Biomedical subjects

W Wilke

Publications and source records attributed to W Wilke.

At least 19 recordsLinked to original sources

PubMed2001

[CT-guided marking of lung lesions before minimally invasive operation].

Video-assisted thoracoscopic surgery (VATS) is an established method for resection of suspicious pulmonary lesions. However, there are problems to detect small subpleural lesions. A procedure for localization of such lesions will be demonstrated. Since may 2000 our experience includes 5 patients (4m, 1f) suffering from solitary pulmonary lesions. In preparation of VATS a CT-guided marking was carried out using both a lasermarker system as well as a special marker system for lung lesions. All 5 procedures were successful. With the laser system the pulmonary nodule was exactly marked and the special wire was placed without any complications. Consequently, the pulmonary nodule was fixed. During video-assisted wedge resection the nodule can be tracted outside. Operating time was reduced in comparison to time consuming search of unmarked lesions. The combined application of CT-guided marking, transthoracic fixation of pulmonary nodule and VATS is recommended preoperatively. It should apply in lesions, which are located subpleural and thoracoscopically not visible.

Adult↗

PubMed2000

[Diagnosis and therapy of laryngitis gastrica].

We treated 64 patients with the diagnosis of laryngitis gastrica with Antra (Omeprazol) in doses of 10, 20, and 40 mg. To determine the success of the therapy, pH monitoring of the esophagus and hypopharynx, the voice status and measurement of vocal penetrating capacity were used. The results prove that a 20-mg dose of Antra is suitable for the therapy of laryngitis gastrica with a high rate of success. Problems which arose during the investigation, consequent changes of the original concept of the project as well as new aspects and questions which resulted from this are discussed with respect to further investigation.

Adult↗

PubMed2000

CT-guided intervention using a patient laser marker system.

To prove the usefulness of a simple laser marker system (LMS) in target definition as well as examination procedure for CT-guided interventions, 130 cases of diagnostic biopsies and lumbal sympathectomies were compared. In 75 cases LMS and in 55 cases a simple crossgrid was used. Taking advantage of the LMS, the parameters of intervention (cutaneous location, length, and angle) can be planned, exactly demonstrated, and it is possible to check the needle position during the whole procedure. Thus, the number of necessary control scans decreased to 30%, and corrections of needle location were reduced to approximately 30%. Moreover, the average target deviation of the needle decreased below 5 mm in 50% of cases, and the duration of interventional procedure was reduced considerably. It can be concluded that LMSs are recommended in CT-guided interventions for quality assurance, dose reduction, and improvement of handling. It will be especially advantageous in cases of small target volume, oblique needle path, and tilted gantry.

Biopsy, Needle↗

PubMed1999

[24 hour pH monitoring of the hypopharymx].

Monitoring of pH of the esophagus is a routine diagnostic procedure, whereas until now pH-monitoring of the hypopharynx has been used only for scientific research. In the present study a critical evaluation scale was used to record the results of 112 patients who underwent pH monitoring to determine possible reflux. Since high refluxes often remain unnoticed clinically, further study is required in certain cases. The extent of reflux in the esophagus may not represent pathological changes in the hypopharynx. In such cases 24-h pH monitoring of the hypopharynx can be a useful diagnostic procedure and may also help detect the pathogenesis of "gastric laryngitis".

Circadian Rhythm↗

PubMed1999

Downregulation of T helper type 1 immune response and altered pro-inflammatory and anti-inflammatory T cell cytokine balance following conventional but not laparoscopic surgery.

BACKGROUND: The clinical advantages of laparoscopic procedures result from a minimized surgical trauma. The present study was performed to investigate immunosupression following laparoscopic operations as compared with open surgery. Our analysis focused on the T cell secretion of cytokines that regulate the critical balance of either T helper type-1 (Th1)- and Th2-mediated immune responses on pro- and antiinflammatory activities. METHODS: In a prospective study, immunological data of 26 patients submitted to laparoscopic cholecystectomy (LCE) and 17 patients undergoing conventional cholecystectomy (CCE) for symptomatic cholecystolithiasis were compared. Patients with acute cholecystitis and patients developing postoperative complications or receiving immunosuppressive medication were excluded. Production of interferon (IFN)-gamma, interleukin (IL)-2, IL-4, tumor necrosis factor (TNF)-alpha, and IL-10 by isolated T cells stimulated by cross-linking of CD3 and CD28 was evaluated preoperatively as well as on postoperative days 1 and 6 or 7. Cytokines were measured by immunoenzymometric assay. RESULTS: IFN-gamma, TNF-alpha, and IL-2 production by T cells decreased significantly by 48.3%, 36.6%, and 36.8%, respectively, on postoperative day 1 after CCE, but not after LCE. These results indicate severe suppression of Th1-type and proinflammatory cytokines after the open operation. In contrast, IL-4 and IL-10 did not show significant changes in either group suggesting that Th2 cell response and anti-inflammatory activity remained normal. CONCLUSIONS: The present study shows that open, but not laparoscopic cholecystectomy is associated with a marked suppression of T lymphocytes functions as indicated by deregulation of both the Th1/Th2 and the pro-/anti-inflammatory cytokine balance. The results therefore suggest that downregulation of Th1 cell-mediated immune response and pro-inflammatory activity of T cells is a hallmark of open, but not laparoscopic surgery.

Adult↗

PubMed1999

[Forgetting of word associations in relation to indicators of emotionality. A possibility for evaluating Freud's concept of repression?].

In replication of the well-known study by Levinger & Clark, 30 subjects were presented a list with 60 words under several conditions. In the first part of the experiment they had to tell the first word which came to mind as a response to the stimuli read by the experimenter. Reaction times and skin conductance reactions (SCRs) during associations were recorded. Immediately afterwards the list was read again with the instruction to recall the associations given before. In part 2 of the study, one week later, subjects had to recall again their first associations; in addition, they scaled the emotionality of the word stimuli. Intraindividual correlations were computed for indices of emotionality (reaction time, SCR, perceived emotionality) and forgetting in both short-term and long-term memory. Associations accompanied by larger electrodermal reaction and showing longer reaction time were more likely to be forgotten both for short and long intervals. This is in line with Freuds concept of repression. However, alternative explanations should also be discussed.

Adult↗

PubMed1998

Normal T lymphocyte and monocyte function after minimally invasive surgery.

BACKGROUND: The aim of this study was to evaluate immune defense mechanisms after laparoscopic (LCHE) and open cholecystectomy (CHE), particularly with regard to monocyte and T-lymphocyte function. METHODS: In a prospective study, we evaluated the following immunological data from 27 patients (21 women, six men; mean age, 47.2 years) submitted to elective LCHE and 14 patients (seven women, seven men; mean age, 60.8 years) undergoing elective CHE: T-lymphocyte proliferation (stimulated by SEA, SEB, TSST-1 with antigen presentation by patient monocytes), expression of cell surface molecules on monocytes (HLA-DR, CD80, L-Selectin), CD4+ T lymphocytes (HLA-DR, CD25, ICAM-1, L-Selectin), and granulocytes (L-Selectin). Blood samples were collected preoperatively and on postoperative days 1 and 6-7. Statistical analysis was performed using the Mann-Whitney U test for paired samples. RESULTS: HLA-DR on monocytes significantly decreased after LCHE during the early postoperative course but returned to preoperative levels within 1 week. After CHE, significant downregulation of HLA-DR expression persisted throughout the whole observation period. This decrease, however, did not alter the antigen-presenting capacity of monocytes in both groups. Moreover, the APC-independent proliferative capacity of T lymphocytes was unimpaired. CD25 expression was significantly increased on postoperative day 1 after CHE but not after LCHE. Expression of HLA-DR, ICAM1, and L-Selection on CD4+ T cells was not altered in either group. CD80 on monocytes and L-Selection on monocytes and granulocytes remained unchanged after both procedures. CONCLUSIONS: HLA-DR surface molecules on monocytes that are required for antigen presentation were significantly decreased in both groups; they returned to normal within 1 week after LCHE but not after CHE. However, the antigen-presenting capacity for monocytes remained normal in both groups. T-cell stimulation, reflected by an increase of CD25 expression, was observed only after CHE, not after LCHE. We therefore conclude that LCHE interferes less with immune defense than CHE; however, the clinical relevance of the changes noted after the open operation remains to be determined.

Adult↗

PubMed1997

[CT-guided intervention by means of a laser marking and targeting aid].

PURPOSE: The present study evaluates the use of a laser guidance system for CT-guided intervention. MATERIAL AND METHODS: 94 cases of diagnostic biopsies and lumbar sympathectomies (54 cases with laser guidance system and 40 without) were compared. RESULTS: Using the laser guidance system, the number of control scans decreased by 30 to 50%, and necessary corrections of needle location were reduced by a maximum of 30%. The average target deviation of the needle decreased to less than 5 mm in 50% of cases. CONCLUSION: The laser guidance system is strongly recommended in CT-guided interventions for quality assurance and higher efficiency. The advantage is especially marked if the target area is small.

Adolescent↗

PubMed1995

[Improved measurement of vocal penetration].

By measuring the vocal penetration a characteristic feature of the efficiency is covered which is essential for all three parts of the communication chain of speech with special emphasis on the recipient. Results are expressed in decibel (AS) of a defined masking noise, at which 50% of the logatomes spoken by the test persons are recognized. The vocal efficiency is indicated by the sound pressure of the masking noise, subtracting the sound level of speech used. Individuals with a healthy voice lie within the range of 12-24 dB (AS), average value 20 dB(AS), patients affected with a vocal disorder lie within the range of 0-12 dB(AS), average value 9 dB(AS). The vocal penetration significantly correlates with the auditive features of the vocal swinging-in phase; it proves to be a sensitive indicator of treatment efficacy for dysphonia and a useful tool for predicting the vocal capacity in all voice professions.

Humans↗

PubMed1995

An examination of the dental state of an Egyptian mummy by means of computer tomography: a contribution to 'dentistry in Ancient Egypt'.

In 1991 mummies from Leipzig collections were investigated by means of conventional X-ray techniques and by computer tomography. The dental state of one of these mummies prompted a re-examination of the question of whether a dental profession actually existed in Ancient Egypt or not. To answer this question, different types of source material are discussed.

Egypt, Ancient↗

PubMed1993

H-ras-1 point mutations in soft tissue sarcomas.

The H-ras-1 protooncogene is activated by single base substitutions occurring in either codon 12, 13, or 61. These mutations have been described with varying frequencies in several human tumor types. Since ras oncogenes were first discovered as the transforming sequences of Harvey and Kirsten murine sarcoma viruses (which also contain activating point mutations compared to the homologous cellular sequences), we wished to investigate the possibility that ras mutations might also occur in human sarcomas. We extracted DNA from six malignant fibrous histiocytomas (MFH), three embryonal rhabdomyosarcomas (ER), one alveolar rhabdomyosarcoma, one pleomorphic rhabdomyosarcoma, and one leiomyosarcoma. The DNA from regions flanking codons 12/13 and codon 61 was amplified by the polymerase chain reaction and sequenced with an automated DNA sequencer. As controls, we amplified and sequenced normal DNA (placenta) and DNA with known point mutations (T24 bladder carcinoma cells). We found three cases with mutations, all occurring in codon 12. One ER showed a G-to-T mutation in the second position of codon 12 (coding for valine instead of glycine). Two MFHs showed G-to-A mutations in the second position of codon 12 (coding for aspartic acid instead of glycine). Although a limited number of cases were sampled, we conclude that study of H-ras-1 mutations may be relevant to MFH and ER. Additional studies of N and K-ras mutations as well as more cases investigating H-ras will be required before we can ascertain the significance of ras mutations in the oncogenesis of human soft tissue sarcomas.

Base Sequence↗

PubMed1992

Nitrogen mustard as induction therapy for rheumatoid arthritis: clinical and immunologic effects.

We treated 5 patients diagnosed with rheumatoid arthritis (RA) with nitrogen mustard (HN2) and monitored clinical and immunologic variables. HN2, 0.3 mg/kg ideal body weight was given over 7 days. Disease activity and immune function were monitored during and after treatment. Duration of morning stiffness (p = 0.0044), joint count (p = 0.0140), and assessment of pain (p = 0.0264) and function (p = 0.0057) improved by Day 6. T lymphocytes (p = 0.0060), especially T memory cells (CD4CD29; p = 0.0017) fell dramatically. HN2 is effective for rapidly gaining control of active RA. This effect is T cell specific.

Aged↗

PubMed1992

Chronic fatigue syndrome.

Fatigue is one of the most common complaints among patients seen in the primary care setting. Chronic fatigue syndrome, which has recently been called chronic fatigue immune dysfunction syndrome, is distinctive, with an abrupt onset of symptoms that wax and wane for at least six months. Usually there is low-grade fever, pharyngitis and tender, but not enlarged, lymph nodes. The fatigue can be disabling and is often made worse by physical activity. Some patients with this disorder have also been found to have highly characteristic immunologic abnormalities. Treatment can be rewarding and is based on patient education and support, exercise and symptomatic therapies for abnormal sleep patterns, musculoskeletal pain and other symptoms.

Adolescent↗

PubMed1990