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Biomedical subjects

H Höffken

Publications and source records attributed to H Höffken.

At least 37 records · Page 2Linked to original sources
PubMed1990

Kinetics of pulmonary leukocyte sequestration in man during hemodialysis with different membrane-types.

Although it has been suggested that pulmonary sequestration of leukocytes could account for membrane-dependent white blood cell depletion in HD, direct evidence in patients is still lacking. Therefore a study was initiated to test whether and how leukocytes distribute in the lung circulation during HD with different membranes. Thirteen patients suffering from chronic renal failure underwent lung scintigraphy during HD with cuprophane (n = 3), hemophane (n = 8) and polysulfone (n = 2) lowflux capillary dialyzers. Isolated autologous leukocytes were labelled with 99m-Technetium and reinfused before starting HD. Distribution of leukocyte related activity was registered by lung scintigraphy. In comparison to normal lung scintigraphy performed without HD, an impressive redistribution peak was demonstrated 10-20 min after the start of HD with cuprophane and also to a lesser extent with hemophane. When HD was performed with polysulfone the decrease in activity was delayed but no real redistribution was obtained. In accordance with other phenomena, such as peripheral leukopenia and changes in granulocyte oxidative metabolism, pulmonary sequestration of leukocytes takes place in man in the initial phase of HD and appears to be strongly dependent on the type of membrane.

Humans↗
PubMed1990

[99mTc-2-methoxy-isobutyl-isonitrile in the diagnosis of coronary heart disease: results of a multicenter study].

A total of 226 patients was studied in a phase-III multicenter trial to compare the results of stress/rest 99mTc-MIBI with 201TI scintigraphy and/or coronary arteriography. The evaluation of planar and SPECT imaging was based on a semiquantitative visual scoring. A congruent diagnosis was generated from all planar 201TI and 99mTc-MIBI scintigrams performed in 36 patients. In 62 of 63 patients, SPECT-studies with 99mTc-MIBI and 201TI led to an identical diagnosis. In one patient a positive result was obtained with 201TI-SPECT whereas 99mTc-MIBI was negative. Segmental agreement for 1509 SPECT segments was 85.7%, for 554 planar segments it was 86.6%. In comparison to coronary arteriography, performed in 180 patients, the overall sensitivity for the correct diagnosis of coronary artery disease (CAD) was 86% for planar MIBI scintigraphy or 92% for MIBI-SPECT. Overall specificity was 100% for planar imaging and 57% for SPECT. The low specificity of MIBI-SPECT was probably due to high prevalence of CAD in this study population. In a subgroup of 43 patients, who underwent coronary angiography, identical results were found with 99mTc-MIBI and 201TI. Only one patient showed a positive scintigraphic result with both 99mTc-MIBI and 201TI without angiographically proven stenosis greater than 50% or prior myocardial infarction. Vessel sensitivities in stenosed coronary arteries (greater than 50% stenosis) were 54% for the LAD and 87% for the RCX/RCA areas with MIBI-SPECT, or 51% or 79% for planar scintigraphy, respectively. Vessel specificities for SPECT were 65% in the LAD or 52% in the RCX/RCA, or 90% or 83% in planar imaging.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Effect of fenofibrate on fibrinogen concentration and blood viscosity. Consequences for myocardial microcirculation in coronary heart disease?].

The effect of fenofibrate (a clofibrate derivative) on fibrinogen concentration, blood viscosity and myocardial microcirculation was examined in 35 patients with coronary heart disease (n = 27) or hypertension (n = 8). After eight weeks' administration of 250 mg fenofibrate daily cholesterol and triglycerides levels decreased significantly, as did the fibrinogen concentration, from a mean of 300.7 +/- 75.1 mg/dl to 252.3 +/- 61.2 mg/dl (P less than 0.01). Plasma viscosity and erythrocyte aggregation were also significantly lowered (from 1.43 +/- 0.09 to 1.37 +/- 0.07 mPas and 15.0 +/- 3.1 to 13.5 +/- 2.2, respectively; P less than 0.01). In eight of twelve subjects selected from the whole group thallium myocardial scintigraphy demonstrated, after eight weeks of treatment with fenofibrate, a global (in two) or regional (in six) increase in blood flow. Reduction of fibrinogen concentration may in coronary heart disease achieve an improvement in myocardial microcirculation with decreased myocardial ischaemia.

Blood Viscosity↗
PubMed1989

Granulocyte-related bioincompatibility of hemodialysis: inhibition of oxidative metabolism, degranulation reaction, enzyme release and leukocyte sequestration in the lung.

Hemodialysis (HD) induced contact of granulocytes with cuprophan and modified cuprophan, i.e. hemophan, membranes leads to over-stimulation of their oxidative metabolism. This is shown by the fact that after starting HD the peripheral granulocytes are less stimulable to chemiluminescence (CL) and peroxide production (cytochrome C reduction). Such alterations are likely to be connected with a granular staining loss, enzyme release and sequestration of granulocytes in the lung, which coincides with reported clinical features like dyspnoea and drop in arterial oxygen pressure. HD with polysulfone membranes causes a degranulation reaction too, but does not produce granulocyte inhibition and pulmonary sequestration of leukocytes, clearly indicating that these phenomena strongly depend on the different dialyzer membranes.

Biocompatible Materials↗
PubMed1988

In vivo labelling of granulocytes with 99mTc anti-NCA monoclonal antibodies for imaging inflammation.

We looked for inflammatory lesions in 45 patients using in vivo labelled granulocytes. For the purposes of cell labelling we used a murine, monoclonal antibody reacting with NCA and CEA (BW 250/183) (Bosslet et al. 1985) labelled with 99mTc-pertechnetate. All abscesses and other inflammatory lesions were visualized with excellent quality scintigrams between 2 and 6 h after the injection. As the antibody can be stored in a freeze-dried form and labelled at any time in any Department of Nuclear Medicine with 99mTc-pertechnetate, without cell isolation being necessary, the method appears to be suitable even for use in acute diagnosis. No side-effects have so far occurred, even in patients injected up to three times.

Antibodies, Monoclonal↗
PubMed1988

Imaging of inflammation with granulocytes labelled in vivo.

We have looked for inflammatory lesions in 37 patients using granulocytes labelled in vivo. For the purpose of cell labelling we used a monoclonal murine antibody reacting with NCA and carcinoembryonic antigen (CEA) (BW 250/183) labelled with 99Tcm. All abscesses and other inflammatory lesions were visualized with excellent quality scintigrams between 2 and 6 h after the injection. As the antibody can be stored in a freeze-dried form and labelled at any time in any department of nuclear medicine with 99Tcm without cell separation being necessary, the method appears to be suitable even for use in acute diagnosis. No side effects have so far been found.

Antibodies, Monoclonal↗
PubMed1987

[99mTc tin colloid scintigraphy in the diagnosis of acute rejection reactions in kidney transplants].

Quantitative measurements of 99MTc-tin colloid uptake in renal transplants permits differentiation of acute rejection from other causes of deteriorating renal function, such as acute tubular necrosis, cyclosporin A nephrotoxicity or chronic rejection. 144 99mTc-tin colloid scintigrams were performed on 71 renal transplants; the results were compared with clinical, biochemical and histological findings. Sensitivity of colloid scintigraphy is 97.4% and specificity is 80%. Compared with other isotope methods, this has the advantage that it does not depend on comparison with repeated examinations.

Cyclosporins↗
PubMed1984

[Clinical and patho-anatomic aspects of metastases of breast cancer].

The importance of carcinoma of the breast in female malignancies demands a critical examination of the condition of metastases by means of certain clinical and pathological data. The clinical data and the results of autopsies of 384 patients with breast carcinoma were examined. The frequency and the chronology of occurrence of metastases put out metastases of lymphnodes , skeleton, lung, liver and local recurrences. The importance of the mediastinal lymph node metastases in the distribution of metastases in thoracical organs was established and is discussed. The relation of frequency of the metastases to primary tumour staging (TNM) shows a 63% rate of metastases in patients with No and 86% in patients with N+. A comparison of two decades (I = 1960-1969; II = 1970-1979) shows certain trends 1. In decade II more patients with primary stage T1-T2 NoMo were found in autopsies having less metastases. 2. More local recurrences and metastases of genital organs were diagnosed. 3. In decade II more "late-metastases" (2-10 years after primary diagnosis) were found. These developments are explained by better primary diagnostic methods, more frequent follow-up examinations after primary therapy, and more frequent application of secondary therapies (chemotherapy, radiotherapy).

Adenocarcinoma↗
PubMed1984

[Potentials and limits of conventional differential diagnosis of the endometrium].

The reproducible identification of various histological types of the endometrium is of special interest for many reasons. The controversy in endometrial classification and terminology led us to study the algorithm of conventional endometrial diagnosing. This study is to examine the significance of historical morphologic parameters for differential diagnosis by semiquantitative or binary recording and computer-assisted evaluation. The results are based on cross-tables and cluster-analysis. The statistical test showed that most of the historical parameters were neither adequate for reclassification nor exclusion of historical typing of the endometrium. An objective and reproducible classification of endometrial changes by using binary parameters can only be achieved for specific histological types of normal endometrium and several types of hyperplastic endometrium. The dedifferentiated carcinoma is a diagnosis "per exclusionem ", since nearly all of the binary parameters cannot be analysed. The individual borderline lesions cannot be differentiated from each other by descriptive parameters. They cannot even be distinguished from the highly differentiated endometrial carcinomas. This kind of differential diagnosis is obviously not based on conventional formalistic criteria but on nonquantifiable empirical data. This might be a reason for the above mentioned controversy in endometrial diagnosis and terminology.

Diagnosis, Differential↗
PubMed1983

[Considerations on computer-assisted pattern recognition in the endometrium].

Histomorphological diagnosing very much depends on subjective empiric data. In histomorphology of the endometrium nomenclature as well as diagnostic classification lack uniformity and are full of controversy in literature. This results in opposing assessments of dignity of endometrial hyperplasias and prognosis of varying grades of carcinoma differentiation. One of the reasons is the lack of objective and reproducible diagnostic categories, not yet found. Morphometry with so-called computer-assisted interactive pattern recognition systems might offer the solution to numerous problems. Since there are no specific parameters for diagnostic identification of endometrial hyperplasias and carcinomas, only a combination of sensitive and reproducible parameters can allow for diagnostic identification. We report on our first computer-assisted pattern recognition studies and results that appear to provide an adequate basis for leaving descriptive diagnosing and turning to objective diagnosing. Such an objective diagnosing might not only be of clinical and therapeutic significance but also provide a new evaluation of the today's significance -- still full of controversy -- and prospective potency of endometrial hyperplasias. In computer-assisted interactive pattern recognition also lies the possibility of a contribution to objective tumour grading that appears to have high prognostic significance.

Diagnosis, Computer-Assisted↗
PubMed1983

[Clinical demands on the morphologist in the area of surgical gynecology].

At present in gynecologic oncology no therapeutic strategy is possible without exact histopathological diagnostic procedures according clinical rationales. Describing morphological records, exact details are therefore necessary on clinical staging, histological grade and type of the tumor. This requires a standardized preparation technique and a clinically adapted microscopic working procedure on surgery material. Above all this is necessary for discrimination of defined early cancerous changes and invasive carcinomas.--Analysis of tumor metric is more and more completed by methods of picture analysis (tissue-texture). The principals of an optimal cooperation between clinicians and morphological workers in gynecologic oncology are presented as an example on common used macroscopic and microscopic preparation methods at the histological laboratory of the Department of Gynecologic Morphology at the University Hospital Heidelberg.

Biopsy↗
PubMed1982

DNA-flow-cytometric measurements on the normal, atrophic, hyperplastic and neoplastic human endometrium.

DNA distribution patterns and the fractions of the cell cycle phases were determined by means of flow-through cytometry in 87 samples of normal, atrophic, hyperplastic and carcinomatous human endometrium. The S-phase fractions vary during the normal menstrual cycle between 1 and 3% and reach a periovulatory maximum between 4.4 and 4.7%. Atrophic endometrium and regressive glandular cystic hyperplasia have little DNA synthesis (1.01% and 1.68% S-phase fractions respectively). Proliferating glandular cystic hyperplasia reveals 3.38% S-phase fraction, whereas adenomatous hyperplasia has an increased number of DNA-synthesizing cells (4.81%). The well-differentiated endometrial carcinoma shows no cytophotometrically detectable differences in comparison to adenomatous hyperplasia. All endometrial samples except for poorly differentiated endometrial carcinoma showed a diploid to tetraploid DNA distribution pattern. The poorly differentiated endometrial carcinoma displays two different types: one rapidly growing diploid-tetraploid tumor with 8.0 to 9.6% S-phase fractions, and another type with stemline deviations, polyploid nuclei and less pronounced synthetic activity.

Adenoma↗