 1 gene. The markers in the NRAMP1 gene were not associated with inflammatory bowel disease. Also, the mutations in the interferon-gamma receptor 1 were not found in the 186 IBD patients. Genetic markers in NRAMP1 are thus not associated with IBD. Therefore this gene is not likely to play a role in the pathogenesis of IBD. The mutation in the interferon-gamma receptor was not found in our IBD patients group.

Adult↗
PubMed1992

Detection of colorectal carcinomas by intraoperative RIS in addition to preoperative RIS: surgical and immunohistochemical findings.

The immunoscintigraphic detection of tumour foci less than 1 cm in diameter fails even with single photon emission tomography (SPET) owing to low contrast against background activity. In an attempt to improve detection of macroscopically invisible tumour spread, intraoperative scintimetry (IOSM) with a hand-held gamma-probe was performed in addition to SPET 24-30 and 41-48 h after injection of the technetium-99m carcinoembryonic antigen (CEA MoA) on 12 patients with colorectal carcinoma and 3 patients with different neoplastic and inflammatory diseases. Tumour specimens were measured in vitro in a gamma well counter. For comparison, the presence and amount of CEA in the tumour cells were evaluated immunohistochemically. After modification, the gamma-probe originally designed for iodine-131 was 20 times more sensitive; activities of 99mTc located close to the collimator hole were measured with absolute sensitivity of 100 cps = 2.5 kBq 99mTc. The unfavourably high background activity affected both the in vitro and in vivo analysis: SPET results had been considered positive in 8 of 15 cases. In vitro tumour/non-tumour (t/nt) ratios greater than 2.0 were found in 4 cases. In vivo IOSM resulted in t/nt ratios greater than 2.0 in only 3 patients. In most cases, there was no coincidence of elevated t/nt ratios from the different methods. A correlation was derived between positive immunoscintimetric in vitro findings and immunohistochemically proven interstitial localization of CEA in tumor cells. In conclusion, the measurement technique of IOSM seems adequate, but clinical success will depend on a more specific enrichment of MoA in tumour tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Perforation of gastroduodenal ulcer. Risk factors and choice of procedure].

The well known surgical risk factors, such as age, time of perforation as well as size and localisation of necrosis, were confirmed in retrospective and prospective analyses of perforation of gastroduodenal ulcers (n = 504). Incidence was unchanged in the two different time-related groups, with 3.2 or 3.7 cases in one month. There was a clear-cut need for excision of the ulcer or necrotic margin. Perforation was attributable to malignant tumours in 2.1 per cent of the cases. The authors have definitely adopted the concept of earlier primary surgery (23 per cent of all cases, as compared to 10.4 per cent before). The risk associated to it was found to be lower than linked to palliative operations. The lethality rate was as low as 7.6 per cent, once due consideration was given to the above risk factors for adequate choice of surgical methods. Particular attention was given to ulcer localisation and clinical course. Hence, lethality has clearly dropped below earlier data.

Adult↗
PubMed1989

[Identification of the recurrent laryngeal nerve in thyroid gland surgery--a status determination].

The recurrent laryngeal nerve palsy is the most important complication in thyroid surgery. It seems to be possible to reduce the rate of palsies by consequently identifying the recurrent laryngeal nerve. A comparison of statistics out of the literature with and without identification of the recurrent laryngeal nerve shows this. A follow-up of our patients of the years 1980-1982 (1312 operations) confirms this finding.

Adult↗
PubMed1987

[Metastases of the thyroid gland--morphology and clinical aspects of 25 secondary thyroid neoplasms].

Morphological and clinical findings in 25 secondary tumours of the thyroid are described. The most common sources of such lesions were the kidneys (32%), lung (28%) and breast (20%). In the majority of cases, thyroidectomy was performed prior to identification and treatment of the primary cancer. Conversely, among renal cell carcinomas, the metastatic lesion frequently appeared many years after resection of the primary tumour. This suggests that secondary thyroid tumours occasionally may be the only important malignant disease remaining. Hence, adequate surgical treatment may prove to be life-prolonging or life-saving.

Aged↗
PubMed1987

[Ethinyl estradiol and hepatocarcinogenesis. An experimental study].

The influence of ethinylostradiol on hepatocarcinogenesis was investigated in the female Dawley-rat. After 14 weekly gastric instillations of 50 mg diethylnitrosamine/kg and simultaneous administration of diet supplemented with ethinylostradiol 10 mg/l kg diet, 77.8% of the rats developed a hepatocellular carcinoma. In contrast, only 31.8% had carcinoma of the liver under similar experimental conditions. The relation of preneoplastic lesions correlated with that of carcinoma induction in both groups. If the results were to be valued on clinical relevance without difficulties a new orientation on surgical indication and transformation of the dignity of benign focal nodular hyperplasia would have to be considered.

Animals↗
PubMed1987

Increased thyrotropin binding in hyperfunctioning thyroid nodules.

The object of this study was to investigate TSH receptors in hyperfunctioning thyroid nodules (HFN). In HFN, obtained from seven patients, 125-I-TSH binding as determined by equilibrium binding analysis on particulate membrane preparations, was found to be significantly increased as compared with normal thyroid tissues (five patients; P less than 0.001). Scatchard analysis of TSH-binding revealed two kinds of binding sites for both normal thyroid tissue and HFN, and displayed significantly increased association constants of high- and low-affinity binding sites in HFN (Ka = 11.75 +/- 6.8 10(9) M-1, P less than 0.001 and Ka = 2.1 +/- 1.0 10(7) M-1, P less than 0.025; x +/- SEM) as compared with normal thyroid tissue (Ka = 0.25 +/- 0.06 10(9) M-1, Ka = 0.14 +/- 0.03 10(7) M-1; x +/- SEM). The capacity of the high-affinity binding sites in HFN was found to be decreased (1.8 +/- 1.1 pmol/mg protein, x +/- SEM) in comparison with normal thyroid tissue (4.26 +/- 1.27 pmol/mg protein; x +/- SEM). TSH-receptor autoradiography applied to cryostatic tissue sections confirmed increased TSH binding of the follicular epithelium in HFN. These data suggest that an increased affinity of TSH-receptor sites in HFN in iodine deficient areas may be an important event in thyroid autonomy.

Humans↗
PubMed1986

[Differential indications in perforation of gastroduodenal ulcer].

The differential indication of perforated peptic gastroduodenal ulcer is presented giving emergency surgical intervention preference. Simple closure after radical excision with a mortality rate of 12.1% as demonstrated in our clinical material is generally performed and in some selected cases the so-called primary definitive therapy excision, SPV or distal gastric resection. In cases of doubt simple closure is performed. An absolute acute indication for simple closure is also valid for the atypical perforation.

Aged↗
PubMed1984

[Stress tolerance of patients with hemorrhage from ulcus ventriculi sive duodeni].

448 patients with severe haemorrhage from gastroduodenal ulcera during the last 15 years are presented. Within this period indication, organisation and the choice of method have changed in 3 phases. Included are the endoscopic diagnosis and treatment with very good results. As a result of endoscopy there is a negative selection of patients for surgery causing a depression of the results after surgical treatment. The propagation for early indication even in high risk patients still has validity.

Duodenal Ulcer↗
PubMed1984

Histopathologic types and clinical behaviour of occult papillary carcinoma of the thyroid.

On studying 182 papillary neoplasms of the thyroid, 32 nonencapsulated lesions were found to be occult papillary carcinomas (maximum diameter 1.5 cm); out of these 32 patients 18 cases of cervical lymph node metastases were observed. Histologically, 4 circumscribed microcarcinomas, 3 partially encapsulated carcinomas, and 25 occult sclerosing carcinomas were distinguished. The mean diameter of the 4 circumscribed tumours as compared to that of the remaining 28 lesions proved to be statistically significantly smaller, but no significant differences could be observed regarding the rate of lymph node metastasis. One occult sclerosing carcinoma showed a morphologic pattern different from the remaining cases--namely that it had an exclusively solid appearance in the primary lesion and also in its lymph nodes metastases. The follicle cell origin of this lesion was established immunohistochemically by patchy thyroglobulin synthesis. The excellent prognosis of the occult category of papillary thyroid carcinoma was confirmed by a follow-up (mean 7.7 years, range 1.1 to 16.3 years), in which only 2 instances of eradicable recurrent lymph node metastases within the group of occult sclerosing carcinomas were recorded.

Adult↗
PubMed1984

[Postoperative course and tactics of aftercare in hyperthyroidism].

In a follow-up study of 112 patients who had subtotal thyroidectomy because of Graves' disease and nodular goitre with hyperthyroidism, 81% were euthyroid, 10,7% developed hypothyroidism and 8% had persistent or recurrent hyperthyroidism. 12,5% of the euthyroid patients had goitre; 10 of these patients had cold thyroid nodules. The assessment of the dignity of the cold nodules and guidelines for the therapeutic procedure are stressed. The importance of considering clinical findings on one hand and thyroid function tests on the other hand in the choice of effective treatment - prophylaxis against euthyroid goitre, substitution with hormones, iodine-131 therapy, antithyroid drugs or reoperation - is outlined.

Follow-Up Studies↗
PubMed1983

Morphological alterations of the esophagus after endoscopic sclerotherapy of varices.

With the combined peri- and intravascular sclerosing technique esophageal varices can be completely eliminated in an average of three treatment sessions. In order to check the success of the procedure, endoscopic and histological findings at the various stages of treatment after sclerosing with 1% Polidocanol were compared. Clinical and autopsy findings are in agreement. After sclerosing, necroses of the mucosa and intramural inflammations occur regularly in the first week. The varices are thrombosed. Later, the inner wall of the esophagus is cicatricially changed. Histologically the fibroses extend transmurally and in some parts even reach the musculature.

Adolescent↗
PubMed1983

[Experiences with fiber endoscopy sclerosing of esophageal varices with polidocanol].

Endoscopic sclerosing of oesophageal varices is only a palliative measure, which should be performed when the bleeding came to a standstill. The aim of treatment is to sclerose all visible varices in the oesophagus. This can be done with intervals in 4 to 5 weeks. Anaesthesia is not necessary. We observed perforations in 1%, stenosis of the oesophagus in 10% (n = 414 cases), treated in the last 4 years. The results obtained until now confirm our impression that, at present, injection sclerotherapy is the method of choice.

Adolescent↗
PubMed1982

[Endoscopic injection for haemostasis in the gastrointestinal tract].

Haemostasis by endoscopic injection was attempted in 169 patients with acute gastrointestinal haemorrhage between 1976 and 1982. Despite various caused initial haemostasis in the upper and lower digestive tract was achieved in 95%. Recurrences were seen in 10%. Definitive haemostasis thus was 85%. Best results were obtained in Mallory-Weiss syndrome, angiodysplasia and post-polypectomy haemorrhage. The success rate for gastroduodenal ulcers was around 75 to 80%. Until now no complications have been observed. Apart from effectiveness, the injection method has the advantage of simplicity and little technical needs over other procedures.

Endoscopy↗
PubMed1981

[Protective effect of cholestyramine in the hepatocarcinogenesis of the rat (author's transl)].

The influence of cholestyramine on hepatocarcinogenesis was investigated in the Wistar rat. After 14 weekly gastric instillation of 50 mg diethylnitrosamine/kg and simultaneous administration of diet supplement with 1.3% cholestyramine, half of the animals developed hepatic tumors. In contrast, nearly all the animals in the control group under similar experimental conditions, but without the cholestyramine supplement in their diet, developed hepatic tumors. The sequestration of bile acids and the reduction of the noxious lithocholic acid could be considered as an explanation for the modification of hepatic tumors induced by diethylnitrosamine in the Wistar rat.

Animals↗