Search PubMed⌕ Search

Biomedical subjects

G Strohmeyer

Publications and source records attributed to G Strohmeyer.

At least 127 records · Page 7Linked to original sources
PubMed1989

[Epidemiology and clinical aspects of chronic hepatitis B and non-A, non-B virus infections].

Hepatitis B and Non-A-non-B infections often become chronic and proceed to cirrhosis associated with a shortened life expectancy. Both infections are transmitted by parenteral or sexual routes. New insights in the structure of the hepatitis B virus (HBV) as well as in the immune response mechanism of the organism permit by serological testing a clear definition of the replicative state of the virus. Together with the parameters of inflammation (e.g. transaminases, liver histology) it is possible to determine the activity of the hepatitis. The most effective treatment of chronic HBV-infection today is the therapy with alpha- or beta-interferon. The aim of this treatment is the inhibition of HBV replication and accellerated elimination of the virus, indicated by seroconversion of HBEAg to anti-HBEAg. The most significant advance in the knowledge of percutaneous Non-A-non-B hepatitis is the identification of the responsible virus and the development of a diagnostic test for its serological detection. Since this type of hepatitis becomes chronic in 50-60% of the cases, therapy is urgently required. Clinical studies showed that also for Non-A-non-B virus infection alpha-interferon is most effective. Currently the optimal dosage, duration and point in time for interferon treatment is being evaluated.

Follow-Up Studies↗
PubMed1989

[New electrophysiological findings on the incidence of brain involvement in clinically and neurologically asymptomatic HIV infections].

Motor (postural tremor of the outstretched hands, most rapid voluntary alternating index finger movements and rise times of most rapid voluntary isometric index finger extensions) and psychometric tests (multiple choice vocabulary test - form b, syndrome short test, the German version of the standard progressive matrices - Raven, and the psychic and somatic findings according to the AMDP-system) as well as MRI-Scans were analysed in 100 HIV-infected patients of all stages according to the actual CDC-classification, but without any central-nervous or psychic deficit. Patients with drug, alcohol or tranquilizer abuse, opportunistic, cerebral infections or fever were excluded from the study. Tremor-peak-frequencies and reaction times did not show any significant difference to an age- and sex-matched control group; the other motor parameters revealed significant slowing in the patient group and a worsening with the CDC-stages. MRI-scans of all the patients were normal. The psychometric tests did not show significant alterations on a group statistical level, especially not in the depression scales. Morphologically, the motor performances of the HIV-infected patients resembled those of patients with basal ganglia diseases (M. Huntington, M. Wilson, M. Parkinson). Correspondingly, in some cases of clinically demented HIV-positive patients, MRI-scans showed lesions in the basal ganglia. It can be concluded, that there is an early subclinical central-nervous system affection in HIV-infected patients, especially of the basal ganglia, detectable with appropriate motor function tests sometimes considerably preceeding structural deficits seen later in the course of the disease in MRI-scans.

AIDS-Related Complex↗
PubMed1989

Investigation of genetic markers in patients with Crohn's disease and ulcerative colitis.

Inflammatory bowel diseases (IBD) as Crohn's disease (CD) and ulcerative colitis (UC) are believed to have a genetic basis. Additional factors are supposed to promote the development of IBD. However, apart from a few reports of HLA associations which await confirmation by other groups strong associations to (a) particular genetic marker(s) are still lacking. We here report on previously unobserved associations of CD to MNSS and UC to the immunoglobulin heavy chain allotype Gm 1,-2,10. We suggest that these factors play a role in a wider spectrum of genetic markers for the development of IBD.

Acid Phosphatase↗
PubMed1989

Pepsinogens A and C: purification from human gastric mucosa and determination in serum by optimized radioimmunoassays.

Pepsinogen A and pepsinogen C were purified from human gastric mucosa. The preparations were immunochemically homogeneous and contained only their characteristic components. Specific, sensitive, and reliable radioimmunoassays for both pepsinogen A and pepsinogen C were developed. The concentration of pepsinogens in serum was log distributed. In 144 healthy control subjects the mean level of pepsinogen A (means +/- s) was 65.7 ng/ml (range: 49.8-86.6 ng/ml), significantly higher than the level of pepsinogen C (means = 12.2 ng/ml, range 9.2-16.1 ng/ml, p less than 0.001), with a Pg A/Pg C ratio of 5.8 +/- 2.7. In contrast, pepsinogen C was predominant in the serum of 26 patients with pernicious anemia. Since the mean level of the proenzyme (means = 10.2 ng/ml, range 7.7-13.4 ng/ml) did not differ (p greater than 0.05) from that of the control group, whereas the concentration of pepsinogen A was significantly lower (means = 6.1 ng/ml, range 3.7-9.5 ng/ml, p less than 0.001), the Pg A/Pg C ratio dropped to 0.6 +/- 0.3 (p less than 0.001). In 27 patients with total gastrectomy the levels of both pepsinogen A (means = 2.5 ng/ml, range 2.2-2.8 ng/ml) and pepsinogen C (means = 1.9 ng/ml, range 1.3-2.9 ng/ml) were significantly lower (p less than 0.001) than in patients with pernicious anemia. The results indicate that the stomach is the main source of serum pepsinogens, that under normal conditions the gastric chief cells release more pepsinogen A than pepsinogen C, and that only small amounts of the proenzymes originate from extragastric tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Anemia, Pernicious↗
PubMed1989

Pathogenesis and management of ulcerative colitis.

The etiopathogenesis of ulcerative colitis (UC) is still largely unknown, although the role of genetic influences now seems to be fairly clear. Diagnosis is based on clinical, endoscopic and histological findings. The most important differential diagnosis of UC is Crohn's disease (CD). UC always first arises in the rectum and can spread continuously to upper parts of the colon. One of the severest complications consists in the development of toxic megacolon, which is seen in 1.6%-8% of cases. Another point is the occurrence of carcinoma in longstanding and extensive UC. The risk of this complication may have been overestimated in earlier studies: A realistic rate could be 0.5%-1% per person and year of pancolitis. However, carcinoma may occur even in less extensive cases. The conclusions which have to be drawn are still controversial. Some authors recommended regular endoscopy with serial biopsies, but others do not. The standard oral therapy is based on sulfasalazine (SASP) and corticosteroids. For topical treatment, 5(4)-amino-salicylic acid has proven to be effective in distal colitis, as has cortisone. Also, oral treatment with 5-ASA preparations seems to be beneficial, even if some of the published studies are open to criticism. Presumably, the drug is more clearly effective at higher doses than those commonly used.

Colitis, Ulcerative↗
PubMed1989

[Nutrition and Crohn disease--an etiologic factor?].

Epidemiological data indicate that exogenous noxes are important in the etiology of nonspecific inflammatory bowel disease. In several studies the influence of nutritional factors in the pathogenesis of Crohn's disease was investigated. The conflicting results, the inappropriate methods of investigation, the limited number of patients, and differences between patients and controls in many of these studies require a careful interpretation. Evidence for an etiological significance of nutrition in the development of Crohn's disease is still missing. Therefore, a specific diet for these patients does not exist. The physician should recommend a balanced diet which considers the needs in energy supply, corrects preexisting deficiencies, and is adapted to subjective intolerances and to disease related complications such as malabsorption or partial intestinal obstruction.

Crohn Disease↗
PubMed1989

[Late initial manifestations of Crohn disease with atypical symptoms].

The case of a 55-year-old patient with Crohn's disease and chronic intermittent diarrhea as well as progressive weight loss of 20 percent of his body weight is reported. The establishment of the diagnosis was difficult at the beginning, since characteristic symptoms were missing and radiological and endoscopical findings were normal. Loam-coloured glossy stools, repeated registration of a reduced chymotrypsin concentration of the stool and the response of the symptoms to a substitution of pancreatic enzymes were initially regarded as signs of an exocrine pancreas insufficiency. Not before multiple biopsies were taken from the macroscopically largely normal small and large intestine during persisting complaints, an extensive infiltration with Crohn's disease could be shown. This case report emphasizes the importance of taking multiple biopsies in etiologically unexplained chronic diarrhea even from macroscopic inconspicuous intestinal mucosa. Because of the rising incidence of Crohn's disease late onset is gaining increasing significance in the differential diagnosis of chronic diarrhea in the elderly patients.

Biopsy↗
PubMed1988

[Biofeedback training in fecal incontinence].

In 19 patients with incontinence of various causes a treatment programme was instituted in which by biofeedback training they would learn how to increase the force of contraction of the external anal sphincter in response to balloon distension of the rectum. The degree of incontinence was objectified by anorectal manometry before and after training, as well as 3-6 months after the end of training. This programme significantly increased the force of contraction of the sphincter and pelvic-floor musculature. Twelve patients became continent and have remained so at follow-up. The training regimen was especially successful in patients with an organic cause of the incontinence and those most highly motivated. The investigation also demonstrated that anorectal manometry is a suitable method for the diagnosis of and monitoring the response to treatment of anal incontinence.

Adult↗
PubMed1988

[Orthotopic liver transplantation in Wilson's disease and acute liver failure].

Liver histology demonstrated progressive cirrhosis in a 19-year-old girl with a subacute form of Wilson's disease. Despite D-penicillamine administration her liver functions rapidly deteriorated further. Orthotopic liver transplantation was performed. Postoperatively there were two mild rejection episodes, an organic psychiatric syndrome and generalized tremor. Copper metabolism and clinical symptoms became normal postoperatively. Five months after the transplantation she was in a good general condition, able to continue her education.

Acute Disease↗
PubMed1988

[Exudative enteropathy in Klippel-Trenaunay syndrome].

The triad of the Klippel-Trénaunay Syndrome consists of varicose veins, "port-wine" haemangioma of the skin and bone and soft-tissue hypertrophy with a different extension. Often an obstruction of lymphatic vessels and lymphoedema accompany the syndrome. We observed for the first time a patient with an impressive Klippel-Trénaunay-Syndrome in combination with a symptomatic exudative enteropathy. In spite of a regular intravenous protein substitution for many years, this patient had developed a monstrous elephantiasis of the lower extremities. A lymphography demonstrated a blockade of the lymph flow at the height of the middle paraaortic lymph nodes. The cysterna chyli and the Ductus thoracicus were not visualised. The measurement of 51Cr-labelled albumin excretion in the stool for two days after the intravenous injection of 3.07 MBq 51Cr showed an excretion of 17.9% of the total dose, which means an elevated gastrointestinal protein-loss. However, intestinal lymphangiectasia was not seen on histologic examination of bioptic material of duodenal and jejunal mucosa. These results show that the Klippel-Trénaunay Syndrome may be accompanied by a protein-loosing enteropathy due to obstruction of the gastrointestinal lymph flow. As the intestinal lymphangiectasia may occur locally, it is not always demonstrable directly on pathologic examination of biopsies.

Adult↗
PubMed1988

[Intrahepatic cholestasis and aplastic anemia following administration of prajmaline].

Intrahepatic cholestasis and aplastic anemia after N-propylajmaline. A 43 year old female patient taking oral contraceptives for more than five years received the antiarrhythmic drug N-propylajmaline for treatment of ventricular arrhythmia. After twelve days (total dosage 510 mg N-propyl-ajmaline) acute severe intrahepatic cholestasis and aplastic anemia developed. The erythropoeisis improved after three weeks of treatment with corticosteroids. However, despite treatment with phenobarbital the jaundice receded very slowly. Even after nine years of follow-up cholestatic enzymes are still significantly elevated although serum bilirubin levels are in the normal range. This case report demonstrates that antiarrhythmic drugs may induce nearly irreversible intrahepatic cholestasis and severe hematological disturbances.

Adult↗
PubMed1988

Abnormalities in estrogen, androgen, and insulin metabolism in idiopathic hemochromatosis.

Of 44 male patients with idiopathic hemochromatosis who were diagnosed at an early stage without morphological or biochemical evidence of liver disease, 25% suffered from impotence and 34% manifested glucose intolerance. Impotence was correlated with a 50% reduction in plasma testosterone, resulting from a 63% decrease in testosterone production. Testicular atrophy was caused by insufficient secretion of gonadotropins due to the selective accumulation of iron in gonadotropic cells of the pituitary gland. However, peripheral sexual hormone metabolism, in particular the conversion of androgens to estrogens, remained unaltered. It was therefore possible to employ substitution therapy successfully with testosterone in these men, and hyperestrogenism was not observed as a side effect. The pathogenetic factors in the development of diabetes mellitus in patients with idiopathic hemochromatosis include impaired insulin secretion caused by the selective deposition of iron in B-cells of the pancreas and insulin resistance due to iron accumulation in the liver. In particular, the insulin resistance is markedly improved after depletion of body iron stores by phlebotomy treatment, resulting in lower insulin requirements in patients with insulin-dependent diabetes as well as improvement of carbohydrate metabolisms in about half of the patients with non-insulin-dependent diabetes. We have concluded that hypogonadism and carbohydrate intolerance are caused by the specific distribution pattern of excess iron in the organism, accompanied by functional impairment of affected parenchymal cells.

Adult↗
PubMed1988

Survival and causes of death in hemochromatosis. Observations in 163 patients.

Survival and causes of death were analyzed among 163 patients with hemochromatosis diagnosed between 1959 and 1983. Mean followup was 10.5 +/- 5.6 years (+/- SD). Cumulative survival was 76% at 10 years and 49% at 20 years. Life expectancy was reduced in patients who presented with cirrhosis or diabetes compared to patients who presented without these complications at the time of diagnosis. Patients who could be depleted of iron during the first 18 months of venesection therapy had a markedly better prognosis compared to those patients who could not be depleted during this time period, probably due to greater amounts of excessive iron. Prognosis was not influenced by sex. Patients without cirrhosis or diabetes had a life expectancy that was virtually identical to that of an age-matched normal population. Analysis of the causes of death in 53 patients showed that liver cancer (n = 16) was 219 times more frequent, cardiomyopathy (n = 3) was 306 times more frequent, liver cirrhosis (n = 10) was 13 times more frequent, and diabetes mellitus (n = 3) was seven times more frequent compared to death rates expected for an age-matched normal population. The risk of death from other causes, including extrahepatic cancer (n = 7), did not differ from rates expected. Thus, patients with hemochromatosis diagnosed in a precirrhotic stage and treated by venesection have a normal life expectancy. Cirrhotic patients had a shortened life expectancy and a high risk of death from liver cancer even when complete iron depletion has been achieved.

Adult↗
PubMed1988

Association of Crohn's disease with HLA phenotype B44, Cw5.

Genetic influence on the development of Crohn's disease (CD) is commonly accepted. However, proof of definite genetic markers is still pending. Most investigations have focused on HLA antigens, and associations with HLA B12 and HLA A2 have been reported, but the design of these retrospective studies is open to criticism. We have undertaken a consecutive study of 96 patients with CD under well-defined conditions in order to test the hypothesis that CD is associated with particular HLA antigens. Our results identify a significant association of CD with the phenotype HLA B44,Cw5. But since a major proportion of the CD patients do not bear this phenotype, other predisposing genetic factors, which have not yet been defined, may exist in addition to environmental factors.

Adolescent↗