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Biomedical subjects

M Hofmann

Publications and source records attributed to M Hofmann.

335 records · Page 19Linked to original sources

Ineffectiveness of methylprednisolone to reduce infarct size in experimental coronary occlusion.

Two medium-sized branches of the left coronary artery were prepared in each of 10 anesthetized open chest dogs for later occlusion. The first artery was occluded during 90 minutes and reperfused thereafter. This occlusion produced the control infarct. Methylprednisolone (50 mg/kg i.v.) was injected and the second artery was occluded also for 90 minutes and reperfused thereafter. Both infarcts were made visible by staining left ventricular rings with p-nitrobluetetrazolium. Infarct size was compared with the size of the perfusion area, which we obtained from the postmortem angiogram. Both infarcts were equal in size and comprised 50% of the area of perfusion of the occluded artery. Methylprednisolone in a single high dose given prophylactically did not influence infarct size nor any of the measured parameters.

Animals↗

The PHA-induced calcium signal in lymphocytes is altered after blockade of K(+)-channels in Alzheimer's disease.

Several lines of evidence indicate that alterations in intracellular calcium homeostasis with sustained elevation of free calcium ions ([Ca2+]i) might be important in the pathophysiology of Alzheimer's disease (AD). Recent studies with peripheral blood-cells have demonstrated that investigation of regulatory mechanisms in calcium homeostasis might be more promising than determining only resting or stimulated [Ca2+]i values. With respect to the importance of potassium (K+)-channels in intracellular calcium regulation we have investigated whether a potassium channel dysfunction, already demonstrated for AD fibroblasts (Etcheberrigaray et al., 1993, Proceedings of National Academy of Sciences USA, 90, 8209-8213), could be observed in circulating lymphocytes as well. Thus, we studied the influence of the K(+)-channel inhibitor tetraethylammonium (TEA) on basal and PHA-stimulated [Ca2+]i in lymphocytes from AD (n = 20), non-demented depressed patients (n = 15) and age-related healthy controls (n = 23). Preincubation of lymphocytes with 100 mmol/l TEA resulted in a 45.5 +/- 8.8% inhibition (mean +/- SD) of the PHA induced rise in [Ca2+]i in healthy controls and 37.3 +/- 11.3% inhibition in depressed patients. With lymphocytes of AD patients, this effect of TEA was significantly reduced (23.2 +/- 8.8%, p < .001). If the individual data are considered there was almost no overlap between AD patients and healthy controls, since only three (15%) AD patients responded to TEA with > 30% inhibition, but only one of the controls (5%) responded with < 30% inhibition. Besides the reduced signal-inhibition by blockade of K(+)-channels we have observed a delayed response of AD lymphocytes in [Ca2+]i rise after PHA stimulation, suggesting that functional plasticity of the cells is reduced. Although the significance and molecular basis of this K(+)-channel dysfunction are not yet determined, the presented data are of great significance because of diagnostic reasons and especially because this model thus offers a possibility to investigate functional cellular alterations in vivo.

Adult↗

Interactive computer-based cognitive training in patients with Alzheimer's disease.

The present paper presents data from ten patients suffering from mild to moderate Alzheimer's disease (AD), all of whom were trained to use an interactive computer-based program. Using photographs of the patient and his or her personal surroundings, an everyday task of relevance to the patient was simulated on a PC-touch screen, which the patient was trained to operate. After three weeks of training (three to four sessions a week), the patients needed less help in performing the programs, they became faster, and eight out of ten made fewer mistakes. The results were most pronounced in patients with a poor performance at the beginning, and there was no difference between early-onset (EO) and late-onset (LO) AD patients. Although the training was generally well received, there was no evidence of a general cognitive improvement, and it remains an open question whether the results achieved with PC training can be transferred to real-life situations.

Activities of Daily Living↗

Multivariate independent prognostic factors in endometrial carcinoma: a clinicopathologic study in 181 patients: 10 years experience at the Department of Obstetrics and Gynecology of the Mainz University.

The aim of this study was to evaluate the biologic outcome of endometrial carcinomas as compared to clinical and pathologic parameters and to identify multivariate independent prognostic factors. Charts were abstracted from patients with endometrial carcinoma from 1985 to 1995. Data on clinicopathologic variables, adjuvant treatment, site of recurrence, and survival were collected. chi2 test was used to test association between variables. Kaplan-Maier method was used for survival analysis and Cox proportional hazards model for multiple regression analysis. Univariate analysis revealed that FIGO stage, tumor grade, depth of myometrial invasion, biochemical analysis of progesterone receptor status, age, additional diabetes mellitus, lymph node metastasis, and type of tumor were significantly associated with the overall-survival. For disease-free interval, FIGO stage, tumor grade, depth of myometrial invasion, biochemical analysis of progesterone receptor status, lymph node metastasis, and type of tumor were also significantly associated. Multivariate analysis revealed that FIGO stage, tumor grading, tumor type, depth of myometrial invasion, and biochemically measured progesterone receptor status were associated significantly with overall survival. A significant correlation as independent prognostic factors were also seen for recurrence free interval for FIGO stage, tumor grade, and biochemical progesterone receptor status. In multivariate statistical analysis we identified FIGO stage, tumor type, tumor grade, biochemical analysis of progesterone receptor status, and depth of myometrial invasion as independent prognostic factors for overall survival, and FIGO stage, biochemical analysis of progesterone receptor status, and tumor grade as independent prognostic factors for recurrence-free interval.

Adenocarcinoma↗

Propionic acidemia revisited: a workshop report.

Propionic acidemia (PA) is one of the most frequent organic acidurias, but information on the outcome of individuals with PA is rather limited. We present data of 49 patients with PA, which were gathered from 18 metabolic centers throughout Central Europe on the occasion of an international workshop. All patients were identified by selective metabolic screening, and 86% of them were classified as having early-onset PA owing to their presentation with clinical symptoms within the first 90 days of life. Mortality rate was one third, and details of symptoms and treatment of the surviving patients are discussed. The great variation of phenotypic expression of the disease and different therapeutic strategies (especially in regard to the degree of protein restriction) used at the various institutions involved in this study imply the need for a registry of PA patients and for a multicenter prospective treatment study.

Amino Acid Metabolism, Inborn Errors↗

Factors contributing to late hospice admission and proposals for change.

INTRODUCTION: Hospice seeks to provide high-quality, holistic end-of-life care. Most insurances will reimburse hospice care for a period of six to seven months. However, the majority of patients are not referred to hospice until they are very close to death. The purpose of this study was to examine characteristics of an urban hospice program that may be associated with inordinately late admission to hospice care. METHODS: A retrospective chart review of 100 consecutive admissions was carried out. Patient data from the referral/intake forms were reviewed and length of stay of each patient was calculated. RESULTS: The average length of stay in this hospice was 34 days. Over half of the patients (51 percent) died within 14 days, and more than one-third (35 percent) died within seven days of admission. African-Americans made up nearly one-third of the patient group (32 percent). A considerable number of patients had a non-cancer diagnosis (39 percent). More than half of the patients were referred from acute care hospitals/specialists (58 percent). CONCLUSION: The study shows that most patients were referred to this urban hospice program when they were very close to death. Three characteristics may contribute to this underutilization of the hospice benefit: (1) the large representation of African-Americans, (2) the high enrollment of patients with non-cancer diseases, and (3) the high number of referrals from acute care hospitals/specialists. Initiatives to overcome barriers to hospice care for minority populations, to better prognosticate terminal illnesses, and to educate physicians and patients about palliative care are needed so that more patients can benefit more fully from hospice care at the end of life.

Adult↗

Comparison of the DNA content in liver cell adenoma, hepatocellular carcinoma and regenerative nodules.

With regard to neoplasms of hepatocytes, diagnostic pitfalls have been reported for differentiation of liver cell adenoma (LCA) from well differentiated hepatocellular carcinoma (HCC). Since cytophotometric analysis of the DNA content with the help of image analysis has proven to be of diagnostic value in various neoplasms, we examined its ability to discriminate between LCA and HCC as well as regenerative liver nodules. The material investigated consisted of 54 cases of HCC, 10 benign liver tumours and 10 cases suspicious for HCC. All the benign liver tumours demonstrated an euploid histogram. 9 out of 10 borderline tumours were euploid while 1 out of 10 was suspiciously aneuploid. Among HCC, 21 out of 54 were euploid, 18 out of 54 suspiciously and 15 out of 54 clearly aneuploid. 5c exceeding rate differed significantly between benign liver changes and borderline lesions (p = 0.0474) as well as between borderline lesions and malignant tumours (p = 0.0108). We conclude that the use of image cytometry is helpful as an additional criterion for more diagnostic accuracy in morphologically difficult cases.

Adenoma, Liver Cell↗

[Accident classification of workers in the construction industry in the 2d half of life].

On the basis of 3,631 accidents from the Surgical Department of the Central Outpatient's Department of construction workers it could be established by means of the industrial-medical diagnostic accident index numbers that an adequate estimation of function, work and capability is also possible in the second half of life. It is in accordance with the biological age characteristics that in the second half of life twice as much moderately severe and severe accidents have been registered as in the first one, and that this also applies to selected injuries such as fractures, contusions and open wounds.

Accidents, Occupational↗

[Pre- and postpartum hemostatic characteristics in pregnancy-related hypertension and pre-eclampsia in comparison with normotensive pregnancies].

Pregnancy is accompanied by a physiological activation of intravascular coagulation; however without disorder. Normal markers of coagulation are unchanged despite activation. Special coagulation parameter--such as Thrombin-Antithrombin-III-complex (TAT) or D-Dimer are increased also in normal pregnant women. Pregnancy induced hypertension (SIH) and preeklampsia may be associated with a disorder of coagulation that precedes the well known clinical manifestation of hypertension. Therefore it was the aim of the study to distinguish both the pregnancy induced hypertension (15 patients) and preeklampsia (10 patients) as far as it is possible by coagulation parameters such as thrombin generation (by TAT), fibrinolysis (by D-Dimer), AT-III, platelets and others comparing them with 25 normotensive pregnancies. In preeklampsia, the results showed that clinical signs were associated with simultaneous coagulation abnormalities. TAT and D-Dimere are significant increased whereas a decrease of AT-III and platelets was observed. There are no significant differences between SIH and normal pregnancies. Three days after delivery there was an increase of D-Dimer, AT-III and platelets and a decrease of TAT-complex in all groups. For risk pregnancy, the parameters TAT and D-Dimer may be useful as screening test. They although may support confirming the diagnosis of preeklampsia.

Adult↗

Comparison of MIBG and pentetreotide scintigraphy in children with neuroblastoma. Is the expression of somatostatin receptors a prognostic factor?

BACKGROUND: Neuroblastoma (NB) is the fourth most common pediatric malignancy and recent reports suggest a prognostic role of somatostatin receptor scintigraphy (SRS) in this disease. MATERIALS AND METHODS: Twenty two patients (pts. mean age 43.9 months) with NB were investigated by 1-123-MIBG and SRS (In-111-pentetreotide). Twenty-seven comparative scans were evaluated and compared for catecholamin excretion, Ultrasound, CT and MRI data. The patients were then divided into three groups. I: patients with manifest disease, II: patients with relapse or minimal disease and III: patients with no evidence of disease. RESULTS: MIBG and SRS scans were concordant in 85% (12 true positive, 7 true negative, 4 false negative). In 4 pts only the MIBG scan was positive. In 9 pts with stage I-III disease or complete remission no relapse was recorded during 19.8 months. In 4 out of 5 pts who died SRS failed to localize the tumor sites but three MIBG scans were positive. Five out of 6 pts with a relapse free interval of 7.9 months had positive SRS and MIBG scans. CONCLUSIONS: in NB SRS can be applied as a specific imaging modality. However, in some pts SRS failed due to the lack of receptor expression. Somatostatin receptor expression seems to be related with a more favourable clinical outcome.

3-Iodobenzylguanidine↗