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Biomedical subjects

H Henning

Publications and source records attributed to H Henning.

At least 73 records · Page 4Linked to original sources
PubMed1984

Hepatitis B e-antigen titres for evaluating infectivity during hepatitis B virus infection.

By means of an ELISA the level of hepatitis B e-antigen (HBeAg) titre was determined in 51 patients with acute and 123 patients with persistent hepatitis B virus (HBV) infection. We also investigated 120 sera of these patients for infectivity by detecting HBV-specific DNA polymerase (DNA-P). Additional determination of the HBeAg titre revealed that the detection of HBeAg at a dilution of at least 1:50 correlates with the detection of DNA-P in 95% of cases, while in sera with an HBeAg titre of 1:25 or less DNA-P is only detectable in up to 5% of cases. Since the detection of DNA-P indicates high infectivity, certain titres of HBeAg can be employed to differentiate three different degrees of infectivity: (1) Sera without HBeAg show no or only little infectivity; (2) sera containing HBeAg greater than or equal to 1:50 are highly infectious; (3) HBeAg titres up to 1:25 indicate a medium degree of infectivity. These three markers for different degrees of infectivity were applied to study the course of infectivity during acute and persistent forms of HBV infection. In acute hepatitis B the period for the elimination of HBeAg is independent of the HBeAg titre in the first serum sample. In all cases the elimination of HBeAg in acute hepatitis B did not exceed 4 months. Patients with persistent HBV infection and an initial HBeAg titre greater than or equal to 1:50 remained at this high degree of infectivity for at least 18-30 months in 70% of cases. Only 30% of this collective showed a decrease in infectivity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Prediction of late mortality after myocardial infarction from variables measured at different times during hospitalization.

The long-term prognostic importance of sets of variables from different times in the hospital course after acute myocardial infarction was examined in 818 patients discharged from the hospital. Cardiac mortality during the first year after discharge was 11.1%. For the end point death within 1 year after admission, discriminant function analysis identified 5 important factors from the history and the first 24 hours of hospitalization: maximal level of blood urea nitrogen, previous myocardial infarction, age, displaced left ventricular apex (abnormal apex) on physical examination, and sinus bradycardia (negative correlation). When data from the entire hospitalization were included, extension of infarction and maximal heart rate were also selected. When variables obtained at discharge were included, only the presence of S3 gallop and abnormal apex were selected. In subgroups of patients, neither the left ventricular ejection fraction nor the presence of complex ventricular arrhythmias during a 24-hour ambulatory monitoring were independent predictors. Correct prediction was similar for each analysis, with 55 to 60% of the deaths and 79 to 81% of survivors correctly identified. The high-risk group consisted of 25% of the patients with 28 to 30% predictive value for death in the first year. In conclusion, outcome up to 1 year after acute myocardial infarction can be predicted early after admission. Addition of more information later during the hospitalization and at discharge did not improve correct prediction and may be redundant for prognostic evaluation.

Aged↗
PubMed1984

Usefulness of the chest x-ray for predicting abnormal left ventricular function after acute myocardial infarction.

We evaluated 229 patients discharged after a definite acute myocardial infarction. Pulmonary venous congestion determined from chest x-ray films during the hospitalization and at discharge and the cardiothoracic ratio at discharge were compared to the left ventricular ejection fraction measured at discharge by a gated radionuclide technique. During hospitalization, pulmonary venous congestion was found on at least one x-ray frame in 94 patients (41%). At discharge 134 patients (59%) had abnormal ejection fraction (less than 0.51) and 35 had pulmonary venous congestion (15%). The sensitivity of the x-ray for detecting an abnormal ejection fraction was 20% when pulmonary venous congestion was observed on the discharge x-ray film (specificity 92% and predictive value 77%), 52% if pulmonary venous congestion was present on any x-ray film during the hospitalization (specificity 74% and predictive value 73%), and 47% if the cardiothoracic ratio was abnormal (greater than or equal to 0.50) on the discharge x-ray film (specificity and predictive value 66%). We conclude that an abnormal x-ray film at discharge or during the hospitalization will identify approximately one-half of the abnormal ejection fractions at the time of hospital discharge. Therefore, to reliably assess left ventricular function, either for prognostic or therapeutic purposes in the individual patient, a more direct measure of left ventricular function such as radionuclide angiography must be obtained.

Adult↗
PubMed1984

Prognostic importance of digitalis after acute myocardial infarction.

Because previous reports have suggested that digitalis administration may lead to increased mortality after hospital discharge for acute myocardial infarction, the independent importance of digitalis therapy in long-term prognosis after acute myocardial infarction was investigated by analyzing 1,599 patients after definite myocardial infarction. After hospital discharge, mortality rate for the entire group at 4 months was 7.7% and after 1 year 14.2%. At discharge, 36.6% of the patients were taking digitalis. Compared with those not taking digitalis, those taking digitalis had more historical risk factors and a higher incidence of important clinical prognostic variables during the hospitalization. Their cardiac mortality rate after 4 months and 1 year (12.5 and 22.4%, respectively) was significantly higher than that of patients not taking digitalis (5.0 and 9.6%, respectively). Mortality was higher for patients taking digitalis whether or not they had congestive heart failure during hospitalization. However, in a multivariate Cox analysis for 1 year outcome, neither digitalis nor any other medication variable displaced the important clinical variables of age, congestive heart failure during the hospitalization, previous myocardial infarction, maximal heart rate during the hospitalization and previous angina. Quinidine and digitalis at discharge were selected sixth and seventh (not significant) by the analysis. It is concluded that digitalis therapy at discharge after myocardial infarction was not an independent predictor of late mortality in these patients.

Aged↗
PubMed1984

[Laparoscopy findings of the yellow spot, a focal fatty liver infiltration].

From 1976 to 1982 in 279 patients amongst 3719 laparoscopies focal fatty liver infiltrates were found at the right and/or left liver edge next to the insertion point of the round ligament. These so-called "yellow spots" mainly could be recognized in case of normal liver tissue and in cases suffering from chronic hepatitis insofar as a cirrhotic transformation or a significant fibrosis had not taken place. The localization and the shape of these focal lesions indicate, that an abnormality in the portal blood supply of the corresponding area may play an etiologic role for the development of the fatty infiltration.

Fatty Liver↗
PubMed1983

[Glucose tolerance in alcoholic hepatitis. Studies preceding and following alcohol abstinence].

In 51 patients with alcohol-induced liver injury glucose tolerance and insulin incretion were followed under alcohol abstinence over a period of 4 weeks. In 63% of the cases a pathologic glucose tolerance was found at the beginning. After 4 weeks, when the biochemical liver parameter had become normal, glucose tolerance also returned to normal. The serum insulin levels, in contrast, did not develop any changes. Thus, glucose tolerance improved under unchanged absolute insulin concentrations. From these results, we suggest an insulin resistance in cases of active alcoholic liver injury being reversible under the improvement of liver function during alcohol abstinence.

Blood Glucose↗
PubMed1983

Diffuse alveolar damage syndrome associated with amiodarone therapy.

Amiodarone is an effective antiarrhythmic that has been used in Europe for over a decade and has been available for investigational use in North America for a shorter time. It has several well recognized side effects. Recent reports have related pulmonary disorders to the use of this drug; fibrosing alveolitis has been found by lung biopsy. Amiodarone's toxicity to the lung does not appear to be dose-related. Besides cessation of amiodarone administration, management of this complication includes steroid therapy. A case is described of nonspecific diffuse alveolar damage syndrome in a patient who had received amiodarone.

Adrenal Cortex Hormones↗
PubMed1983

Periods of differing mortality distribution during the first year after acute myocardial infarction.

The mortality rate after acute myocardial infarction (AMI) has generally been modeled by a single exponential function. The present study was undertaken to determine, in 3 different populations, whether or not periods exist during the first year after AMI which have mortality distributions that differ from this pattern. The 3 patient populations included San Diego (346 patients, 71 deaths), Vancouver (704 patients, 146 deaths), and Copenhagen (1,140 patients, 262 deaths). Hospital admission was within 24 hours of the onset of symptoms, and patients dying within the first 24 hours after hospital admission or of noncardiac or unknown causes were not analyzed. The mortality between 2 and 21 days in the combined data base was 11.4% (range 10.9 to 11.7) and from 3 weeks to 1 year 10.5% (range 9.0 to 11.3). A high degree of similarity was noted among the shapes of the 3 survival curves. The hypothesis of an exponential mortality rate during the entire first year was rejected. Using a special statistic, changepoints at days 17, 23, and 24 in the 3 populations (21 days for the combined data base) were identified and used thereafter to divide the year into 2 separate periods of mortality within which exponentiality for the mortality rate was not rejected. The point by which exactly 50% of deaths had occurred was day 19, with 75% of deaths occurring by day 100. These data further define the natural history after AMI and indicate optimal follow-up periods for short- and longer-term management strategies based on risk assessment or trials of risk reduction after AMI.

Aged↗
PubMed1983

Evaluation of prognosis one year after myocardial infarction.

Three multivariate methods for predicting death within 1 year for patients discharged after acute myocardial infarction were evaluated: Cox model, discriminant function analysis and recursive partitioning. Discriminant function analysis was utilized to predict a new myocardial infarction (any new or nonfatal infarction). A Cox classification model developed in a population of 260 patients (group 1) discharged after myocardial infarction was tested in 886 patients from the same institution (group 2) and 582 patients from another institution (group 3). Discriminant function analysis and recursive partitioning were developed in group 2 and tested in group 3. Data gathered during the entire period of hospitalization were utilized. The important variables (ordered as selected by the analyses) for the end point death were: heart failure, ventricular tachycardia and atrioventricular block in the Cox model and heart failure, previous myocardial infarction, age and ventricular premature beats in the discriminant function analysis. For the end point new myocardial infarction, the important variables were: previous myocardial infarction, heart failure, extension of infarction during the acute phase and infarct site. For predicting death and survival within 1 year, each of the three schemes was comparable. For estimating the actual risk of death, the Cox model was best. Recursive partitioning had the advantage of using only one variable--heart failure. Total correct classification ranged from 65.4 (Cox model) to 71.6% (discriminant function analysis) for the original population (groups 1 and 2) and from 47.9 (discriminant function analysis) to 54.3% (recursive partioning) when the schemes were tested in patients in group 3. The Cox model and discriminant function analysis were able to correctly predict over half of the new infarctions within 1 year.

Analysis of Variance↗
PubMed1983

Risk prediction after myocardial infarction. Comparison of three multivariate methodologies.

We predicted 30-day mortality and survival following acute myocardial infarction in two different hospital populations utilizing several multivariate statistical methodologies [linear discriminant analysis (LDA), logistic regression (LR), recursive partitioning (RP), and nearest neighbor]. Variables used were identified as predictive univariately from the base hospital and were obtained during the first 24 h after admission. LDA, LR, or RP all performed similarly within a given population; although each used the information contained in the prognostic variables differently. Application between different populations of prediction schemes based on LDA and LR was shown to be feasible but prior validation is essential.

Aged↗
PubMed1983

[Ketoconazole-induced hepatitis. Case report].

Since Oct. 1981 a new systemic antifungal drug Ketoconazole is available in the Federal Republic of Germany that has proven effective even in severe cases with fungal infections. This case-study will call attention on a rare but important side effect, namely Ketoconazole induced hepatitis. As an acute icteric viral hepatitis, type Non-A-Non-B-hepatitis possibly misdiagnosed only a carefully compiled history of the recent intake of drugs points at the real cause of hepatitis. In our case-report we observed a considerable increase in serum enzymes, especially GOT, GPT and GLDH after a drug-challenge with two tablets. We recommend so-called liver functions tests 2 to 3 weeks after beginning of therapy and further-on in monthly intervals. Histologically at that time toxic hydropic changes of the liver cells and a mesenchymal reaction with portal and intralobular mainly eosinophilic infiltration could be established. The serum enzymes came to normal only after 12 weeks.

Alanine Transaminase↗
PubMed1983

Diagnostic procedures in the evaluation of hepatic diseases. Laparoscopy.

In the more than 80 years that it has been practiced, laparoscopy has proved to be a procedure that provides a high level of differential diagnostic information. Although its main indications, general application, and practical assessment have been variously assessed by various investigators at different times in different countries, our own experience, based on more than 12,500 investigations involving predominantly hepatological problems, indicates that laparoscopy today remains one of the main pillars of our differential-diagnostic armamentarium.

Carcinoma, Hepatocellular↗
PubMed1983

[Results of active preventive vaccination against hepatitis B with a German vaccine].

53 persons at high risk for hepatitis B infection have been vaccinated with a hepatitis B vaccine produced in the Hygiene Institute of the University of Göttingen. The vaccine proved to be without side effects in all vaccinees. Only minor complaints at the site of inoculation were registered. Three vaccinations are necessary. Protective antibodies were present in 96% of the vaccinees after the third inoculation. The female vaccinees developed anti HBs earlier than the males, moreover they showed significantly higher antibody titers. A simultaneous active and passive immunization is possible. To minimize the risk of contracting a hepatitis B or a non A- non B hepatitis as a result of the vaccination only such vaccines should be used which have been prepared from sera containing anti-HBe and which have been inactivated with a high dose of formaldehyde.

Adult↗