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Biomedical subjects

R Hartung

Publications and source records attributed to R Hartung.

At least 73 records · Page 4Linked to original sources
PubMed1996

Priming of NADPH oxidase by tumor necrosis factor alpha in patients with inflammatory and autoimmune rheumatic diseases.

Oxidative damage caused by oxygen free radicals from activated phagocytes contributes to the pathology of arthritis. The present study evaluates the activity of NADPH oxidase of neutrophils and monocytes from patients suffering from various inflammatory and autoimmune rheumatic disease. Production rates of reactive oxygen species [ROS] of neutrophils and monocytes from rheumatic patients are compared to those of healthy controls and non rheumatic disease controls and correlated with the plasma levels of tumor necrosis factor alpha, C-reactive protein and the sedimentation rates of erythrocytes. There was a two- to eightfold increase in phagocytic superoxide production in rheumatic patients, when compared to healthy subjects or patients with non-rheumatic internal diseases [p < 0.005]. The enhanced NADPH oxidase-dependent superoxide generation correlated well with elevated levels of tumor necrosis factor alpha [TNF-alpha] in plasma [p = 0.005], suggesting a causal relation. There was no correlation with the plasma levels of C-reactive protein and a weak though significant correlation with the sedimentation rates of erythrocytes [p = 0.043]. Removal of circulating TNF-alpha by dialysis of patients blood and inhibition of NADPH oxidase by prednisolone treatment normalized elevated ROS production to the levels of healthy controls and correlated with the clinical improvements. Our data support the hypothesis of a central role for TNF-alpha during the development of arthritis. The chemiluminescence assay described here may be useful as a convenient screen and as a potential follow up procedure for individual patients with rheumatic diseases.

Acridines↗
PubMed1996

On the analysis of CO(2), H(2)- and CO, H(2)-mixtures by water-gas potentiometry with solid electrolyte cells.

The potentiometric analysis of CO(2), H(2) and CO, H(2)O-mixtures using oxide ion-conducting solid electrolytes requires the adjustment of the water-gas equilibrium without side reactions in the high-temperature galvanic cell. Conventional cell designs suitable for the analysis of H(2), H(2)O and CO, CO(2)-mixtures are not applicable due to the insufficient gas residence times in the cells and the insufficient catalytical activity of the platinum electrodes. Solid electrolyte cells have to be modified by integrating of suitable catalysts. Under optimized conditions of gas velocity and cell temperature both gas systems can be analyzed only by measuring the cell tension U (=-emf) and temperature in the favorized temperature range around 813 degrees C. Here systematical errors of the component ratio or the mole fraction were smaller than 6%. Several fundamental requirements for the application of catalysts in solid electrolyte cells for the analysis of reactive water-gas mixtures are pointed out.

Journal Article↗
PubMed1996

Rare metastases of signet ring cell carcinomas to the scrotum: report of two cases.

Metastases of signet ring cell carcinomas to the scrotum are rare. We present 2 patients with this kind of tumor. In 1 patient, the scrotal pathologic examination helped to detect an adenocarcinoma of the appendix with a signet ring cell component, with an extent that had not been apparent clinically. The other patient was seen at an advanced stage of signet ring cell carcinoma of the sigmoid colon following surgical therapy and palliative chemotherapy. The route of metastases seems to be via seeding along the testicular cord and via lymphatic dissemination.

Appendiceal Neoplasms↗
PubMed1996

Depression among aging persons with schizophrenia who live in the community.

OBJECTIVES: The study used the social antecedent model of depression in later life proposed by Linda K. George to develop a multifactorial model of predictors of depression among aging persons with schizophrenia living in the community. METHODS: The SHORT-CARE and the Network Analysis Profile, along with supplemental items, were administered to 117 outpatients age 55 and older who received DSM-III-R diagnoses of schizophrenia before age 45. Bivariate and multivariate analyses examined associations between 27 variables derived from George's model and the presence of depression. A cutoff score for the depression scale of the SHORT-CARE was used to detect clinically significant depression. RESULTS: Forty-four percent of the sample had probable pervasive depression. Bivariate analysis indicated that 16 variables were significantly associated with depression, and logistic regression showed that six variables were strong predictors. Depression was associated with the presence of positive symptoms, physical limitations interfering with activities, younger age, diminished linkage of members of the social network, lower income, and a smaller proportion of social network members who provided sustenance such as food and money. An 11-variable model correctly classified 81 percent of cases. CONCLUSIONS: The level of depression among older outpatients with schizophrenia is approximately one and a half to three times the level in the general older population. Depression in this patient group is associated with nonclinical variables that are independent of psychoses and that resemble patterns found among general older populations. Several of the variables are potentially alterable and therefore afford opportunities to enhance the well-being of persons with schizophrenia who live in the community.

Activities of Daily Living↗
PubMed1996

Prognostic value of urokinase plasminogen activator and plasminogen activator inhibitor-1 in renal cell cancer.

PURPOSE: Urokinase type plasminogen activator and its inhibitor plasminogen activator inhibitor are associated with invasion and formation of metastases in tumors. In a prospective study urokinase and plasminogen activator inhibitor-1 content in renal cell cancer and benign renal tissue was correlated with the traditional factors of TNM staging and grading as well as ploidy and actual clinical outcome of the patients. MATERIAL AND METHODS: A total of 152 patients, who underwent transperitoneal tumor nephrectomy for renal cell cancer, was followed for a mean of 23.9 months. Urokinase and plasminogen activator inhibitor-1 from the tumor tissue and corresponding benign renal tissue were quantified from detergent extracted tissue samples (1% triton-X = 100 in TBS) and measured with an enzyme-linked immunosorbent assay. RESULTS: Urokinase content correlated with the development of distant metastases (log rank 4.32, p = 0.037). Cutoff value was 0.84 ng/mg. A group of 11 patients were considered to be at high risk for metastases (9 events) based on urokinase greater than 0.84 ng/mg., while 94 patients were considered to be at low risk (5 events) with urokinase less than 0.84 ng/mg. Plasminogen activator inhibitor-1 significantly correlated with the prevalence of distant metastases (log rank 5.17, MO, 10.04 versus M1, 23.79, p = 0.02) and the development of new metastases postoperatively (MO, 10.85 versus M1, 27.36, p = 0.001). Cutoff value was 12 ng/mg. protein. A group of 41 patients were considered at high risk for relapse (6) based on plasminogen activator inhibitor-1 greater than 12 ng/mg. protein compared to 55 patients with plasminogen activator inhibitor-1 less than 12 ng/mg. protein with only 1 relapse during followup. CONCLUSIONS: Plasminogen activator inhibitor-1, the specific inhibitor of urokinase is a strong and independent prognostic factor in predicting early relapse of renal cell carcinoma. High and low risk groups for disease-free survival can be discriminated by plasminogen activator inhibitor-1 antigen content in the tumor tissue.

Carcinoma, Renal Cell↗
PubMed1995

Biomodulation of 5-Fu cytotoxicity by folinic acid and its stereoisomers: in vitro experiments with different cell lines of prostatic cancer.

The results of cytotoxic chemotherapy for advanced, hormone-escaped prostate cancer have been disappointing. Evaluation of the effect of new drugs or new combinations with already known ones is required. The antimetabolite 5-fluorouracil (5-FU) has been shown to be active in prostate cancer, acting via inhibition of thymidylate synthase, an essential enzyme in DNA de novo synthesis. Experiments with cell lines of different tumors have shown that 5-FU activity can be modulated by addition of the coenzyme tetrahydrofolic acid (folinic acid). We investigated the effect of folinic acid and its stereoisomers on 5-FU action in different cell lines of prostate cancer. It was found that addition of non-toxic folinic acid led to a two- to fourfold better antiproliferative effect of 5-FU. The unnatural 6R isomer, which is a compound of chemically synthesized folinic acid, inhibited the modulatory effect of the natural 6S isomer. Our results indicated that a combination of folinic acid and 5-FU may result in a better response of patients with hormone-resistant prostate cancer than of patients treated with 5-FU alone.

Antineoplastic Agents↗
PubMed1995

No association of converting enzyme insertion/deletion polymorphism with immunoglobulin A glomerulonephritis.

It has been recently reported that in type 1 diabetes the insertion/deletion (I/D) polymorphism of the angiotensin I-converting enzyme gene is associated with the presence of diabetic nephropathy. Tissue angiotensin I-converting enzyme is determined by I/D polymorphism, and it has been speculated that in diabetes differences of local angiotensin II availability determine the risk of renal disease. Since angiotensin II is thought to play an important role in the evolution of renal disease in general, we tested whether genotype distribution of the I/D polymorphism is also different in patients with immunoglobulin A-glomerulonephritis (IgA-GN). Furthermore we compared IgA-GN patients with (1) stable renal function or (2) terminal renal failure to investigate a potential role of the I/D polymorphism in the renal prognosis. We examined 122 patients with biopsy-confirmed IgA-GN who had stable renal function and 82 dialysis-dependent or transplanted patients with biopsy-confirmed IgA-GN. Furthermore, in 134 healthy individuals used as controls we analyzed the DNA for normal distribution of genotypes and allele frequencies. The polymorphic region was amplified using polymerase chain reaction with specific primers. Alleles were detected on 2% agarose gels. Genotype distributions and allele frequencies were not significantly different between controls and patients with IgA-GN and stable renal function. Furthermore, no significant difference in genotype distribution was detected between patients with IgA-GN and stable renal function compared with patients with IgA-GN and end-stage renal failure, although a trend for a higher frequency of DD-homozygotes was noted in the latter group (P = 0.07).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Negotiating ureteral stenoses and kinks with a hydrophilic wire.

Negotiating a tortuous or obstructed ureter with a wire can be time-consuming and sometimes tiring. The principle of using a slippery floppy wire and then replacing it with a stiff wire through a 5-french open-ended ureteral catheter yields a high success rate. The ureteral catheter can be used for a radiocontrast study and allows access for a 0.035 'coaxial wire', which can be used as a guide wire for a single or double J stent.

Humans↗
PubMed1995

Prostate-specific antigen density and age-specific prostate-specific antigen values: the solution of prostate cancer screening?

The results of 225 systematic prostate biopsies from 1992 to 1993 were evaluated retrospectively. The parameters prostate-specific antigen (PSA) density and age-specific PSA values were compared with digital rectal examination, transrectal ultrasound, and PSA as single parameters and possible combinations. The PSA density proved to have the highest specificity of all single parameters, but the sensitivity was low. Age-specific PSA values are offering a good compromise of sensitivity and specificity as compared with fixed cutoff levels. Since there is no sufficient screening parameter up to now, a combination of all parameters is recommended for screening of early prostate cancer.

Aged↗
PubMed1995

Transurethral prostatectomy (TURP): still the gold standard?

1. The indication for treating BPH can be established very precisely today. It is important to select the alternative procedures with a good workup for individual therapy. 2. A large volume prostate with proven obstruction is an indication for TURP or open prostatectomy, still the best choice of treatment with the best longterm results concerning all obstructive parameters. In future there may be less surgery due to the other possibilities but teaching and handling the gold standard should not be forgotten in using alternative techniques. 3. Especially for high risk patients there are minimal invasive methods so that a permanent catheter in a patient should be an exception. 4. Also with new medications we expect better results. Prostate selective alpha-blockers and reduction inhibitors probably also in combination of both may be sufficient therapy for many patients. It has to be examined whether minimal invasive instrumental treatments like transurethral thermotherapy can be compared with medication. The most important result of the discussion in the last years was improving the clinical workup for finding the indication for surgery. Too many new instrumental methods appeared at the same time and we are in a period of selection and investigation to know which technique can be compared with the gold standard of TURP. Also in using minimal invasive therapy the indication must be very clear because also the new techniques are not totally free from complications.

Catheterization↗
PubMed1994

Prostate-specific antigen in urine.

We investigated concentrations of prostate-specific antigen (PSA) in mid-stream urine of 213 patients. Among them were 34 females. Diagnoses of the male patients were 42 benign prostatic hypertrophy (BPH), 21 localized prostate cancer prior to radical prostatectomy (RP), 15 post-RP without distant or local recurrence, 5 post-RP with local recurrence and 82 with other urological diseases. PSA levels were determined by the Hybritech Tandem E method. Female urine samples were positive in 38% of the cases. This and the finding of PSA in urine of men after RP is most likely due to extraprostatic production by periurethral glands. Urinary PSA levels do not differ between patients with BPH, organ-confined prostate cancer and other diagnoses. In some cases, however, urine PSA levels can be elevated in men with local tumor recurrence after RP when serum levels are still undetectably low. This indicates that the determination of urinary PSA concentration might be useful in the follow-up of patients after RP.

Biomarkers, Tumor↗
PubMed1994

[Reconstruction of the bladder neck after radical retropubic prostatectomy using a tubular bladder flap].

To improve urinary continence after retropubic prostatectomy, especially in the early postoperative phase, we used a 1.5 cm tubularized anterior bladder flap for bladder neck reconstruction in 30 patients. We compared the continence rates of these patients with 30 patients with standard bladder neck closure operated on in the same period of time. Continence rates were assessed by a personal interview 1 day after catheter removal (postoperative day 22) and 3 months postoperatively by a questionnaire. While only 2/30 (6.6%) of the patients with standard bladder neck closure were completely continent 1 day after catheter removal, 9/30 (30%) of the patients with the tubularized neourethra were completely dry. After 3 months the standard procedure led to a 58% rate of complete continence. This was achieved in 75% of patients with the tubularized flap. Ten percent of the patients with conventional operations developed a bladder neck contracture. This complication occurred in 20% of the patients with the new method. Analyzing subgroups, we found that patients with a tubularized neourethra who received adjuvant irradiation of the prostatic bed because of positive surgical margins developed a bladder neck stenosis in 40% of the cases due to shrinking of the flap.

Adult↗