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Biomedical subjects

U Krause

Publications and source records attributed to U Krause.

At least 163 records · Page 9Linked to original sources
PubMed1988

Repair of rectal prolapse by rectosacral suture fixation.

In 46 patients with complete rectal prolapse a simple method of rectopexy was used, fixing the mobilized rectum to the sacrum with sutures. In 17 cases the rectopexy was supplemented with levator sutures. The patients' age range was 20-87 years and follow-up was 6 months to 17 years. There was no associated mortality and almost no morbidity. Prolapse recurred in two cases, in one of them due to incomplete fixation because of a congenital pelvic deformity. Rectopexy with sutures seemed to give results as good as the Teflon mesh and Ivalon sponge methods in regard to recurrence rate, while avoiding the complication risks associated with insertion of foreign material.

Adult↗
PubMed1987

[Basedow's disease and mitral valve prolapse].

The prevalence of mitral valve prolapse was investigated in 60 patients with Graves' disease (42 with ophthalmopathy) and in 20 patients with toxic nodular goitre. 2410 patients from the echocardiography laboratory served as controls. Standard M-mode, Doppler and two-dimensional echocardiography were performed. Mitral valve prolapse was defined as a systolic buckling greater than or equal to 3 mm. In patients with thyroid disease HLA antigens were determined. Patients with Graves' disease showed a significantly higher incidence of mitral valve prolapse (36/60, 60%) compared to the group with toxic nodular goitre (2/20, 10%) and to controls (238/2410, 9,9%) (P less than 0.0001). 16 of 36 patients had a prolapse of the anterior, in 3 of 36 the posterior leaflet was involved and 17 of 36 had both. Mean systolic buckling was 4.3 +/- 1.5 mm. 28 of 42 patients with ophthalmopathy (67%) showed a mitral valve prolapse. 20 of 60 patients (33.3%) with Graves' disease but none in the goitre group showed a thickened myxomatous valve (P less than 0.001). Thyroid function did not influence the incidence and intensity of the prolapse. The HLA phenotypes B8 were seen in 22 of 36 and DR3 in 24 of 36 patients with mitral valve prolapse. Since thyroid function was comparable in both groups an involvement of the mitral valve in an autoimmune process affecting several organs can be considered probable.

Adult↗
PubMed1987

Naloxone increases the response of growth hormone and prolactin to stimuli in obese humans.

Opiates stimulate the growth hormone and prolactin responses to stimuli in non-obese humans. Obese patients, however, show lowered growth hormone and prolactin responses and raised beta-endorphin levels. We therefore investigated the effect of the opiate antagonist naloxone on the stimulated growth hormone and prolactin secretions in a controlled double-blind study in obese patients. All patients received 200 micrograms TRH and 0.5 g/kg b.w. arginine together with 2 mg of naloxone or placebo i.v. in a randomized sequence. The TRH- and arginine-induced increases in prolactin and growth hormone were significantly greater after administration of naloxone (p less than 0.05). Naloxone also produced a significant increase in ACTH, cortisol and beta-endorphin when compared with placebo. TSH, triiodothyronine, thyroxine, insulin, glucagon and blood glucose showed no significant differences between both days of the trial. The effect of naloxone on growth hormone and prolactin secretions in obese humans can thus be regarded as a partial normalization. We therefore conclude that the hypothalamic regulatory disturbance of growth hormone and prolactin secretions in the obese could be caused by raised opiate levels.

Adrenocorticotropic Hormone↗
PubMed1987

The influence of parathyroid hormone and its fragments on results from midregion and C-terminal specific radioimmunoassays.

We compared a midregion (44-68) human parathyroid hormone (hPTH) specific radioimmunoassay (M-RIA) with a C-terminal (65-84) hPTH specific radioimmunoassay (C-RIA). The M-RIA discriminated 21 of 23 patients with primary hyperparathyroidism from 95 normals (normal range: 22.4-106.5 pmol/l). With the C-RIA 12 patients including the 2 patients not discriminated by the M-RIA had immunoreactive PTH (iPTH) values within the normal range of this assay (normal range: undetectable to 88.6 pmol/l). To investigate the reasons for these different abilities of separation, hyperparathyroid sera were subjected to gel-filtration and analyzed using the two assays. Intact PTH appeared to have a major influence on the immunoreactivity of circulating PTH in the M-RIA. In contrast, the C-RIA showed the highest immunoreactivity with midregion-C-terminal PTH fragments. Hyperparathyroid sera not discriminated by the C-RIA but with elevated iPTH in the M-RIA showed decreased amounts of midregion-C-terminal PTH fragments, while intact PTH comprised the highest amount of total circulating PTH immunoreactivity in the M-RIA. From the present results we conclude that the superiority of the M-RIA is due to the determination of intact PTH which is preferable for clinical measurements with relation to the diagnosis of primary hyperparathyroidism.

Adolescent↗
PubMed1987

The effect of high parathyroid hormone concentration on calcitonin in patients with primary hyperparathyroidism.

Serum calcitonin (CT), parathyroid hormone (PTH), and calcium levels were measured in 23 patients with primary hyperparathyroidism. PTH was determined by a midregion (M-RIA) and a carboxyl-terminal (C-RIA) specific PTH-RIA. Only 2 patients had elevated CT levels. In contrast to the findings in 46 healthy controls, the CT levels did not correlate with calcium levels. Patients who had the highest iPTH values showed a negative correlation between CT and iPTH (M-RIA (n = 7): R = -1.0000, p less than 0.001; C-RIA (n = 13): R = -0.5604, p less than 0.05). The results of the C-RIA were subtracted from those of the M-RIA. In 12 patients with the highest levels of intact PTH (M-RIA - C-RIA), serum PTH concentration was inversely correlated with serum CT concentration (R = -0.7343, p less than 0.01). In the same patients a negative correlation between CT and calcium was found (R = -0.6783, p less than 0.02). These findings suggest that high PTH levels may have a direct suppressive effect on CT concentration and this may be, at least in part, responsible for failure of CT concentrations to rise in many patients with primary hyperparathyroidism.

Calcitonin↗
PubMed1987

The effect of oxotremorine on in-vitro secretion of parathyroid hormone.

The effect of the muscarine-like acting parasympathomimetic drug oxotremorine and its antagonist atropine on PTH release was tested using single cell suspensions obtained from a) primary parathyroid adenomas, and b) secondary hyperplastic parathyroid tissue from patients undergoing chronic hemodialysis. For both cell-types we found a dose-dependent suppression of PTH release with oxotremorine. The suppressive activity could be antagonized with atropine, suggesting that parasympathomimetic nerval impulses play a suppressive role in the regulation of PTH release. Muscarine-receptors appear to be responsible for this mechanism.

Adenoma↗
PubMed1987

Suppression of growth hormone and somatomedin C by long-acting somatostatin analog SMS 201-995 in type I diabetes mellitus.

The effect of a new long-acting somatostatin analog SMS 201-995 (SMS) on hormonal mechanisms controlling the glucose metabolism was tested in 8 type I diabetics over a 3-day period. In addition to dietary measures and conventional insulin therapy, the patients received a subcutaneous dose of 50 micrograms SMS three times daily for 3 days. Serum growth hormone (GH) was measured at various intervals throughout the investigational period. Glucagon, somatomedin C (SM-C), triiodothyronine, thyroxine, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin (PRL) were also determined before and at the end of the therapy with SMS. Basal GH and plasma SM-C had decreased significantly (p less than 0.05 and p less than 0.01, respectively) by the 3rd day. In all cases the insulin requirements could be reduced (mean 28%) without deterioration of the metabolic control. Moreover, blood glucose profiles showed a tendency to lower postprandial peaks after SMS treatment. Glucagon, triiodothyronine, thyroxine, LH, FSH and PRL showed no significant changes. No side effects or alterations in laboratory chemistries were recorded. Dampening of glucose oscillations and counterregulatory mechanisms, and reduction of insulin dosage by SMS may enable a better control of unstable diabetes. Its slow plasma clearance and long action compared to the native peptide will warrant the use of this analog as a additive to standard diabetes therapy in more prolonged trials.

Adult↗
PubMed1987

[Diagnosis of angiomyolipoma of the kidney].

It is reported on three cases of a solitary angiomyolipoma of the kidney. The now as before considerable portion of unnecessary losses of organs in the operative treatment of this benign renal tumour should be the cause to critically think over the therapeutic behaviour. The preoperative diagnosis makes great demands upon the investigator. The uncertain radiological procedures including angiography might have found an efficient supplementation in the sonography nowadays everywhere accessible. By this means it is possible preoperatively anyway to make the well-founded tentative diagnosis of an angiomyolipoma of the kidneys. By the rapidly increasing spreading of the ultrasonic examination in future the more frequent detection of an echo-intensive space-occupying process in the area of the kidney is to be expected. When diagnostic references are given it is important generally to think of the possibility of an angiomyolipoma. For the purpose of the necessary histological ascertainment one should possibly use the intraoperative immediate section for microscopic examination. Then the adequate therapy would in most cases consist in the partial resection of the kidney as an on principle organ-preserving operation.

Adult↗
PubMed1986

Fine-needle biopsy of parathyroid adenomas.

High-resolution real-time sonography was performed in 15 cases of clinically and chemically suspected primary hyperparathyroidism and in 20 patients with different thyroid nodules. The suspected enlarged parathyroid glands and the thyroid nodules were percutaneously punctured under sonographic control. Concentrations of parathyroid hormone, human thyroglobulin, and human calcitonin were measured in the aspirate, and immunocytology was performed. The mean concentration of the aspirated parathyroid hormone in the parathyroid glands was 4,013.6 pmol/l +/- 4,519 (SD) as compared with 14.9 pmol/l +/- 8.7 in the thyroid nodules. Thyroglobulin was present in the aspirated fluid of parathyroid adenomas located behind the thyroid (mean +/- SD, 398.1 ng/ml +/- 317). In comparison, the aspirated thyroglobulin from the thyroid nodules averaged 9,689.7 ng/ml +/- 3,732. Immunocytology for parathyroid hormone was positive in 14 of the 15 biopsied specimens. Of 15 patients who were scanned for suspected hyperparathyroidism, six had concomitant thyroid nodules. It is concluded that the measurement of high concentrations of parathyroid hormone in the aspirate from a cervical mass, with sonographic control of needle position and/or positive immunocytology provides absolute localization of parathyroid tissue.

Adenoma↗
PubMed1986

Long-term treatment of acromegaly with the somatostatin analogue SMS 201-995 over 6 months.

This study examined the effects of the long-acting selective mini somatostatin analogue (SMS) 201-995 in two acromegalic patients who were treated for 3 and 6 months, respectively. During treatment the mean growth hormone levels (25.3 and 20.8 ng/ml vs 5.9 and 10.6 ng/ml) and somatomedin C levels (6.2 and 6.2 IU/ml vs 3.3 and 3.8 IU/ml) decreased and the patients reported an improvement in their symptoms. The main side effect was an increase in stool fat excretion which did exceed the normal range (less than 7 g/day) in one patient. Five acromegalics who received 2 X 50 micrograms SMS 201-995/day for 5 days showed a significant increase of stool fat excretion (1.7 vs 3.5 g/day; p less than 0.05). Fasting blood glucose levels, glucose tolerance, and glycosylated hemoglobin were not essentially effected. It is concluded that SMS 201-995 offers new possibilities in the treatment of acromegaly. The gastrointestinal and diabetogenic side effects of this substance, however, should be carefully monitored.

Acromegaly↗
PubMed1986

[Malignant fibrous histiocytoma. Prognostic value of the histological findings].

Surgical specimens after excision of malignant fibrous histiocytomas from 41 patients were classified histologically according to subtype; semiquantitatively by cell content, mitosis count, necrosis tendency and cell polymorphism; and "subjective grading". There was no significant difference in survival time between storiform-pleomorphic and myxoid subtypes. The marked scatter in the storiform-pleomorphic subtype reflects the inhomogeneity of this group. Analysis of the individual semiquantitative criteria gave better results. Cases with many mitoses, many necroses, marked cell polymorphism and high cell content had significantly shorter survival times than those with less marked changes. "Subjective grading" was also of prognostic value. However, overlapping of prognostic factors and limitations due to tumour biology allow of only a rough orientating prediction based on histological assessment of malignancy grade.

Histiocytoma, Benign Fibrous↗
PubMed1986

The secretion of parathyroid hormone and its fragments from dispersed cells of adenomatous parathyroid tissue at different calcium concentrations.

The effect of varying calcium concentrations on PTH release from dispersed cells of adenomatous parathyroid tissues (n = 15) was studied. During high calcium concentrations PTH secretion was inhibited up to 62.5% as compared to low calcium concentrations. There was no correlation between iPTH secretion rate and suppressibility. Each adenoma had a different iPTH secretion rate. Three adenomas showed a high suppressibility (28.0%, 53.8%, and 62.5%). The supernates of their media were chromatographed and examined by midregion and C-terminal specific PTH-RIAs. Carboxyl-terminal PTH fragments were found to be released by two adenomas. There was no evidence for the release of midregion PTH fragments. Comparison of incubation media revealed that the adenoma with the lowest suppressibility released the highest amount of intact PTH (per 100,000 cells/ml). This adenoma exclusively secreted intact PTH, whereas PTH fragments were only released from two adenomas with higher suppressibility. In these media the ratio of PTH fragments to intact PTH increased with the calcium content of the media. The ratio was also dependent on the suppressibility of the adenomas; i.e. the ratio was greater when the suppressibility was higher. This suggests that in adenomas the intracellular hormone degradation is responsible for the degree of PTH suppression. As the suppressibility of PTH secretion is reduced in hyperfunctioning parathyroid tissue, diminished intracellular hormone degradation seems to be involved in the pathogenesis of primary hyperparathyroidism.

Adenoma↗
PubMed1986

[Selective blood sampling from the inferior petrosal sinus using digital subtraction angiography].

Simultaneous bilateral venous sampling of blood from the inferior petrosal sinuses helps in the differentiation between peripheral and central ACTH hypersecretion. One can also locate the site of a hormonally active hypophyseal micro-adenoma that cannot be demonstrated by other methods. The authors have experience with fifteen patients and discuss the indications, technique and problems as well as the advantages of using digital subtraction angiography.

Adenoma↗
PubMed1986

Ciclosporin and prednisone v. prednisone in treatment of Graves' ophthalmopathy: a controlled, randomized and prospective study.

Forty patients with Graves' ophthalmopathy stages III-V were divided into two groups in a random manner according to their year of birth. Group I received prednisone in decreasing dosage. Group II received prednisone at a comparable dosage and ciclosporin. Steroids were discontinued after 10 weeks in the two groups. In the patients of group II, ciclosporin was continued over 12 months. The therapeutic effect was assessed by an activity score based on subjective and objective symptoms (computerized tomography and sonography of the orbit, Hertel values, clinical findings). All signs of endocrine ophthalmopathy improved significantly in both groups (P less than 0.01 in group I; P less than 0.001 in group II). The improvement was significantly greater in group II (P less than 0.05) according to the predefined score. After corticosteroids were discontinued, inflammatory signs recurred in nine patients in group I and in one of group II. During the observation period of 12 months, relapses occurred in eight out of twenty patients in group I and in only one out of twenty in group II. Muscle thickness decreased in nine patients in group II, 6 months after beginning therapy. At this time, the results were not influenced in any of the twenty patients in group I. Microsomal antibodies decreased significantly (P less than 0.001) in the ciclosporin group, whereas no change was seen in the other group. Renal values rose within the normal range in group II. In this group, an infection with Klebsiella pneumoniae occurred in one patient after 4 months of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Dislocated intraocular lens after biodegradation of fixation loops. A case report.

A boy aged 3 years had a Worst Medallion intraocular lens with loops made of nylon 6 implanted in his right eye after aspiration of traumatic cataract. Post-operatively, the eye was irritated and showed increased tendency to secondary membrane formation. The patient was lost to follow-up 3 months post-operatively. He returned 5 years later because of 4 days of pain and redness in his right eye. On examination, the optic part of the intraocular lens was seen to lie free in the anterior chamber. The loops were broken near their insertions in the lens body. The distal ends of the broken loops could not be detected in the pupillary region. No traces of the iris fixation suture were to be seen. The lens was removed and subjected to scanning electron microscopy which revealed extensive biodegradative changes in the 3 loop stumps, the 4th being totally dissolved. The young age of the patient and the chronic inflammation may have had an accelerating effect on the nylon degradation. We conclude that children with eyes implanted with nylon-loop lenses should stay under regular ophthalmological control.

Anterior Chamber↗
PubMed1986

Somatostatin analogue SMS 201-995 in type I diabetes mellitus. Initial experience after repeated administration.

We have recently obtained encouraging short-term results after a single subcutaneous injection of the long-acting somatostatin analogue SMS 201-995 in acromegalic patients. Increased growth hormone (GH) levels may be involved in the pathogenesis of proliferative retinopathy in type I diabetes mellitus. In this study we thus investigated the effect of 3 X 50 micrograms SMS 201-995 daily on the metabolic control and hormone secretion of eight type I diabetics over a 3-day period. GH levels decreased by 32% (p less than 0.05) and somatomedin C levels by 31% (p less than 0.01) on the 3rd day of treatment compared with a control day. The insulin requirements during conventional subcutaneous insulin therapy were reduced by 28% (p less than 0.01) in seven patients without deterioration of metabolic control (mean blood glucose levels, 153.8) versus 154.7 mg/dl). Triiodothyronine, thyroxine, glucagon, prolactin, luteinizing hormone and follicle-stimulating hormone showed no significant changes. We conclude that SMS 201-995 could be an excellent tool for further clinical investigation and therapy of diabetic vascular complications.

Adult↗