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Biomedical subjects

H Buhr

Publications and source records attributed to H Buhr.

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

Postoperative pentagastrin-stimulated serum calcitonin concentrations in patients with medullary thyroid carcinoma: reoperations in patients with concentrations bordering the detection limit.

The case reports on two patients with medullary thyroid carcinoma show that even postoperatively stimulated serum calcitonin (CT) concentrations near the detection limit (using a polyclonal antibody against synthetic CT) can demonstrate persistent disease. Stimulated CT concentrations can be lowered to nondetectable levels by a second and third operation if a meticulous technique is used for dissection of the lymph compartments. The patient can then be assumed to be cured. Diagnostic accuracy at very low CT concentrations can be improved by selective venous catheterization with blood sampling for CT after stimulation.

Adult↗
PubMed1988

Identification of gastroenteropancreatic neuroendocrine cells in normal and neoplastic human tissue with antibodies against synaptophysin, chromogranin A, secretogranin I (chromogranin B), and secretogranin II.

Gastroenteropancreatic human neuroendocrine (NE) cells (normal and neoplastic) were investigated for the expression of the neuroendocrine-specific polypeptides synaptophysin, chromogranin A, secretogranin I (chromogranin B), and secretogranin II, using immunohistochemistry and immunoblotting. Monoclonal antibody against synaptophysin stained most, and possibly all, of the neuroendocrine cells in both normal and neoplastic tissue. Monoclonal antibody against chromogranin A also stained a high proportion of normal and neoplastic neuroendocrine cells. Immunostaining with polyclonal antisecretogranin I and antisecretogranin II antibodies was detectable in almost all of the normal and neoplastic tissue sections that were analyzed, and it was confined to a smaller population of neuroendocrine cells than that observed for synaptophysin and chromogranin A. Consistent with the immunohistochemical observations, immunoblotting revealed the presence of all four antigens in various tumors. The data show that synaptophysin and chromogranin A, for which monoclonal antibodies are commercially available, may be used as diagnostic markers for human gastroenteropancreatic tumors. Our results also suggest that the development of monoclonal antibodies against human secretogranins I and II will provide additional tools for a refined diagnosis of such tumors.

Antibodies, Neoplasm↗
PubMed1988

[Life-threatening hemorrhage in pelvic fractures of polytraumatized patients. Diagnostic issues and embolization treatment].

Between 1984-1987 6 multiple trauma patients with pelvic fractures and bleeding from pelvic vessels were treated by transcatheter embolization. Although diagnosis and therapy were early in two cases, there was an overall time delay of median 17 hours (1-38 h) until localisation of bleeding lesions. In this period multiple transfusions (median: 33.7 units of packed erythrocytes, 14.5 units of fresh frozen plasma) could not control hemorrhage. After successful transcatheter embolization circulation stabilized immediately and durably. 4 patients died, 2 of them from septic-toxic multi-organ-failure.

Adolescent↗
PubMed1986

[Acute rectus sheath hematoma (differential diagnosis of acute abdomen)].

The rectus sheath hematoma is a generally rare disease, however the frequency of occurrence has increased with introduction of anticoagulant therapy. It almost always mimics the symptoms of acute abdomen. In 7 out of 14 cases, which we observed, an anticoagulant therapy was administered. During this therapy 5 rectus sheath hematomas occurred spontaneously. In the remaining 2 patients severe coughing attacks were reported additionally. The case histories of the other 7 patients included 3 patients with bronchitis, 2 patients with trauma and 2 patients without a relevant history ("spontaneous"). The correct diagnosis of rectus sheath hematoma could primarily be revealed by sonography in 8 of 14 patients, after which an appropriate therapy followed. In 6 patients a laparotomy was performed, because rectus sheath hematoma was not considered. The correct diagnosis was found intraoperatively as a surprising assessment. By inclusion of rectus sheath hematoma in the differential diagnosis of acute abdomen and the verification by sonography an emergency laparotomy because of a false diagnosis in the often severe ill patients can be avoided in favour of a minor and more appropriate procedure.

Abdomen, Acute↗
PubMed1982

[Early results of valgus osteotomy in treatment of unstable intertrochanteric fractures of the femur (author's transl)].

Unstable intertrochanteric fractures of the femur in aged patients primarily require a full weight-bearing stabilization because of the high vital risk due to immobilization. Valgus osteosynthesis with 160 degrees angled plate fixation and more or less medial displacement of the shaft fragment has produced good clinical results. The very low lethality of only 10% in our patients with an average age of 78.6 years suggests valgus osteosynthesis in the treatment of unstable intertrochanteric fractures to be the method of choice in age patients.

Aged↗
PubMed1979

Investigation of cardiac glycoside levels in human post mortem blood and tissues determined by a special radioimmunoassay procedure.

Even after the introduction of radioimmunological methods the question of a cardiac glycoside causing or contributing to the death of a patient can not be answered satisfactorily. By means of a special radioimmunoassay procedure for digoxin as well as for the structurally related methyl- and acetylderivatives we measured the concentrations in human blood and post mortem tissues. We investigated the glycoside contents in the blood of intravenously digitalised (Novodigal) al) patients before and after death. At autopsy blood specimens were taken from the heart and the femoral vein. We found an increase of the glycoside level up to a highly toxic range (7--15 ng/ml) especially in the heart blood. Thus post mortem blood levels of digoxin and its derivatives are not suitable for a final decision in alleged cases of fatal poisonings. Measuring various concentrations in tussues and body fluids of the above cardiac glycosides mentioned revealed the kidney concentration to be of high value in confirming a digitalis poisoning. This organ and the heart show the highest tissue concentrations. Interpretations of fatal digitalis poisonings should be based on the additional knowlege of these concentrations. Individual cardiac glycosides may be analyzed by a combination of thin layer chromatography and radioimmunoassay.

Cardiac Glycosides↗
PubMed1978

[Surgical treatment of carcinoma of the oesophagus (author's transl)].

Cervical oesolphagogastrostomy (Kirschner's operation) was performed on 16 patients with carcinoma of the oesophagus. There were five hospital deaths (two due to myocardial infarction). The average hospital stay of the survivals was 22 days. This operation is preferred to colon interpolation because it requires only one anastomosis, which is extrathoracic.

Aged↗
PubMed1977

[Prophylaxis of peritoneal adhesions with streptokinase and streptodornase (Varidase). An experimental study in animals (author's transl)].

Animal experiments on 40 Wistar rats show that intraperitoneal application of Varidase can reduce or prevent the formation of adhesions after intra-abdominal interventions. This effect is interpreted as the sequel to a local increase in fibrinolytic activity which leads to the accelerated breakdown of fibrinous pseudo-membranes. The healing of intestinal sutures appears not to be impaired by Varidase.

Animals↗
PubMed1975

[Local gastric fibrinolysis activation].

Hemorrhagic gastric juice contains a higher fibrinolytic activity than normal gastric juice. It is liberated from damaged muco and possibly from hemolytic erythrocytes.

Fibrinolysis↗
PubMed1975

[The juvenile bone cyst. Diagnosis, therapy and late results. Report about 60 cases (author's transl)].

60 patients were operated for a solitary bone cyst during a 20 years period. In about 50% the patients were between 8 and 14 years old. The quotient male to female was 2:1. In 65% the cyst was located in the femur and humerus. The therapy was in 43 patients autoplasty, in 8 cases heterotransplantation--"Kieler Span", in the other cases resections were carried out. The follow-up study covered 41 patients. The results were excellent in 50%, sufficient in 36%, poor in 12%. The best results were achieved with autoplasty bone chips. Among 43 cases 1 recurrency.

Adolescent↗
PubMedDate not supplied

Immunohistochemical reclassification of anaplastic carcinoma reveals small and giant cell lymphoma.

Thirty-one cases of thyroid malignancies which were originally classified as anaplastic carcinoma were reexamined immunohistochemically using PAP methods (peroxidase:antiperoxidase) for IgM, IgG, IgA, cytokeratin, calcitonin, lysozyme and alpha-1-antitrypsin. The reclassification results were compared with patient data such as clinical symptoms, treatment modalities, and clinical outcome. Postoperative radiotherapy was carried out in more than 80% of cases, chemotherapy in none. Seven of 31 tumors showed a positive staining for IgM (n = 4), IgG (n = 2), and IgA (n = 1) antibodies. All of these cases were negative for epithelial markers. Surprisingly, not only all small cell tumors (n = 3) but also 4 tissues with predominantly giant cell areas were among those reclassified as primary malignant lymphoma.

Carcinoma↗
PubMedDate not supplied

Intraoperative and postoperative PTH secretion mode in patients with hyperparathyroidism.

The development of a sensitive 2-site immunoradiometric assay which detects only intact human PTH (1-84) enabled us to study kinetics of PTH secretion intraoperatively. In a prospective study, we assessed the PTH (1-84) secretion mode intraoperatively in 54 patients with adenomas, in 14 patients with tertiary hyperparathyroidism (HPT), and in 2 patients with persistent HPT. After the removal of adenomatous or hyperplastic tissue, a significant drop of PTH (1-84) concentration was seen. A 50% decrease in the basal PTH concentration was reached significantly earlier for adenomas than for hyperplasias. In the 2 cases with unrevealing neck exploration, the PTH (1-84) concentrations showed hardly any change. The recovery of PTH secretion was studied in 23 patients, 20 of whom had a single adenoma; in 2 cases, a hyperplasia was present and 1 patient showed the clinical signs of a toxic HPT. We found an initial drop of PTH concentration 4 hours postoperatively below the limit of detection and a rapid recovery within 24 hours postoperatively. The PTH concentration values were well within the normal range after 48-72 hours.

Adenoma↗
PubMedDate not supplied

Serum chromogranin A in the diagnosis and follow-up of neuroendocrine tumors of the gastroenteropancreatic tract.

Hormonally active neuroendocrine tumors may easily be diagnosed by elevated serum levels of their specific peptides and hormonal products, but there are no reliable markers for neuroendocrine tumors without hormonal activity. Chromogranin A (CgA), a secretory protein of neuroendocrine cells, has recently been characterized as a valuable tissue marker in hormonally active and non-functioning neuroendocrine tumors. This study analyzes the role of CgA as a serum marker for different neuroendocrine tumors. Thirty-three patients with neuroendocrine tumors of the stomach (n = 7), the ileum (n = 18), and the pancreas (n = 8) were investigated. Serum CgA levels were analyzed by radioimmunoassay at the time of diagnosis and during follow-up under different therapeutic regimens. Serum CgA was elevated in 30 (91%) patients. Mean CgA serum levels varied with tumor location (pancreas: 7068 +/- 3008 ng/ml, ileum: 5381 +/- 1740 ng/ml, stomach: 529 +/- 179 ng/ml, x +/- SEM ng/ml) but did not differ between functioning and non-functioning tumors. Eight of 10 patients treated with either somatostatin or interferon-alpha showed changes of CgA concentrations corresponding to tumor growth. We conclude that CgA is a useful broad-spectrum tumor marker in gastroenteropancreatic neuroendocrine tumors. Its determination is especially recommended in tumors without hormonal activity.

Adult↗