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Biomedical subjects

P Kluge

Publications and source records attributed to P Kluge.

At least 19 recordsLinked to original sources
PubMed2004

Autoimmune hepatitis in transplanted liver.

Liver transplantation is recognized as the appropriate treatment for end-stage liver disease. Four patients undergoing liver transplantation for classical end-stage liver disease developed de novo autoimmune hepatitis (AIH) in the graft. Recurrence of AIH after orthotopic liver transplantation and after reduction in immunosuppressive treatment is reported in one other patient. Markedly elevated serum transaminases were observed, together with an elevated serum IgG and/or globulin fraction and histological feature typical of AIH on liver biopsy.

Adolescent↗
PubMed2001

[Tubulointerstitial nephritis related to immunotherapy and immunostimulation: a report of two cases].

Two cases of tubulointerstitial nephritis (TIN) with renal failure related to immunotherapy (case 1) and immunostimulation (case 2) have been described. Case 1: 18 years old male patient with hay fever was admitted because of rapid increase of serum creatinine from 1.1 mg/dl to 5.5 mg/dl, fever, weight loss and anemia which developed during 6 months after second course of immunotherapy. Case 2: 12 years old boy was admitted because of fever, weight loss and rapid progression to renal failure after treatment of pharyngitis with antibiotics and immunostimulant drug. In both patients renal biopsy was performed and TIN with huge lymphocytes T infiltrates was diagnosed. After 6 months treatment with corticosteroids renal function turned back to previous levels in both patients. Pathogenesis and treatment of TIN is discussed.

Adjuvants, Immunologic↗
PubMed1999

Treatment of progressive familial intrahepatic cholestasis: liver transplantation or partial external biliary diversion.

Progressive intrahepatic familial cholestasis (PFIC), previously called Byler's disease, is a syndrome in which children develop severe cholestasis progressing to biliary cirrhosis and chronic liver failure, usually during the first decade of life. Clinical features include jaundice, hepatomegaly, splenomegaly, growth retardation and severe pruritus. Laboratory tests demonstrate elevated bilirubin and bile acids, without an increase in serum gamma-glutamyl-transpeptidase or cholesterol. This study was performed to evaluate our experience with medical therapy as well as two types of surgical treatment used in children with PFIC, particularly partial external biliary diversion (PEBD) as an alternative method of therapy to liver transplantation (OLTx). Between 1979 and 1998 we have treated 46 children with PFIC (27 boys and 19 girls), aged 10 months to 19 yr (at the time of this study). Medical treatment with ursodeoxycholic (UDCA) was used in 39 patients for the period between 6 and 82 months. PEBD (cholecysto-jejuno-cutaneostomy) was performed in 16 patients, OLTx in eight children (including one after unsuccessful PEBD). Retrospective analysis of the clinical course and selected laboratory tests (bilirubin, ASPAT, ALAT, bile acids), and histopathological examinations were performed. Results of treatment were assessed by means of influence of the type of treatment on clinical symptoms, laboratory tests, progress of liver cirrhosis and hepatic failure, as well as physical development and survival. Medical therapy was effective in the long term in four (10%) of the patients resulting in clinical and biochemical normalization. Both surgical methods of therapy of PFIC, PEBD and OLTx, resulted in an 80% success rate and therefore should be used as complementary therapies. In patients before established liver cirrhosis, PEBD should be the first choice of treatment. Patients presenting with cirrhosis or after ineffective PEBD should qualify for OLTx. With this strategy most children with PIFC can be cured.

Adolescent↗
PubMed1998

[Needle testicular biopsy in the diagnosis of male infertility].

OBJECTIVES: Evaluation of testicular tissue is very important diagnostic procedures in cryptozoospermia and azoospermia. It is verified the patient for treatment (stimulation spermatogenesis), for micromanipulation ICSI or for insemination donor semen procedure. Surgical biopsy is very popular between andrologist and urologist, but needle biopsy seems to be easier and safer. DESIGN: The authors present their experience with needle testicular biopsy during the diagnosis patients with azoospermia or cryptozoospermia and the men with paraplegia after trauma and without ejaculation. MATERIAL AND METHODS: The study group included 63 biopsies in 58 men with azoospermia and severe oligoasthenozoospermia (cryptozoospermia) and 2 with paraplegia. The specimens were taken from 125 testes under general anesthesia (i.v-Diprivan, Propofol, Zeneca and Fentanyl) using biopsy needle from Hepafix B. Braun Melsungen, Germany. All procedures were performed as a day case. RESULTS: In 95% specimens were adequate for histopathological investigations and for planning the treatment. Only one complication (0, 8%) -small haematoma testis was observed. CONCLUSIONS: The needle biopsy of testicular tissue is sufficiency in histopathological examination, safe for patients and easy for urologists. The total cost is much more lower than cost of surgical biopsy.

Adult↗
PubMed1997

[QT dispersion in surface ECG and QT dynamics in long-term ECG in patients with coronary heart disease in the chronic post-infarct stage with and without ventricular tachyarrhythmias--correlation with other risk parameters].

QT-dispersion (QTD) in 12-lead surface-ECG and QT-dynamics in Holter-ECG, defined as the time-course of the frequency corrected QT-interval (mQTc), were determined in 42 patients with coronary artery disease in chronic postinfarction stadium without ventricular tachyarrhythmias (CAD/VTA-) and in 24 CAD patients with ventricular tachyarrhythmias (CAD/VTA+). 14 healthy volunteers served as control group (CG). Correlations with hemodynamic data (LVEF, severity of CAD) and with other risk-parameters (ventricular late potentials, short-time heart rate variability) were calculated. QTD in CAD/VTA-was significantly higher compared to CG (48.4 ms+/- 19.6 vs 31.4 ms +/- 9.8, p < 0.05). There were no intergroup differences in QT-dynamics. CAD/VTA+ patients showed the highest QTD-values (59.5 ms +/- 31.1, p < 0.05 compared to CG/CAD/VTA0) and a significantly altered QT-dynamics compared to CG/CAD/VTA- (mQTc: 431.3 ms +/- 38.8 vs 400.8 ms +/- 25.5 vs 406.3 ms +/- l0.6, p < 0.05). Only parameters of QTD were significantly correlated to severity of CAD (r = +0.41, p < 0.01) and to LVEF (r = 0.43, p < 0.01). We did not find significant correlations between the parameters of QT-dispersion/QT-dynamics among one another and to the risk-parameters. These results indicate that the QT-dispersion in CAD-patients also in chronic post-infarction stadium is elevated and that CAD-patients with VTA are characterized by an altered QT-dynamics. Parameters of both methods are independent of other validated risk-parameters. So the measurement of QT-dispersion and QT-dynamics as markers of inhomogenous repolarization could contribute to an improvement of risk-stratification of CAD-patients.

Coronary Disease↗
PubMed1995

[Correlation among clinical and histopathologic criteria in selection of donors for orthotopic liver transplantation].

The aim of this work is to present the correlation between the initial microscopic pattern of the liver graft and clinical and laboratory findings. In the Department of General Surgery and Liver Diseases 6 specimens were taken from 4 livers destined for planned liver transplantations. They were taken from the organ rinsed in UW solution, processed and stained extemporaneously. Quick HE staining was performed in some cases. Two livers were qualified for transplantation although they showed negligible histopathological changes. In one of these cases there was a clinical and pathological disagreement. The results of histological examination were crucial in qualification of the liver for grafting. One organ was disqualified because of negative clinical and pathological findings, while two other livers were disqualified after clinical examination. We resigned from the transplantation of liver of the last donor, who exhibited unsatisfactory clinical tests in spite of good pathological results.

Adolescent↗
PubMed1994

Multifocal central nervous system glioma--a case history.

A case history of the multifocal brain glioma in 13-year-old girl is reported. Numerous neoplasmatic foci were found using MRI within the vermis and cerebellar hemisphere and, later, also within the brain stem, cervical spinal cord and both brain hemispheres. Bioptical examination of the tumors revealed the structure of anaplastic astrocytoma with oligodendromatous component. The authors suggest that the foci may be considered as multiple metastases from the primary cerebellar astrocytoma and the neoplastic cells might have been transported within CNS through cerebrospinal fluid.

Cerebellar Neoplasms↗
PubMed1993

[Disorders of myocardial function in patients with normal coronary angiography].

An attempt is made to estimate the value of intraventricular injection of contrast media in the procedure of angiocardiography for registration of a latent disease of the myocardium. For this purpose the parameter of the cardial function of 350 patients are analysed depending on the severity of the coronary heart disease. Under resting conditions the left ventricular end-diastolic pressure (LVEDP) of patients with coronary heart disease was 19.9 +/- 7.98 mmHg. The LVEDP of patients with the angina pectoris syndrome but normal epicardial coronary arteries was 15.6 +/- 5.45 mmHg. The LVEDP of the most of the patients rose after injecting contrast medium in the left ventricle independent of the resting level. Patients with coronary heart disease had a LVEDP of 23.7 +/- 9.48 mmHg after injecting the contrast media, while patients with normal coronary arteries had a LVEDP of 19.2 +/- 7.21 mmHg. The left ventricular systolic pressure and the parameters of contractility did not change significantly after injecting contrast media. The injection of contrast medium into the left ventricle--i.e. the ventriculography--is in a qualified sense a volume stress to the left ventricle. That means an increase of a normal LVEDP after an injection of contrast medium uncovers a preclinical disease of the left ventricular myocardium.

Adult↗
PubMed1981

Ames testing of Direct Black 38 parallels carcinogenicity testing.

Studies have established that Direct Black 38 and two other benzidine-based dyes are carcinogenic. The carcinogenic effect has been generally considered attributable to the metabolic release of benzidine from Direct Black 38 and similar dyes. However, Ames tests indicated that when Direct Black 38 is reduced with sodium dithionate it is more mutagenic than can be accounted for by complete release of all the benzidine present in the dye molecule. While most dyes are not mutagenic when tested with S-9, a series of benzidine congener dyes were all found to be mutagenic with either TA 98 or TA 100 strains, if the dyes were first reduced with sodium dithionate. Unreduced dyes were not mutagenic. Neither anaerobic conditions nor addition of riboflavin induced mutagenicity of these dyes under the condition of our experiments.

Anaerobiosis↗