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Biomedical subjects

H Reh

Publications and source records attributed to H Reh.

At least 19 recordsLinked to original sources
PubMed2001

Fluorescence induced with 5-aminolevulinic acid for the endoscopic detection and follow-up of esophageal lesions.

BACKGROUND: The aim of this study was to investigate the use of orally administered 5-aminolevulinic acid (ALA) for in vivo photodynamic diagnosis and follow-up of premalignant and malignant esophageal lesions. METHODS: Twenty-two patients with known or treated malignant and precancerous esophageal lesions were sensitized with orally administered ALA (15 mg/kg). Six patients had Barrett's esophagus, with or without severe dysplasia, 5 squamous cell cancer or early-stage (uT1N0M0) adenocarcinoma, 1 advanced-stage (uT3N1) adenocarcinoma, and 1 patient a lesion with an appearance that suggested esophageal cancer. Nine patients underwent photodynamic diagnosis for follow-up after treatment of esophageal cancer with curative intent; 6 had no macroscopically visible lesion and 3 a barely visible lesion under standard (white-light) endoscopy. Photodynamic diagnosis was conducted 6 to 7 hours after oral administration of ALA by using a special light source capable of delivering either white or violet-blue light. Red fluorescence was detected with a charged coupled device camera attached to a fiberoptic endoscope. Corresponding endoscopic, fluorescence, and microscopic findings were compared. RESULTS: By using histology as the reference standard (n = 86 biopsies), 85% of the biopsy sites with premalignant or malignant histopathology exhibited red fluorescence, whereas only 25% were detected with white-light endoscopy. CONCLUSION: ALA-induced fluorescence might be useful for the early endoscopic detection of malignant esophageal lesions and follow-up after treatment of such lesions with curative intent.

Administration, Oral↗
PubMed1999

Endoscopic photodynamic diagnosis: oral aminolevulinic acid is a marker of GI cancer and dysplastic lesions.

BACKGROUND: Dysplasia and early cancer of the upper gastrointestinal (GI) tract often are undetected at white-light endoscopy. We describe oral administration of 5-aminolevulinic acid for the in vivo photodynamic diagnosis of premalignant and malignant lesions during endoscopy. METHODS: Four patients with known gastric adenoma (n = 1), macroscopically undetected but histologically proven esophageal squamous cell cancer (n = 1), suspected early cancer of the esophagus (n = 1), and multiple duodenal adenomas (n = 1) were sensitized with 5-aminolevulinic acid administered orally (15 mg/kg body weight). Photodynamic diagnosis was conducted after a retention time of 6 to 7 hours with a special light source capable of delivering either white or violet-blue light. Red fluorescence was detected through the gastroscope with an image-intensifying camera. RESULTS: All malignant lesions exhibited red or bluish fluorescence during photodynamic diagnosis. Fluorescence-negative mucosal areas proved to be histologically benign. CONCLUSION: Fluorescence induced with 5-aminolevulinic acid might be useful for the endoscopic detection of dysplasia and early carcinoma in the upper GI tract. Further investigations are needed to evaluate the sensitivity and specificity of photodynamic diagnosis for different tumor entities.

Adenoma↗
PubMed1990

[Experiences of forensic medicine with death in foreign travel].

In cases of death which occur in a foreign country, the official post mortem diagnosis does often not correspond with our findings at obduction. Therefore an obduction should be performed in dubious cases at arrival in the native country. Even in a state of embalming and/or putrefaction the findings at obduction are still reliable.

Adult↗
PubMed1990

Human papillomavirus type 8 contains cis-active positive and negative transcriptional control sequences.

Human papillomavirus type 8 (HPV-8) is one aetiological agent of macular and flat wart-like lesions in patients with epidermodysplasia verruciformis and appears to be closely linked to skin carcinogenesis. A 1.2 kb region of the genome, which was previously shown to contain a viral E2-dependent enhancer, was progressively shortened from both ends with Bal 31. The resulting fragments were tested for their ability to stimulate chloramphenicol acetyltransferase (CAT) expression from the simian virus 40 (SV 40) promoter. This analysis showed a complex interaction between cis-active, positive and negative control elements located throughout the non-coding region and the flanking reading frames. Two separate positively acting sequences significantly stimulated expression only in cooperation with a third region, which led to 12-fold, E2-dependent enhancement on its own. A major negative element was not only active in the context of HPV-8 sequences, but also down-regulated SV40 enhancer-promoter-driven CAT expression when cloned downstream of the transcription unit. It acted at the transcriptional levels as shown by RNase protection assays and can therefore be regarded as a cis-acting silencer of transcription.

Base Sequence↗
PubMed1984

[Early postmortem course of washerwoman's skin of the fingers].

Studies were carried out systematically in both corpses and the hands of corpses in order to find out when " washerwoman 's skin" begins. The temperatures ranged between 10 degrees and 18 degrees C and the time of the experiments did not exceed 300 min. The initial formation of washerwoman 's skin could be observed after 20-30 min at the fingertips and after 50-60 min in the entire finger. The longest intervals observed were 100 or 150 min, respectively. These long intervals were interpreted as being exceptions from the norm, probably due to either extraordinarily heavy strips of fat on the fingers or abnormally hard skin on the hands. The course of washerwoman 's skin obviously depends on the water temperature, and afterwards it disappears rather slowly--even after a short immersion--in the open air. We will carry out additional experiments in the future.

Adult↗
PubMed1977

[The estimation of the time of death of corpses recovered from water (author's transl)].

Putrefaction, autolysis and maceration of water corpses follow a regular sequence depending on the water temperature and the interval in the water, the socalled water period. We have determined the beginning of characteristic exterior and interior changes in 395 water corpses of adult persons with known immersion intervals and water temperatures at the place of discovery at the time of recovery. The corpses had been kept in a cooling-rrom at 4 degrees C for 2 to 3 days until they were studied. Altogether 10 parameters have been considered and plotted (Fig. 1-3): intensive dyscoloration of the skin, gasformation, loosening of hair, loss of hair, putridity transsudate of more than 500 ml into the pleural cavitiesn, bloodlessness of heart, softening and liquefaction of the brain, loosening of fingernails, loss of washer-woman's skin from the hands and loss of fingernails. Several parameters are synchronous (Fig. 1,2). The studied intervals of exposure to water were from 2 to 47 days at water temperatures between 22 and 3 degrees C. - By means of the three diagrams it can be found out how many days at the minimum a corpse had been submerged, if the water temperature at the place of discovery is known and storage in a cooling-room has taken place for 2 to 3 days. Also statements are possible about the maximal period of time. - Corpses found in the Rhine will develop washer-woman's skin on hands and feet after no less than 5 hours, even at summer temperatures, and adipocere after no less than 2.5 to 3 months. There is no difference between running and stagnant water in the chronological developments of the parameters investigated. Also the degree of water pollution does not affect the estimation of the time of death.

Cadaver↗
PubMed1976

[About the problem of "lungs in drowning" (author's transl)].

In order to remove any misunderstanding I would like to reply to the publication by HEINEN und DOTZAUER as follows: The statements and conclusions of the authors must inevitably give rise to the impression that my detailed investigations of the reticular fibre texture of the drowned lung is to a large extent non-specific and thus of no use for an expert opinion on death by drowning. The authors, who base their statements on a dissertation by Mrs. HEINEN, have apparently overlooked the differences in aetiology between typical and atypical drowning and thus also have misunderstood the pathogenesis of the typical drowned lung both with respect to gross and fine tissue aspects. Characteristic of typical drowning is acute diffuse bronchostenotic emphysems of the lung.

Bronchi↗
PubMed1975

[The significance of the settling of blood into dependent and soft tissues as evidence for death by throttling and choking (author's transl)].

14 fresh cadavers of adult persons were placed with the head or body tilted in atypical positions 3 to 65 hours after death. The persons concerned were neither asphyxiated nor had they suffered cranial trauma. Hypostasis in the head and neck occurred more rapidly and intensively the deeper the cranial parts of the body were placed. In the simulated cadaver positions, artificial ecchymoses were observed in only a few places, mainly in the eyelids, the conjunctiva, the galea and the temporal muscles except when the head was vertically downwards. Just as with the postmortem haematomas, the hypostatic settling to the plane of the heart was decisive.

Autopsy↗