Search PubMed⌕ Search

Biomedical subjects

E Frick

Publications and source records attributed to E Frick.

At least 19 recordsLinked to original sources
PubMed1995

[Diagnosis of round liver lesions].

Ultrasound and computed tomography are dominant in the diagnosis of liver lesions. Angiography, magnetic resonance imaging, and scintigraphic procedures complete the spectrum. Ultrasound and computed tomography are able to detect focal liver lesions and to distinguish between hypoechoic, anechoic and hyperechoic lesions. We differentiate in addition between liver lesions found accidentally or in patients suffering from a known tumor. For a definite diagnosis of a haemangioma a computerized tomography with rapid contrast bolus or MRI should be performed. If there is suspicion of an adenoma or a focal nodal hyperplasia a hepatobiliary sequence scintigraphy should be performed. In the following the essential procedures for the differential diagnosis of liver lesions based on there sonomorphological appearance is presented.

Adenoma, Liver Cell↗
PubMed1994

[Current status of abdominal pancreatic ultrasound. A retrospective analysis of 585 pancreatic ultrasound examinations].

BACKGROUND: In the recent years several investigations focused on the diagnostic value of abdominal ultrasonography in pancreatic disorders. However, the diagnostic accuracy in these studies ranged between 40 and 90% probably related to variations in study design and other methodologic criteria. PATIENTS: We examined retrospectively 585 patients subdivided into six subgroups. 385 patients had a clinical question aimed at the pancreas and the remaining 200 functioned as screening patients. RESULTS: Using laboratory tests, CT, ERCP, surgery and autopsy as reference methods the positive predictive value for all pancreatic disorders was 85% with the best results for chronic pancreatitis (86% versus 77.5% for acute pancreatitis and 79.5% for malignant tumors). The prevalence of pancreatic disease in symptomatic patients was 28.6% versus only 2.5% in the screening groups. Therefore no significant differences could be detected in groups where the pancreas was not clearly visualized and groups with negative sonographic findings (4% false negative findings versus 1%, respectively). In groups with suspected pancreatic disease the negative predictive value was 86% which was independent of the visualization of the pancreas. CONCLUSION: In summary positive sonographic findings have a high predictive value for pancreatic disorders and negative results are not more reliable than missing visualization of the pancreas. The positive predictive value is independent from the kind of pancreatic disease and in screening examinations negative findings and findings without clearly visualization of the pancreas have both high negative predictive values.

Acute Disease↗
PubMed1994

Clinical significance of sonographic findings in outpatient clinics.

In the literature substantial controversy exists about the clinical significance of abdominal screening procedures. Therefore, the aim of our prospective study was to determine the clinical relevance and the differences of sonographic findings in both symptomatic and asymptomatic screening outpatients. We therefore systematically analyzed the sonographic findings in 200 consecutive patients of a medical outpatient unit. The patients were divided into 2 subgroups: group I consisted of 128 patients without specific clinical symptoms in the abdomen (screening group); group II included 72 patients with abdominal symptoms and therefore well-defined sonographic requests. The consequences drawn from the sonographic results were analyzed separately for both patient groups. All findings were subdivided into relevant, prospectively relevant or not relevant, depending on their individual influence on the patients' course. In all cases the entire abdomen and basal parts of the thorax were examined. In the 1st group (n = 128/93 findings) 6 findings (6.5%) were relevant, 24 (26%) prospectively relevant and 63 not relevant (67.5%). In contrast, the 2nd group (n = 72/68 findings) contained 13 relevant (19%), 27 prospectively relevant (40%) and 28 not relevant sonographic findings (41%). The differences between group I and II were statistically significant for the relevant findings (2p < 0.05) and the not relevant findings (2p < 0.01). In conclusion, abdominal ultrasonography provides--even for the screening of the outpatient population--in up to 30% additional clinically acute or prospectively relevant information. Therefore, it completes the physical examination adding a substantial amount of clinical information to the medical record of outpatients.

Abdomen↗
PubMed1993

[Social workers in the commitment procedure].

Regular inclusion of a social worker alongside the expertising physician whenever a judge has to decide on committing a person to a psychiatric hospital, is known in German legal practice as "Stuttgart model". Our experiences with this procedure are discussed on an interdisciplinary level. In our opinion this model agrees with the spirit of the new German law governing guardianship and care.

Adult↗
PubMed1989

Immunological studies of the pathogenesis of multiple sclerosis. Cell-mediated cytotoxicity by peripheral blood lymphocytes against basic protein of myelin, encephalitogenic peptide, cerebrosides and gangliosides.

Cell-mediated cytotoxic reactions against myelin basic protein (MBP), encephalitogenic peptide, cerebrosides and gangliosides were studied in 165 MS cases. The cytotoxicity, which is detectable only in the autologous system, is mediated by T lymphocytes bearing antigens reactive with antibody OKT8. The cytotoxicity is highest during active MS regardless of whether it is relapsing or chronic progressive. During inactive MS cytotoxicity is significantly less and remains virtually unchanged at a low level over long periods. The degree of cytotoxicity is thus, predominantly, dependent on the activity stage of the disease. Further, there is a correlation with the severity of the clinical deficiencies. The pathogenetic significance of cytotoxic reactions can be recognized by the close correlation between the stage and course of MS, which can be demonstrated both statistically and individually.

Adolescent↗
PubMed1988

[McArdle disease: differential diagnosis of the increase in creatine kinase induced by the exercise test].

In a Turkish couple presenting atypical precordial pain, muscle pain and a massive increase of creatine kinase during and one day after bicycle ergometry, suspicion of McArdle's disease was confirmed by a pathologic ischemic forearm worktest, a pathologic serial stimulation test and by pathologic glycogen content with lack of myophosphorylase activity on histochemical examination of thigh muscle tissue. Characteristic signs of McArdle's disease such as muscle weakness, muscle pain and muscle swelling, especially after exertion, were detected only after specific questioning of the patients. McArdle's disease was also detected by phosphor nuclear resonance in the two male children. Frequent consanguinity in the small isolated mountain village where the family originated explains why all four members of two generations are affected by the autosomal recessive disease.

Adult↗
PubMed1988

Optic neuritis and multiple sclerosis. Cell-mediated cytotoxicity by peripheral blood lymphocytes against basic protein of myelin, encephalitogenic peptide, cerebrosides and gangliosides.

On examination in the first weeks after onset of the disease, cell-mediated cytotoxicity against encephalitogenic peptide, myelin basic protein (MBP), cerebrosides and gangliosides was demonstrable in 32 (76%) of 42 patients with optic neuritis (ON). 14 patients with ON and concomitant neurological symptoms (ON/MS) had positive findings with all antigens, especially with the encephalitogenic peptide. The cytotoxic reactions against all antigens showed a close correlation with the course of ON: when the disease improved, the cytotoxicity decreased and became negative on average 4 months after ON onset. As previously reported, cell-mediated cytotoxicity against the above-mentioned antigens, especially the encephalitogenic peptide, may be considered as a pathogenetic factor in multiple sclerosis (MS). A positive reaction with this antigen in patients with ON only probably indicates the first manifestations of MS.

Adolescent↗
PubMed1985

[Immunologic multiple sclerosis research].

In multiple sclerosis (MS) different autoimmunological phenomena can be held responsible for the inflammatory demyelinating process. A cytotoxic reaction of lymphocytes against the encephalitogenic peptide of the myelin basic protein is assumed to be the primary factor; furthermore, demyelinating antibodies play an important part in the destruction of the myelin sheath. As can be identified at the acute stage of the disease, anomalies in the immunoregulation and the suppression of the control mechanism give additional indications towards the immunopathogenesis of MS. The cause of the demyelinating autoimmune process is unknown. According to epidemiological studies, a virus infection is the most likely etiology for MS.

Antibodies, Viral↗
PubMed1985

Reactivity of sera and isolated monoclonal IgM from patients with Waldenström's macroglobulinaemia with peripheral nerve myelin.

Sera of 23 patients with Waldenström's macroglobulinaemia and six monoclonal IgM paraproteins, which had been isolated from these sera, were examined for reactivity against peripheral nerve tissue. Of these 23 patients, 12 had clinical signs of peripheral polyneuropathy (PN). Using an indirect immunofluorescence method, all sera and monoclonal IgM preparations reacted with peripheral nerve structures, displaying a distinct granular fluorescence pattern with anti-IgM sera. The Waldenström sera reacted mainly with structures at the border of the myelin sheath, as well as between myelin and axon, and occasionally with the axon itself. There was no difference between sera of patients with PN and those without. Negative results were obtained in a complement fixation assay. Of the 23 sera, 15 reacted in an antibody-dependent lymphocyte-mediated cytotoxicity reaction (ADLC) with peripheral nerve myelin, and to a much lesser extent with myelin basic protein from CNS. Five of the six isolated monoclonal IgM preparations also gave positive ADLC reactions. These results constitute additional evidence for an immunological mechanism in the pathogenesis of PN in Waldenström's macroglobulinaemia.

Aged↗
PubMed1982

Specificity of antibody-dependent lymphocyte cytotoxicity against cerebral tissue constituents in multiple sclerosis. Studies with basic protein of myelin, encephalitogenic peptide, cerebrosides and gangliosides.

In patients with multiple sclerosis (MS) there is not only an antibody-dependent lymphocyte cytotoxicity (ADLC) against basic protein of myelin (MBP), as was demonstrated earlier, but also against encephalitogenic peptide, cerebrosides and gangliosides. The reaction against cerebrosides and gangliosides is not specific for MS; it is also frequently positive in patients with other neurological diseases (OND), syphilis and rheumatoid arthritis. The ADLC against encephalitogenic peptide shows a very high specificity for MS. Out of 35 cases with OND, 23 had a positive result with MBP, but only one with encephalitogenic peptide. Patients with syphilis and rheumatoid arthritis reacted negatively without exception. According to this, the encephalitogenic peptide is a highly specific antigen for MS; MBP shows less specificity. The ADLC against the encephalitogenic peptide shows a markedly increased sensitivity in MS compared with MBP. Specificity and frequency of positive findings with encephalitogenic peptide support the pathogenic significance of the reaction in MS.

Adult↗
PubMed1980

Antibody-dependent lymphocyte cytotoxicity against basic protein of myelin in multiple sclerosis.

An antibody was demonstrated in the serum of 166 out of 200 patients with MS which enabled normal lymphocytes to develop a cytotoxic (ADLC) reaction against MBP. The ADLC correlated with the stage of the process and was positive in 94% of those with active and in 62% of those with inactive disease independent of the type--relapsing or chronic progressive--and of the severity of the disease. Control studies in 200 patients with other organic nervous complaints gave positive findings in patients with carcinoma (7.5%), in rheumatoid arthritis (10-15%) and in syphilis (30%). On the ground of its good specificity and the frequency of positive findings, the reaction may be of diagnostic significance. In 55 of 57 CSF samples investigated in MS, the ADLC was positive. The intensity of the cytotoxicity in serum and CSF is practically identical. This finding supports the pathogenetic significance of the ADLC against MBP although it has no validity as a primary aetiological factor.

Autoantibodies↗
PubMed1980

Optic neuritis and multiple sclerosis. An immunological study.

On examination in the first weeks after onset of the disease, an antibody-dependent lymphocyte cytotoxicity (ADLC) against myelin basic protein (MBP) was demonstrated in 32 (71%) of 46 patients with ON/only and in 8 of 10 patients with ON/MS. The findings were positive in 21 out of 22 CSF samples. The intensities of the cytotoxicity in the serum and in the cerebrospinal fluid were largely in agreement. No correlation was found between the cytotoxicity in the CSF and the IgG content. The ADLC against MBP is highly specific for MS. Only 5% of 200 patients with other neurological complaints had positive findings. Active disease phases in MS are positive in 94% of the cases according to earlier investigations. A positive ADLC against MBP in patients with ON/only is in all probability at first sign of MS.

Adolescent↗
PubMed1979

[Experiences with clindamycin in orthopedic surgery and traumatology].

60 cases of orthopedic surgery and traumatology were treated 64 times altogether with an average dose of clindamycin of 3 X 300 mg/day. 40 patients were given clindamycin as preventive treatment. 12 patients were treated for acute infections of the locomotor system and other 8 patients 12 times for chronic osteitis. In the group having received preventive trqatment, infection occurred bu 1 out of 40 patients. As to the 12 cases of acute infections, 10 recovered, 1 improved and 1 patient got worse. Concerning the 12 treatments of 8 patients with chronic osteitis, in 1 case the inactivation of the infection was obtained. 9 cases showed significant improvement whereas in 2 cases an aggravation was noticed. In 5 patients the following side effects occurred: 2 cases of allergic exanthema, 2 cases of mild diarrhoe and 1 case of pyrosis. This study shows that clindamycin is an antibiotic with a broad field of application in orthopedic surgery.

Abscess↗