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Biomedical subjects

G Judmaier

Publications and source records attributed to G Judmaier.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Tumor markers in internal medicine hepatology].

Primary liver tumour, i.e. hepatocellular carcinoma (HCC) is one of the world's most common malignancies. The age-standardized incidence rate varies widely from 6/100,000 (Austria) to 100 and more per 100,000 in Mozambique and Taiwan. In these high-risk areas, infection with hepatitis B virus is considered the main risk factor. In low-incidence areas as in Western Europe, main risk factors are older age, male sex and liver cirrhosis. The prognosis depends mainly on the size of the tumour. Alpha-fetoprotein is an ideal tumour marker for prospective screening in high-incidence areas. There is not much information, however, on the value of this marker for screening in low-incidence areas. There is some information that HCC-associated alkaline phosphatase could be a good tumour marker in non-viral liver tumours. Furthermore, des-gamma-carboxyprothrombin and vitamin B 12-binding protein could be specific markers for tumours in non-cirrhotic livers. But large clinical studies have not yet confirmed the value of these markers. Hormonal and haematological markers and some isoenzymes are tumour markers characterized by high sensitivity but low specificity. There are no specific tumour markers for metastatic liver disease.

Biomarkers, Tumor↗
PubMed1989

[Non-invasive morphologic and functional assessment of arteriovenous fistula in dialysis patients with duplex sonography].

In 61 patients with end-stage renal disease the results of 89 consecutive Duplex examinations of the arteriovenous fistulas used for haemodialysis were evaluated. The examinations were performed because of various problems concerning the vascular access or before the first puncture. Using 7.5 and 10.0 MHz probes (pulsed Doppler 3.0 and 4.5 MHz) the morphology and the function of the fistulas were evaluated. In 35 cases the results were normal, in a further 27 cases minor anomalies were seen without influencing the function. Complete thrombosis was observed in 7, partial thrombosis and severe stenosis in 4 cases each. Large aneurysms were documented in 6 examinations and in the remaining 6 the fistulas had not matured sufficiently within 4 weeks. The ultrasound results correlated well with consecutive angiography or surgery. The mean flow in normal fistulas was 514 +/- 223 ml/min. It was higher in PTFE shunts (614 +/- 242 ml/min) than in Cimino-Brescia fistulas (464 +/- 199 ml/min). Complications were observed more often in the PTFE group (63.9% vs. 58.5%). We think that Duplex sonography offers an accurate, non-invasive way to evaluate the morphology and the function of arteriovenous fistulas of patients on haemodialysis. This should therefore be performed as the first imaging method whenever problems concerning the fistula occur.

Adult↗
PubMed1989

[Differential diagnostic importance of sonographically detected lymph node enlargement of the liver hilum in non-malignant liver diseases].

A total of 234 patients, 112 of whom were suffering from inflammatory liver disease and 122 from non-inflammatory liver disease were examined for enlarged lymph nodes in the hepatoduodenal ligament. Patients with malignancy were excluded from the study. In the 112 patients with inflammatory liver disease, enlarged lymph nodes in the hepatoduodenal ligament were demonstrated in 29 cases (25.9%). In cases with acute hepatitis (n = 25), lymphomas were seen in 18 examinations (72%). These enlarged lymph nodes disappeared when the liver enzymes fell to normal values. In patients with chronic inflammatory liver disease (n = 54), enlarged lymph nodes were found in only nine cases (16.7%). Of 27 "healthy" HBsAG-carriers, 26 were without lymph node enlargement. None of the patients without inflammatory, non-malignant liver disease showed lymph nodes in the hepatoduodenal ligament. Once malignancy is ruled out, lymphomas in the hepatoduodenal ligament should be considered an indication of inflammatory liver disease.

Diagnosis, Differential↗
PubMed1989

Neopterin excretion after liver transplantation and its value in differential diagnosis of complications.

The aim of this study was to investigate patterns and clinical utility of a neopterin marker in liver allograft recipients. Urinary neopterin levels were studied in 59 transplant patients daily until discharge. During the early postoperative period (days +1 to +20) neopterin excretion exhibited a liver-specific pattern that clearly differed from that seen in renal and bone marrow transplant recipients. Neopterin concentrations increased and reached peak values on day +7. The height of this early peak varied in context with complications such as infection or rejection, and was correlated with an unfavorable prognosis. In contrast to the early phase, no liver-specific pattern was observed after day 20. As seen in all other transplant patient populations, values normalized in patients with an uncomplicated course but again increased during infection or rejection episodes. Neopterin levels were particularly high during CMV infection, and their increments were directly related to the severity of CMV disease. The neopterin marker, although not specific, enables discrimination between patients with a complicated and uncomplicated clinical course. High neopterin values early after transplantation are associated with unfavorable prognosis and correlate with an increased risk of developing CMV disease.

Biopterins↗
PubMed1989

[Is percutaneous liver biopsy using the Trucut (Travenol) needle superior to Menghini puncture?].

The aim of this study was to compare the quality of biopsy cylinders obtained by the Menghini or Trucut liver biopsy-method as well as the frequency of complications observed with both these methods. For this purpose, 74 Menghini and 62 Trucut biopsies were analyzed. Both groups were comparable with respect to histologic diagnosis, but no final diagnosis could be made in eight cases of Menghini biopsy because of insufficiency of the material obtained. Fragmentation of the sample occurred significantly more often in the Menghini group (p less than 0.05; chi 2 test). Trucut biopsies were significantly longer (12 mm versus 8 mm mean value; p less than 0.001; Wilcoxon rank sum test) and contained significantly more portal tracts (16 versus 6 mean value; p less than 0.001). None of the total 136 biopsies led to serious complications. We conclude that Trucut liver biopsy is superior to the Menghini method since tissue yield is better and both methods are equally safe.

Adolescent↗
PubMed1988

Urinary neopterin excretion in pulmonary sarcoidosis: correlation to clinical course of the disease.

Urinary neopterin levels were determined by high pressure liquid chromatography in 36 patients with pulmonary sarcoidosis. Values were above normal range in 69.4% of all patients. Neopterin excretion was significantly higher in radiologic types II/III than in type I disease (p = 0.0265, Mann-Whitney U-test). Urinary neopterin showed a weak, but significant inverse correlation to disease duration (r = -0.36; p = 0.034, Spearman's rank correlation). No significant correlation could be found between neopterin and the presence of pulmonary or extrapulmonary symptoms, vital capacity, forced expiratory volume in the first second, steroid treatment, and serum angiotensin converting enzyme. Follow-up studies revealed that worsening or improvement of chest X-ray findings was invariably accompanied by rising or decreasing neopterin excretion, respectively. Patients with normal neopterin at initial evaluation had a higher tendency towards spontaneous healing, and none of them deteriorated during the follow-up period. We conclude that urinary neopterin excretion reflects one aspect of alveolitic "activity" in pulmonary sarcoidosis and that normal values probably indicate a favorable prognosis.

Adult↗
PubMed1988

[Sonography of the liver in Wilson's disease. Sonographic studies of the liver in Wilson's disease--significance for assessing prognosis?].

Five patients with Wilson's disease with prognostically different hepatic manifestation were studied via ultrasound. Three of them presented histologically with fatty changes, fibrosis and interspersed areas of normal parenchyma. In these three patients, a peculiar ultrasound picture of the liver was observed which was quite different from the findings in the two others and which has not yet been recognized in the context of Wilson's disease. The parenchymal echo pattern was of increased echogenicity with numerous roundish foci of decreased echogenicity resembling metastatic liver disease. In contrast, the echo texture of the two patients with chronic active hepatitis leading to hepatic failure, was coarse, diffusely enhanced and without focal lesions. These findings indicate that ultrasound may help to define Wilson patients with good prognosis for the predominance of fatty changes and fibrosis in the liver.

Adolescent↗
PubMed1988

Enhanced serum levels of beta-2-microglobulin, neopterin, and interferon-gamma in patients treated with recombinant tumor necrosis factor-alpha.

The effect of different doses of recombinant human tumor necrosis factor-alpha (rTNF-alpha) on serum levels of neopterin, beta-2-microglobulin and interferon-gamma (IFN-gamma) was investigated in tumor patients. Twelve patients with advanced malignant disease were treated and received single doses of either 1, 10, or 100 micrograms/m2 rTNF-alpha on days 0 and 7. Neopterin, beta-2-microglobulin and IFN-gamma serum levels were measured from day -2 to day 12 of the study. Application of rTNF-alpha leads to a marked and dose-dependent increase of neopterin and beta-2-microglobulin levels; no rTNF-alpha-dependent changes were observed after 1 microgram/m2, and maximum increments were seen in patients receiving 100 micrograms/m2. Serum levels of both parameters peaked after 2 days and returned to baseline values within 1 week. IFN-gamma levels were also elevated after application of rTNF-alpha. We failed, however, to demonstrate a clear correlation between the serum levels of IFN-gamma, beta-2-microglobulin, and neopterin because of the wide range of pre- and posttreatment levels of IFN-gamma. We conclude that neopterin and beta-2-microglobulin represent useful markers for monitoring biological response to treatment with rTNF-alpha.

Adult↗
PubMed1988

A comparison of roxatidine acetate and ranitidine in gastric ulcer healing.

A randomised multicentre double-blind study was conducted to compare the efficacy and safety of roxatidine acetate 75 mg twice daily and ranitidine 150 mg twice daily in 295 patients with endoscopically confirmed gastric ulcers. Substantial reductions in ulcer diameters and healing rates of 85.6 and 88.2% for roxatidine acetate and ranitidine, respectively, were obtained after 8 weeks of treatment. There was no difference in healing rates between smokers and non-smokers in either group. The relief of day and night-time epigastric pain was comparable for both treatment groups, as was antacid tablet consumption, with the majority of patients pain-free at the end of the study. The incidence of side effects was low, with 3 patients treated with roxatidine acetate, compared with 4 ranitidine-treated patients, reporting adverse reactions. There were no clinically significant changes in laboratory values. The present study suggests that 8 weeks of treatment with roxatidine acetate 75 mg twice a day produces effective and safe acute management of gastric ulcers which is comparable to that seen with ranitidine.

Adolescent↗
PubMed1988

Longitudinal study of major histocompatibility complex antigen expression on hepatocytes in fine-needle aspiration biopsies from human liver grafts.

Expression of MHC class II antigens on hepatocytes is part of the natural history of liver grafts. The expression appears to be enhanced by rejection episodes but not during infection and seems to persist on higher levels in chronic rejection and multigraft recipients. Intense expression of class I antigens is a nonspecific feature of the posttransplant situation.

Biopsy, Needle↗