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Biomedical subjects

M Hoppe

Publications and source records attributed to M Hoppe.

At least 55 records · Page 3Linked to original sources
PubMed1996

An intracerebral sonographic catheter as an adjunct to stereotactic guided endoscopic procedures.

To facilitate stereotactic biopsies of intracerebral tumor lesions, to obtain important additional diagnostic information during the procedure and to precisely guide biopsy instrumentation devices to spots of interest, catheter sonography was combined with intracerebral endoscopy intraoperatively in two patients. All catheter instrumentation was performed through the stereotactic puncture channels. A 30 Megahertz ultrasound transducer mounted on the tip of a flexible 5 French catheter is sufficiently penetrating surrounding brain tissue, resulting in high resolution images at a maximum radial penetration depth of 15 mm. Normal brain tissue could be differed from intracerebral tumor tissue in both patients. Smaller tumor lesions within the close surrounding of a solid intracerebral tumor mass clearly appeared in ultrasound. Since diagnostic endoscopy in stereotactic procedures is limited to the surface of a puncture channel, intracerebral ultrasound adds important information about the underlying type of tissue. We found that the combination of both methods facilitates guiding of biopsy instrumentation devices to the spots of interest in stereotactic procedures. In both examined patients all biopsy samples were histologically identified as intracerebral lymphoma. Since ultrasound clearly identified intracerebral blood vessels as tubular hyporeflective structures, the risk of biopsy related hemorrhage could be diminished.

Aged↗
PubMed1995

[Iatrogenic esophageal perforation in inoperable esophageal carcinoma. Its therapy with a plastic-coated metal stent].

A 60-year-old man was admitted to hospital because of severely impaired swallowing, retrosternal pain and marked weight loss. History and physical examination of the patient, whose general condition was obviously much reduced, pointed to carcinoma of the oesophagus. Contrast-medium swallow demonstrated subtotal stenosis in the oesophagus. Computed tomography and magnetic resonance imaging showed a space-occupying mass originating from the oesophagus, in close relationship to the trachea, main bronchi and descending aorta. Biopsy confirmed the diagnosis of oesophagus carcinoma and exploratory thoracotomy excluded curative surgical treatment. An attempt was made to introduce a feeding tube endoscopically to provide nutritional palliation. But the oesophagus was perforated during this manoeuvre and resulted in an oesophagobronchial fistula with subsequent mediastinitis and mediastinal emphysema. Using a self-expandable plastic-covered metal stent it was possible to cover the perforation and overcome the patient's dysphagia. The mediastinitis healed under intravenous administration of cefotaxim (2 g three times daily), netilmicin (400 mg daily) and metronidazole (500 mg three times daily), for 5 days.

Carcinoma, Squamous Cell↗
PubMed1995

[Percutaneous intraluminal ultrasound studies of the biliary tract in the diagnosis of malignant biliary obstruction].

The diagnostic value of percutaneous intraluminal ultrasound examination of the biliary tract (PIBUS) for the staging of malignancies that had obstructed the biliary tract was assessed in a prospective study. Intrabiliary sonography was performed 25 times in 22 patients (seven women, 15 men; mean age 66.4 +/- 16 years) with obstructive jaundice in whom percutaneous transhepatic drainage of the biliary tract had been undertaken. The obstruction involved the hepatic duct bifurcation in 15 patients, the distal portion of the choledochal duct in five and its central portion as well as hepaticojejunostomy in one patient each. Ultrasound examination made it possible to assess tumour infiltration into the lumen of the biliary tract, its wall or its surrounding structures. Correct T-staging was successful in all 12 patients with carcinoma of the biliary tract (T1: n = 4; T2: n = 2; T3: n = 6), judged against the "gold standard" of exploratory laparotomy in nine. Infiltration of the portal vein was demonstrated in three patients, lymph node metastases in the region of the hepatoduodenal ligament in seven. This experience indicates that PIBUS makes it possible correctly to T-stage carcinoma of the biliary tract, but because of its limited depth penetration it has to be combined with conventional imaging procedures for precise definition of the N and M stages.

Aged↗
PubMed1995

Noninvasive electroencephalography and mesial temporal sclerosis.

In this study, preoperative interictal and ictal scalp EEG findings from 24 patients with histologically proven hippocampal sclerosis were analyzed. The electrophysiological findings showed a rather uniform picture: all interictal epileptiform discharges were confined to the temporal region most frequently located at the sphenoidal electrodes. In 50% of the patients contralateral temporal spikes were found, 66% of which were at homologous temporal electrode sites. Initial ictal EEG seizure patterns consisted of rhythmical activity in the delta, theta, or alpha range regionalized over the ipsilateral temporal area or lateralized to the ipsilateral hemisphere. Only 3% of the 173 recorded seizures were found to build up over the side contralateral to the seizure origin. Topographic mapping of temporal spikes in most cases shows a dipolar field with a narrow negative field at the basal temporal area and a widespread positivity at the frontocentroparietal midline, i.e., a vertical dipole. Multiple dipole modeling reveals a spike propagation system between basal and lateral temporal areas. There is evidence that the characteristic initial EEG seizure pattern in mesial temporal lobe epilepsy is of the hypersynchronous form consisting of rhythmic repetitive epileptiform discharges.

Adolescent↗
PubMed1995

[Analysis of postoperative seizure recurrence after 65 temporal lobe partial resections].

Sixty-five patients (aged between 3 years 5 months and 60 years) suffering from medically resistant temporal lobe epilepsy (TLE) were operated on over a period of 33 months in Bethel Epilepsy Center. Thirty-three patients had mesial TLE and 32 patients had TLE of different etiology. The postoperative follow-up lasted 2 years in 30 patients and was on average 13.2 months or at least 8 months in the 35 patients who did not have their last examination 2 years after surgery. Many of the patients (70.9%) were seizure-free; 92.3% achieved a rewarding improvement in seizure frequency and quality of life. Reduction of medication was the cause for relapse in 10 patients, in 6 patients incomplete resection, and in 5 patients the prognosis was not good even before surgery. The cause remained unclear in 4 patients. Freedom from seizures was achieved again by renewed medication or by repeated operation in 10 of 25 patients.

Adolescent↗
PubMed1993

Parasomnia with rhythmic movements manifesting as nocturnal tongue biting.

The case of a healthy 2-year-old girl with repeated nocturnal tongue biting as a result of rhythmic movements of the jaw associated with body rocking in non-REM sleep is described. Parasomnias manifesting with rhythmic, stereotyped movements of the head, trunk and extremities are well described in healthy children. The term rhythmic movement disorders (RMD) was introduced for these repetive movements in sleep which may appear as head banging (jactatio capitis), body rocking or leg rolling. Severe injuries including fractures, subdural effusions and eye injures are reported. Repeated tongue injuries have not been described as a consequence of RMD. The differential diagnosis from nocturnal seizures is crucial to avoid overtreatment of this benign albeit dramatically presenting condition.

Bites, Human↗
PubMed1992

The effect of inhaled gallopamil, a potent calcium channel blocker, on the late-phase response in subjects with allergic asthma.

The effect of gallopamil on the late-phase response to inhaled allergen was evaluated in six young adults with allergic asthma in a crossover manner. During 2 study days, subjects received 20 mg of inhaled gallopamil or placebo 30 minutes before challenge with the same dose of allergen. In addition, a histamine challenge was performed 1 1/2 hours before and 24 hours after allergen challenge. On 2 additional study days, in the absence of allergen, basal airway responsiveness to histamine was measured before and after gallopamil or placebo administration. During the early phase, the mean +/- SD decrease in FEV1 was 28.0% +/- 11.3% after placebo and 25.1% +/- 8.4% after gallopamil administration (p greater than 0.05; beta = 0.14). During the late phase, the maximum decrease in FEV1 was 26.9% +/- 11.9% after placebo and 25.3% +/- 10.3% after gallopamil administration (p greater than 0.05; beta = 0.21). Airway reactivity to histamine 24 hours after allergen challenge could not be measured in three subjects after gallopamil administration and in one subject after placebo administration because of persistent bronchospasm. In contrast, basal responsiveness to histamine in the absence of allergen was modestly decreased by gallopamil. Since gallopamil is one of the most potent calcium channel blockers when it is administered by the inhaled route, it is unlikely that this group of drugs will be clinically useful for allergic asthma.

Administration, Inhalation↗
PubMed1992

Relative amount of albuterol delivered to lung receptors from a metered-dose inhaler and nebulizer solution. Bioassay by histamine bronchoprovocation.

The results of previous studies comparing bronchodilatation from beta agonists administered by metered-dose inhaler (MDI) and nebulizer solution have been conflicting. We therefore evaluated a range of albuterol doses administered by these two methods, using histamine bronchoprovocation as a bioassay for the amount of drug reaching the beta 2 receptors in the lung. Twelve stable asthmatic volunteers received, in a double-blind, randomized, crossover design on different days, placebo or one, two, four, or six puffs from an MDI attached to an InspirEase device (90 micrograms per puff) or 0.625, 1.25, 2.5, or 5.0 mg of solution delivered in 2 ml of buffered saline through a Hudson Updraft II nebulizer. The histamine concentration required to decrease FEV1 by 20 percent (PC20) was measured 1 h before and 30 min after administration of each treatment and expressed as the increase in PC20 from baseline. The dose-response curves for change in PC20 indicated that the higher doses of the nebulizer solution delivered more drug to beta 2 receptors in the lung than the lower doses from the MDI. For example, the geometric mean increase in PC20 was 1.1 +/- 1.6 (SD) after placebo, 7.5 +/- 2.7 after two puffs from the MDI, and 20.0 +/- 2.1 after 2.5 mg of nebulizer solution (p less than 0.05). Using this bioassay method and administration technique, we estimated that ten puffs from the MDI (0.9 mg) would deliver approximately the same amount of albuterol to lung receptors as 2.5 mg of the nebulizer solution. Taking into account previously published reports and the results of the present study, we conclude that differences in dose, administration technique, nebulizer system efficiency, and severity of airway obstruction can alter the amount of drug reaching the beta 2 receptors in the lungs and, thus, the clinical response.

Adult↗
PubMed1991

A controlled trial of insulin infusion and parenteral nutrition in extremely low birth weight infants with glucose intolerance.

To determine whether a continuous insulin infusion improves glucose tolerance in extremely low birth weight infants, we conducted a prospective, randomized trial in 24 neonates 4 to 14 days old (mean birth weight 772.9 +/- 128 gm; mean gestational age 26.3 +/- 1.6 weeks). Infants who had glucose intolerance were randomly assigned to receive either intravenous glucose and total parenteral nutrition with insulin through a microliter-sensitive pump or standard intravenous therapy alone. One infant assigned to receive insulin never required it. The groups were similar in birth weight, gestational age, race, gender, medical condition, and energy intake before the study. The mean duration of therapy was 14.6 days (range 7 to 21 days). During the study, the 11 insulin-treated infants tolerated higher glucose infusion rates (20.1 +/- 2.5 vs 13.2 +/- 3.2 mg/kg/min (1.1 +/- 0.1 vs 0.7 +/- 0.2 mmol/L); p less than 0.01), had greater nonprotein energy intake (124.7 +/- 18 vs 86.0 +/- 6 kcal/kg/day; p less than 0.01), and had better weight gain (20.1 +/- 12.1 vs 7.8 +/- 5.1 gm/kg/day; p less than 0.01) than the 12 control infants. The incidence of hypoglycemia, electrolyte imbalance, chronic lung disease, and death did not differ between groups. We conclude that a controlled insulin infusion improves and sustains glucose tolerance, facilitates provision of calories, and enhances weight gain in glucose-intolerant premature infants.

Blood Glucose↗
PubMed1989

[Ultrasound microscopy findings of artificial lenses].

Acoustic microscopy permits a native, nondestructive and artefact-free analysis of the surface of intraocular lenses with regard to manufacturing defects, biologic cellular and membranaceous layers, and signs of degradation. Furthermore, it enables structures below the surface to be evaluated, so that inclusions, pores, microcracks and zones of deformation can be detected. In addition to performance of a one-dimensional, relative intensity profile of the surface and the corresponding pseudo-3D image, the properties of the materials inside the intraocular lens can be characterized by computerized analysis of the reflected ultrasound energy.

Computer Graphics↗
PubMed1988

Specific intellectual deficits in children with early onset diabetes mellitus.

27 children with early onset (less than 4 years) diabetes (EOD), 24 with late onset (greater than 4.0 years) diabetes (LOD), and 30 sibling controls were compared in their performance on tests of intellectual functioning and school achievement. The results indicated that children with EOD, particularly girls, scored lower than the other groups of diabetic children and siblings on tests of visuospatial but not verbal ability. Many of the children with EOD were also having difficulty at school, and a number were currently receiving special education. Diabetic children with earlier onset had more hypoglycemic convulsions than those with later onset. Regression analyses revealed that duration of illness, age of onset, and hypoglycemic convulsions significantly predicted spatial ability.

Child↗
PubMed1987

Behaviour problems in children with diabetes as a function of sex and age of onset of disease.

Twenty-seven children with early onset (less than or equal to 3 years) diabetes (EOD), 24 with late onset (greater than or equal to 4 years) diabetes (LOD) and 30 sibling controls were compared on measures of psychosocial adjustment. These included parent rating scales of behaviour problems and temperament; direct measures of self-esteem, body image and school achievement; and indices of diabetic control. Results indicated that LOD boys showed increased incidence of behaviour problems, 83% of whom could be assigned a diagnostic classification and more distortions of body image. The results were not related to any indices of diabetic control.

Adolescent↗
PubMed1983

[Clinical importance of Acinetobacter calcoaceticus isolations from blood and venous catheters].

From 1980 to 1982 Acinetobacter calcoaceticus (A.c.) derived from blood cultures and venous catheters of 29 patients could be grown. 6 patients with clinical signs of Gram-negative septicemia had two or more blood cultures positive for A.c. Thus, the role of A.c. as the etiologically relevant pathogen seems to be evident. In 14 cases with clinical signs of septicemia but only one set of blood cultures positive for A.c. it is felt to be the causative agent since no other cause could be found. In 9 cases isolation of A.c. seems to be due to contamination - most likely from skin -, because neither evidence of septicemia nor relationship to the diseases present of A.c. existed.

Acinetobacter Infections↗