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Biomedical subjects

K Kupka

Publications and source records attributed to K Kupka.

At least 19 recordsLinked to original sources
PubMed2003

Comorbidity of parkinsonism and schizophrenia in a patient treated with clozapine.

Clozapine is the least likely anti-psychotic to induce extrapyramidal symptoms (EPS). We present a surprising case of a woman schizophrenic patient treated with clozapine suffering from EPS. Single photon emission computed tomography (SPECT) revealed a low density of presynaptic dopamine transporters in our patient's brain. A comorbid diagnosis of Parkinson's disease in schizophrenia was confirmed in this way. This helped us to find a proper therapeutic strategy for our patient.

Antipsychotic Agents↗
PubMed2001

Analysis of large and small samples of biochemical and clinical data.

Statistical software often offers a list of various descriptive statistics of location and scale, but rarely selects an efficient estimate that is statistically adequate for an actual univariate sample. The sample interval estimate for a specified degree of uncertainty seems to be more meaningful if it covers an unknown value of the population parameter. The concept of an interval estimate in medicine is then used for medical decision-making. The proposed methodology, which uses the S-Plus algorithm for biochemical, biological and clinical data analysis contains the following steps: (i) Exploratory data analysis identifies basic statistical features and patterns of the data, the distributions of which are mostly non-normal, non-homogeneous and often corrupted by outliers. (ii) Sample assumptions about data, independence of sample elements, normality and homogeneity are examined. (iii) Power transformation and the Box-Cox transformation to improve sample symmetry and stabilize the spread. (iv) Classical and robust statistics for both large (n>30) and medium-sized samples (15<n<30), point and interval estimates for the parameters of location, scale and shape. For an analysis of small samples (4<n<20) the Horn procedure of pivot measures is recommended. The proposed methodology is demonstrated in two case studies, a large sample analysis of mean pregnenolone concentrations in the umbilical blood of newborns, and a small sample analysis of mean haptoglobin concentrations in human serum.

Adult↗
PubMed2000

Transformation in the PC-aided biochemical data analysis.

Data transformations enable expression of original data in a new scale, more suitable for data analysis. In computer-aided interactive analysis of biochemical and clinical data an exploratory data analysis often finds that the sample distribution is systematically skewed or does not accept a sample homogeneity. Under such circumstances the original data should be transformed. The power transformation and the Box-Cox transformation improve sample symmetry and also stabilize variance. Both the Hines-Hines selection graph and the plot of logarithm of a maximum likelihood function allow selection of an optimum transformation parameter. The proposed procedure of data transformation in univariate data analysis is illustrated on a determination of 17-hydroxypregnenolone in umbilical blood of a population of newborns. Lower levels of free 5-ene steroids in umbilical blood and elevated levels of 5-ene steroid sulfates indicate a congenital sex-specific placental sulfatase insufficiency. After examination of statistical assumptions by diagnostic plots of an exploratory data analysis the best estimate of a mean value of 17-hydroxypregnenolone is derived.

17-alpha-Hydroxypregnenolone↗
PubMed2000

Comparison of clinical, laboratory, radiographic, and scintigraphic findings in erosive and nonerosive hand osteoarthritis. Results of a two-year study.

OBJECTIVES: The primary objective was to compare the clinical, radiologic, laboratory, and scintigraphic features in 28 patients with erosive hand osteoarthritis and in 24 with non-erosive hand osteoarthritis. Other objectives were to evaluate clinical, radiographic, and scintigraphic progression in the two groups over a two-year period and to estimate the value of bone scintigraphy for predicting clinical and radiographic progression. METHOD: Prospective two-year study of 52 patients with hand osteoarthritis, of whom 28 had at least three subchondral erosions and 24 patients had no erosions. RESULTS: The group with erosive disease had higher serum immunoglobulin G levels (14.53 +/- 3.79 mg/L vs. 12.03 +/- 4.01 mg/L; P < 0.05) and a higher radiographic index (91.81 +/- 3.67 vs. 25.88 +/- 12.81; P < 0.001), whereas the group with non-erosive disease had a higher rate of paresthesia (66.7% vs. 39.3%; P < 0.05) and higher values for the erythrocyte sedimentation rate (25.21 +/- 20.86 vs. 13.21 +/- 12.85; P < 0.05) and serum C-reactive protein level (8.82 +/- 6.08 vs. 3.25 +/- 6.92; P < 0.01). None of the other study parameters showed any significant differences, and both age and sex distribution were also similar in the two groups. At completion of the two-year follow-up, no changes versus baseline were found in any of the study parameters in the overall study population or in either of the two groups. The baseline scintigraphic index was significantly correlated with the radiographic index at baseline (r = 0.497; P < 0.01) and at study completion (r = 0.550; P < 0.001). Joints with a positive baseline scintigram were significantly more likely to show radiographic progression (21.09%, vs 6.68% in negative joints; P < 0.001) and joint tenderness exacerbation (21.22% vs. 13.73%; P < 0.001). CONCLUSION: These data suggest that bone scintigraphy may be useful for predicting clinical and radiographic progression of hand osteoarthritis with or without erosions.

Aged↗
PubMed1990

Hepatic copper concentrations in purebred and mixed-breed dogs.

Histomorphologic, histochemical, and atomic absorption analysis studies were performed on liver tissue from 623 clinically normal purebred and mixed-breed dogs to assess the range of hepatic copper concentrations, the histologic distribution of copper, and the histomorphologic changes associated with the various copper concentrations that were found. Atomic absorption analysis revealed a continuous numerical spectrum ranging from less than 100 parts per million on a dry weight basis (ppm dw) to more than 2,000. No decisive numerical criterion was found that could be used to separate normal from abnormal copper concentrations because of this continuous array. The threshold for histochemical demonstration of copper-containing granules using rhodanine or rubeanic acid staining was 400 ppm dw. At this concentration the copper-containing granules were located in the centrilobular hepatocytes (zone 3 of Rappaport). Copper-containing granules were found in the midzonal and periportal hepatocytes (zones 2 and 1 of Rappaport) in livers with 1,000 ppm dw and higher copper concentrations. The majority of the 623 livers were normal histomorphologically. Multifocal hepatitis characterized by mixed inflammatory cell accumulation and centrilobular distribution was found to be associated with copper concentrations in the range of 2,000 ppm dw or higher. An appropriate upper limit for normal hepatic copper concentration in the dog was not determined based on the present study.

Animals↗
PubMed1984

Erdheim-Chester disease.

A new case of Erdheim-Chester lipoid granulomatosis is described in a 40-year-old man. In this lipid storage disease, characteristic symmetrical osteosclerotic areas are observed mainly in metadiaphyses of long tubular bones. Bone biopsy is mandatory for definite diagnosis, although characteristic radiographic pictures often provide an important clue to the correct diagnosis.

Adult↗
PubMed1978

[The role scalene node biopsy in the treatment in carcinoma of the cervix (author's transl)].

Of 75 scalene node biopsies 18 (24%) were positive. In 56 metastasizing carcinomas of the cervix 11 (20%) scalene node biopsies were positive. In primary inoperable cases (57%) or in recurrent spreading cases (54%) of carcinoma of the cervix the scalene node biopsy is valuable for the treatment plan. Irrespective of treatment the patients with metastases to the scalene node survived a mean of 10--11 months. The scalene node biopsy has few complications (6.7%). In the less than 3% carcinomas of the cervix confined to metastases in the lesser pelvis, the scalene node biopsy is not necessary. 2/3 of the prescalene lymph node metastases can be palpated by an experienced examinar.

Female↗
PubMed1977

[Experience with the Marshall-Marchetti operation for stress incontinence (author's transl)].

From 1962 to 1975 severe stress incontinence or recurrent stress incontinence was operated according to Marshall-Marchetti In 64 cases. Sixty patients were followed up. More than 2/3 of the patients were satisified with the result. Objective follow-up with urethrocystotonometry showed that only slightly more than 50% of the patients were cured. It was possible to divide the cases in 4 groups to elucidate the discrepancy between subjective and objective cure. The operative and postoperative complications were minor. The recurrence rate was the same with follow-up from 3 to 14 years. The results can probably be improved by precise pre-operative diagnosis regarding intrinsic urinary tract disease and by an extension of the indication for this operation or risk cases. The patients must be warned that the result also depends on their cooperation.

Female↗
PubMed1976

Excretion of Dische positive compounds in rats after irradiation and after administration of some cytostatic drugs.

In order to verify some pathophysiological aspects in radio- and chemotherapy of tumors the excretion of Dische positive compounds in rats was followed. During fractionated whole-body irradiation of animals it was found that up to the exposure with 50 R/day the organism is able to repair the disturbances provoked by irradiation for a certain time and that within the course of irradiation a permanently higher excretion of Dische positive compounds occurs. On the contrary, following the exposure of 100 R/day after a short increase continual decrease occurs lasting until the death of the animal. The excretion of Dische positive compounds in rats was followed also after the application of Cyclophosphamide, cis-dichlorodiammineplatinum (II) and Vinblastine. All these three cytostatic drugs produce an increased excretion of Dische positive compounds on the first day after the application. In the case of Cyclophosphamide, it was demonstrated that the excreted amount of Dische positive compounds was dose dependent.

Animals↗
PubMed1975

[The needle biopsy in suspected pelvic recurrence].

The Silverman needle biopsy for the diagnosis of suspicious palpatory findings in the pelvis in cancer patients is recommended. Occasional trauma cannot be avoided but is of secondary importance in the light of the diagnostic value of the procedure. The risk of treatment of a recurrence is much higher. Only 1 trauma necessitated long term antibiotic treatment because of a parametritis. Perforation or biopsy of the bladder or the rectum usually remained asymptomatic. The needle biopsy confirmed the diagnosis of recurrent tumor in 47 out of 74 patients with the first try. In 6 out of 10 patients the tumor diagnosis was confirmed by a second needle biopsy 2 to 3 months later. Two patients had a third negative biopsy. A total of 11 patients were saved from the fate of treatment of a clinically suspected cancer recurrence as confirmed by the subsequent clinical course over the next 1 to 6 years.

Biopsy, Needle↗