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Biomedical subjects

J Wilke

Publications and source records attributed to J Wilke.

At least 19 recordsLinked to original sources
PubMed2006

[Chronic anaemia in a patient with hereditary haemorrhagic telangiectasia and juvenile gastric polyposis].

HISTORY: A 52-year-old woman with chronic anaemia presented with recurrent epistaxis, telangiectasias and haemangiomas, suggesting the presence of hereditary haemorrhagic telangiectasia (Osler-Rendu-Weber disease). Moreover, previous investigations had also shown multiple polyps of the stomach. INVESTIGATIONS: A severe microcytic iron deficiency anaemia in combination with hepatic haemangiomas and duodenal angio-dysplasia were detected. Gastrointestinal endoscopy revealed multiple juvenile polyps in the gastric fundus and body, indicating the diagnosis of hereditary haemorrhagic telangiectasia in combination with juvenile polyposis. THERAPY AND COURSE: A gastrectomy was performed because of recurrent gastrointestinal bleeding and the malignant potential of juvenile gastric polyposis. Histopathology confirmed the diagnosis and did not reveal any malignancy. CONCLUSION: The association of hereditary haemorrhagic telangiectasia and juvenile polyposis, as seen in this patient, has been reported repeatedly. A diagnosis of one of the described entities should initiate the screening for evidence of the other one to prevent (life-threatening) complications.

Anemia, Iron-Deficiency↗
PubMed2001

[Surgical palliation of pancreatic carcinoma. Results of a 7 year period].

INTRODUCTION: High perioperative complication rates in the 1980s led to preferred use of endoscopic therapy for surgical palliation of pancreatic cancer. This encouraged us to analyse our own patients retrospectively. MATERIAL AND METHODS: In the period from 1 January 1992 to 31 December 1998, 253 patients with an exocrine carcinoma of the pancreas were operated on at the St. Elisabeth Hospital Cologne-Hohenlind: 73 patients (28.9%) underwent curative resection (R0) while 180 patients (71.1%) had palliative operative treatment (R1/R2). Palliative resection was performed in 22 patients (8.7%). Intestinal bypass surgery was done in 113 patients (44.7%) as a gastrojejunostomy and in 16 patients (6.3%) as a duodenojejunostomy. A biliodigestive anastomosis was performed in 85 patients (33.6%). This procedure was combined with a gastroenterostomy in 78 patients (30.8%). In 18 patients (7.1%) no surgical palliation was possible and the operation finished as a diagnostic laparotomy. RESULTS: The overall mortality rate within the first 30 (60) days was 5.5% (12.7%). Patients whose carcinoma had been resected curatively had a 30 (60)-day mortality rate of 2.7% (4.1%), compared to a rate in palliatively treated patients (resection/bypass/probatoria) of 6.7% (16.1%). Patients with palliatively resected tumor had perioperative mortality of 4.5% (4.5%), whereas patients who did not undergo resection had 6.9% (17.7%). The survival rate for curatively resected patients after Kaplan-Meier extrapolation was 64.7% after 1 year and 31.2% and 26.2% after 3 and 5 years, with a median survival time of 552 days. Palliatively operated patients had a survival rate of 19.4%, 2.5% and 0% for 1, 3 and 5 years. Median survival time was 171 days in this situation. Compared to patients without resection (17.4% and 2.0%), patients with palliative resection had survival rates for 1 and 3 years of 40% und 5.9%. After 5 years none of these patients were alive. CONCLUSIONS: Our data show a high success of surgical palliation in pancreatic cancer in centers with a high frequency of pancreatic surgery. Patients that could not be cured (R1/R2), although undergoing extensive procedures, had better survival rates than patients treated with bypass surgery. Perioperative mortality rate was comparatively low. This justifies aggressive surgical management of pancreatic carcinoma.

Aged↗
PubMed1999

Prevalence and clinical importance of Helicobacter pylori infection in patients after partial gastric resection for peptic ulcer disease. A prospective evaluation of Helicobacter pylori infection on 50 resected patients compared with matched nonresected controls.

UNLABELLED: There have been only a few surveys on the prevalence of persistent Helicobacter pylori (Hp) infection in patients who have undergone surgery for peptic ulceration. The aim of the study was to evaluate the prevalence and clinical importance of Hp infection after partial gastric surgery due to peptic ulcer disease. METHODS: We examined 50 patients who had partial gastric resection for peptic ulcer disease and years later underwent upper gastrointestinal (GI) endoscopy. 50 controls matched with respect to indication for GI endoscopy, age and gender were also studied. Three specimens from the fundus of gastric remnant were examined for Hp infection (histology and rapid urease test). The prevalence of Hp infection and pathology findings were compared between the two groups using chi-square statistics. RESULTS: 32 men and 18 women were examined (40 x BII, 10 x BI). The prevalence of Hp infection was 38% in the resected group compared to 60% in the control group (p = 0.015). We found a significant association (p = 0.0004) between Hp infection and endoscopic findings in the control group but not in the group of partially resected patients (p = 0.66). CONCLUSION: The prevalence of Hp infection in hospitalized patients with partial gastric resection is significantly lower than in matched controls. Hp infection does not play a significant pathogenic role in recurrent ulcer after partial gastric resection in these patients.

Adult↗
PubMed1995

From a survivor. The emotional experience of genetic testing.

1. HD is a family disease, transmitted by an autosomal dominant gene: any child of an affected person has a 50:50 chance of developing the disease. 2. The average age of onset of symptoms is between 30 and 45. 3. The guidelines for genetic testing for HD contain strong recommendations for pre- and posttest counseling.

Abortion, Spontaneous↗
PubMed1992

[Conventional roentgen functional diagnosis--videodensitometry. 1. Densitometric and topometric measurements of roentgen video images: technique and method of measuring].

It is possible to measure movements in the human body with the help of X-ray television systems. A great number of different techniques has been published in the scientific literature. They all based on only two principles with qualitative differences in signal acquisition. The densitometric and topometric measurements are assessed and compared. Neither the densitometric nor the topometric principle seems to be superior. To support the experimental work the videoanalyser VIANA MP was developed on the Ilmenau Institute of Technology.

Computer Systems↗
PubMed1987

Isogeneic monoclonal antibodies against anti-alpha(1----3)dextran idiotypes. I. Isotypes, idiotope specificity and representation of idiotopes in antisera from mice of various genetic constitutions.

Eight isogeneic anti-idiotypic hybridomas were raised against BALB/c myeloma protein MOPC 104E and one against J558. Both myelomas react specifically with the alpha(1----3) glucosidic linkage of dextran B1355 fraction S (Dex). Six anti-MOPC 104E proteins were IgG1, one was IgG2b and one IgM. The anti-J558 protein was IgG1. Competitive interactions of the anti-idiotopes and antigen with anti-Dex proteins were measured. Dex itself was effective, but also an alpha(1----3) glucosidic heptasaccharide (N7-CHO). In order to assess the anti-idiotope specificity of hybridoma proteins, three anti-Dex molecules were used: MOPC 104E, J558 and hybridoma protein Hdex14. These differed from each other in VH amino acid positions 54-55, or 100-101, respectively. By their serological reaction pattern our anti-idiotope proteins could be divided into 3 groups: cross-reactive, partially cross-reactive and strictly specific for the immunogen. The latter ones were in the majority, and were called "private", in contrast to the cross-reactive "public" anti-idiotopes. The serological pattern was followed, in general, by the mouse-to-mouse distribution of idiotopes in physiological anti-Dex sera. Public idiotopes were closely correlated in their expression with anti-Dex activity. "Private" idiotopes showed no correlation, and displayed a characteristically high degree of fluctuation from mouse to mouse. Among the different mouse strains that were compared with respect to idiotope expression in anti-Dex sera, two stand out: C57BL-Igha, which carries chromosome 12 of BALB/c, (as selected through allotype) on the C57BL/6 genome, and BALB-Ighb, dex+, a recombinant in chromosome 12 linking the dex+ trait from BALB/c to the CH allotype from C57BL/6. The latter strain expressed significantly more of the private idiotopes than the former. This observation is discussed in terms of the position effect of classical genetics and network concepts.

Amino Acid Sequence↗
PubMed1987

Isogeneic monoclonal antibodies against anti-alpha(1----3)dextran idiotypes. II. Neonatally induced idiotope-specific suppression: a comparative analysis.

From a panel of isogeneic monoclonal anti-idiotope antibodies several were used as agents in neonatal idiotope suppression. They differed from one another in isotype, and in idiotope specificity, as described in the preceding report (Eur. J. Immunol. 1987. 17: 255). In their effects they were compared with respect to the following variables: minimum dose required for suppression; duration of suppression, and its relationship to the dose applied neonatally; half-life of anti-idiotope in the immune system of the young mice; specificity of suppression as achieved by a given anti-idiotope: in how far does it affect idiotopes defined by alternate anti-idiotopes? The following results were obtained: the minimum effective dose varied widely between anti-idiotopes. One, belonging to the IgM class, was completely ineffective; others varied from approximately 10 micrograms/mouse, required for complete suppression, to approximately 100 micrograms/mouse. The dose-response characteristic was independent of whether the state of suppression was tested (by immunization against alpha(1----3)dextran) 26 days or 70 days after neonatal anti-idiotope treatment. We take this as an indication that the anti-idiotope effect occurs during an early postnatal period. There appeared to be a relationship between the rate of decay of anti-idiotope in the system and the dose required for complete suppression: the faster the decay, the more is needed initially. The persistence of effective molecules in the animals appears to depend on their isotype (as has been noted by others before): IgM decays fastest, and was ineffective in our experiments; IgG1 stays longest, and the smallest dose was required for suppression. IgG2b was intermediate. The specificity of neonatal suppression was clearly correlated with the serological specificity of the anti-idiotope monoclonal antibodies, as well as with the representation of the corresponding idiotopes in physiological anti-dextran sera, as described in the preceding report: private anti-idiotopes suppressed their counterpart idiotopes only, while the public anti-idiotope suppressed all other idiotopes in concert.

Aging↗
PubMed1987

Monoclonal anti-allotype antibody towards BALB/c IgM. Analysis of specificity and site of a V-C crossover in recombinant strain BALB-Igh-Va/Igh-Cb.

Polyclonal IgM obtained by fractionation of a BALB/c serum pool was used as the immunogen for C57BL/6 mice. Draining lymph nodes from selected animals donated cells for fusion with myeloma Sp-2/0. Fifteen hybridomas were productive, and one (RS-3.1) was cloned and the affinity-purified product analyzed for its reactivity pattern by MOPC 104E-enzyme-linked immunosorbent assay inhibition. Among five BALB/c myelomas only TEPC 183 (IgM) was active, not those belonging to other Ig classes. Among normal sera from 8 mouse strains only those of BALB/c, DBA/2J and CBA/J showed inhibition. The recombinant strain BALB-Igh-Va/Igh-Cb did not react, which shows that its C mu stems from parental strain C57BL/6, and that therefore the recombination event had occurred 5' of this gene.

Animals↗
PubMed1983

[Antibody formation against specific Epstein-Barr virus antigens in infectious mononucleosis with tonsillectomy in the acute phase of the disease].

In the present study, the clinical course and the specific humoral immunological response to Epstein-Barr virus antigens have been investigated in patients affected with infectious mononucleosis after tonsillectomy in the acute phase of the disease, compared against conservatively treated patients. Clinical results confirm that tonsillectomy in the acute phase of infectious mononucleosis has a favourable effect on the course of the disease, and reduces the duration of the disease by about half of the usual time. Statistically significant differences - indicating a confined, delayed humoral immunological response or unresponsiveness to some extent - regarding the examined antigens after tonsillectomy in the acute phase of infectious mononucleosis, could be observed between the two groups of patients in respect of the production of antibodies against viral capsid and nuclear antigens of the Epstein-Barr virus and heterophilic antibodies. For this reason, tonsillectomy should be suggested only as therapy of infectious mononucleosis in anginous courses of the disease which appear life-threatening.

Acute Disease↗
PubMed1982

Cytostatic drugs are without significant effect on digitoxin plasma level and renal excretion.

In three patients with malignant lymphoma who received 0.5 mg digitoxin before and 24 hr after combination therapy with cyclophosphamide, Oncovin, procarbazine, and prednisone (COPP) or cyclophosphamide, Oncovin, and prednisone (COP), plasma glycoside concentrations and renal excretion were measured 0 to 168 hr after digitoxin and the areas under plasma concentration-time curves *(AUCs) were calculated. In 10 patients receiving 0.1 mg digitoxin, daily plasma glycoside concentration and daily renal excretion were measured before and after COPP, COP, or cyclophosphamide, Oncovin, cytosine-arabinoside, and prednisone (COAP) treatment schemes. In contrast to previous reports on digoxin, cytostatic drug therapy does not lead to a reduction in steady-state digitoxin plasma levels and daily renal excretion. During cytostatic therapy attainment of peak digitoxin level was delayed after a single dose, showing that the rate of digitoxin absorption was reduced, but that the AUCs and renal excretion of digitoxin (parameters of the extent of digitoxin absorption) were not diminished. Since the absorption rate is not clinically relevant in patients on long-term glycoside therapy, our results indicate that digitoxin is preferable to digoxin in such patients.

Adolescent↗
PubMed1982

[Contribution to the true non-African Burkitt's lymphoma (author's transl)].

It is reported on a 6-year-old Middle European boy suffering from a nasopharynx tumor with involvement of a submandibular lymph node. The tumor was classified by morphologic, serologic and virologic data as a true or Epstein-Barr virus-associated Burkitt's lymphoma, resp., which has been, up to now, seldom seen outside Africa. The patient died 3 months after diagnosis. Autopsy has shown tumor involvement of nasopharynx and soft tissues in the left neck region, several lymph nodes, kidneys, liver, spleen, and bone marrow. Cytologic, light and electron microscopic data are reported and the structural change of the tumor is referred to.

Autopsy↗
PubMed1981

Effects of cytostatic drugs on plasma level and renal excretion of beta-acetyldigoxin.

Mucosal defects decrease digoxin absorption in patients with malabsorption syndromes. Since the intestinal mucosa can be damaged by cytostatic drugs, we investigated their effects on digoxin plasma levels and urinary digoxin excretion. In six patients with malignant lymphoma who received 0.8 mg beta-acetyldigoxin before and 24 hr after treatment with a combination of cyclophosphamide, oncovin, procarbazine, and prednisone (COPP) or cyclophosphamide, oncovin, and prednisone (COP), plasma digoxin concentrations were measured 0 to 8 hr after the dose and areas under the plasma concentration-time curves were calculated. In 15 patients on 0.3 mg of beta-acetyldigoxin daily, plasma glycoside concentrations and renal excretion were measured daily before and after COPP, COP, cyclophosphamide, oncovin, cytosine-arabinosine, and prednisone (COAP), or adriamycin, bleomycin, and prednisone (ABP) treatment schemes. The diminished steady-state glycoside plasma concentrations and daily renal glycoside excretion during the 24 to 168 hr after the cytostatic drug established reversible impairment of digoxin absorption. The delayed time to peak after a single dose of digoxin during cytostatic drug therapy shows that extent and rate of digoxin absorption are reduced. To maintain adequate control of digoxin therapy in patients treated with cytostatic drugs, plasma levels should be monitored.

Acetyldigoxins↗