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Biomedical subjects

R Lamerz

Publications and source records attributed to R Lamerz.

At least 19 recordsLinked to original sources

[CEA blood level in patients with Crohn's disease with reference to localization, duration and severity of the disease].

CEA-serum-levels were determined in 24 patients with Crohn's disease over a period up to 35 months. 13 patients showed elevated CEA-Levels (greater than 3 ng/ml). A positive correlation between the extent of the lesion and the CEA-serum-level could be demonstrated. This correlation could not be demonstrated in regard to the duration of the disease. The attempt to utilize CEA-serum-levels for the estimation of the activity of Crohn's disease showed a good correlation between the activity and CEA-levels in a few cases; the activity was measured by means of the Crohn's Disease Activity Index (CDAI), which was recommended in the National Crohn's Disease Study in the United States.

Adolescent

[Radioimmunologic serum determinations of alpha-fetoprotein in patients with tumors of the testis (author's transl)].

Alpha-fetoprotein (AEP) serum levels were determined by a new radioimmunoassay (sensitivity about 5 ng/ml) in 47 patients with teratocarcinoma of the testis and in 58 cases with seminoma before operation and during the postoperative course of the disease. In 140 healthy adult persons normal AFP levels below 15 ng/ml were measured. Of 14 preoperative cases with teratocarcinoma, 12 (86%) showed pathologic AFP levels over 20 ng/ml up to 3875 ng/ml. Postoperatively, cases free of metastases developed normal AFP concentrations within 4 to 10 weeks, whereas cases with distant metastases retained constant or increasing pathologic levels following a clinical deterioration. Only in three postoperative cases were Ouchterlony-positive results (AFP sensitivity about 10 000 ng/ml) observed. In contrast, patients with seminoma showed normal AFP levels below 20 ng/ml pre- and postoperatively. According to the results, AFP radioimmunoassay is recommended as an important tool for the differentiation of teratocarcinoma from other tumors of the testis and as a useful parameter for the control of therapy and the course of the disease.

Animals

[Significance of serum alpha-fetoprotein determination. Experiences with our own radioimmunoassay].

Alpha-fetoprotein (AFP) was determined by a new radioimmunoassay in the sera of patients with different liver diseases. Compared to a normal group (n = 140, AFP levels below 15 ng/ml), most elevated AFP concentrations were found in 18 patients with primary liver cancer (PLC), 7 of whom showed Ouchterlony-positive levels (above 10,000 ng/ml). In 3 cases with liver cirrhosis, PLC was first suggested by high AFP levels between 1000 and 3600 ng/ml and later confirmed by histology. On the other hand, only 6 from 15 patients with other primary tumors and liver metastasis had AFP concentrations between 20 and 111 ng/ml. In 90% of 102 patients with liver cirrhosis AFP levels below 20 ng/ml were determined, while 13 cases showed elevated values up to 134 ng/ml. A transitory AFP increase between 20 and 238 ng/ml was seen in 32% of 63 cases in the early stage of acute hepatitis but 65% of 31 these cases in follow-up studies. 3 of 7 cases of chronic hepatitis gave similar results. The maximal AFP levels developed following the maximal transaminase activities by 5-18 days and coincided with a decrease of cholinesterase activity. The radioimmunological determination of AFP is recommended for earlier detection of the development of PLC in liver cirrhosis patients.

Female

[Immunglobulins G, A, M, and E in lymphogranulomatosis (author's transl)].

IgG, IgA and IgM were determined in 68, and IgE in 30 patients with Hodgkin's disease. Their relation to the dissemination stage, histological type, clinical stage and peripheral lymphocytes as well as the correlation of IgE to the peripheral eosinophils was investigated. In the untreated collective all Ig concentrations were above normal, but in the treated patients only IgG and IgE. With increasing dissemination, there was a decline of IgG, IgA and IgM in both groups which, however, was only significant for IgM. IgM was lowered in the lymphocytopenic type, raised in nodular sclerosis. There is a confirmed correlation between the absolute peripheral lymphocytes and IgM and between the peripheral eosinophils and IgE. IgE and IgA are slightly and IgM significantly lowered in the treated compared with the untreated patients. The findings suggest a disturbance of the humoral immunity in stage IV, in the lymphocytopenic type and in the treated patients.

Adolescent

[Bence-Jones proteinemia and amyloidosis (author's transl)].

In a 55-year-old patient with Pattern I amyloidosis it was possible to detect a Lambda-Bence-Jones protein in plasma by means of CAF and immunelectrophoresis and column chromatography, but not in urine because of possible polymerisation.

Amyloid

[Determination of carcinoembryonic antigen (CEA) in patients with tumors of the large intestine. Experience with a new radioimmunoassay (author's transl)].

Specimens from 93 patients with histologically confirmed tumors of the large bowel (53 single, 40 sequential determinations) were investigated by a new CEA radioimmunoassay (double antibody method, direct serum determination). Of the single and preoperative sequential determinations 37-40% were normal (below 2.5 ng/ml), one third was intermediately elevated (2.6-15 ng/ml) and 26-28% were highly pathological leveled (over 15 ng/ml). Following operation, cases with local or regionally confined tumor showed significantly more normal or normalizing CEA levels within 1-6 weeks (17/27), whereas patients with overt metastases developed more pathological or increasingly pathological levels (8/11).

Adenocarcinoma

[Carcinofetal antigens. III. Further carcinofetal antigens (author's transl)].

The occurrance and significance of important carcinofetal antigens other than AFP and CEA are reported. These included the alpha 2 H-protein which is produced in the liver and increases in serum of patients with various tumors, the fetal sulphoglycoprotein antigen FSA from the gastric juice of patients with gastric cancer, the carcinoplacental alkaline phosphatase (REGAN-isoenzyme)which is found in the serum of patients suffering from e.g. bronchogenic, mammary, urogenital and gastrointestinal carcinomas, the beta-S-fetoprotein which is most likely to be identical with C-reactive protein, gamma-fetoprotein, the carcinofetal antigen in glial tumors (CFGA); ectopic production of placental hormones like human gonadotropin, placental lactogen, plasminogen-activators; leukemia-associated antigens. Furthermore, some other less known carcinofetal antigens are mentioned.

Adult

[Carcinofetal antigens. II. Carcinoembryonic antigen (CEA). (author's transl)].

CEA is a beta1-glycoprotein (mol. w. approx. 200 000) which in embryonic life is usually found as a cell membrane associated antigen in the gastrointestinal (GI) tract and pancreas. Furthermore, it is secreted into body fluids. In healthy adults a very low serum concentration may be found. The clinical significance of CEA lies in its increased formation in primary and secondary adenocarcinomas of colon and rectum and pancreatic carcinoma, where values of 20 ng/ml and more are observed. However, other gastrointestinal (e.g. oesophagus, stomach, gall-bladder) and extragastrointestinal tumors (e.g. lung, breast, urogenital, prostatic, ovarial carcinomas) as well as non-malignant diseases mainly of the GI tract (e.g. hepatitis, cirrhosis, pancreatitis, colitis, diverticulitis) may provoke less frequent and lower increases in the CEA level. Healthy smokers also tend to show a slight increase in CEA concentration. A certain relationship exists between the CEA level and the size and extent of the tumor so that a decrease following operation may account for complete tumor removal, whereas a persistent or recurring increase in the CEA level is highly suspicious of metastases and/or recurrent tumor. Difficulties in proving and purifying CEA are mainly caused by multiple cross-reactions of CEA with other substances, e.g. blood group substances (A, B, Lea, Leb) and normal or other antigens (NGP, NCA, CEX, CCEA 2, NCA 2, CCA-III, FSA, BCGP). The radioimmunoassay is the most suitable method to determine CEA levels in body fluids. The 3 procedures used differ in the precipitation of the specific immune complex by ammonium sulphate (AS), Z-gel (ZG) or a second antibody (SA). Depending on the method, the upper normal limit in serum or plasma corresponds to approximately 2.5 (AS, ZG) or 12.5 (SA) nanogramme/milliliter. CEA determination in the urine is of interest in patients suffering from bladder carcinoma.

Antibodies, Anti-Idiotypic

[Carcinofetal antigens. I. alpha-fetoprotein (author's transl)].

Alpha-fetoprotein (AFP) is an alpha1-glycoprotein (M.W. about 65000) appearing in the fetal serum of most mammals including man during the early stages of pregnancy; 4 weeks after birth it disappears altogether or exists at very low concentrations as in the normal adult. AFP is formed in the yolk sac, the fetal liver and the gastro-intestinal tract. One of its physiological functions in fetal life is supposed to be the protection of the fetus from maternal oestrogens (oestrophilic property). The clinical significance of AFP is based on the regular and increasing production in primary liver cell carcinoma, less frequently in teratogenetic tumors where it serves as a control of therapy and course of the disease. Less frequent, minor and temporary increases in the AFP serum level occur in several primary tumors with secondary liver involvement, and in inflammatory gastro-intestinal diseases, e.g. of the liver (hepatitis, cirrhosis). AFP has an increasing importance in gynecology (gestational age, fetal distress syndrom, malformations, hydatidiform mole/chorion carcinoma). The physico-chemical properties of AFP are widely known. Both fetal and tumor AFP appear to be immunologically and biochemically identical, as are that of tissue and biological fluids. The differences observed (variants, microheterogeneity) depend mainly on the different content of sialic acid. An antigenetic relationship exists, between the AFP of most species. The immunodiffusion (Ouchterlony) is the most frequently used but relatively insensitive test (1-5 mug/ml) in finding AFP, whereas the radioimmunoassay is the most sensitive one (up to 0,25 ng/ml) and permits the determination of normal serum levels in adults (below 20 ng/ml). The serum concentration in healthy pregnant women lies up to 500 ng/ml, in patients with hepatitis, liver cirrhosis and other liver diseases mostly under 3 mug/ml, whereas in those with primary liver cell carcinoma levels up to and above 600 mg-percent have been found.

Age Factors

[Variations of human serum alpha-fetoprotein concentration after partial hepatectomy (author's transl)].

Alpha-fetoprotein serum concentrations were determined by radioimmunoassay in 5 patients with echinococcus involvement of the liver. In 4 cases a partial hepatectomy was possible, whereas in 1 case laparotomy had to be confined to an exposure of the liver hilus because of too many dispersed echinococcus cysts. All patients showed normal AFP levels below 20ng/ml before operation. Within the first to third postoperative day maximal AFP increases of AFP level between 2760 and 5600 ng/ml developed, which returned to normal during the following days and weeks. One patient who was submitted to strumectomy and to the same anaesthetic liver charge had no change in her normal AFP concentration. The postoperative changes of AFP level observed are interpreted as an expression of a quick and intense liver cell regeneration following the surgical treatment.

Adult

[Quantitative behavior of immunoglobulins in Hodgkin patients following splenectomy].

The values of immunoglobulins in 14 patients with malignant lymphoma were determined before and 1 to 44 weeks following splenectomy. The IgM-fraction showed a significant decrease in all cases, whereas the IgG- and IgA-fraction showed no change in its concentrations. The reason for the IgM-decrease is probably due to the absence of IgM-producing cells in the spleen.

Adolescent