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Biomedical subjects

H Vogelsang

Publications and source records attributed to H Vogelsang.

At least 19 recordsLinked to original sources
PubMed1992

[Results of allogenic and autologous bone marrow transplantation in children with acute myeloid leukemia].

We report on our experience of bone marrow transplantation (BMT) in children with acute myeloblastic leukaemia (AML) and high risk of relapse (initial WBC greater than 20 x 10(9)/l, FAB M 5, M 6, M 7). 32 children were grafted between november 1982 and october 1991 at the Children's Hospital of the University of Jena. Two patients underwent an allogenous BMT in relapse and died from progressive disease. In 13 children an allogeneic BMT was performed in first complete remission. One patient relapsed, two patients died from severe acute graft-versus-host disease, and two patients died from encephalopathy and cardiomyopathy. Eight of the 13 patients are living and well 18 months to eight and a half year after BMT. Seventeen patients received an autologous (unpurged) BMT. Four of them relapsed four to seven months after BMT. The disease free survival (DFS) for the 29 patients grafted in remission was 0.65. There was no statistical significant difference in DFS between patients with allogeneic and autologous BMT. We conclude that in children with AML and high risk for relapse BMT offers a real chance for better survival. Autologous BMT avoids the problems of graft-versus-host disease and of finding suitable donors for allogeneic marrow transplantation.

Adolescent↗
PubMed1991

Comparison of enteral nutrition and drug treatment in active Crohn's disease. Results of the European Cooperative Crohn's Disease Study. IV.

This study compared the effect of enteral nutrition as the sole therapy of active Crohn's disease with drug treatment. Patients with active Crohn's disease (Crohn's Disease Activity Index greater than 200) were randomized to receive either enteral nutrition with a liquid oligopeptide diet (n = 55) or a combination of 6-methylprednisolone, 48 mg daily, subsequently tapered, and sulfasalazine, 3 g daily (n = 52). The two groups were not different with respect to age, sex, body weight, location of disease, or treatment before the study. The severity of disease was similar at the beginning of the study in both groups [Crohn's Disease Activity Index (mean +/- SEM), 323 +/- 12 vs. 316 +/- 11]. Remission was defined as a decrease of the initial Crohn's Disease Activity Index by 40% or at least 100 points. Twenty-nine patients in the diet group and 41 patients in the drug group reached remission within 6 weeks of therapy (chi 2 test, P less than 0.01). The median elapsed time to remission was 30.7 days in the diet group compared with 8.2 days in the drug group (Mantel Cox, P less than 0.01). To determine whether one of these treatments was more beneficial for a subgroup of patients, the effectiveness of both treatments was analyzed separately in patients with very severe disease (initial Crohn's Disease Activity Index greater than 300) and less severe disease (initial Crohn's Disease Activity Index less than 300), and in patients with different disease location. However, no influence of initial disease activity or disease location on the effect of either treatment could be shown. These data show that enteral nutrition is less effective than a combination of 6-methylprednisolone and sulfasalazine in treating active Crohn's disease.

Adult↗
PubMed1989

Bone disease in vitamin D-deficient patients with Crohn's disease.

Vitamin D deficiency is frequently observed in patients with Crohn's disease and may be associated with an increased risk of development of metabolic bone disease. To estimate the incidence of metabolic bone disease by noninvasive methods, 31 patients (17-75 years old) with Crohn's disease and low 25-hydroxyvitamin D (25-OHD) levels in winter were investigated in the following summer by measuring the bone mineral content (BMC) of the distal radius by single photon absorptiometry and the cortical area ratio (CAR) calculated from radiographs of the right hand and by x-ray of the lumbar spine. Forty-five percent of the patients showed signs of metabolic bone disease. BMC and CAR correlated with 25-OHD serum levels (P less than 0.05), especially in men. Furthermore, the amount of sun exposure has an influence not only on 25-OHD serum levels both in summer and in winter (P = 0.0006), but also on the BMC (P = 0.07). Consequently, vitamin D deficiency is of major importance for the development of metabolic bone disease in patients with Crohn's disease. Vitamin D deficiency can be prevented by increasing sun exposure and long-term vitamin D supplementation.

Adolescent↗
PubMed1989

Small bowel function after surgery for chronic radiation enteritis.

The retention of the gamma-emitting 75Se-homotaurocholic acid (SeHCAT) after 72 and 168 h was assessed in 10 patients after ileal resection for radiation injury (group I). 6 patients suffering from chronic postirradiation diarrhea (group II) and 6 patients in whom the ileum had been resected for other indications (group III) were also examined. The retention of SeHCAT was abnormally low (less than 50%) in all cases after 72 h and below 20% in 19 out of 21 cases after 168 h. The length of resected small bowel (groups I and III) was inversely related with SeHCAT retention after 72 h (r = 0.63; p = 0.015), but not after 168 h. There was no correlation between the diarrhea score and the extent of bowel resection, SeHCAT retention or xylose absorption. Hydrogen breath test with lactulose revealed a significantly shortened orocecal transit time in group I, compared to groups II and III. Xylose absorption was significantly reduced in patients with positive 5 g xylose-H2 breath test. In groups I and III, however, xylose absorption tended to improve with increasing time interval following resection (r = 0.79; p = 0.003). It is concluded that radiation injury in addition to small-bowel resection contributes significantly to malabsorption and diarrhea in patients after ileal resection for radiation sequelae. The chronic radiation damage seems to act mainly through impaired motility.

Body Weight↗
PubMed1989

Plasma level and renal excretion of iotrolan after lumbar injection in patients.

Ten milliliters of iotrolan containing 240 mg I/ml were injected into the lower lumbar subarachnoid space of ten patients. Plasma level and urinary and fecal excretion were monitored for 3 days after injection. The mean iodine concentration in the plasma of about 50 micrograms/ml (6% of the dose given in the total plasma volume) peaked at 1 to 2 hours after injection. After reaching the maximum values, the iotrolan concentration in the plasma decreased with a half-life of about 4 hours (median value). About 90% of the injected dose was found in the urine and about 1% was detected in the feces.

Adult↗
PubMed1988

Acidic colonic microclimate--possible reason for false negative hydrogen breath tests.

About 5% of normal subjects fail to produce increased hydrogen breath concentration after ingestion of the non-digestible carbohydrate lactulose (low hydrogen producers). The existence of low hydrogen producers limits the diagnostic use of hydrogen (H2) breath tests. We studied the effects of lactulose and of magnesium sulphate (MgSO4) pretreatment on stool-pH and on hydrogen exhalation after oral loading with lactulose or lactose in 17 hydrogen producers and 12 low hydrogen producers. In seven hydrogen producers acidification of stool pH by lactulose pretreatment (20 g tid) decreased hydrogen exhalation and three of seven (43%) became low hydrogen producers. In contrast, after pretreatment of eight low hydrogen producers with magnesium sulphate (5 g twice daily) all eight produced hydrogen after a lactulose load. Similarly four lactose intolerant low hydrogen producers had abnormal lactose hydrogen breath tests after MgSO4 pretreatment. MgSO4 pretreatment neither resulted in false positive lactose hydrogen breath tests in five lactose tolerant hydrogen producers, nor increased the hydrogen exhalation in five additional hydrogen producing controls after ingestion of lactulose. The results of these studies confirm that hydrogen production from lactulose decreases when the colonic pH is lower (lactulose pretreatment), and increases when colonic pH is higher (MgSO4 pretreatment). In low hydrogen producers the lacking increase of H2 exhalation after ingestion of non-digestible carbohydrates can be overcome by MgSO4 pretreatment, thus increasing the sensitivity of the test by avoiding false negative hydrogen breath tests in low hydrogen producers with disaccharide malabsorption or maldigestion. The underlying mechanism of this remarkable effect of MgSO4 pretreatment warrants further investigation.

Breath Tests↗
PubMed1988

[T-cell subpopulations and suppressor activity in atopic and infection-induced asthma].

We determined the T-lymphocyte subpopulations by means of monoclonal antibodies (CD 3, CD 4, CD 8) and the so-called suppressor index (increased lymphocyte stimulation after 24 h preincubation) in 20 patients with extrinsic asthma and in 18 patients with intrinsic asthma. In patients with extrinsic asthma we found an increase of ratio CD 4/CD 8. The short-living suppressor activity was significantly decreased in patients with intrinsic asthma.

Antibodies, Monoclonal↗
PubMed1987

Morphologic criteria of progression and regression of cardiac hypertrophy.

The heart is able to adapt itself to a demanded load by increasing (hypertrophy) or decreasing (regression of hypertrophy) its muscular mass within a wide range. Overstressing of the ability of adaptation is accompanied by degenerative changes of myocytes. Semiquantitative investigations of endomyocardial biopsies (EMCBs) of patients with dilative cardiomyopathy (DCM) and hypertrophic nonobstructive cardiomyopathy (HNCM) show a fibrosis of the interstitial space, as well as almost similar changes of myofibrils and mitochondria. A reduced number of myocytes in hearts with DCM could explain the decreased functional capacity. Quantitative investigations of endomyocardial biopsies and myectomy specimens in patients with hypertrophic obstructive cardiomyopathy have revealed that hypertrophy and, to a certain extent, hyperplasia of muscle fibers cause asymmetrical thickening of the septum. Experimental investigations of the regression of training-induced hypertrophy in rats have shown that nearly all parameters (cardiac weight, thickness of muscle fibers, myofibrillar mass, interstitial space, and capillary width) returned to the values of controls 14 days after termination of a swimming training regimen. A significantly higher density of capillaries after regression of muscle fiber hypertrophy compared to controls points to a temporal dissociation in the regression of myocyte size and capillary network. Decrease in RNA concentration and an increased number of autophagic vacuoles give evidence for decreased anabolism and increased catabolism may occur during regression. In humans, fibrosis of the myocardium and scar formation explain the irreversibility of cardiac hypertrophy, as observed in some patients with valvular heart disease, despite valve replacement.

Adult↗
PubMed1986

[Morphologic studies following coronary thrombolysis and PTCA].

Compared with those of other species human coronary arteries show a particularly marked diffuse thickening of the intima. Superimposed on this diffuse thickening local sclerotic changes develop. In early stages they contain plenty of lipids which are mainly stored in modified smooth muscle cells, partly also in cells of monocytic origin. Normally ruptures of arteriosclerotic plaques are responsible for thrombotic occlusions in extensive transmural myocardial infarctions. They are caused by ruptures of the fibrous layer covering the necrotic core of the plaque. By thrombolytic therapy platelet thrombi can be dissolved but the causal stenosing plaques remain. Arteriosclerotic stenoses can be dilated by PTCA. In doing so tears in the area of the plaque can be observed. Often there is partial detachment of the intima from the media, sometimes even extensive dissection. Proliferation of smooth muscle cells is important regarding healing of these tears. They build up a neointima and can cause restenoses in cases of massive proliferation. So far it is unknown how often platelet thrombus formations and their successive stages are involved in causing restenoses. In addition it is not yet clear how far stretching of the media and the collagenous fibers of the adventitia contributes to a permanent dilatation of the lumen after PTCA.

Angioplasty, Balloon↗
PubMed1985

[Comparative MR and CT research in selected neuroradiological problems].

Magnetic resonance (MR) is a new digital imaging method which is of particular interest in the radiological diagnosis of the central nervous system. It provides a new form for demonstrating the brain and the spinal cord. To evaluate the scope of the method, it was compared with CT. The results in patients with epilepsy of unknown origin, cerebral infarcts, sellar space-occupying lesions and spinal angiomas are described. MR provides information concerning tumours causing epilepsy and also fresh infarcts at an earlier stage than CT. MR has not, so far, provided any new insights in the diagnosis of sellar tumours or spinal angiomas. In these cases, MR can, nevertheless, compete with CT and with conventional radiological methods. Present experience, particularly with problem cases, indicates that MR is becoming an important method of examination in neuroradiology.

Adult↗
PubMed1985

Role of cardiac sympathetic nerves in the genesis of myocardial ischemia distal to coronary stenoses.

This manuscript summarizes the effects of cardiac sympathetic nerve activation on coronary blood flow and myocardial function, metabolism, and morphology distal to stenoses. Whereas cardiac sympathetic nerve activation induces an increase in myocardial function and metabolism accompanied by metabolic coronary dilation under physiological conditions, this response is different in the presence of coronary stenoses. With decreasing coronary hyperemic reserve, distal to an increasing degree of coronary stenosis, the predominant response to sympathetic stimulation is continuously shifted from metabolic dilation to alpha-adrenergic vasoconstriction. With a severe coronary stenosis, both electrical stimulation of cardiac sympathetic nerves and reflex sympathetic activation by carotid occlusion induce poststenotic vasoconstriction and ischemia of the dependent myocardium. Poststenotic vasoconstriction is mediated by vascular alpha 2-adrenoceptors and is prevented by phentolamine, rauwolscine, and nifedipine. Prolonged sympathetic activation even results in patchy subendocardial necroses. There is a vicious cycle between poststenotic vasoconstriction, myocardial ischemia, and cardiac sympathetic nerve activity that results in a progressive perfusion impairment during 20 min severe coronary stenosis.

Animals↗
PubMed1985

[CT findings in chordomas of the base of the skull].

Nine chordomas of the skull base and their CT appearances are described. Destruction of the clivus and of the parasellar portions of the middle fossa are characteristic, as is calcification which may be spotty, coarse or ill-defined. The tumour is characterised by marked enhancement following contrast but, on the unenhanced CT, contrary to statements in the literature, it is hypodense or isodense with respect to cerebral tissue. The tendency to recurrence and an altogether poor prognosis is confirmed.

Adolescent↗
PubMed1985

[The quantitative determination of the IgM rheumatoid factor using a solid-phase radioimmunoassay. Comparison with the agglutination test and the radioimmuno-polyethyleneglycol precipitation test].

A solid-phase radioimmunoassay capable of detecting nanogram quantities of human IgM rheumatoid factor using a monoclonal anti-mu-chain antibody is described. Human IgG did not interfere with the detection of IgM RF by this method. The small nonspecific binding of nonRF IgM to the human IgG coated tubes utilized in the assay must be corrected for by assaying samples in parallel bovine serum albumin coated control tubes only in cases of deviation of IgM from normal range. 69 coded and randomly arranged sera from patients with rheumatoid arthritis (RA), nonrheumatic joint diseases and healthy adult control subjects were investigated by this method, agglutination techniques as well as RIPEGA. A good correlation between solid-phase radioimmunoassay and agglutination techniques was found. Patients with seropositive RA had significantly higher concentrations of IgM RF than seronegative RA patients or control subjects (mean +/- 1 SD = 133,3 +/- 187,2 micrograms/ml versus 4,7 +/- 6,5 micrograms/ml and 2,2 +/- 4,0 micrograms/ml; resp.).

Agglutination Tests↗
PubMed1985

[Intrasacral meningoceles].

The author reports on 8 patients with cystic enlargements of the canalis sacralis (occult intrasacral maningocele). The clinical pattern of signs, x-ray findings (plain radiography, myelography, computed tomography) and possible treatment are discussed in comparison with the cases published to date.

Adolescent↗