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Biomedical subjects

A Kehl

Publications and source records attributed to A Kehl.

18 recordsLinked to original sources
PubMed1986

[Right bundle-branch block configuration in the pacemaker ECG--3 different observations].

We report on 3 cases of right bundle branch block configuration in the ECG after pacemaker implantation. In case 1 it was not noticed that the catheter had been directed through an unknown sinus venosus defect into the left atrium and the left ventricle. In case 2 the catheter reached the left ventricle via an iatrogenic perforation of the lower part of the atrial septum. In case 3 the catheter was situated correctly in the right ventricle, but the tip was penetrating the septum. Different possibilities of interpretation of this phenomenon are discussed, and a description of further pacemaker catheter misplacements which may be responsible for a right bundle branch block configuration is given. The authors take the view that a pacemaker catheter should not remain in the arterial area, in the pericardial space and in the coronary sinus. A lateral radiograph, a 12-lead ECG and an echocardiographic study are helpful for detecting and interpreting an unusual catheter position or a right bundle branch block configuration in the pacemaker ECG.

Aged↗
PubMed1985

Does an antifoaming agent improve the quality of abdominal ultrasonography? A double-blind study with special reference to the pancreas, the aorta and the para-aortic region.

To overcome the effects of intestinal gas which may be a problem for ultrasound examinations, a double-blind study was undertaken in 42 patients in whom the first ultrasound examination was unsatisfactory due to excessive intestinal gas. The patients received either a liquid dimeticon preparation over 24 hours (total dosage 480 mg) or a placebo. Criteria for the evaluation of the treatment were the ability to visualize the pancreas, the aorta and the para-aortic region at the second examination. The quality of the ultrasonic images was found to be improved in 52% of the controls by repetition and in 71% of the test substance group, the difference being not significant (p greater than 0.05). It is concluded that: It is worthwhile asking the patient to return for a second examination 24 hours later before resorting to invasive and/or expensive procedures when the first scan was of poor quality and liquid dimeticon has no significant defoaming effect in these patients.

Aorta↗
PubMed1984

Immune complex-like material in the serum and plasma exchange in patients with metastatic cancer.

Clinical significance of immune complex-like material in the serum was investigated in tumour patients undergoing plasma exchange with albumin-saline solution and subsequent chemotherapy. Immune complexes were detected by the Clq binding assay or the Raji cell radioimmunoassay in nine out of forty-five patients before this therapy. Levels of immune complexes were decreased to 10-30% of the initial value by plasma exchange depending on exchanged plasma volume. In contrast to other serum proteins like alpha 1-antitrypsin and alpha 2-macroglobulin, which showed protein specific increase during follow up after plasma exchange in all patients, recovery rates of immune complexes and IgG were highly individual but parallel in each patient. Clinical response to this protocol did not correlate with immune complex status, suggesting that removal of the measured immune complex like material had little clinical significance or was not longlasting enough to provide therapeutic benefit.

Albumins↗
PubMed1984

Critical aspects of the 125I-C1q binding assay for detecting immune complexes in tumor patients.

Clinical studies on C1q binding activity in tumor patients showed contradictory results and it was suggested that methodical problems might be partly responsible for those discrepancies. Therefore, precision of the C1q binding assay when testing tumor sera, influences of assay modifications on test results and possible interfering substances were investigated. Compared to aggregated human IgG and BSA: anti-BSA complexes as standards the C1q binding material in tumor sera was more unstable after freezing-thawing and distinctly more susceptible to methodical influences like testing with different 125I-C1q preparations or variations of PEG concentration and ionic strength of PEG solution. Addition of heparin and fibrinogen influenced the C1q binding of some tumor sera more than the C1q binding of standards and normal sera. Thus, instability and sensitivity to methodical influences of the C1q binding material have to be considered, when clinical studies using the C1q binding assay to detect immune complexes in tumor sera are interpreted.

Antigen-Antibody Complex↗
PubMed1983

Overwhelming infection after splenectomy in spite of some spleen remaining and splenosis. A case report.

A fatal case of overwhelming postsplenectomy pneumococcal sepsis is presented occurring in a 37-year-old female 11 years after removal of the spleen because of traumatic rupture. The patient died 11 h after admission to hospital and about 32 h after sudden onset of illness. At necropsy splenic tissue, splenosis, disseminated intravascular coagulation, and thrombi within the arterioles consisting of gram-positive cocci and adrenal hemorrhage were found. The clinical, laboratory, and postmortem findings are described. Reports had been published of 41 other cases of overwhelming postsplenectomy infection (OPSI) in patients aged 20 years or more, but only three of these cases of OPSI syndrome occurred in spite of remaining splenic tissue. The longest interval between extirpation of spleen and subsequent sepsis was 42 years, indicating a small but lifelong risk of severe infection in asplenic patients. In view of the literature, the role of spleen in infection defence, the splenic function in blood clearance, and the prevention of postsplenectomy infections by antibiotic prophylaxis, pneumococcal vaccine, and reimplantation of autochthonous splenic tissue or infrared contact coagulation are discussed.

Adult↗
PubMed1983

Chromatofocusing combined with the ELISA technique. A sensitive method for the analysis of immune complexes.

A sensitive method which permits analysis of IgG containing circulating immune complexes without detailed knowledge of the nature of the antigens and the specificity of the antibodies involved is described. Soluble BSA: anti-BSA were used as model immune complexes and isolated from serum. The procedure involves the use of gel chromatography for the separation of the high molecular weight fraction containing the immune complexes as measured by binding to 125I-labeled Clq, followed by absorption of the immune complex fraction to immobilized protein A-Sepharose CL-4B. After desorption from protein A-Sepharose the complexes were dissociated and separated into free antigen and antibody by chromatofocusing in the presence of urea. The isolated free antigen and antibody retained their immunological activity as shown by immunodiffusion, binding after their recombination to 125I-labeled Clq, and by recombining antigen and antibody with much enhanced sensitivity using a microplate ELISA system. By means of the ELISA recombination technique it is possible to analyze less than 1 microgram of BSA:anti-BSA model complexes. Application of this technique may provide more information about the nature of immune complex like material associated with diseases.

Animals↗
PubMed1983

Clinical significance of circulating immune complexes in patients with metastatic breast cancer.

Serum circulating immune complexes (CIC) were repeatedly measured by means of the CIq binding assay (Cba) and the Raji cell assay (Rca) in 158 patients with metastatic breast cancer (mbc). Frequency of occurrence and levels of CIC were only slightly increased in mbc when compared to age-matched healthy women. They were identical to those of patients with localized breast cancer prior to mastectomy and to those of post mastectomy patients without evidence of recurrent disease. In mbc the results of the Cba and the Rca showed a poor correlation, whereas in a control group of patients with rheumatoid arthritis both tests showed significantly elevated levels of CIC. Patients with mbc were followed up clinically and biochemically by serially measuring CIC for an average of 10 months. Patients with positive CIC did not prove to be an unfavorable group regarding progression of disease and response to chemotherapy. When CEA and CIC levels were compared, CIC, unlike CEA, was a poor tumor marker. In conclusion, CIC as measured by CIq binding assay and Raji cell assay are not clinically significant tumor markers or prognostic indicators in patients with metastatic breast cancer.

Antigen-Antibody Complex↗
PubMed1982

[Clinical significance of circulating immune complexes in patients with metastatic breast cancer].

In 68 patients with metastatic breast cancer a follow-up study was performed to correlate circulating immune complexes (CIC) as detected by the C1q binding assay and the Raji cell radio immunoassay with the state of disease. Clinical examinations and determinations of CIC were carried out all four to eight weeks over at least six months. 19 patients were positive for CIC in the C1q binding assay and 12 in the Raji cell radioimmunoassay. There was no correlation between the results of both tests. In comparison 26 patients out of 68 with rheumatoid arthritis were positive in the C1q binding assay and 32 in the Raji cell assay. In these patients the results of both tests correlated significantly. There was only in a few cases of metastatic breast cancer a positive correlation between levels of CIC and changes of tumor burden. Furthermore, CIC did not prove to be of prognostic value.

Antigen-Antibody Complex↗
PubMed1981

Solid-phase radioimmunoassay for detection of alcoholic hyalin antigen (AHAg) and antibody (anti-AH).

Alcoholic hyalin (AH) was isolated and purified from post-mortem livers of patients with alcoholic hepatitis. Antibodies against AH (anti-AH) were raised in guinea-pigs. Their specificity was demonstrated by immunofluorescence and by immunoabsorption. The antisera were positive in immunofluorescence and complement fixation up to serum dilutions of 1:320 and 1:32 respectively. In order to achieve a higher sensitivity a solid-phase radioimmunoassay (SP-RIA) was established for detection of alcoholic hyalin antigen (AHAg) and anti-AH. Anti-AH could thus be measured up to a 10(5) serum dilution. Using a blocking test, solubilized AH at protein concentrations as low as 80 to 160 ng/ml could be detected. With this SP-RIA, neither AHAg nor anti-AH was found in the sera of 32 patients with histologically proven alcoholic hepatitis. The sera were likewise negative by indirect immunofluorescence, complement fixation and immune adherence haemagglutination test.

Antibodies↗
PubMedDate not supplied

Ultrasound-guided percutaneous fine needle aspiration biopsy of abdominal and retroperitoneal masses. Accuracy of cytology in the diagnosis of malignancy, cytologic tumor typing and use of antibodies to intermediate filaments in selected cases.

The reliability of ultrasound-guided fine needle aspiration biopsy (FNAB) in the detection of intraperitoneal and retroperitoneal malignancies was evaluated in 308 consecutive cases seen between 1979 and 1983. The prevalence of malignant neoplasms was 68.5%. The overall accuracy of FNAB diagnosis was 88.9%, with a sensitivity of 84.4% and a specificity of 98%. The predictive value of positive and negative results were 98.9% and 74.6%, respectively. Additionally, the cytologic results were statistically evaluated with respect to the different sites of the biopsied lesions (including pancreas, liver, kidneys and miscellaneous sites). The overall accuracy was highest for malignant lesions in the liver (96.4%) and in miscellaneous sites (89.5%). Reasons for false-negative results included incorrect areas sampled, limited material due to fibrosis or necrosis and cytologic misinterpretations. The accuracy of cytologic tumor typing with respect to histogenetic origin was 96.8%. Cytologic subclassification was performed with lower accuracy (82.5%), and exact determination of the site of the primary tumor from cytologic criteria alone was possible for 35.7% of carcinomas. In selected cases, routine cytologic examination was supplemented by intermediate filament typing using well-characterized antibodies against cytokeratin, vimentin, desmin and neurofilaments. Examples are shown in which use of this method clearly increased the accuracy of the diagnosis. Only two serious complications (bleeding) of fine-needle aspiration biopsy were encountered in this series.

Antibodies↗