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Biomedical subjects

E Böhm

Publications and source records attributed to E Böhm.

At least 19 recordsLinked to original sources
PubMed2007

[Visualized medicine. Macroscopy, molecular anatomy and medical art].

Quite frequently clinicians avail themselves of works of well known artists in order to illustrate certain diseases. In contrast, pathologists find it harder to use art to demonstrate morphology. My approach to compensate for this is twofold: on the one hand, with 8 mostly three dimensional wooden objects with either mirror or aluminium elements, on the other with 449 collages consisting of pictures exclusively with a medical background (histology, radiology, nuclear medicine) or showing a combination of histological or cytological photos with pictures of flowers, trees or landscapes. My experience is that this technique arouses interest in complex medical issues even with medically unqualified individuals.

Anatomy↗
PubMed2004

The CD63 basophil activation test in Hymenoptera venom allergy: a prospective study.

BACKGROUND: The basophil activation test (BAT), which relies on flow cytometric quantitation of the allergen-induced up-regulation of the granule-associated marker CD63 in peripheral blood basophils, has been suggested to be a useful approach in detecting responsiveness to allergens. The purpose of this study was to establish the usefulness of the BAT with regard to the clinical history and current diagnostic tools in Hymenoptera venom allergy using a prospective study design. METHODS: Fifty-seven consecutive patients allergic to Hymenoptera venom as defined by a systemic reaction after an insect sting, and 30 age- and sex-matched control subjects with a negative history were included. The degree and nature of sensitization was confirmed by skin testing, specific immunoglobulin E (IgE), serum tryptase levels and BAT. In the nonallergic control group only analysis of specific IgE and BAT were performed. Correlation of BAT, skin test and specific IgE, respectively, with the clinical history in the allergic group was termed as sensitivity and in the control group as specificity. RESULTS: Twenty one of 23 (91.3%) bee venom allergic patients and 29 of 34 (85.3%) patients allergic to wasp and hornet venom tested positive in BAT. The overall sensitivity of BAT, specific IgE and skin tests were 87.7, 91.2 and 93.0%, respectively. The overall specificities were 86.7% for BAT and 66.7% for specific IgE. No correlation between the severity of clinical symptoms and the magnitude of basophil activation was observed. CONCLUSION: The BAT seems to be an appropriate method to identify patients allergic to bee or wasp venom with a comparable sensitivity to standard diagnostic regimens. The higher specificity of BAT as compared with specific IgE makes this test a useful tool in the diagnosis of Hymenoptera venom allergy.

Animals↗
PubMed1999

Therapeutic use of the natriuretic peptide ularitide in acute renal failure.

BACKGROUND: Ularitide is a member of the natriuretic peptide family. This hormone exhibits an N-terminal extension by four amino acids compared with atrial natriuretic peptide. Ularitide was shown to exert strong diuretic and natriuretic effects when infused intravenously. Its main action sites are the glomerulum, inducing preglomerular vasodilation and postglomerular vasoconstriction and thereby elevating the glomerular filtration rate, and the tubular system inhibiting Na(+)-reabsorption. In initial uncontrolled clinical trials, this peptide was shown to have beneficial effects in patients suffering from oliguric acute renal failure. METHODS: We conducted a double-blind, placebo-controlled, multicenter, dose-finding trial recruiting 176 patients randomized into 4 different Ularitide doses groups (U5, U20, U40, and U80 ng/kg/min) and a placebo group (U0). Ularitide/placebo infusion was performed for 5 days with half the originally infused dose on day 5. The primary objective of the study was to test various doses of Ularitide in patients suffering from oliguric acute renal failure to avoid mechanical renal replacement therapy during the first 12 hours. FINDINGS: The results indicate that Ularitide does not reduce the incidence of mechanical renal replacement therapy compared with placebo-treated patients during the first 12 h of treatment (U0: 36 (20), U5: 35 (11), U20: 36 (9), U40: 28 (8), U80: 41 (12), (% (n) (p = 0.87)). Diuresis increased in the Ularitide-treated groups and the placebo group after onset of infusion and did not show any significant difference in the first 12 h collection period (U0: 576, U5: 514, U20: 500, U40: 360, U80: 158 ML/12h (Median), (p = 0.16)). INTERPRETATION: In summary, the incidence of mechanical renal replacement therapy in critically ill patients suffering from oliguric acute renal failure could not be altered positively by Ularitide administration according to our protocol. Further prospective clinical trials are needed to answer the question whether a different patient collective or a prophylactic administration of Ularitide are more promising approaches in the clinical setting of oliguric acute renal failure.

Acute Kidney Injury↗
PubMed1998

[Alveolar hemorrhagic syndrome in sarcoidosis].

BACKGROUND: Alveolar hemorrhage is uncommon in sarcoidosis, even in the presence of severe alveolitis. PATIENT: A heavy smoker with bihilar adenopathy presented with severe alveolar hemorrhage in the absence of radiological signs of pulmonary involvement. Sarcoidosis was confirmed histologically by transbronchial and mediastinal lymph node biopsies. The bleeding stopped before the installation of anti-inflammatory medication and did not reoccur within 9 months of follow up, but BAL analysis demonstrated the persistence of alveolar siderophages. CONCLUSIONS: Sarcoidosis should be considered as a rare cause of diffuse alveolar hemorrhage.

Biopsy↗
PubMed1997

[Differentiated metastasis of mature testicular teratoma as differential kidney and adrenal tumor diagnosis].

We report on the eighth known case of a mature metastasis of a mature teratoma of the testis. In a 19-year-old patient who had undergone a pyeloplasty of the left renal pelvis 6 years before, a mature metastasis of an occult mature teratoma of the testis was found at the former operation site. This case--in addition to those published previously--emphasizes the fact that a mature teratoma of the testis has to be regarded as a malignant tumor in adults. It is supposed that the mature teratoma originates, as other testicular tumors, from carcinoma-in-situ-cells, which are responsible for metastasize and are not detected after lysis.

Adrenal Gland Neoplasms↗
PubMed1996

The impact of disease pattern, surgical management, and individual surgeons on the risk for relaparotomy for recurrent Crohn's disease.

OBJECTIVE: The authors provide a multivariate analysis of a large single-center experience with limited surgery for Crohn's disease. SUMMARY BACKGROUND DATA: During the past decade, the aim of surgery for Crohn's disease has shifted from radical operation, achieving inflammation-free margins of resection, to "minimal surgery," intended to remove just grossly inflamed tissue or performing strictureplasties. METHODS: Seven hundred ninety-three cases of resection and/or strictureplasty in 689 individuals with histologically verified Crohn's disease were followed for a mean period of 50 months (range, 5-166 months). Two different end points were analyzed: 1) any relaparotomy for recurrent (or persistent) Crohn's disease and 2) relaparotomy for site-specific recurrence. More than 30 variables of patient/disease characteristics and surgical management were included in a proportional hazard model. RESULTS: Five parameters were associated independently with the risk for relaparotomy: increased risk coincided with young age at onset of disease, involvement of jejunum, enterocutaneous fistula, or performed strictureplasty, and decreased risk followed ileocecal resection. Site-specific risks of reoperation were calculated on the basis of 1260 intestinal resections or anastomoses performed in these patients. Young age at onset, duodenal and jejunal involvement, presence of enterocutaneous or perianal fistula, and a single surgeon (of 23) were associated significantly with increased risk of regional recurrence but not strictureplasty or inflammation at margins of resection. CONCLUSIONS: Limited surgery for Crohn's disease is not associated with increased risk of regional recurrence requiring reoperation. However, patients with juvenile onset, proximal small bowel disease, and some types of fistulae are at a considerable risk of experiencing early surgical recurrence.

Adolescent↗
PubMed1996

Ularitide: from renal natriuretic peptide to clinical trials.

Ularitide is a member of the natriuretic peptide family which is presumably synthesized in the kidney. In physiological experiments a correlation between Ularitide excretion and natriuresis has been found. Ularitide infusions and bolus injections in animals initiated profound diuresis and natriuresis as the most prominent effects. On the basis of findings in in-vitro and in-vivo experiments, Ularitide was used in clinical trials, and the results indicate that it could be a promising new drug to prevent and treat acute renal failure in patients after cardiac surgery and organ transplantation.

Acute Kidney Injury↗
PubMed1993

[A combination of spermatocytic and classic seminoma, mature teratoma and carcinoma in situ of the testis. An attempt at an etiologic explanation].

We report of a 39 years old patient with a large testicular tumor found during an examination for infertility. The tumor consisted of a spermatocytic seminoma (SS) and a differentiated teratoma (TD). Furthermore, two small foci of seminoma were seen in the surrounding testicular tissue, several testicular tubuli contained carcinoma in situ (CIS). The diagnosis was based on the results obtained with various immunohistochemical markers: keratin, vimentin, desmin, LCA, CD3, CD20, CD45R, ferritin, PLAP, AFP. On the basis of the macroscopic and histopathological features, we propose the following etiology: CIS progressed in an earlier phase to the (larger) TD and later to the (smaller) classical seminoma; likewise, in an earlier phase, SS developed from a still unknown precursor stage. Our case of a mixed tumor as well as other cases reported in the last years do not allow the explanation of a differing etiology for SS. On the contrary, it may be presumed that the origins of seminoma and teratoma on the one hand and SS on the other hand are less divergent than hitherto thought.

Adult↗
PubMed1992

What's new in exogenous osteomyelitis?

By the increase in road and occupational accidents during the past few decades posttraumatic osteomyelitis has become not only the most important type of exogenous but of all inflammatory bone processes. The major morphologic, bacteriologic and immunologic studies about posttraumatic bone inflammation will be outlined in this survey. The histologic classification of chronic osteomyelitis has proved useful for the observation of the course and for the selection of the treatment in 1,500 patients. Detailed morphological studies have shown that posttraumatic osteomyelitis often begins with a necrosis of the outer tangential lamella of the tubular bone partly promoted by partial periosteal retrogression, possibly followed by a necrosis of the fracture ends caused by a disturbance of the medullary blood circulation. Type and extent of osteomyelitis are determined by several traumatic, therapeutic and endogenous factors. Bacteriologically an infection with staphylococcus aureus is still prevailing. Comparative studies about the causative agents shortly after the trauma and during the following osteomyelitis have basically shown an identical range of causative agents. Immunologic studies with monoclonal antibodies in the actual site of inflammation have on the one hand found a decrease in the number of T-lymphocytes and the T-helper cells and on the other hand an increase in the T-suppressor cells, natural killer cells, macrophages in the osteomyelitic site. The impact of these findings on the therapy of osteomyelitis can presently not be estimated. However, they will become important after immunohistochemical studies of the bone and soft tissue Lager in osteosynthetic material after aseptic bone surgery have been carried out.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents↗
PubMed1992

[Angioarchitecture of the ileum and colon in Crohn disease].

Vascular changes in resected bowels of Crohn's disease were examined angiographically, microangiographically, micro-preparatorily and histologically. The proper angioarchitecture of the small and the large bowel is being destroyed in the course of the ongoing inflammatory process. Dilated capillaries, destruction of the primary angioarchitecture and its replacement by an irregular, partially bizarre pattern of scar vessels with bundling of the unchanged Vasa recta as varying vessel diameters caused by obliterating secondary fibroses can be seen in advanced Crohn's disease. The angioarchitecture of the pseudo-polyps in Crohn's disease is characterized by an increased number of vessels, bizarrely bended vessels and a radial pattern of veins. All these vascular changes in Crohn's disease are to be seen as secondary changes due to the inflammatory reaction.

Adult↗
PubMed1990

Pharmacological characteristics of the stereoisomers of carvedilol.

The racemic compound carvedilol possesses two complementary pharmacological effects, vasodilation and beta-blockade. The R- and S-enantiomers of carvedilol and the racemate were investigated with respect to the beta-blocking, vasodilating, and hypotensive actions. In agreement with results obtained with other beta-blockers, only the S-enantiomer of carvedilol exerts beta-blocking effects. In contrast, no substantial difference between the enantiomers could be seen with respect to alpha-blockade. The greater hypotensive activity of S-carvedilol may be attributed to beta-blockade, which inhibits counter-regulatory mechanisms provoked by vasodilation. From these results it is concluded that there is a rationale for using carvedilol as the racemate. Using the S-enantiomer would lead to relatively strong beta-blockade with only a weak vasodilating effect. The R-enantiomer alone would act only as a hypotensive agent without beta-blockade.

Adrenergic alpha-Antagonists↗
PubMed1990

[Achilles tendon rupture. Anamnestic and morphologic studies and considerations on the etiology].

From 1. October 1985 to 31. December 1987 93 patients (82 male, 11 female) with rupture of the achillestendon were investigated by means of a questionnaire, the specimens obtained at operation were examined histologically. In two cases the operation was for a rerupture of the tendon, 7 and 8 weeks respectively after the first operation. In 6 cases a rupture followed a so-called incomplete rupture on the same side. 9 patients had had a tendonrupture of the other side between 2.5 and 10 years previously. 85.4% of the ruptures took place during a sporting activity. Of the 93 patients 55 (59%) regularly took part in long term sporting activities. Symptoms in the area of one or both achilles tendons were experienced by 32% of the patients. 80 patients with an achilles tendon rupture who were operated within 10 days demonstrated structural degeneration of at least moderate proportions, mostly severe or very severe (there was no relationship between the degree of degeneration and the age of the rupture). The signs of repair were consistent with the age of the rupture. In 56% of the ruptures up to four days old the repair process was considerably more advanced than the age of the rupture would suggest. 6 of 10 patients with the so-called "Archillodynie" demonstrated minor changes although 3 had more severe degenerative changes. Our inquiry clearly demonstrates that structural changes in the tendon took place before the injury. In the cases of achilles tendon rupture the processes of repair are an-adequate to compensate for the degenerative changes. The etiology of the structural degenerations is dependent on many endogenous and exogenous factors particularly the inadequacy of the repair processes.

Achilles Tendon↗
PubMed1988

[Multiple lipomas of the colon. Case report with clinical, roentgenologic, angiographic and histologic findings].

Case report on a 26 year old woman with multiple lipomas of the colon and rectum and a neurofibromatosis simultaneously. Description and discussion of clinical data and differential diagnosis. The vascularisation of the lipomas and of the overlying mucosa was proved to be good angiographically. This is the reason for the frequent bleeding of the lipomas of the colon. The coincidence of multiple lipomas and neurofibromatosis is rare. Therefore conclusions for a possible common etiology of the two diseases should be drawn only after further reports.

Adult↗