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P Huber

Publications and source records attributed to P Huber.

At least 19 recordsLinked to original sources
PubMed1992

[Evaluation of TSH suppression using a 3d-generation TSH assay: diagnostic and therapeutic consequences].

UNLABELLED: We measured basal and TRH-stimulated TSH values with a 3rd generation assay in patients under suppressive thyroxine (T4) therapy for thyroid carcinoma or goiter and in patients with overt hyperthyroidism. All hyperthyroid patients had undetectable basal TSH levels (< 0.01 mU/l). In patients on suppressive T4 treatment basal TSH values were undetectable in 37.5% (= group A) and measurable in the intermediate range of 0.01-0.05 mU/l in 62.5% (= group B). After TRH administration there was no TSH increase in the hyperthyroid patients (< 0.01 mU/l in 100%). T4-treated patients of group A showed no relevant TSH stimulation in 58% (peak < or = 0.05 mU/l = total TSH suppression). An increase of > 0.05 mU/l could be measured in 42% of group A and 100% of group B (= subtotal TSH suppression). Many of these TSH values measured by a 3rd generation assay are in the undetectable range for most of the commercially available 2nd generation assays (< 0.10 mU/l). CONCLUSION: TSH assay of the 3rd generation decisively improves the diagnosis of hyperthyroidism and probably also borderline hyperthyroidism. Against the background of increased risk of osteoporosis and cardiac function disorders as a result of suppressive T4 treatment, our results suggest the following practical therapeutic guidelines: total TSH suppression with the risk of iatrogenic hyperthyroidism should be confined to high risk patients (eg with metastatic thyroid cancer). Where the risk is low, however (thyroid cancer with favourable prognosis, goiter, goiter prophylaxis), only subtotal TSH suppression is indicated.

Adult↗
PubMed1992

Localization of central lesions by correlation of CT findings and neurological deficits.

In a prospective study involving 100 patients with lesions in the precentral gyrus or pyramidal tract we sought to correlate clinical findings and the results of an axial computed tomography (CT) to localize the lesion. In 85% of patients the size and location of the lesion visible on CT correlated well with the type and severity of the neurological symptoms and signs. However, in the remaining 15% of patients the CT findings did not correlate well with the patient's neurological deficit, showing that in these patients the anatomy of the central area was variable or distorted by the space-occupying lesion. We suggest that in such patients neurophysiological techniques be used intra-operatively for reliable localization of the motor strip.

Adolescent↗
PubMed1992

Association between the activation of macrophages, changes of iron metabolism and the degree of anaemia in patients with malignant disorders.

In this study, we investigated a possible association between the degree of macrophage activation - as measured by serum neopterin concentrations - and disturbances of iron metabolism, determined by the concentrations of ferritin and serum iron, in patients with malignant disorders. Additionally we evaluated correlations between these factors and the degree and type of anaemia. Seventy-three patients, who suffered from non-Hodgkin's lymphoma (NHL) (n = 43), Hodgkin's disease (n = 11), myeloma or monoclonal gammopathy of unknown significance (n = 9), myelodysplastic syndrome (n = 1), and solid tumours (n = 9), were examined. Mean neopterin levels were raised in all groups, patients with NHL showing the highest concentrations. Ferritin but not neopterin concentrations were higher in males than in females. A significant correlation was found between neopterin and ferritin concentrations (p less than 0.01). Considering only female patients the strength of the correlation was the same (p less than 0.02). In addition, we found inverse correlations of neopterin with haemoglobin and iron concentrations (all p less than 0.01). Similar relationships existed in patients during follow-up. Our results support the hypothesis of an association between the degree of activation of macrophages and the development of anaemia by a shift or iron towards the storage sites.

Adult↗
PubMed1992

Spinal leptomeningeal neoplastic disease. Evaluation by MR, myelography and CT myelography.

Out of 16 patients, spinal leptomeningeal neoplastic disease was diagnosed by MRI in 4 patients, myelography in 14 patients and CT myelography in 12 cases. MR was superior to myelography in 2 patients, in another 2 patients MRI was equally diagnostic. The cerebrospinal fluid of every patient contained malignant cells. Histological evidence for primary central nervous system tumors was found in 5 cases. In 10 cases, non-neuraxial malignancy consisted of small cell carcinoma of the lung (7 cases), and leukemia and lymphoma (3 patients). In 1 patient, primary leptomeningeal malignant melanoma was confirmed at autopsy. Preferential thoracolumbar neoplastic morphologic manifestation correlated with the presence of conus and cauda equina syndrome in 9 patients, low back pain, paresthesia and spinal root signs in 7 patients. False-negative interpretation of myelography in 2 patients with positive MR findings, and the impressive sensitivity of gadolinium Dota to improve visualization of subarachnoid spread, favor MRI as an alternative imaging technique in the assessment of patients with suspected intradural extramedullary malignancy.

Adult↗
PubMed1991

Comparison of magnetic resonance angiography, magnetic resonance imaging and conventional angiography in cerebral arteriovenous malformation.

10 patients with an AVM of the brain were examined by magnetic resonance angiography (MRA), magnetic resonance imaging (MRI) and conventional cerebral angiography (CCA). From MRA in 7/10 patients important information about vascular supply could be provided; in 3 patients, all with small AVM's it could be only suspected. CCA revealed the vascularisation of the AVM's in all patients and showed additional hemodynamic aspects better than MRA. With MRI in all cases the AVM could be diagnosed, but only the involvement of the main cerebral vessels could be demonstrated: however, MRI is superior to MRA and CCA in showing the nidus and the involved brain structures.

Adolescent↗
PubMed1991

Prenatal stroke suggested by intrauterine ultrasound and confirmed by magnetic resonance imaging.

Cerebral infarction is rare in premature newborns and is most commonly the result of arterial embolization from the placenta. A focal echodense area was identified on prenatal cranial ultrasonography (US) in a premature infant (34 weeks of gestation). After birth, cerebral infarction was confirmed by magnetic resonance imaging (MRI). The clinical findings, imaging findings and pathogenesis are discussed. New diagnostic methods such as MRI show to be a useful approach in the neonatal period facilitating recognition of cerebrovascular accidents also in low-birth-weight infants.

Cerebral Infarction↗
PubMed1991

Synthesis of Newcastle disease virus (NDV)-like envelopes in insect cells infected with a recombinant baculovirus expressing the haemagglutinin-neuraminidase of NDV.

Electron microscopical examination of negatively stained extracellular fluids (ECF) from Spodoptera frugiperda cell cultures infected with a recombinant baculovirus expressing the Newcastle disease virus (NDV) haemagglutinin-neuraminidase (HN) revealed NDV-like envelopes which resembled the envelopes of authentic NDV. Immunogold staining with anti-NDV HN monoclonal antibodies demonstrated HN antigen in spikes on the NDV-like envelopes. The ECF from the recombinant-infected cultures also contained baculovirus particles which resembled standard baculovirus particles except that some showed polar protrusions of the envelope. It was concluded that the HN of NDV, in the absence of the matrix protein, might be able to initiate and control the production of viral envelopes which are morphologically identical to those of authentic NDV.

Animals↗
PubMed1991

Neuro-Behçet: acute and sequential aspects by MRI and MRS.

Three patients with neuro-Behçet underwent MRI and MRS during acute illness. After therapy, MRI and MRS were performed in 3 and 1 patients, respectively. MRI revealed a marked improvement of the initial lesion in 2, a complete remission in 1 patient. MRS showed a reduction of the N-acetyl-aspartate (NAA)/phosphocreatine (CR) ratio within the acute lesion in all patients and a normalization in the follow-up spectrum of the examined patient.

Adrenal Cortex Hormones↗
PubMed1991

[Characteristic contributions of the venous duplex exam].

The major advantage of non invasive duplex scanning is the ability to combine its imaging capability (information on the morphology) with the possibility to detect Doppler spectra (hemodynamic information) of the visualised segment. This new method, mainly used for the investigation of arterial diseases, is more and more applied in phlebology too. The technique is very reliable in the diagnosis of deep vein thrombosis and in the investigation of varicose veins and their junctions with the deep venous system. In these indications duplex scanning is likely to become a standard technique. The use of duplex in phlebology, however, should not be limited to these indications. In this paper the results of some special phlebologic duplex studies are presented: A) changes in the subclavian vein induced by pace maker electrodes; B) utility in the differential diagnosis of deep vein thrombosis; C) efficacy in the control of caval filter; D) measurements of physiologic venous hemodynamics and quantification of phlebologic drug effects.

Humans↗
PubMed1990

Identification of amino acids in the gamma-carboxylation recognition site on the propeptide of prothrombin.

A gamma-carboxylation recognition site on the propeptide of the vitamin K-dependent blood coagulation proteins directs the carboxylation of glutamic acid residues by binding to the vitamin K-dependent carboxylase. To determine residues that define this site, we evaluated the effect of mutation of certain residues in the prothrombin propeptide on the extent of carboxylation. The prothrombin cDNA modified by site-specific mutagenesis was expressed in Chinese hamster ovary cells using a system that yields functional fully carboxylated prothrombin. The cell supernatants containing recombinant prothrombin were evaluated for the extent of gamma-carboxylation by immunoassay. Conformation-specific anti-prothrombin:Ca(II)-specific antibodies measure native completely carboxylated prothrombin; anti-prothrombin:total antibodies measure all forms of prothrombin, regardless of gamma-carboxyglutamic acid content. Mutation of His-18 to Gly, Val-17 to Ser, Leu-15 to Gly or Asp, or Ala-10 to Asp was associated with a partial (30-65%) inhibition of gamma-carboxylation. Mutation of Ala-14 to Ser or Ser-8 to Val did not inhibit gamma-carboxylation. From this and earlier work, residues whose mutation leads to a significant impairment of carboxylation include His-18, Val-17, Phe-16, Leu-15, and Ala-10. Residues whose mutation does not alter the carboxylation recognition site include Ala-14, Ser-8, Arg-4, and Arg-1. To determine the size of the recognition site, the in vitro carboxylation of propeptide-containing synthetic peptides was compared. A 28-residue peptide, based upon residues -18 to +10 of prothrombin, and a 54-residue peptide, based upon residues -18 to +36 of prothrombin, were carboxylated by partially purified bovine carboxylase with similar Km values of 2-5 microM. These results indicate that the gamma-carboxyglutamic acid-rich region of prothrombin makes a minimal contribution to carboxylase binding. A molecular surface of about five amino acids located within the propeptide appears to define the carboxylation recognition site on the precursor forms of the vitamin K-dependent proteins.

Amino Acid Sequence↗
PubMed1990

Human beta-fibrinogen gene expression. Upstream sequences involved in its tissue specific expression and its dexamethasone and interleukin 6 stimulation.

The synthesis of fibrinogen in the liver is drastically enhanced during the inflammatory process. Two factors are involved: glucocorticoids and the hepatocyte stimulating factor which is identical with interleukin 6 (Il6), also called interferon beta 2. The function of the 5'-flanking region of the human beta-fibrinogen (beta-Fg) gene has been studied by deletion analysis with the chloramphenicol acetyltransferase (CAT) gene as a transient expression vector. In this analysis, a fragment containing 150 base pairs (bp) upstream from the cap site is sufficient to drive expression of the CAT gene in the hepatoma cells HepG2, but not in HeLa cells. The beta-Fg gene is induced by dexamethasone and Il6 in HepG2. We identify a domain located between -2900 and -1500 bp upstream from the transcription start point involved in dexamethasone sensibility. This distal regulatory region can confer hormone inductibility to a heterologous promoter and exert its effect in either orientation. The sequence located between -150 and -82 bp upstream from the transcription start point is responsive for the Il6-stimulated expression. This 68-bp sequence contains probably all the cis-acting Il6-responsive element of the human beta-Fg gene.

Base Sequence↗
PubMed1990

Fluid flow rates in human peritumoural oedema.

Five patients with various types of brain tumours were infused with x-ray contrast material in a schedule designed to maintain a constant plasma concentration of tracer over a period of 3 hours. CT scans from an equatorial section of the tumour were taken at frequent intervals the first hour; then at 2 and 3 hours, and when possible up to 14 hours. Two different mathematical models-1. simple diffusion, and 2. transport by bulk flow plus diffusion were used to analyze the changes in tracer amount along profiles placed radially from the tumour center into the oedematous white matter. We found that the simple diffusion model could not account for the spread of contrast material in 3 cases. Adding bulk flow transport gave a very good fit to the measurements, also for the late scans. This model gave bulk flow rates of 0.0005 to 0.005 ml cm-2 min-1 for the extratumoural tissue close to the tumour, and values from 0.25 to 0.55 for the extracellular space in this region. We conclude that the peritumoural tissue is "perfused" by oedema fluid at relatively high flow rates and that this flow transports tracer and other components of plasma into the extracellular space.

Body Fluids↗
PubMed1990

Thirty-four-year mortality follow-up of BASF employees exposed to 2,3,7,8-TCDD after the 1953 accident.

2,3,7,8-Tetrachlorodibenzodioxin (TCDD) was formed in an uncontrolled decomposition reaction at BASF Aktiengesellschaft on 17 November 1953. This report presents the findings of a 34-year mortality follow-up study of 247 workers who were partly heavily exposed; 78 thereof had died. We divided these employees into three cohorts based on the amount and reliability of the exposure information. The mortality was compared with the national mortality rates in the Federal Republic of Germany (FRG) and is presented in terms of standardized mortality ratios (SMRs) together with 90% confidence intervals (CI) for different periods of time since the first exposure. In general, the overall mortality of these workers was similar to the rates of the national population. The SMR for all malignant neoplasms based on 23 deaths was 117 (90% CI: 80, 166), suggesting no overall increase in cancer among those employees. When workers with chloracne were examined separately, the SMR for all malignant neoplasms was not significantly elevated overall (SMR 139; 87, 211), but it was for the time period 20 or more years after the first exposure (SMR 201; 122, 315). Results for 22 causes of death as well as additional information on the type of exposure and skin findings are presented and discussed in relation to the current literature. In general, our results do not appear to support a strong association between cancer mortality and TCDD, but they do suggest that some hazard may have been produced.

Accidents, Occupational↗
PubMed1990

Immunoprotective effects of cyclooxygenase inhibition in patients with major surgical trauma.

Dysfunctional monocytes (M phi), exerting their inhibitory functions via prostaglandin E2 (PGE2), have been implicated in the depression of immune responses following major surgical, accidental, and burn trauma. A randomized prospective study of the PG-synthetase inhibitor indomethacin (Indo) was performed in 43 patients undergoing major surgical procedures, to evaluate its efficacy in correcting postoperative abnormalities of the cell-mediated immune system (CMI) and preventing infectious morbidity and mortality. Patients, following gastrectomy (GX) or reconstruction of the abdominal aorta (AG), in the treated group (PIndo), received 100 mg IV of Indo 6 hours postoperatively and 3 x 50 mg IV Indo over 24 hours on postoperative days (D) 1,2,3,4. The rate of infectious complications was recorded. Parameters of CMI evaluated preoperatively (D0) and on D1,D3,D5,D7 were: Delayed type hypersensitivity (DTH) response to recall antigens, mitogen-induced lymphocyte proliferation (LP), interleukin 2 (IL-2) synthesis, and phenotyping of mononuclear blood leukocytes (PBMC's) with the monoclonal antibodies for CD3+, CD4+, IL-2 receptor (IL-2R)+ and LeuM3+ receptor sites. In contrast to the group of untreated patients (Pc), PIndo did not show a depression of their preoperative DTH responses, and they also showed a lower rate of early opportunistic infections. The in vitro test of CMI revealed that there was a higher LP capacity in PBMC's of PIndo (p less than 0.05); the postoperative profile of IL-2 synthesis was not statistically different between the groups. Indomethacin administration resulted in a considerable alleviation of postoperative monocytosis (p less than 0.05) and in a protective effect on lymphocyte receptor expression of CD3+, CD4+, and IL-2R+ cells. From these data it is concluded that in vivo cyclooxygenase inhibition may be useful to prevent impairment of CMI, a crucial predisposing factor of the high susceptibility to postoperative infection.

Aged↗
PubMed1990

[The value of computed tomography for the staging of esophageal carcinoma].

64 patients were operated on for carcinoma of the oesophagus during a five-year period (1/83 to 1/88) at the Department of Surgery of the University of Cologne; 95.3% of these suffered from squamous cell carcinoma. A preoperative CT of the thorax was performed in 38 patients, 13 of whom underwent abdominothoracic surgery and 25 blunt oesophagus dissections. The CT and plain diagnostic results were compared retrospectively and postoperatively with the intraoperative or histological findings. Three of seven oesophageal carcinomas of up to 2 cm size were not identified by CT. Infiltration of adjacent mediastinal structures by T3 carcinomas was detected in 16 of 22 cases with 3 false positive findings. In blunt oesophagus dissection the preoperatively diagnosed lymph node status agreed with the histological findings in more than 80% of the cases; a limitation, however, was the fact that only those lymph nodes could be assessed that clung to the resectate. In contrast, agreement was seen in only 7 of 13 cases (with 6 false negative findings) after abdominothoracic resection of oesophageal carcinomas. On the whole, there was agreement between preoperative and histological staging according to the TNM classification (UICC = in 50% of the cases, whereas in almost 40% (n = 15) the size or extension of the tumour growth had been underestimated preoperatively. Hence, the value of CT for the preoperative staging of oesophageal carcinoma is restricted.

Aged↗
PubMed1989

[Interdisciplinary treatment of pancreatic cancer].

Resection of the pancreas due to carcinoma represents with an operative mortality of 3.5% and three-year-survival of 15% an operative strategy, which should be carried out as a therapy of choice only on selected patients with an early cancer stage (ex. T1). But no other treatment offers the chance of long-time survival and curation. There seems to be no influence of operative therapy on patient prognosis in advanced cancer stages. In these cases, palliative treatment (ex. biliodigestive anastomosis or transcutaneous biliary drainage) are methods of choice. A main palliative aspect should be a painless patient. This can be achieved by oral or i.v. medication and/or chemical neurolysis of plexus coeliacus.

Adult↗