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Biomedical subjects

K Helmke

Publications and source records attributed to K Helmke.

At least 91 records · Page 5Linked to original sources
PubMed1986

Meta-iodobenzylguanidine scintigraphy in neuroblastoma--a comparison with conventional X-ray and ultrasound.

To evaluate the accuracy of meta-iodobenzylguanidine (MIBG) imaging in comparison with bone X-ray and ultrasound, 15 patients with histologically verified neuroblastoma were investigated using 123- or 131MIBG scintigraphy. 123MIBG and 131MIBG are used as the abbreviations for 123-iodine-labeled-MIBG and 131-iodine-labeled-MIBG, respectively. Either 7.4 MBq 131MIBG (n = 4) or 111-185 MBq 123MIBG (n = 11) was applied, and scans were performed 24 and 48 h PI. Anatomical orientation was provided in selected cases by single-photon emission CT or scintigraphy of other organs. X-ray procedures or ultrasound depicted 27 neuroblastoma manifestations (primary tumors and metastatic deposits); 24 of these (89%) were identified by MIBG scintigraphy. Of 42 primary neuroblastomas and metastatic deposits, 27 (64%) were detected by corresponding bone X-ray or ultrasound. The 15 neuroblastoma lesions depicted solely by MIBG scans were mainly (80%) situated in the skeletal system. Because of the pronounced physiological MIBG uptake by liver tissue, detection of intrahepatic or perihepatic tumor involvement is difficult. MIBG scintigraphy is a safe and noninvasive means of locating a wide range of neuroblastoma lesions. Its main diagnostic advantage in comparison with bone X-ray lies in the detection of bone marrow infiltration.

3-Iodobenzylguanidine↗
PubMed1986

[Therapy of rheumatic diseases with inosiplex].

27 patients (13 rheumatoid arthritis, RA; 4 systemic lupus erythematosus, SLE; 5 systemic sclerosis, PSS; 5 undifferentiated connective tissue disease, UCTD) were treated with inosiplex for more than 23 months (7.7 +/- 1.3). Clinical improvement was impressive by the end of the first month of therapy in 7 patients with moderate active RA (p less than 0.01), and 5 of these patients treated for more than 8 months continued to do well (p less than 0.05). In contrast, patients with very active RA did not show any clear-cut improvement. In the other diseases studied, 5 patients responded rapidly (reduction in arthritis, improvement of pulmonary involvement). A concomitant rise in the T4/T8- (helper-/suppressor-) cell ratio with increased numbers of T4+-cells was observed in patients with RA and PSS. Our data suggest that some patients with rheumatic diseases may benefit from long-term treatment with inosiplex.

Adult↗
PubMed1986

[Suppressor cell activity in patients with undifferentiated collagenoses].

Undifferentiated connective tissue syndromes (UCTS) have been considered as early stages of classical rheumatic diseases. We have studied the immunoregulatory function of T8+ cells from patients with UCTS by measuring the effects on pokeweed-mitogen-induced immunoglobulin production. Compared with normals the suppressor activity of T8+ cells was shown to be markedly diminished. These results indicate that an abnormality in generation of suppressor function may be a general feature of early stages of rheumatic diseases.

Adult↗
PubMed1986

B lymphocyte activation by insoluble anti-mu antibodies in patients with systemic lupus erythematosus.

In order to study the capacity of anti-immunoglobulin (Ig) antibodies to induce proliferative responses in peripheral blood mononuclear cells (PBC) from patients with systemic lupus erythematosus (SLE), anti-mu coupled to Sepharose beads (anti-mu) was used as a polyclonal activator. In 18 patients, a strong proliferative response was associated with inactive disease, and the response was lower in clinical active disease (P less than 0.02). An inverse correlation could also be observed in six patients who were studied longitudinally (P less than 0.01). These results indicate that anti-mu responsiveness is closely related to disease activity in SLE. In addition, sequential data obtained from two patients during an early stage of clinical deterioration suggest that a low anti-mu response might be an early indicator of a clinical relapse. In the patients investigated, the anti-mu response was not correlated with the response to pokeweed mitogen (PWM), or with the quantity of B cells. When T cell depleted cell fractions were studied, marked increases in the proliferative responses to anti-mu were observed in some patients. These studies suggest that the response to anti-mu might be modified by T cells to a variable extent in patients with SLE.

Adult↗
PubMed1986

[Immunomodulating therapy of collagen diseases].

The treatment of connective tissue disorders still proves problematic. Most forms of therapy are based on empirical data because of a lack of specified therapy regimes. The time period, during which controlled studies have been performed, was brief. Furthermore, the spectrum of diseases and drugs investigated has been inadequate. The uncertainty regarding the therapeutics, however, is confronted by a number of powerful and high-risk drugs. As a result of a better understanding of the immunoregulatory mechanisms and advances in the development of drugs, the original concept of nonselective immunosuppression has been replaced by attempting the influence of specific parameters. Cortisone is still considered to be of basic importance for the treatment of most of these diseases. Other available drugs are immunosuppressives such as azathioprine, methotrexate, cyclophosphamide, chlorambucil, and D-penicillamine. New developments include the use of cyclosporine A, high-dose immunoglobulins, plasmapheresis, antithymocyte globulins, levamisole, inosiplex, and radiation of lymph nodes. A causal specific therapy, other than for rheumatic fever, is not in sight. In order to find a form of therapy which is disease-specific, low-risk and with a high success rate, long-term controlled studies on large groups of patients need to be performed.

Adrenal Cortex Hormones↗
PubMed1985

Ultrasonic diagnosis and follow-up of malignant brain tumors in childhood. A report of 4 cases and a review of the literature.

Four patients between the ages of 2 and 20 years with malignant brain tumors were given several sonographic examinations, using an operative calvarial defect or sutural diastasis as an acoustic window. Three of our cases and 86% of cases with malignant brain tumors reported in the literature are echogenic, making possible primary sonographic diagnosis of tumor recurrence and echographic monitoring of tumor therapy.

Adolescent↗
PubMed1985

[Studies on B cell activation in collagenoses].

An inverse correlation between PWM and anti mu responses of peripheral blood lymphocytes, and a close relationship to clinical activity were demonstrated in 9 patients with systemic lupus erythematosus.

Arthritis, Rheumatoid↗
PubMed1985

[Scintigraphy with radioiodinated meta-iodobenzylguanidine in the diagnosis of neuroblastoma].

19 patients with histologically verified neuroblastoma (n = 18) or suspected of suffering from neuroblastoma (n = 1) were investigated 35 times using 123I- or 131I-labelled meta-iodobenzylguanidine (MIBG) scintigraphy. The purpose of this investigation was to evaluate the accuracy of MIBG imaging in comparison to other diagnostic procedures. X-ray or sonographical procedures depicted 40 neuroblastoma manifestations (primary tumours and metastatic deposits), 36 of these (90%) were found by MIBG scintigraphy. Out of 63 primary neuroblastomas and metastatic deposits, depicted by MIBG scintigraphy, 40 (63%) were detected by corresponding sonographic or x-ray procedures. The 23 neuroblastoma lesions solely depicted by MIBG scans were mainly (87%) situated in the skeletal system. In 12 patients biopsy of the bone marrow confirmed the scintigraphic findings (9 times true positive, 3 times true negative). Three times bone marrow infiltration was not recognized by MIBG scintigraphy. False positive results were not observed. 13 patients were examined before and after chemotherapy; scintigraphic results corresponded to therapy results. Because of the pronounced physiological MIBG uptake by liver tissue, detection of intrahepatic or perihepatic tumour involvement may be difficult. MIBG imaging seems not to be suitable for detecting minimal bone marrow infiltration by neuroblastoma. It is a safe and noninvasive procedure for locating a wide range of neuroblastoma lesions. Its main diagnostic advantage in comparison to x-ray procedures lies in the detection of bone marrow infiltration.

3-Iodobenzylguanidine↗
PubMed1984

CCT and sonographic findings in congenital craniopharyngioma.

In a case of congenital craniopharyngioma results of the sonographic and CCT examinations are reported and compared with postmortem macroscopic cuts. Comparison is made of clinical data from six cases with congenital craniopharyngioma as reported in the literature.

Craniopharyngioma↗
PubMed1984

Complications of mumps infection, islet-cell antibodies, and HLA.

To investigate whether the development of islet-cell antibodies (ICA) in the course of mumps infection is associated with a "diabetes-like" immunogenetic condition, 45 children with mumps complications as well as 56 children with insulin-dependent diabetes mellitus (IDDM) were typed for HLA ABC and DR antigens. ICA were detected in 14 out of 35 mumps patients. In the IDDM group, significant deviations from antigen frequencies of normal controls were observed for HLA Bw39, DR2, DR3, and DR4. In contrast, in ICA positive mumps patients, the frequency of these antigens was normal, but Aw24 was significantly increased. Thus, no immunogenetic similarities of both groups of patients could be detected.

Adolescent↗
PubMed1984

Sonographic demonstration of contusional white matter clefts in an infant.

In abused children cerebral contusion can lead to neurologic sequelae or mental retardation. Cerebral injury has been found with and without external evidence of head injury. We report the sonographic findings in a case of battered-child syndrome. Cerebral sonography could demonstrate cerebral contusion at the time of admission. On repeated examination white matter clefts developed in both frontal lobes. The sonographic findings were confirmed by CCT.

Battered Child Syndrome↗
PubMed1984

[Cerebral sonography in children and adolescents with acquired skull defects].

16 patients between 20 months and 21 years of age with acquired defects of the calvarium were examined by static and real time sonography. The first cerebral sonogram of every patient was compared with his CCT scans. There was no difference between sonographic and CCT-examination results in 8 patients. Additional diagnostic information was found in two sonographic and 6 CCT examinations when compared with each other. In large defects, detailed echographic visualization of normal and pathological anatomy was possible, resulting in prompt diagnosis of tumor recurrence. If cerebral sonography is compared with CCT, there are several advantages of sonography lack of preparation: no transport of severely ill patients, no contrast application, low cost. These advantages makes cerebral echography especially suitable for close follow up of tumor therapy and patients of intensive care units.

Adolescent↗
PubMed1984

Virus infection islet cell antibodies and islet cell function in type I diabetes mellitus.

The detection of islet cell antibodies has led to an increasing interest in autoimmune mechanisms in Type I diabetes mellitus. Other phenomena, such as insulitis in juvenile diabetics and in experimental animals, cellular immune reactions and concommitant antibodies against other endocrine organs, antinuclear antibodies and circulating immune complexes have supported such speculations. HLA-association and viral-infections could be predisposing and inducing factors. However, with one exception, the occurrence of ICA in a group of mumps infected children did not result in the development of diabetes mellitus over 3-4 years, nor could it be correlated with HLA-pattern. The islet cell antibodies block glucose stimulated insulin secretion in vitro without complement, while Type I diabetic sera with complement are beta cell cytotoxic irrespective of their ICA concentration. It is still not clear whether these mechanisms play any role in vivo. Therapeutic intervention before the clinical manifestation of the disease is as yet not possible due to the lack of markers indicating a subclinical autoimmune process.

Adolescent↗
PubMed1984

Mumps, mumps vaccination, islet cell antibodies and the first manifestation of diabetes mellitus type I.

To connect mumps and diabetes mellitus in children is an old problem in medical literature. The typical occurrence of ICA at the onset of diabetes in children, as well as the incidence of ICA approximately 3 weeks after mumps infection support the hypothesis of a direct relationship between virus infection and diabetes. But the mumps infection alone is not the key factor. Mumps vaccination may not provide protection against diabetes mellitus, it may even provoke it. (Genetic determination, expressed by the HLA-phenotype in all the patients reported, does not allow a differentiation.)

Adolescent↗