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Biomedical subjects

L Horbach

Publications and source records attributed to L Horbach.

At least 19 recordsLinked to original sources
PubMed1996

[Reliability and interobserver concordance in detection of prostatic carcinoma with magnetic resonance tomography].

PURPOSE: To determine the reliability and the measuring agreement between two radiologists in the identification of relevant structures of prostate anatomy in patients with prostate carcinoma. PATIENTS AND METHOD: 15 patients with prostate carcinoma proved by histology underwent MR Imaging on 1.5 Tesla MR-system (Siemens Erlangen). T1- and T2-weighted sequences were used in the depiction of important anatomic structures for diagnosing prostate cancer. 5 sequences of every patient were evaluated for 5 times by each reader. Reliability was proved by the intraclass correlation coefficient and the measuring agreement was proved by Cohen's cappa test. RESULTS: Only the T2-weighted sequence was of sufficient sensitivity to reach a moderate reliability (r1 = 0.74) and a moderate measurement agreement between the two readers (kappa = 0.5). CONCLUSION: For the evaluation of MR images in staging prostate carcinoma, besides the validity and the measuring agreement, the reliability of the radiologist is the important factor.

Analysis of Variance↗
PubMed1995

International standards for hospital communication systems.

A major problem for many Hospital Information Systems is separating modules to meet the information requirements of specialized parts before integration into one system. In most cases the interfaces are proprietary, leading to an enormous amount of implementation work for access to other systems. International Standards, such as a common language in Medical Communication, offer the possibility of reducing this variety and enhancing the information interchange by connecting more systems in shorter time with less cost.

Computer Communication Networks↗
PubMed1995

RDA: a standard for client server communication in a hospital information system.

The University of Erlangen-Nürnberg contains a large medical faculty with many hospitals, laboratories, and other departments distributed in the town of Erlangen, and it is necessary to exchange medical data between them. For example the basic patient data which are held on central computers, must be distributed to various stations and departments. In addition medical reports which are prepared on or generated by computers in central departments must be transmitted to various points in the hospitals [1]. When the network, based on ethernet cabling within the hospitals and a glass fiber backbone, has been completed, the Erlangen hospital communication system will support an electronic exchange of medical information. Two separate communication methods are used: data exchange via electronic mail according to the international standard X.400 and remote access to central databases using the software product NET-WORK.

Computer Communication Networks↗
PubMed1995

Dissemination of patient data in the Erlangen Hospital communication and information system.

It is necessary to exchange information between the various institutions of the medical faculty of the University of Erlangen-Nurnberg. For example, basic patient data, which is collected in a central computer, must be distributed to various stations and laboratories. Also medical findings, which are already captured in computers in central laboratories, must be transmitted to various parts of the university hospitals. After the data network, consisting of a glass fiber backbone linking the buildings and cabling in the individual departments, had been implemented, it became possible to provide an electronic exchange of medical information.

Computer Communication Networks↗
PubMed1995

Secure and protected network connection between medical and external networks.

Internal and world-wide communication, access to medical databases, and information services are essential demands in the science of medicine not only for research, but also for improving patient care. A network connection between the medical network of the Erlangen University Hospital and other international networks was examined as a concept within the scope of a Erlangen Hospital Communication System (EKKS) project and tested with an actual installation.

Computer Communication Networks↗
PubMed1994

Polypropylene production workers and colorectal cancer in Germany: a brief report.

OBJECTIVE: A retrospective cohort study of 640 male polypropylene production workers in Germany was performed to evaluate the reported association between colorectal cancer and polypropylene. METHOD: The follow up period was 1956 to 1990. Expected numbers of cancers were derived from incidence rates adjusted for age and calendar year from the Saarland cancer registry. RESULTS: Three colorectal cancers were identified compared with 4.0 expected (standardised incidence ration (SIR) = 0.75, 95% confidence interval (95% CI): 0.15-2.19). For total cancers there were 27 cases in the cohort compared with 35.4 expected (SIR = 0.76, 95% CI: 0.50-1.11). DISCUSSION: These results do not support earlier reports of a link between polypropylene production and colorectal cancer, but are consistent with a number of recent investigations of polypropylene production workers that have reported no association with risk of colorectal cancer. Due to the small size of this and other similar studies, however, a small to moderate increase in risk cannot be ruled out.

Cohort Studies↗
PubMed1986

[Gabexate mesilate in the treatment of acute pancreatitis. Results of a Hannover multicenter double-blind study with 50 patients].

We investigated the effect of a new synthetic protease- and phospholipase A2-inhibitor gabexate mesilate (FOY) in a multicenter (6 hospitals in Hannover and vicinity) double-blind study on the clinical course of acute pancreatitis. 50 patients were randomized into two subgroups. One group was treated with 3 X 300 mgs of gabexate mesilate per day for 9 days as a continuous intravenous infusion, the control group received placebo. There was no difference in these two groups regarding age and sex, but there was a discrepancy concerning the severity (stage I-IV) of the acute pancreatitis at the onset of treatment. More of the patients in the gabexate mesilate-group had severe disease on admission to hospital. Of the 7 patients (14%) who died, 5 were in the gabexate mesilate-group whereas only 2 were in the placebo group. This difference in the mortality rate is not significant. There was, however, a significant difference at the 5% level between the verum-group and the control group concerning the decline in alpha-amylase activity in serum and the number of complications. The difference was greatest in alcohol induced acute pancreatitis. A non-parametric test showed a significant reduction in hospitalisation time in the gabexate mesilate-group. Due to the small number of patients and the inhomogeneous clinical course of the acute pancreatitis a definite conclusion concerning the effect of gabexate mesilate on the clinical course of acute pancreatitis is not possible. Further studies with a much greater number of patients and more homogeneous groups with respect to the severity of the acute pancreatitis at the onset of the therapy with gabexate mesilate or placebo are necessary.

Acute Disease↗
PubMed1986

[Biometry as a methodologic principle of clinical research in otorhinolaryngology].

The basic biometric theories for different types of clinical studies in Oto-Rhino-Laryngology are presented with a minimum use of formulae. A check-list is sketched with all points to be taken into account in the design of a study. The prerequisites for organisation of work and data processing are outlined. The understanding of this methodological basis can be very helpful in promoting the collaboration of clinicians and statisticians in pursuing successful clinical investigations in the field of Oto-Rhino-Laryngology.

Biometry↗
PubMed1984

[Premedication for sonography. Enzyme-paractol in comparison with a placebo].

In a randomized double-blind comparative study involving a total of 50 patients divided into two equal groups, the effects of Enzym-Paractol and placebo on the ultrasonographic representation of internal organs in two planes--pancreatic and paraaortic--were compared. The visualizability was estimated as percentage figures, and revealed an improvement of about 15% for Enzym-Paractol as compared with placebo. With respect to undesired side effects, there was no difference between the two substances.

Adult↗
PubMed1984

[Diagnostic value of increased lactate dehydrogenase activity in vaginal secretions for the early detection of diseases requiring treatment of the female genitals and breast].

The Diagnostic Validity of Enhanced Lactate Dehydrogenase Activity in the Vaginal Secretion for Early Diagnosis of Diseases of the Female Genitals and the Mamma in Need of Treatment. An impregnated hygiene tampon (Gynaegnost) was used, which by a colour reaction permits the determination of augmented activity of lactate dehydrogenase (LDH) in vaginal secretion. The diagnostic validity of the results of the findings by this method in the detection of diseases of the female genitals and the mamma needing treatment was examined in two clinical diagnostic studies. The first study including 486 patients chiefly suffering from manifest carcinoma was aimed at solving a deliberately limited question. In patients with carcinoma stages I to IV of the most important genital locations augmented LDH-activity (correct positive results) was found in about 90%. A second study comprised 1955 women entering into outpatient gynaecological services for preventive examination; the definition of this series was difficult. Three categories of diagnostic groups can be determined by the results of this study. In the first category with the most important subgroup "routine examination without specification of a pathological finding" less than 20% "false" positive test results by the indicator were observed. A second category with inflammatory diseases (colpitis, endometritis) showed positive results in about one-third of the examinations. The third category comprised a minor number of malignant tumors roughly with a percentage of positive results corresponding to that of the first study. Augmented LDH activity in vaginal secretion is a diagnostic criterion which detects not only cancer; it is similar to the test of occult blood in faeces.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast Neoplasms↗
PubMed1982

[Carbohydrate infusion in internal diseases. A comparative study in metabolically healthy, liver diseased and diabetic patients. VI. Infusions of a glucose/xylitol mixture (1:1 ratio) over a 48-hour period].

By central venous catheterization, 6 control persons, 7 patients with liver cirrhosis and 6 patients with diabetes mellitus were infused for 48 h with a 20% (w/v) mixture of glucose/xylitol (1:1). The infusion 48 h with a 20% (w/v) mixture of glucose/xylitol (1:1). The infusion rate of 0.125 g monosaccharide/kg/h could be maintained with minor deviations. There were no significant changes in blood glucose levels using this infusion regimen. Lactate levels, however, did increase constantly during the whole infusion period. In the liver group as well as in the diabetic group we could measure values between 1.5 and 3.9 mmol/l. Triglycerides increased solely in the diabetic group. Uric acid concentrations were elevated in all 3 groups. Clinically significant side effects were not observed.

Blood Glucose↗
PubMed1982

[Carbohydrate infusion in internal diseases. A comparative study in metabolically health, liver diseased and diabetic patients. VII. Infusions of a glucose-fructose-xylitol mixture (relationship 1:2:1) over 48 hours].

3 groups (6 control persons, 6 patients with liver cirrhosis, 6 patients with diabetes mellitus) were infused with 20% (w/v) carbohydrate mixture (glucose/fructose/xylitol, 1:2:1) for 48 hours. The metabolical status was controlled in defined intervals by means of 39 different laboratory parameters. The infusion rate was supposed to be 0.25 g carbohydrates/kg B. W. and hour. There were no significant changes in blood glucose levels in any of the 3 groups. However we could observe a slight but constant increase in lactate and triglyceride concentrations. Free fatty acids and keton bodies were suppressed on a low level. Only the diabetics showed a significant renal carbohydrate loss with up to 15% of the amount administered. No clinically relevant side effects were observed.

Adult↗
PubMed1982

[Carbohydrate infusions in internal diseases. A comparative study in metabolically normal subjects, patients with liver diseases and diabetics. V. Infusion of a glucose-sorbitol mixture (ratio 1:1) for 48 hours].

Three groups (6 patients with liver cirrhosis, 6 patients with diabetes mellitus, 6 controls) have been infused for 48 h with a 20% (w/v) glucose/sorbitol-solution (1:1). The only group where the infusion rate of 0,25 g carbohydrates/kg/h could not be reached was the control group with 0,232 g carbohydrates/kg/h. We could not see any significant changes in blood glucose levels during the total infusion period. Sorbitol levels dropped very slowly after the end of the infusion, a time when sorbitol was still excreted in the urine. The concentration of triglycerides was steadily increasing. Besides there were no further changes compared to equicaloric glucose or glucose/fructose infusions.

Diabetes Mellitus↗
PubMed1981

[Stress-metabolism after myocardial infarction-demonstrated by means of the behaviour of plasma proteins with short half-life (author's transl)].

The kinetics of plasma proteins with short half-life during stress-metabolism in patients after myocardial infarction with and without clinical complications and after angina pectoris were compared. The acute-phase proteins alpha1-antitrypsin, C-reactive protein (CRP), fibrinogen, haptoglobin, and the transport proteins prealbumin and transferrin were analyzed with the method of radial immunodiffusion. Whereas angina pectoris doesn't influence the protein kinetics, one can recognize after myocardial infarction a continuous increase of the acute-phase proteins to maxima between the 3rd and 5th day after the attack. Parallel to these changes, the transport proteins decrease with subsequent increase. The changes, which are similar to those seen after surgical trauma, are dependent on the severity of illness, and can be used as prognostic parameters. During stress metabolism, the concentrations of the proteins depending on nutrition, prealbumin and transferrin, are modified by the type and severity of stress, and by nutritional influences. The mechanisms of these changes and the consequences for their use as diagnostic parameters are discussed.

Aged↗
PubMed1981

[Prediction of local recurrences after surgery of carcinoma of the middle reticulum (author's transl)].

On the basis of completely and exactly documented follow-up data of 237 patients on whom carcinomas of the middle rectum were resected for cure, a multivariate statistical model was developed and the corresponding parameters were calculated. With this model the individual risk of local recurrences can be estimated after anterior resection with a small margin of clearance (11-30 mm on the fresh specimen without stretching), after anterior resection with a wide margin of clearance (more than 30 mm), and after excision of the rectum. Seven prognostic factors are taken into consideration that can be determined pre- and intraoperatively. Estimations of the risk of local recurrences on the basis of observed and documented follow-up data can be used as decisive factor for differential indication between restorative and excisional surgery on future patients. After anterior resection the risk of local recurrences is calculated according to macroscopic findings on the specimen and to frozen section histology. If the risks in anterior resection and excision are approximately equal, the resection is ended by anastomosis; otherwise the operation will be extended to excision of the rectum. This statistical model enables the surgeon to select the proper operative procedure for each individual situation (histology- and stage-adapted surgery).

Humans↗
PubMed1981

[Carbohydrate infusion in internal diseases. A comparative study of metabolically healthy persons and liver disease and diabetic patients. III. Glucose infusion over a 48-hour period].

6 metabolically healthy control persons, 6 patients with liver cirrhosis, and 6 patients with diabetes were infused for 48 hours with a 20 % (w/v) glucose solution. The infusion rate was 0,25 g glucose/kg body weight and hour. A constant surveillance of the metabolical status was performed by control of 39 different laboratory values. In all 3 groups, glucose infusion alone was sufficient for basal metabolic rate. This was shown by the inhibition of lipolysis as well as in the decreased catabolism. Only the diabetic group exhibited high blood-sugar values and an energy loss up to 10 % of the administered glucose. We could not observe any side effects.

Blood Glucose↗
PubMed1981

[Carbohydrate infusion in internal diseases. A comparative study of metabolically healthy persons and liver disease and diabetic patients. IV. Infusion of a glucose-fructose mixture (1:1 ratio) over a 48-hour period].

6 patients with liver cirrhosis, 6 patients with diabetes and 6 control persons were infused for 48 h with a mixed carbohydrate solution (glucose/fructose, 1:1). The infusion rate was supposed to be 0,25 g carbohydrates/kg and hour. The metabolical status was surveilled by 39 different laboratory values. The results showed that compared to a pure glucose solution blood glucose levels where decreased. Basic blood glucose levels were passed only in patients with diabetes mellitus. However, the glucose values were not as much elevated that permanent insulin administration would have been necessary. The antilipolytic, antiketogenic and anticatabolic efficacy was comparable to an equicaloric glucose infusion.

Blood Glucose↗