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Biomedical subjects

M Hamm

Publications and source records attributed to M Hamm.

At least 55 records · Page 3Linked to original sources

Prediction of tumor recurrence after radical prostatectomy using elimination kinetics of prostate-specific antigen.

The serum half-life of prostate-specific antigen (PSA) calculated subsequent to radical prostatectomy can serve to predict which patients are at high risk of bearing residual prostatic carcinoma despite their initial attainment of undetectable PSA serum levels. This report updates previous results to a mean follow-up period of 37 months. The initial results are essentially confirmed in that a mean PSA elimination half-life of 1.6 days in patients considered to be cured at least 24 months after prostatectomy provides additional useful information for predicting outcome in patients with potentially curable prostate cancer.

Adenocarcinoma↗

[The quotient of prostate-specific antigen and prostate volume. Improved differentiation between benign prostatic hyperplasia and locally circumscribed prostate cancer].

Absolute serum prostate-specific antigen (PSA) values are of little help in the identification of locally confined prostatic cancer (PCA), because of a considerable overlap with the PSA values found in benign prostatic hyperplasia (BPH). Prostate gland volumes were estimated sonographically in 112 patients using the product of the three maximal diameters (longitudinal, anterior-posterior, transverse) and the factor 0.52. PSA was determined with a monoclonal immunoenzymetric assay (Tandem-E, Hybritech). The prostates were removed by either transvesical prostatectomy (for BPH) or radical retropubic prostatovesiculectomy (for PCA). In each case the diagnosis was verified by systematic histological examination. The ratio of serum PSA to estimated prostate volume did not exceed 0.4 ng/(ml x ml) in any of the 74 patients with BPH, whereas 23 of the 38 patients with PCA had a ratio above 0.4 ng/(ml x ml). The information provided by the PSA-prostate volume ratio is superior to absolute PSA values in preoperative differentiation between BPH and PCA. With a PSA-prostate volume ratio over 0.4 ng/(ml x ml) patients are at high risk for PCA and should be evaluated by prostate biopsy.

Adult↗

Half-life of prostate-specific antigen after radical prostatectomy: the decisive predictor of curative treatment?

Prostate-specific antigen (PSA) half-life calculated in 51 patients subsequent to radical prostatectomy was found to identify patients with residual disease earlier and more reliably than the criterion of not achieving undetectable PSA levels postoperatively. It is proposed that residual tumor affects the half-life by contributing to the serum level of PSA. When PSA half-life was calculated solely in potentially cured patients, we found a half-life of 1.5 days being considerably shorter than in the previous reports based on patient populations regardless of the outcome of disease in the follow-up.

Adenocarcinoma↗

Evaluation of lung function during pulmonary rejection and infection in heart-lung transplant patients. Hannover Lung Transplant Group.

Pulmonary rejection and infection are the most important complications after lung transplantation. To evaluate the diagnostic value of pulmonary function testing for early detection and discrimination of these complications, seven heart-lung recipients were examined. The diagnosis of each complication was confirmed by clinical and laboratory findings including transbronchial biopsies and bronchoalveolar lavage. Eight episodes of rejection, ten episodes of viral infection and six episodes of bacterial pneumonia were analyzed. Pulmonary rejection was associated with a significant fall in the FEV1/IVC% and the FEF50%. In viral infection, the most impressive finding was a reduction in the DCO, whereas no obstructive or restrictive airway dynamics were observed. During bacterial pneumonia, pulmonary function measurement revealed a decrease in IVC without signs of obstructive airway dynamics. Adequate treatment resulted in reconstitution of pretreatment values. Assessment of lung function provides valuable information for the diagnosis of pulmonary complications following HLTx.

Adult↗

Preoperative corticosteroids. A contraindication to lung transplantation?

Regular preoperative application of corticosteroids has been considered as a contraindication to lung transplantation for fear of an increased risk of postoperative morbidity and mortality. Recently, however, we have accepted patients for transplantation in whom treatment with steroid medication could not be terminated preoperatively. Up to February 1991, 27 unilateral and bilateral transplantations in 26 patients were analyzed. Corticosteroid therapy was discontinued at least three months prior to transplantation in 13 patients (group 1), whereas in 14 cases, the patients continued their daily corticosteroid therapy to the time of transplantation (prednisolone, 0.1 to 0.3 mg/kg/day; group 2). There were no significant differences between the groups with respect to sex, age, diagnosis, or type of transplantation. One limited bronchial dehiscence occurred; the incidence of postoperative bronchial stenosis was identical in both cohorts; one patient died in each group. In conclusion, no increased morbidity or mortality could be found following lung transplantation with regular preoperative administration of prednisolone up to 0.3 mg/kg/day. Thus, patients who cannot be weaned from their steroid medication but who otherwise are acceptable candidates should not be excluded from lung transplantation.

Adolescent↗

Imaging of pulmonary artery and vein anastomoses by transesophageal echocardiography after lung transplantation.

BACKGROUND: In patients after isolated lung transplantation, the postoperative course may be complicated by dysfunction of the pulmonary artery and vein anastomoses. METHODS AND RESULTS: Pulmonary artery and vein anastomoses in 11 transplanted lungs (four left, four right, and three bilateral lungs) in 10 patients were studied 1 day to 11 months after operation by transesophageal echocardiography (TEE). All 14 pulmonary vein anastomoses, all seven right (100%) and five of seven (71%) left pulmonary artery anastomoses could be visualized by TEE. Thrombosis of a left pulmonary vein anastomosis could be identified by TEE and successfully treated by thrombolysis. TEE detected a significant stenosis in one right and one left pulmonary artery anastomosis; anastomoses dysfunction were confirmed by cardiac catheterization and pulmonary angiography and successfully treated by surgical correction in both cases. CONCLUSIONS: Function and morphology of pulmonary artery and vein anastomoses in patients after isolated lung transplantation can reliably be assessed by TEE. In patients with suspected dysfunction of an anastomosis, TEE may be considered the diagnostic technique of choice.

Adult↗

[Meat as component of a balanced diet].

From the point of view of the nutritionist, meat has an important role to play in supplying the body with proteins (essential amino acids, vitamins and minerals). There is no doubt that meat is the most valuable source of dietary iron. These facts make meat an important constituent of a balanced diet in a range of age and performance groups, including children and adolescents, pregnant women and nursing mothers, senior citizens and athletes. In the discussion about the nutritional/physiological quality of meat and meat products, total fat, cholesterol and purines must also be considered. About 80 g of lean meat per day, or a portion of about 150 g three times a week in patients with disorders of fat metabolism or elevated uric acid levels complies with the recommendations for low-fat and low-cholesterol alimentation, and helps ensure a balanced diet.

Adolescent↗

[Unilateral lung transplantation in terminal pulmonary emphysema].

Early attempts of single lung transplantation for end-stage chronic obstructive pulmonary disease mostly failed due to a ventilation-perfusion mismatch between the allograft and the contralateral native lung. We performed unilateral lung transplantation in a 39-year-old female with severe pulmonary emphysema and could demonstrate in a one year follow-up that the transplanted lung will be given preference for both--ventilation and perfusion in approximately the same ratio (80%/90%). With improvement of pulmonary preservation, individual adjustment of immunosuppression and detailed monitoring of the transplanted lung unilateral lung transplantation becomes a therapeutical option in patients with severe emphysema.

Adult↗

[Unilateral lung transplantation].

For patients with terminal pulmonary fibrosis unilateral lung transplantation offers a new therapeutic option. At the Hannover Medical School 5 patients have been successfully treated by single lung transplantation. In 3 patients a left, and in 2 patients a right lung transplant was performed. One patient required intraoperative support by cardiopulmonary bypass. Bronchial omentopexy was used in all instances. Currently all patients are alive. A marked improvement of pulmonary function parameters was seen in all cases. The patients are all able to lead a normal life.

Adult↗

[A computerized processing unit for ambulatory diagnosis of sleep apnea and nocturnal hypoxemia].

A new mobile device for the evaluation of the sleep-apnoea-syndrome in outpatients prior to conventional polysomnography, processes and stores the oronasal airflow detected by a thermistor, and the heart rate and oxygen saturation in a microprocessor unit. The major problem in on-line data processing of these variables is the interpretation of the thermistor signal for correct apnoea detection. This preliminary study investigates the reliability of the computer algorithm by control of the automatic airflow assessment. With a sensitivity of 97.3% the algorithm proved to be extreme reliable. Combined with the detection of heart rate and oxygen saturation it provides the capacity for comprehensive analysis of cardiorespiratory events and appears to be suitable for application in an outpatient setting.

Algorithms↗

[A modified unit for detecting sleep apnea].

A comprehensive diagnostic work-up of patients with a suspected sleep apnea syndrome must include conventional polysomnographic monitoring during the night. On account of the considerable staff and technical requirement, however, this definitive diagnostic measure is not suitable for use as a screening programme. For this reason we undertook to develop a device for the computer-aided recording of sleep apnea. The heart of the unit is a 65816 microprocessor with an address capacity of 16 Mbytes. The oro-nasal airflow is recorded with the aid of thermistors, and, after digital filtering, the respiratory rate is continuously recorded on the basis of this signal. Continuous recording of the heart rate and oxygen saturation, is also effected, the recorded data being stored in the microprocessor. On conclusion of the data acquisition phase, evaluation and a compressed display is shown on any conventional personal computer. Our preliminary experience reveals that the algorithm employed is extremely reliable for the detection of respiration rate and apnea, even in the presence of unfavourable signal forms. Clinically relevant deviations from manual evaluation do not occur. As was to be expected, processing of the signals for heart rate and oxygen saturation presented no problems.

Humans↗

[Protective effect of ketotifen and disodium cromoglycate in bronchial challenge tests with allergens (author's transl)].

The protective effect of ketotifen and disodium cromoglycate (DSCG) was evaluated by a randomised double blind cross-over study in 15 children with allergic bronchial asthma. 13 children were allergic to house dust mite (Dermatophagoides pteronyssinus), two to grass pollen. After a positive bronchial challenge test ketotifen or DSCG was given for 4 days followed by bronchial challenge with increasing allergen concentrations. Seven patients showed better allergen tolerance after ketotifen, 5 after DSCG. Protective action against late reactions was found only in 2 children after ketotifen and one child after DSCG.

Adolescent↗

[Mercury concentrations in the air, in the blood and urine of dentists in dental clinics and free practice].

The concentration of mercury in the air was measured for 12 assistants and students, 27 dentists, and 42 dental assistants. The total concentration of mercury in the blood and the urine was also determined and compared with a control group. The results were as follows: 1. The highest concentration of mercury in the air (3--12 microgram Hg/m3) appeared only briefly. 2. The mercury concentration in the spontaneous urine of the dentists and dental assistants (6 microgram/l) was only slightly higher than that for the nonexposed control group (4 microgram/l). 3. The mercury concentration in the whole blood of the students (22 microgram/l) was the highest; that of the dentists and dental assistants (with several years exposure to mercury vapor, 7.0 and/or 6.5 microgram/l) was only slightly higher than that of the nonexposed control group (5 microgram Hg/l).

Air Pollutants↗