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Biomedical subjects

A Encke

Publications and source records attributed to A Encke.

At least 127 records · Page 7Linked to original sources
PubMed1991

[Metabolic changes in patients with hereditary fructose intolerance. A contribution to the topic of fructose administration for parenteral feeding].

The literature contains a number of reports of death following the intravenous administration of fructose in patients with hereditary fructose intolerance (HFI). The aim of the present study was, therefore, to investigate the metabolic changes occurring during intravenous administration of fructose to patients with HFI, with the aim of identifying metabolic parameters that would permit the early diagnosis of HFI. Also, the deaths reported in the literature were analyzed. In three of our own patients with fruit intolerance known since childhood, and in volunteers with normal metabolism, a one-hour intravenous fructose tolerance test (1.7 g fructose/min) was performed. An analysis was done using the usual enzymatic and chemical methods: blood glucose, fructose, lactic acid, serum uric acid, ammonia, free fatty acids, inorganic phosphate, and serum amino acids (ion exchange chromatography). During fructose infusion, the following metabolic changes were detected: hypoglycemia (20 to 60 mg/dl), increase in blood fructose levels (up to 350 mg/dl), hypophosphatemia (2 to 3 mg/dl), hyperlacticacidemia (up to 60 mg/dl), elevation of plasma ammonia levels (up to 120 mg/dl), increased serum glutamate, and a decrease in serum glutamine, as also hyperuricemia (up to 10 mg/dl). On termination of the fructose infusion, these changes were completely reversible. Analysis of the deaths reported in the literature revealed a known intolerance to fruit or sweets, and that no regular metabolic studies were apparently performed. Although HFI is rare, use should be made of the known advantages of sugar substitutes in post-aggression metabolism.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Synchronous development of benign cholangiomas and a cholangiocarcinoma in the liver of a patient 43 years after thorotrast administration].

This is a report on a 59-year-old patient in whom the synchronous occurrence of benign cholangiomas and a cholangiocarcinoma was observed in the liver 43 years after single intraarterial application of thorotrast. Despite a half-life of over 130 years (alpha radiation), X-ray contrast media containing thorium (colloidal thorium dioxide) were used up to the 1950's in X-ray diagnosis, particularly for angiographies. Thorotrast is mainly stored in the liver, in the spleen and in epigastric lymph nodes and can therefore be easily detected radiologically in a survey radiograph of the abdomen. International studies have shown that thorotrast patients have an up to 100 times greater risk of contracting hepatic malignancies compared to control collectives. Among the causes of death of thorotrast carriers in the (old) Federal Republic of Germany, 15% are attributed to primary hepatic tumours (cholangiocarcinomas, malignant haemangioendotheliomas, hepatic cell carcinomas). In the patient presented here, a cystic mass approximately 2 cm in diameter was detected in the right lobe of the liver during computed tomography of the epigastric region conducted as part of the German Thorotrast Study at the German Cancer Research Centre in Heidelberg, as well as in sonography. Intraoperatively, this finding corresponded to a cystic cholangioma. By chance, a cholangiocarcinoma approximately 1 cm in size and several benign cholangiofibromas were also found in the left lobe of the liver. All of the tumours were excised in toto by atypical segment resection. As shown by this case report, thorotrast-induced hepatic tumours are still to be expected, even 40 years after thorotrast was removed from the market.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma, Bile Duct↗
PubMed1991

[Preventive operations of the gastrointestinal tract in precancerous conditions].

Precancerous conditions are characterized by an increased epidemiological cancer risk, precancerous lesions by a histopathological abnormality (epithelial dysplasia). Adenomas are typical examples of this in the GI tract and therefore must be removed by endoscopy or surgery. The extent of the procedure is dictated by size, growth pattern and histology. The Barrett oesophagus, chronic atrophic gastritis type B, colorectal adenomas and familial adenomatous polyposis are the most frequent serious conditions.

Adenomatous Polyposis Coli↗
PubMed1991

[Diagnosis and therapy of malignant thyroid diseases].

The clinically important malignancies are characterized on the basis of 257 primary surgical procedures performed between 1973 and 1990 (9.1% of all thyroid operations during this period). Our own proceeding is characterized both in diagnostics and surgical technique in primary and recidive operations under special regard of a modified lymph node dissection. Obligatory and facultative adjuvant therapies are described. The follow-up schedule, which has found to be essential for the individual prognosis, should be discussed.

Chemotherapy, Adjuvant↗
PubMed1991

["Routine" versus "on demand" ultrasonography in the surgical intensive care patient. A prospective randomized study].

Between May 1988 und March 1989 all patients who underwent elective or emergency surgery followed by intensive care were randomly assigned to group A (n = 149): routine sonography at the postoperative day 1, 3, 7 and 9, group B (n = 151): sonography on demand. In these two groups, the following parameters were compared: number of relaparotomies, lethality of relaparotomies, total lethality, moment of relaparotomy, period of hospitalisation, time spent with sonography. In the analyzed parameters, our examination showed no difference between the two groups. For this we state that the routine sonographical control of the surgical patient with intensive care being opposed to the sonography on demand shows no significant advantage. The demand for a routine sonography as a postoperative control can not be generally supported.

Adult↗
PubMed1990

[Prognosis following liver transplantation].

Many aspects of liver transplantation need further developments, but in general liver transplantation has come out of the experimental state. Improved immunosuppressive drugs and better defined treatment protocols have had an important impact on the widespread growth of liver transplantation. However, survival after liver transplantation still depends on two distinct factors, the underlying disease leading to transplantation and the stage of the disease. Patients should be referred to transplantation earlier, in order to improve their survival probability.

Disability Evaluation↗
PubMed1990

A 19-year-old female with blue rubber bleb nevus syndrome. Endoscopic laser photocoagulation and surgical resection of gastrointestinal angiomata.

A case of a blue rubber bleb nevus syndrome in a 19-year-old female patient with multiple cutaneous and gastrointestinal hemangiomata is described. Recurrent GI bleeding resulted in severe chronic anemia, which was successfully treated by endoscopic laser photocoagulation and surgical resection. Both forms of therapy had to be repeated 4 years later, the patient having been well in the meantime. This combined endoscopic and surgical approach might also improve the survival of patients with severe GI hemorrhage due to blue rubber bleb nevus syndrome.

Adult↗
PubMed1990

[HIV positive patients in routine surgical practice].

In our daily surgical practice we encounter increasingly HIV-infected and AIDS patients. From January 1 1987 until December 31 1988 119 outpatients and 35 hospitalized patients were treated in the surgical department. They belonged mainly to the known risk groups. Abscesses and diagnostic excisions were predominant in the outpatients while hospitalized patients presented the full scale of surgical diseases. The clinical course was not different from that of other patients. 181 members of the medical staff of our hospital were registered after contact with blood or body fluids of HIV-infected patients and followed. A seroconversion was not observed so far.

Abscess↗
PubMed1990

[Postoperative lung complications--introduction].

Intensive care patients suffer according to literature in 20-60% from pneumonia with a mortality up to 80%. The patient, operation and postoperative therapy influence its pathogenesis. Mechanical ventilation is a special risk factor. However, in this regard origin and sequelae may not be changed by mistake. Specifity of clinical and plain X-ray diagnosis is only 30-50%. Selective gastrointestinal decontamination, exactly monitored fluid balance, and physio-, and paintherapy seem to be valuable preventive measures.

Critical Care↗
PubMed1990

Immunoscintigraphy using a technetium-99m labelled monoclonal anti-CEA antibody in the follow-up of colorectal cancer and other tumours producing CEA.

Using the intact monoclonal IgG1 anti-CEA antibody BW 431/26 (Behringwerke Marburg, FRG) labelled with 99mTc by a new labelling procedure (Schwarz method), 72 patients suspected of tumour recurrences (colorectal cancer, n = 59) and with rising serum carcinoembryonic antigen (CEA) levels were studied. Sixty-nine of 72 studies had a positive result by immunoscintigraphy of which 52 have since been proven histologically/clinically. In six patients only immunoscintigraphy revealed a tumour recurrence while all other diagnostic modalities were negative. Of 52 studies 46 were true positive (diagnostic sensitivity 88%). In this series there was one false positive result. About one-third of all patients injected with the antibody developed a human anti-mouse response (HAMA), but no severe side effects were seen even after four applications. For the follow-up of colorectal and other CEA positive adenocarcinomas this 99mTc-labelled monoclonal antibody seems to be very promising in patients with rising serum CEA, especially if conventional diagnostic imaging procedures remain negative.

Antibodies, Monoclonal↗