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Biomedical subjects

E Ogris

Publications and source records attributed to E Ogris.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Tumor markers in breast cancer: on the diagnostic value of serum determinations in clinical freedom from tumor and manifest disease].

We have analyzed 1301 serum determinations of the tumor markers CA 15-3 and CEA in 405 breast cancer patients. CA 15-3 exhibited a higher accuracy than CEA (sensitivity-specificity diagram). Using cut-off levels of 30 U/ml (CA 15-3) and 5 ng/ml (CEA) we observed a sensitivity of 70.7% versus 61.8% and an approximate specificity of 93.8% versus 83.4%. The sensitivity of the panel of both markers was 80.9%, the specificity 84.5%. The high specificity of both markers caused high positive predictive values. The marker expression was higher in patients with hematogenic metastasis than with local recurrences (the median for CA 15-3 levels was 88.2 U/ml versus 26.6 U/ml; for CEA: 10.0 ng/ml versus 2.5 ng/ml). Less expression of both markers in patients younger than 40 years in comparison to patients older than 40 seems to be remarkable. Early detection of relapse - a marker increase over the cut-off level before clinical proof - was observed in 43.8% (CA 15-3; median of leadtime 6.1 months) of 73 patients; CEA: 24.7%, 7.2 months. Metastasis was predicted 3-6 times more often than local recurrences. Monitoring of the manifest more or less progressed tumor is still the main task of present tumor markers. But the results also suggesting the use of these markers for early detection of metastasis, especially in panels.

Adult↗
PubMed1989

Methotrexate serum-level determinations during low-dose therapy of rheumatoid and psoriatic arthritis.

In 29 patients, 21 suffering from psoriatic arthritis and eight patients suffering from rheumatoid arthritis, methotrexate serum-levels were determined by means of radioimmunoassay. The aim of the investigation was to recognize an eventual dependence of the serum level of methotrexate on the total cumulative dose and to test the possibility of a concomitant therapy control. Beside the determinations of the serum levels of methotrexate, clinical examinations and laboratory tests were done at regular intervals. The values obtained showed no significant increase during the course of therapy compared to the values at the beginning of the treatment. Likewise no correlation to the total cumulative dose, the clinical picture or to the occurrence of side-effects could be found. Nor could any relationship between the changing of laboratory parameters and the methotrexate serum-levels be observed. No differences appeared in the methotrexate serum-levels during therapy of either rheumatoid or psoriatic arthritis patients. In conclusion it seems impossible to monitor a low-dose methotrexate therapy by continuous determinations of the serum levels of the drug.

Arthritis, Rheumatoid↗
PubMed1988

[Hypoglycemic and hyperinsulinemic clamp technic to determine the secretory behavior of insulinoma].

In two female patients of 62 and 76 years of age, respectively, who had insulinomas subsequently confirmed by histology, the secretion pattern of insulin-producing tumours was studied. In the 62-year old patient complete reproducible suppression of insulinoma secretion was achieved by means of large exogenous doses of insulin, whereas this was not possible in the 76-year old patient. A modified hypoglycaemic clamping technique was used in the study. It is concluded that, depending on plasma insulin levels, relative suppression of insulinoma is possible, and it is recommended to use the described differentiated clamping procedure to investigate the secretion pattern of autonomous insulin-producing tumours.

Adenoma, Islet Cell↗
PubMed1988

[Blood cell concentration of methotrexate in long-term therapy of inflammatory rheumatic diseases].

To verify the possibility of a concomitant therapy control in 31 patients (18 psoriatic arthritis [PA], 13 rheumatoid arthritis [RA]) the blood cell concentration of Methotrexate (MTX) was continuously measured over a period of 6 months. The determinations were carried out by using a RIA of the CIS Corp. At any time MTX was determined laboratory and clinical examinations were done and the P-III-P serum-level was measured by using a RIA of the Behringwerke. The cellular MTX showed to be statistically significantly elevated compared to baseline, whereas within ranges of total cumulative dosages only insignificant fluctuations could be noticed. Like in the treatment of Psoriasis a strict correlation between the weekly administered dose and the cellular MTX could be established, the total cumulative dose, however, had no influence on the cellular MTX-level. In the treatment of RA slightly higher weekly dosages were necessary, which caused significantly higher cellular MTX concentrations in RA patients. Some correlations between clinical as well as serological parameters of disease activity could be noticed, nevertheless they do not allow distinct interpretations. In both diseases a significant relationship between the cellular MTX-level and the P-III-P serum-level could be realized. A storage of MTX in blood cells, especially in erythrocytes, seems to be evident. To reach therapeutical benefit in RA slightly higher mean dosages may be necessary. A therapy monitoring by the means of continuous determinations of cellular MTX seems to be impossible. In contrast an approach to the early detection of liver fibrosis can be given by the correlation between cellular MTX and the P-III-P serum levels.

Adult↗
PubMed1987

[Use of genetic technics in medical diagnosis exemplified by hemophilia A].

Recent years have seen the rapid development of molecular probes for the detection of defective human genes. These react either directly with the gene in question or with a DNA sequence which lies in close proximity to the gene and which exhibits polymorphism. In the case of haemophilia A two probes were found that belong to the latter category. We have used one of these probes to test its usefulness in the detection of carriers of haemophilia A. For these tests DNA was isolated from blood cells, but can, in principle, be obtained just as easily from other cells or tissues. The results of tests on several families show that the gene technological method is much more precise and sensitive than conventional methods used so far to detect carriers. In all cases a clear assertion was possible as to whether or not the person in question was a carrier of haemophilia A. The method should be applicable to prenatal diagnosis.

DNA↗
PubMed1987

[Diagnostic criteria in terminating therapy in Basedow hyperthyroidism].

Hyperthyroidism due to Graves disease is characterized by the presence of Thyroid stimulating antibodies (TBI Ab). The time course of the disease shows periods of remissions followed by exacerbations. In principle, treatment with antithyroid drugs is a symptomatic therapy, although there is evidence for an influence of the underlying immunologic disease. In any case there is a need for controlled long term therapy if antithyroid drugs are used. Therefore, it is important to have criteria for the evaluation of a remission during treatment and for the prediction of continuing remission or recurrence of the disease after therapy. Among the function tests which are able to answer these questions two groups can be distinguished. The first group consists of tests for the evaluation of the thyroid feed back mechanism. This group comprises the Thyroid suppression test, the Tc-99m Uptake test (TcTU test) and the TRH-stimulation test. With exception of the TcTU test, the use of these tests is reserved for patients with antithyroid monotherapy. The other group comprises tests by which the underlying immunphenomena are examined. These tests are the TSH-receptor antibody test (TRAK), the determination of Thyroglobulin antibodies (TAK) and of microsomal antibodies (MAK). In addition, recent findings demonstrate the importance of an examination of the HLA status for therapeutical decisions. At present, the recurrence of a positive Thyroid suppression or TRH stimulation test, the normalisation of the antibodies against TSH-receptor, against Thyroglobulin and microsomal antigen as well as lacking HLA-DR 3 frequency is estimated as a strong evidence for long term remission of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Antithyroid Agents↗
PubMed1986

[Nuclear medicine diagnosis of kidney diseases].

Some of the methods described here are in use for more than 20 years for renal function studies of patients with nephro-urologic problems as well as patients after renal transplantation. There are in general four groups of renal function studies with radioisotopes: 1) The first group comprises studies of the renal function kinetics based on the renal handling of radio-hippurate (OIH). The comprehensive renal function procedure use 131J-OIH or 123J-OIH and includes renal scintigraphy, determination of effective renal plasma flow (ERPF), fractional radio-hippurate excretion and evaluation of urinary bladder function. The introduction of computer processing for evaluating of these studies has provided a powerful tool for diagnosis of renal diseases. The method studies the renal tubular function by a combination of an in vivo/in vitro technique, since the procedure comprises renal gamma camera functional-scintigraphy and determination of renal ERPF by in vitro techniques. The combination of the results of both methods allows the calculation of the split renal effective plasma flow. The estimation of the global and the split ERPF is of considerable importance in patients with acute renal failure, hypertension or outpatients with various renal diseases. The procedure is save, simple, inexpensive and has less variations and a greater reproducibility than creatinine clearance since urine collection is not required. In addition to the evaluation of tubular function, the degree of obstruction and the bladder function can be assessed for the individual kidney by inspection or computer assisted analysis of the sequential or functional scintigrams.(ABSTRACT TRUNCATED AT 250 WORDS)

Creatinine↗
PubMed1985

[Percutaneous transluminal angioplasty in the region of the renal artery--indications, technic and results].

The paper reports the results obtained by percutaneous transluminal angioplasty (PTA) in the treatment of renal artery stenosis in 25 patients with secondary hypertension and discusses indications and the technique used. The follow-up period ranged from 0.5 to 12 months. All interventions were performed with the Olbert catheter system. Following PTA a significant decrease in systolic, diastolic and mean arterial pressure was observed in nearly all patients. The response of the plasma renin activity (PRA) to orthostatic stimulation and pharmacological stimulation by furosemide was determined in a subset of 15 patients before and after PTA. A significant decrease in both basal and stimulated PRA values was observed subsequent to PTA. The decrease in PRA values after successful PTA did not, however, correlate with the extent of the blood pressure changes.

Adolescent↗
PubMed1984

[Serum digitoxin levels in pacemaker patients].

In most cases pacemaker patients represent a diverse geriatric group in which ECG and clinical signs are of minor usefulness in diagnosing digitalis toxicity. We therefore determined serum glycoside concentrations in 200 consecutive patients attending our pacemaker clinic (with a mean maintenance dose of 0.093 mg digitoxin per day) and tried to correlate these to clinical, ECG and chemical findings. Multivariate analyses were also carried out to assess whether serum digitoxin concentrations lay in a subtherapeutic (0 to 8.99 ng/ml), therapeutic (9 to 27 ng/ml) or toxic (above 27 ng/ml) range on the basis of a combination of variables. The mean digitoxin concentration was 24.0 +/- 10.3 ng/ml (0 to 45 ng/ml) and correlated poorly with patient compliance (r = 0.36), serum potassium (r = 0.24), weight (r = 0.17) and digitoxin dose (r = 0.13), but not with ECG and subjective or clinical findings. A prediction of the three ranges of the serum digitoxin concentration was possible by means of variable compliance, body weight and digitoxin dose with a probability of up to 79%. In view of the above-mentioned problems indications for digitalis therapy in pacemaker patients must be constantly reviewed and control determination of serum digitoxin concentration should be frequently undertaken.

Adult↗
PubMed1984

Radionuclide imaging after coronary vasodilation: myocardial scintigraphy with thallium-201 and radionuclide angiography after administration of dipyridamole.

Tl-201 imaging was performed in 194 patients who had undergone coronary angiography which had demonstrated coronary artery disease in 149 and normal coronary vessels in 45.91 patients had had previous myocardial infarction. Sensitivity for dipyridamole stress imaging was 92% for all 149 patients. 79% for the patients without previous infarction. Specificity was 81%. In a subgroup of 40 patients (32 patients with reversible Tl-201 defects and 8 normals), an additional dipyridamole wall motion study was performed in order to evaluate the correlation of Tl-201 perfusion abnormalities and ventricular function after dipyridamole. Only 19% of the patients had a dipyridamole-induced drop of global left ventricular ejection fraction, 31% showed dipyridamole-induced wall motion abnormalities; the predictability of specific vessel involvement by regional wall motion and regional ejection fraction assessment was 26% as compared with 70% for thallium imaging. Tl-201 perfusion defects after dipyridamole administration can also occur independent of ischaemia-induced changes in global and regional ventricular function. Coronary vasodilation with dipyridamole using Tl-201 imaging is a reliable alternative method in patients with coronary artery disease with an accuracy comparable to exercise studies with the advantage of not necessarily needing ischaemia as an endpoint of the test.

Cineangiography↗
PubMed1984

[Somatomedin activity in Wiedemann-Beckwith syndrome].

Two patients with Wiedemann-Beckwith-Syndrome and neonatal hypoglycemia are reported. The etiology for the impaired glucose metabolism has not been elucitated as yet. In some patients pancreatic islet-cell hyperplasia resulting in hyperinsulinemic hypoglycemia was suspected. Increased somatomedin activity was also proposed. We have measured somatomedin concentrations in both patients by bioassay and radioimmunoassay and found normal or slightly reduced plasma levels with both methods.

Asphyxia Neonatorum↗
PubMed1983

[Emission-computed tomography of the myocardium with the 7-pinhole collimator].

89 patients (78 with coronary artery disease, 11 normals) were studied comparatively with T1-201 planar myocardial scintigraphy and 7-pinhole emission tomography with a mobile gamma-camera. In 46 patients stress studies were performed, the other studies were performed as resting protocols. In 13 patients a correlation of scintigraphically determined infarct size calculated from the T1-201 tomograms with CK and CK-MB values (maximum values) in the acute infarction period was performed. 17 patients having undergone intracoronary streptolysis were studied to investigate the effect of this intervention. In patients without previous myocardial infarction (n = 35) sensitivity of 7-pinhole tomography was significantly superior over planar reading of images (83% for qualitative evaluation, 91% for quantitative analysis). In patients with previous myocardial infarction (n = 26) comparative sensitivities were not significantly different, although slightly higher, nevertheless the fraction of questionable findings was reduced from 9 to 4%, furthermore in 31% an additional information concerning size or localization could be obtained from the tomograms. Predictive diagnostic accuracy was highest for quantitative 7-pinhole tomography (91%) but not significantly different from qualitative tomography but higher than for planar imaging. Specificities of all methods were comparable. In patients during the acute phase of myocardial infarction a significant correlation (r = 0.76 for CK, r = 0.78 for CK-MB, p less than 0.01) was obtained with enzymatic markers of infarct size. In the group after intracoronary streptolysis 7-pinhole tomography was able to demonstrate a quantitative reduction of thallium infarct size in patients after successful lysis (23.5% vs 48.7%, p less than 0.01) although absolute quantitation is not possible with thallium-201 due to inherent biological limitations. Emission tomography using 7-pinhole collimation leads to an improvement of diagnostic accuracy in all patients with reversible ischemia and helps for better delineation of size and localization of infarct areas and could help in the assessment of interventional effects, as after intracoronary streptolysis.

Adult↗
PubMed1982

[Results of a comparative therapy study for inoperable lung cancer].

In a prospective randomized study 78 selected patients with bronchogenic cancer have been included, and five different treatment modalities have been compared (1. Biologic therapy; 2. Vitamin A + Cytoxan; 3. Vitamin A + Telecobalt irradiation; 4. Telecobalt irradiation; 5. Immunotherapy). No significant differences if survival times between the different groups have been observed. Nevertheless, significant differences of survival times were found between small cell and squamous cell carcinoma patients without respect to the therapy applied. The highest number of remissions was obtained by therapy 3, followed by 4 and 2. Consequences for further studies are discussed.

Adult↗
PubMed1982

[Selective thrombolysis in acute myocardial infarction: evaluation of functional result by metabolic studies and perfusion imaging (author's transl)].

The effects of selective thrombolysis with intra-coronary streptokinase in regard to myocardial protection are still debated. In 25 patients with acute myocardial infarction we evaluated regional metabolism with 123 radio-iodinated heptadecanoic acid and segmental 201 thallium scintigraphy in the distribution of the recanalized coronary vessel. Lysis was successful in 11/16 occlusions of LAD-, 4/7 RCA- and 1/2 CX-vessels. In this group (A) the average defect size on TI-scintigrams was 19 +/- 6% 24 hours after the intervention, whereas unsuccessful recanalisation (group B) resulted in a defect size of 38 +/- 7% (p less than 0.01). There was good concordance between thallium defect size and fatty acid metabolism in group B. However, in group A 6 of 11 patients showed significantly smaller fatty aid accumulation than the thallium defect size reflected. These data suggest that successful reperfusion does result in protection of myocardium in the majority of infarct patients reflected in the smaller TI infarct size. Successful reperfusion, however, does not always immediately restore metabolic dysfunction. This discrepancy will have to be analyzed by further follow-up studies of these patients.

Coronary Vessels↗