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U Köhler

Publications and source records attributed to U Köhler.

At least 91 records · Page 5Linked to original sources
PubMed1989

[The strategy of new imaging procedures in the diagnosis of malignant bone processes].

From the comparison of conventional radiography, computed tomography and angiography the diagnostic value of each of these methods is evaluated. Conventional radiography will remain the most significant method for detecting primary skeletal tumours even if magnetic resonance imaging is considered. CT is an important additional method for the evaluation of tumour size, but is disappointing for tumour classification. Bone scintigraphy is the most sensitive method for the differentiation of solitary and multiple tumours. Angiography is not necessary, except for the planning of surgery in certain cases.

Angiography↗
PubMed1989

[Results of treatment of 718 endometrial cancers with reference to clinical and morphologic prognostic factors].

This article deals with a retrospective analysis of therapeutic achievements in 718 endometrial carcinoma patients in relation to important prognostic factors (clinical stage, age, tumour type/degree of differentiation). The unfavourable age structure (64.9 years) and frequent multimorbidity of endometrial cancer patients require a close interdisciplinary cooperation for optimal management planning. With the priority of a graduated operative procedure with differential additional radiation therapy on the basis of essential clinical and morphological factors in contrast to the primary radiation therapy, the unsettled cumulative 5-year-survival rate accounted for in stage Ia 69%, Ib 64%, II 41%, III 33% and also for the whole material 59%. The obvious deterioration of the prognosis already with the involvement of the cervix (stage II) as well as in the presence of unfavourable prognostic factors in stage I (tumour type, undifferentiated, myometrial invasion, suspicion of lymph node involvement) justify a radical operative intervention (lymphadenectomy, Wertheim-Meigs) in these cases despite possible anaesthesiological risk on the basis of an extended pretherapeutic diagnostic procedures (sonography, lymphography, computer tomography). Under these conditions mentioned above we had only 6 per cent late therapeutic consequences requiring treatment.

Adenocarcinoma↗
PubMed1988

Structural and conformational changes of beta-lactoglobulin B: an infrared spectroscopic study of the effect of pH and temperature.

Infrared spectra of 2.5 mM solutions of beta-lactoglobulin B were recorded as a function of pH (from pH 2 to pH 13) and as a function of temperature (from -100 degrees C to +90 degrees C). An analysis of the pH- and temperature-induced changes in the secondary structure was performed based on changes in the conformation-sensitive amide I bands of beta-lactoglobulin. Whereas the total amount of beta-structure remains constant (56-59%) between pH 2 and pH 10, the proportions of the various beta-components do change. In particular, the dimerization of the monomeric protein, induced by raising the pH from 2 to 3 , leads to an increase in the intensity of the 1636 cm-1 band (associated with antiparallel beta-sheet), at the expense of the 1626 cm-1 band (associated with exposed beta-strands). Both the thermal and alkaline denaturation of beta-lactoglobulin occur in two distinct stages. Although the spectra (i.e., the structures) after complete thermal or alkaline denaturation are clearly different, the spectrum of the protein after the first stage of thermal denaturation (at about 60 degrees C) is the same as that after the first stage of alkaline denaturation (at pH 11), suggesting a common denaturation intermediate, which probably represents a crossover point in a complex potential hypersurface.

Amides↗
PubMed1988

[Maculopapular exanthema during diltiazem therapy].

A maculopapular exanthema developed in a 60-year-old man with coronary heart disease while being treated for angina with the calcium antagonist diltiazem. Epicutaneous and scratch tests were positive, both for the immediate type (type I) and the delayed type (type IV), proving that the drug had caused the allergic reaction. The exanthema quickly disappeared once the drug had been discontinued. Anti-anginal treatment was continued without further complications with nifedipine.

Angina Pectoris↗
PubMed1988

Influence of exercise in water on hormonal, metabolic and adrenergic receptor changes in man.

We investigated hormonal, metabolic, and cardiovascular adaptations as well as changes of alpha 2- and beta 2-adrenergic receptors in response to three different exercise performances in water: 1000 m fin swimming with or without a neoprene suit and, additionally, 600 m diving with a breathing apparatus while performing several tasks. Eight male divers participated in the study. Blood samples were taken at rest on land, 10 min after water immersion, immediately after exercise, and after 20 min recovery. Both free and sulfoconjugated norepinephrine (NE) increased exercise-dependently. Moreover, heat loss in water caused elevation of plasma free NE. Free epinephrine (EPI) increases showed a highly significant correlation with NE except during fin swimming with a neoprene suit where EPI concentrations were constantly higher. ACTH and cortisol levels rose during exercise and paralleled those of plasma NE. Plasma aldosterone decreased in response to water immersion at rest. Blood volume regulating hormones such as plasma renin, aldosterone, and vasopressin were significantly higher during physical exercise. Moreover, increased pressure conditions during diving caused significantly higher secretion rates of all of these hormones, resulting in a higher systolic blood pressure. This clinical issue might be considered when examining diving ability. Lipolysis was elevated to the same degree after the three exercise schedules had been applied. As expected, plasma glucose also increased during physical activity. The lactate values observed after fin swimming, but not after diving with a breathing apparatus were closely related to NE. The lowest lactate levels were obtained during air-assisted diving.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenocorticotropic Hormone↗
PubMed1988

[Unusual course of Goodpasture syndrome].

Description of a case of Goodpasture's syndrome with vasculitis of the retinal vessels and macular edema. Unusually, the ocular signs became manifest some time before the appearance of hemoptysis and renal insufficiency.

Adult↗
PubMed1988

[Concentrations of amiodarone and flecainide in plasma and saliva--indications for the active transport of flecainide].

UNLABELLED: Only the free protein-unbound drug concentration in plasma is pharmacologically active. The concentration of some drugs in saliva is equal to the free drug level. We compared concentrations (in plasma before, 30 and 60 min after the morning dose, in saliva before, 30, 60, 90 and 120 min after the morning dose) of amiodarone (n = 8, 2 x 200 mg orally per day) and flecainide (n = 16, 2 x 100 mg) administered as chronic antiarrhythmic treatment. Drug levels were measured by "high performance liquid chromatography". RESULTS: Just prior to the first morning dose, amiodarone concentrations in plasma were 1.0-2.9 (2.0 +/- 0.6) micrograms/ml, in saliva 0.02-0.25 micrograms/ml; flecainide in plasma 80-560 (316 +/- 163) ng/ml, in saliva 630-3700 (1749 +/- 963) ng/ml. After the morning dose we found maximal flecainide plasma levels of 462 +/- 203 and saliva levels of 3218 +/- 2857 ng/ml. The highest flecainide concentrations in the saliva (13,400 and 11,300 ng/ml) were found in two patients 30 and 60 min after the morning dose. Flecainide, but not amiodarone, is excreted actively in the saliva, probably indicating an enteroenteric circulation. This should be considered to reduce life-threatening flecainide intoxications by gastric and intestinal lavage and suction. The concentration of flecainide in the saliva does not represent the non-protein-bound free drug level in the plasma.

Adult↗
PubMed1988

[Therapeutic results in uterine sarcoma (1955-1985)].

This is a retrospective analysis of prognostic factors and treatment outcomes in 126 uterine sarcoma cases from the period of 1955 to 1985 inclusively. Up to now there lacks unanimity and extensive scientific based therapeutic concept; and treatment results could not be improved despite better operative and radiation therapy possibilities. From the examined charts and materials, the five year survival rate achieved for all stages is 31%. The mean age of the patients is 57.9 years and significant prognostic differences will be appreciated only in relation to the clinical stages at the commencement of therapy and also after local total operative intervention (stages I and II) in conjunction with postoperative radiation therapy. The difference in course in relation to the histologic tumour type can not be statistically verified.

Adult↗
PubMed1987

[Elevated plasma flecainide concentrations in heart failure].

In 42 patients with heart failure who were on long-term treatment with flecainide (2 X 100 mg daily by mouth) plasma concentration of flecainide was measured before the morning dose and compared with the clinical grade of heart failure or left ventricular ejection fraction (in the levo-angiogram). Mean plasma flecainide concentration was 415 +/- 244 ng/ml (110-1035 ng/ml), mean ejection fraction 55 +/- 17.7% (24-84%) (r = -0.60). In seven patients with plasma concentrations over 700 ng/ml (870 +/- 150 ng/ml) in clinical grade III or IV, ejection fractions were 24, 25, 25, 30, 33, 37 and 44%, respectively. In two patients (ejection fraction of 24 and 25%, respectively) the morning plasma concentration was around 1000 ng/ml. The results point to possible high plasma flecainide concentrations--at times in the toxic range--in patients who are in heart failure. In patients with marked reduction in left ventricular pumping function who are on long-term flecainide treatment, a reduction in dosage or monitoring of plasma flecainide concentration is indicated.

Adult↗
PubMed1987

[Inhibition of flecainide resorption by activated charcoal].

The effect of orally administered activated charcoal on plasma concentrations of flecainide were studied in eight volunteers (24-38 years of age). A single dose of 200 mg flecainide were given at 3 days: control (day 1); simultaneous application of flecainide and 30 g charcoal (day 2); application of 30 g charcoal 90 min after flecainide (day 3). Plasma concentrations were determined by HPLC after 2, 4 and 6 h. Absorption of flecainide was almost completely prevented, when flecainide and charcoal was ingested immediately. When charcoal was taken 90 min after flecainide, the following flecainide plasma levels were found: after 2 h 231 +/- 62 ng/ml (266 +/- 30 ng/ml control; n.s.), after 4 h 199 +/- 49 ng/ml (232 +/- 27 ng/ml control; P less than 0.05) and after 6 h 155 +/- 42 ng/ml (231 +/- 51 ng/ml control; P less than 0.01). Charcoal seems to be effective in prevention of the absorption of flecainide. A drug interaction may occur if charcoal is given therapeutically, for example in hypercholesterolaemia. Charcoal may be indicated as an additional treatment of flecainide intoxication.

Administration, Oral↗
PubMed1987

[Histomorphologic prognostic factors in stage I endometrial cancers].

The prognostic significance of qualitative and quantitative morphological tumour characteristics for endometrial carcinoma of stage I (FIGO) is to be ascertained from the available 230 operation specimens from 1976 to 1983 (inclusive). The fundamental objective is to design a standardized and reliably reproducible histological technique. By utilizing a multi-dimensional statistical comparison (multiple regression analysis), the maximal relative extent of the endometrial invasion as a determinant prognostic feature shall also be ascertained. Furthermore, the degree of differentiation (Grading) and tumour type (Typing) influence the survival rate whereas the maximal superficial extension of the carcinoma has no significant prognostic importance.

Female↗
PubMed1987

[Prognostic significance of different therapeutic procedures in stage I endometrial cancer].

The prognostic importance of the different lines of therapeutic management are retrospectively reviewed from 230 patients who have been primarily operated on for endometrial carcinoma stage I (FIGO). The postoperative radiation therapy taking into consideration the prognostic significance of the tumour criteria (tumour type, degree of differentiation and extent of myometrial invasion) as well as the age and the general condition of the patient would largely be individualized. 56 (24%) patients has been operated on only. There were no significant prognostic differences for vaginal and abdominal hysterectomies with bilateral salpingo-oophorectomy. Extensive operative measures have been carried out seldom and could not yet be included in the evaluation. A simultaneous gestagen administration in 39 (17%) of the cases with invasively growing carcinomas (greater than 1/3 myometrial invasion), independent from the previous therapeutic regimen, is shown not to have improved the healing results. The favourable prognosis of women mostly with lower primary risk and operated on only as opposed to postoperatively radiated ones underlines the primary prognostic significance of morphological characteristics of the tumour although no definite conclusions can be derived from the concurrent effectivity of the adjuvant radiotherapy for early tumour stages. A postoperative radiation therapy, because of its late consequences which have been observed during tumour follow up, is indicated only in those cases with unfavourable prognostic criteria.

Adult↗