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Biomedical subjects

M Langer

Publications and source records attributed to M Langer.

At least 271 records · Page 15Linked to original sources
PubMed1991

Gadopentetate dimeglumine as a bowel contrast agent: safety and efficacy.

To determine the safety and efficacy of gadopentetate dimeglumine as a bowel contrast agent, magnetic resonance (MR) imaging (0.5 T) was performed with a formulation of gadopentetate dimeglumine (1.0 mmol/L of gadopentetate dimeglumine, 15 g/L of mannitol, 6-17 mL/kg) in 133 patients with intraabdominal mass lesions. Mostly short-lived gastrointestinal side effects were noted in 32% of patients. Gadopentetate dimeglumine provided uniform hyperintense marking of the bowel and contrast enhancement in the region of interest in 81% of patients. Among 78 patients with images obtained both before and after administration of contrast material, post-contrast improvement of lesion delineation was found in 62%. Among 55 patients with only postcontrast images, gadopentetate dimeglumine proved useful in 65%. Intravenous injection of scopolamine or glucagon effectively eliminated "ghost" images of the opacified bowel in 105 of 109 cases. The authors conclude that gadopentetate dimeglumine is a safe and effective bowel contrast agent for MR imaging.

Adolescent↗
PubMed1991

Penetration of roxithromycin into bronchial secretions.

The penetration of an antibacterial agent into the bronchial secretions is a crucial factor in determining its clinical efficacy in the treatment of bacterial respiratory infections. Roxithromycin is a novel macrolide compound active against the most frequent respiratory pathogens. Following administration of 150 mg p.o., we observed a prompt penetration of the compound into bronchial secretions of critically ill patients. Elevated concentrations above the MICs of the commonest susceptible pathogens are reached and maintained until the next administration.

Absorption↗
PubMed1991

[The evaluation of renal tolerance for roentgen contrast media by determination of urinary kidney-specific proteins].

In the present trial kidney-specific proteins were studied enzymatically or quantitatively in patients' urine after intravascular administration of water-soluble X-ray contrast media, in order to judge about their renal tolerance. 5 clinical trials (phase III), including 198 patients, were carried through, within several radiological examinations. The examined X-ray substance was Iosimide, a new monomeric, nonionic low osmolar c.m. It was compared to the nonionic Iopromide and Iopamidol as well as to the ionic, high osmolar sodium-meglumine-diatrizoate. Enzyme activities of alanine-aminopeptidase (AAP), gamma-glutamyltransferase (GGT), beta-n-acetylglucosaminidase (NAG), kallikrein with creatinine as point of reference were kinetically measured in 4 urine samples (1 before c.m. administration the others as 24 hours urine samples of the following 3 days). Beside the quantitative determination of protein and albumin an electrophoresis was started, when diagnosis was obvious. Kallikrein was brought to the diagnostic palette of this study in order to include the distal segment of the nephron. The specific protein excretion patterns of nonionic c.m. in urine are not different from each other. In contradiction to this, the results of the low osmolar nonionic Iosimide compared to the high osmolar diatrizoate, show evident differences for the benefit of Iosimide.

Acetylglucosaminidase↗
PubMed1991

[Three-dimensional computerized tomography of fractures].

In 32 patients with fractures of different localisation the transverse CT layers were compared with three-dimensional reconstructions. Evaluation showed that three-dimensional CT can better visualize complicated anatomical conditions especially if there are dislocated fragments in the facial part of the skull and in the trunk of the body. Hence, 3-D CT is a valuable complement to axial CT which, however, remains the basis of the findings. Misinterpretations are possible of the reconstructions are used alone because of the lack if visualization of the lesions of the soft parts that accompany fractures and because there may be pseudoforamina at thin osseous lamellae.

Adolescent↗
PubMed1991

[Intra-arterial chemoembolization of non-resectable hepatocellular carcinoma].

During a period of nine months, fifteen patients with extensive hepato-cellular carcinomas were subjected to palliative arterial chemo-embolisation using doxorubicin and cisplatin in an emulsion with Lipiodol and/or Spherex particles. Two patients (stage Child C) died within two weeks as the result of liver failure. The remaining thirteen patients showed improvement in their general condition. Subsequent CT showed evidence of tumour reduction and reduction of ascites. Gas production in the tumour was considered as evidence of tumour necrosis. Biochemical results confirmed these findings with a fall of AFP as tumour marker indicating tumour regression.

Aged↗
PubMed1991

[Recovery after serious mushroom poisoning (grade IV encephalopathy) with intensive care support and without liver transplantation. Clinical case].

Despite consistent improvement in its treatment, amatoxin poisoning still extolls an elevated overall mortality, ranging between 10 and 15%, which approaches 100% when severe (grade 3-4 encephalopathy) hepatic failure supervened. Therefore, the proper treatment of intoxication by amatoxin containing mushrooms, and particularly of its complications, remains a challenge in emergency medicine. Klein and coworkers reviewed the role of liver transplantation in amatoxin poisoning as a useful therapeutic tool for patients with severe impairment of liver function. Their indication for intervention is the presence of any of the following signs: grade 2 encephalopathy or higher; prothrombin time twice than normal, despite fresh frozen plasma infusion; hypoglycemia requiring hypertonic glucose infusion; hyperbilirubinemia (greater than 25 mg/dl). During the past autumn two patients with fulminant hepatic failure due to amatoxin poisoning were referred to our institutions as candidates for liver transplantation, since both satisfied Klein's criteria. However, due to shortage of organ donors it was impossible to transplant them over the following days. Despite they did not receive liver transplantation, both patients wakened from coma, their liver function improved, and they recovered from terminal amatoxin poisoning. After one year, both patients are long-term survivors, in good health and without any sequelae either in brain or liver function.

Adolescent↗
PubMed1991

Trace element intake (zinc, manganese, copper, molybdenum, iodine and nickel) of humans in Thuringia and Brandenburg of the Fed. Rep. of Germany.

The daily dry matter intake of 56 test persons between 20 and 60 years of age from four geographic groups (Wusterhausen and Vetschau in Brandenburg; Jena and Bad Langensalza in Thuringia) was registered on 7 consecutive days by means of the duplicate method. The Zn, Mn, Cu, Mo, I and Ni content of food and beverage dry matter and the daily intake of these trace elements were determined. During the test period, the ration contained 24-29 mg zinc, 6.8-9.2 mg manganese, 1.9-2.6 mg copper, 0.17-0.22 mg molybdenum, 0.10-0.18 mg iodine and 0.36-0.68 mg nickel per kg dry matter. The adults consumed 6.7-11.0 mg zinc, 2.0-3.8 mg manganese, 0.54-0.92 mg copper, 47-89 micrograms molybdenum, 30-67 micrograms iodine and 111-256 micrograms nickel per day. The living area had an effect on the Mn, I and Ni intake. The higher dry matter intake resulted in a better trace element supply of male test persons. The copper, molybdenum and iodine requirement recommended by the WHO was not met.

Adult↗
PubMed1990

[Integration of psychological management strategies in the treatment course of breast carcinoma].

The integration of psychological counselling programmes into the treatment procedures of breast cancer has to overcome specific methodological and contextual difficulties. We present a counselling strategy for breast cancer patients which aims at a reduction of short-term sequelae of the crisis of cancer diagnosis and stress of therapy. Its main features, summarized as follows are based on the relevant literature and the results of a pilot study in our department. Counselling is offered and made available to all patients, since both self- and professional referral lead to a selection bias. Psychological counselling is considered as integral part of the entire diagnostic and therapeutic process. The psychologist acts as a continuous supportive partner at all relevant treatment stages, and is introduced to the patient at the outset of the therapy and is always available as familiar contact person for discussion of all problems. Intensity and structure of counselling closely follow the different stages of somatic treatment. Technically, elements of crisis intervention and Progressive Muscular Relaxation (PME, according to Jacobson) are applied. Aspects of patient/doctor relationship and interdisciplinary cooperation between physicians and psychologists are discussed.

Adaptation, Psychological↗
PubMed1990

Androgen receptors, serum androgen levels and survival of breast cancer patients.

Steroid receptor levels and serum androgen levels were determined in 61 breast cancer patients and 34 patients with non-malignant breast lesions. Testosterone and dehydroepiandrosterone-sulfate did not and androstenedione did show a difference between the two groups. Androgen levels had no influence on survival rates. Androgen receptor (AR) levels correlated with progesterone receptor levels, but not with estrogen receptor levels or with tumor stage. Patients with positive AR findings had a better survival rate; this was independent of tumor stage. AR findings may therefore be a prognostic index in breast cancer patients.

Adult↗
PubMed1990

Large scale optimization of beam weights under dose-volume restrictions.

The problem of choosing weights for beams in a multifield plan which maximizes tumor dose under conditions that recognize the volume dependence of organ tolerance to radiation is considered, and its solution described. Structures are modelled as collections of discrete points, and the weighting problem described as a combinatorial linear program (LP). The combinatorial LP is solved as a mixed 0/1 integer program with appropriate restrictions on normal tissue dose. The method is illustrated through the assignment of weights to a set of 10 beams incident on a pelvic target. Dose-volume restrictions are placed on surrounding bowel, bladder, and rectum, and a limit placed on tumor dose inhomogeneity. Different tolerance restrictions are examined, so that the sensitivity of the target dose to changes in the normal tissue constraints may be explored. It is shown that the distributions obtained satisfy the posed constraints. The technique permits formal solution of the optimization problem, in a time short enough to meet the needs of treatment planners.

Humans↗
PubMed1990

[High-resolution computerized tomography of the petrous bone with two-dimensional and three-dimensional reconstruction].

Fifty patients with various diseases of the petrous bone were examined by HR-CT with a 1024 x 1024 matrix. It is demonstrated that the improved spacial resolution results in a better discrimination of subtle anatomical structures and therefore leads to an expansion of the diagnostic possibilities in diseases of the auditory and vestibular organs. Evaluation of the two-dimensional reconstructed images shows that best quality is obtained with contiguous 1 mm, sections in the primary scans. In most cases these reconstructed images are diagnostically sufficient. In addition they help to reduce patient strain (no problem with patient positioning, no further x-ray exposure, time-saving). Three-dimensional reconstructions from the base of the skull allow a good visualization of complex and extensive osseous destructions of the temporal bone. The disadvantage of this method is on the one hand the lacking representation of soft tissue and the poor spacial resolution (no 3-D imaging of the ossicular chain), and on the other hand the smoothing of contours because of arithmetical filters. Thus tumor expansion and finer osseous erosions may not be distinguishable. Consequently, 2D primary or reconstructed images must continue to be the basis of diagnosis.

Adult↗
PubMed1990

[Value of radioimmunoscintigraphy compared to computed tomography in the diagnosis and follow-up of primary ovarian carcinoma].

In this prospective study the diagnostic merit of radioimmunoscintigraphy (RIS) was compared with computed tomography (CT) and operation in the primary diagnostic procedure and follow-up of women with suspected ovarian cancer. In primary diagnosis, sensitivity, specificity, and diagnostic accuracy was 100%, 60% and 90% for RIS. In follow-up, sensitivity for local recurrence was slightly higher in CT than in RIS. It was possible to detect peritoneal carcinosis in the pelvis and lower abdominal region better with RIS, but in the upper abdominal region, peritoneal carcinosis was detected better with CT. If no differentiation between benign or malignant lesion, is possible with CT, differentiation will in many cases be possible with RIS.

Adenocarcinoma, Mucinous↗