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Biomedical subjects

A Berger

Publications and source records attributed to A Berger.

At least 19 recordsLinked to original sources
PubMed1992

[Hepatobiliary manifestations in AIDS in adults. Place of cholecystectomy].

In AIDS patients an acalculous cholecystitis may be responsible for abdominal pain subsiding after cholecystectomy. But the indications for cholecystectomy are not clear: cholecystitis is usually associated with diffuse cholangitis and this might cause the symptoms. Since 1985, 8 AIDS patients have undergone cholecystectomy for acute cholecystitis. Ultrasonography revealed a 5 to 12 mm thickening of the gallbladder wall in all of them and gallbladder stones in two; four patients had cholangitis. The decision to operate was based on persistent pain associated with fever, poor general condition and muscular rigidity at palpation. Four patients had septic shock at the time of surgery; one died in the immediate postoperative period. In all other patients pain and septic syndrome subsided. Two patients died of AIDS complications 20 days after surgery; the remaining five died of AIDS 6, 9, 10, 12 and 14 months respectively after surgery; in two of them cholestasis had reappeared due to cholangitis. To summarize, in the 8 AIDS patients studied cholecystectomy was performed for clinical deterioration. Gallbladder pathology was responsible for the abdominal pain and the febrile general condition which was relieved by cholecystectomy.

Acquired Immunodeficiency Syndrome↗
PubMed1992

An alternative approach to reduction mammoplasty.

The female breast can be reduced by a number of operative techniques. Their goal is to transform different deformities into a so-called ideal form. The ideal form is obtained by small changes such as fixing the nipple's position in relation to predetermined anatomical marks. Under certain conditions we have to deviate from the ideal form. In these cases the operative method used is not determined by the deformity but by the desired form. Reduction mammoplasty techniques are just variations of a single method whose principles still need to be defined.

Esthetics↗
PubMed1992

Male reduction mammoplasty in serious gynecomastias.

This article is a report on long-term followup of a total of 44 serious gynecomastia cases in the stages I-III (according to Deutinger). The treatment consisted of either a semicircular incision and subcutaneous mastectomy or a superiorly or an inferiorly based nipple transposition while performing male reduction mammoplasty. Aesthetically pleasing results could be obtained by a periareolar approach and mastectomy. This inconspicuous procedure is feasible even in massive gynecomastia cases (stage III) or in cases of male breast asymmetry. On the other hand, all cases with breast reduction plasty and nipple transposition resulted in wing-shaped, mainly broad scars, and subjectively unfavorable results. Consequently, we favor the semicircular approach in male reduction mammoplasty in treating serious gynecomastias. With regard to possible male breast cancer etiology, the histological specimen of the mammary gland in gynecomastia is excised prior to any additional liposuction for supplementary body contouring.

Follow-Up Studies↗
PubMed1992

Effects of various dietary fats on cardiolipin acyl composition during ontogeny of mice.

Cardiolipin (CL) is a unique mitochondrial phospholipid, containing up to 85 wt% 18:2n-6 in mammals. The influence of maternal dietary fatty acids on the acyl composition of offspring CL has not been examined previously. Adult female mice were thus fed diets rich in 18:1n-9 (olive oil), 18:2n-6 (safflower oil), 18:3n-3 (linseed oil) or 20:5n-3 and 22:6n-3 (fish oil/safflower, 9:1, w/w), for a five month period, encompassing two breeding cycles. Offspring from the second breeding cycle were then fed these diets. The acyl composition of CL, phosphatidylcholine and phosphatidylethanolamine from liver and heart was evaluated from mice killed 3, 18 and 42 days after parturition. The primary nutrient sources at these three time points were transplacental nutrients, breast milk and the diet, respectively. Maternal diet was found to influence the acyl composition of CL via both placental transfer of fatty acids and breast milk. Fish oil feeding resulted in replacement of a substantial portion of 18:2n-6 with 22:6n-3; after 42 days, the area% of 18:2n-6 in heart CL was reduced from 62% in safflower oil fed mice to 12%. In comparison to fish oil feeding, linseed oil feeding resulted in a much lower accumulation of 22:6n-3. Olive oil feeding resulted in substantial replacement of 18:2n-6 with 18:1n-9 (18:2n-6 was reduced from 62% to 31%). Physiologically, these findings are relevant because changes in CL acyl composition may influence the activity of associated inner mitochondrial membrane enzymes.

Aging↗
PubMed1992

Implications of modifying cardiolipin acyl composition by diet. 1. Cardiolipin acyl chain is an important determinant in the binding to antiphospholipid antibodies in SLE sera.

Antiphospholipid antibodies (aPL), prevalent in sera of patients with systemic lupus erythematosus (SLE), have been linked to thrombosis, thrombocytopenia, recurrent miscarriages, neurological disorders and ischemic heart disease. Most evidence suggests that phosphodiester-linked phosphate groups are the reactive epitope of cardiolipin (CL) in binding to aPL. Little attention has been given to the acyl moiety. To address this problem we have evaluated the ELISA binding of 12 highly positive IgG anticardiolipin antibody-positive SLE sera to: bovine CL (86.1% 18:2n-6), monolyso CL (MLCL; bovine CL minus 1 fatty acid), dilyso CL (DLCL; minus 2 fatty acids), tetraoleoyl CL (TOCL), myristoyl CL (MCL) and E. coli CL. The reductions in binding of the IgG aPL antibodies relative to bovine CL were as follows: DLCL 83%; MLCL 70.7%; MCL 58%; and TOCL 14% (P less than 0.05). These data suggest that the number of acyl chains and the unsaturation of the acyl chain of CL may be important determinants in the binding to aPL present in SLE sera. To investigate the nutritional relevance of this finding, we examined the incorporation of several dietary fatty acid classes into the CL pool of mice. Mice were fed diets containing n-6 (safflower oil), n-9 (olive oil) or n-3 fatty acids as either 18:3n-3 (linseed oil) or 20:5n-3/22:6n-3 (fish oil) for a 5 month period. The feeding of fish oil and olive oil resulted in replacement of a substantial portion of 18:2n-6 with 22:6n-3 or 18:1n-9, respectively. These results suggest that there may be therapeutic value in modifying the CL acyl composition by nutritional means with respect to binding to pathogenic aPL.

Animals↗
PubMed1992

Relationship between neonatal behavior and subsequent temperament.

The validity of the neonatal behavioral assessment scale in predicting later infant temperament is of theoretical and clinical importance. The scale was administered to 47 full-term healthy neonates. Of these, 40 were followed and the infant characteristics questionnaire was given at four months of age. Significant correlations were revealed between the neonatal assessment items from the clusters of orientation and motor maturity and the temperament factors "fussy-difficult" and "unpredictable". Items from the cluster of autonomic stability correlated with the temperament factor "unadaptable." These correlations possibly indicate that perceived temperament does reflect intrinsic infant qualities.

Adaptation, Physiological↗
PubMed1992

[Pancreas divisum, chronic pancreatitis and diabetes mellitus. Improvement by pancreaticojejunostomy].

The relationship between pancreas divisum and chronic pancreatitis is controversial. We report the cases of two patients aged 40 and 53 years suffering from recurrent pancreatitis and known to have histologically proven idiopathic chronic pancreatitis. One patient had insulin dependent diabetes. Pancreatography demonstrated in these two cases a pancreas divisum with a dilated dorsal pancreatic duct. A pancreatico-jejunostomy was performed, associated in one case with splenopancreatectomy for pseudo-cyst. With a follow-up of 32 and 78 months, both patients were free of symptoms and the diabetic patient had normal blood glucose levels with diet alone. The clinical history of the patients suggests a relationship between pancreas divisum and chronic pancreatitis and that pancreatico-jejunostomy may improve pancreatic pain and pancreatic function.

Adult↗
PubMed1992

[The status of replantation centers and services in the area served by the German Professional Society of Microsurgery of Peripheral Nerves and Blood Vessels (Commission for Replantation)].

This survey concerns the years 1989 and 1990. While the number of institutions performing replantations remained constant in Austria and Switzerland, there has been a noticeable trend in Germany from around-the-clock replantation centers to simple replantation services, offering emergency microsurgery by arrangement only. The total number of replantations performed decreased from 975 replanted parts (903 microreplantations and 72 macroreplantations) in 1989 to 875 in 1990, with a micro-/macroreplantation ratio of 12.8:1. Based on the results of questionaire received from 34 university and city hospitals in Austria, Switzerland and former West Germany, an analysis of clinical organization and management of replantation services is presented.

Amputation, Traumatic↗
PubMed1992

[Diverting loop ileostomy, effective prevention of colonic complications in necrotizing acute pancreatitis].

The operative diagnosis of colonic ischaemia in association with acute necrotizing pancreatitis (ANP) may be difficult in the absence of unequivocal transmural necrosis or perforation. We introduced in May 1988 a new policy whereby, when colonic viability was dubious, resection was avoided and a diverting loop ileostopy (DLI) was performed. If necrosectomy led to extensive mobilization of the splenic flexure with a capillary drainage system placed in close contact, a DLI was again performed. Colectomy was only performed for unequivocal transmural necrosis. Among 30 patients operated on for ANP, 12 underwent DLI. This policy allowed us to spare potentially ischaemic colons. No secondary colonic complication occurred and there was no rise in the mortality rate. Among patients whose colon was kept in circuit there were bouts of bowel distension and unexplained bacteriemia ultimately leading to death from multiorgan failure. When colonic viability is dubious and when drainage is brought up in close contact with the bowel wall DLI might allow colonic resection to be avoided. In our experience DLI also seemed to prevent secondary colonic complications.

Acute Disease↗
PubMed1992

Neonatal behavior of Panamanian and Israeli infants: a cross-cultural study.

The behavior of third-generation Israeli neonates belonging to two ethnic groups--Ashkenazic infants (n = 20) and Sephardic infants (n = 20)--and the behavior of a group of full-term Panamanian infants (n = 30) were compared in order to examine cross-cultural and interethnic predispositions. The Israeli and Panamanian infants differed on 5 of a total of 27 neonatal behavioral assessment items: the difference in 3 of these items, representing the autonomic stability and motor clusters, exceeded 1 scale score. A comparison of the two Israeli ethnic subgroups with the Panamanian group (Duncan's multiple-range test) revealed significant differences between Ashkenazic and Sephardic infants on 2 auditory habituation items, whereas the Panamanian infants differed significantly from both Israeli subgroups on 10 of the items, representing the motor, range of state, and autonomic stability clusters. These results corroborate previous observations concerning cross-cultural neonatal behavioral differences and the possible role of environmental factors in the ongoing modeling process of human behavioral traits and personality.

Child Behavior↗
PubMed1992

[Epitheses of the face].

Despite progress in maxillofacial cancer surgery, most patients present disfiguration of their faces. External prostheses are a pleasing alternative to camouflaging maxillofacial mutilations after tumor ablation. Established indications for external prosthesis are: 1. the patient refusing soft-tissue reconstruction, 2. patient's multimorbidity, and, 3. the impossibility of fully reconstructing a specific maxillofacial defect. Consequently, the benefits of applying external prosthesis include the simple camouflage of an unsightly tumor defect, the ease in supervising any possible local tumor growth beneath the external prosthesis as well as helping to prevent patient's isolation. Thus, external prostheses are a good option in the rehabilitation of maxillofacial surgery patients.

Adult↗
PubMed1992

[Jejuno-ileal diverticula (Meckel excluded). Apropos of 10 cases].

The authors report ten cases of small bowel diverticulosis revealed by a complication in four cases. Aetiologic, pathological, clinical and therapeutic characteristics of this rare disease are reviewed. Main complications are perforations, intestinal obstruction and hemorrhage. The treatment was the resection of the segment of small intestine involved by complicated diverticula. Resection was followed by anastomosis or temporary enterostomy if there was an acute peritonitis. Uncomplicated diverticulae must be respected and left in place.

Aged↗
PubMed1991

Maturation of the immune response in germinal centers.

Germinal centers develop in peripheral lymphatic tissue during the primary immune response and may play a crucial role in affinity maturation. We have compared the diversification of the antigen-specific repertoire of B cells, both from within and from outside the germinal centers, during the murine response to 2-phenyloxazolone (phOx). By sequencing V kappa Ox1 L-chains characteristic of phOx-specific antibodies, we show that somatic mutations accumulate in germinal center B cells and that a mutation conferring high affinity binding is found with increasing frequency. An analysis of V/D/J rearrangements suggests that this mutation occurred independently in many B cells, which were then preferentially expanded. We conclude that, although the hypermutation mechanism may be activated before germinal centers develop, affinity maturation by hypermutation and selection takes place in the germinal centers.

Amino Acid Sequence↗
PubMed1991

Relationship between neonatal excitability and respiratory habituation.

The Brazelton Neonatal Behavioral Assessment Scale was administered and analyzed in the cases of 25 full-term infants in order to assess the relationship between a behavioral measure of excitability and respiratory habituation. Sound and light stimuli were sequentially delivered, and prestimulus and poststimulus respiratory amplitude mean and standard deviation were analyzed. The stimulus with the least interperiod difference was considered as habituation. The correlation between arousal behavioral items and respiratory habituation ranged between 0.16 and 0.44. The two significant correlations were between peak of excitement and respiratory habituation to light (0.44) and between rapidity of buildup and respiratory habituation to sound (0.38). These results may indicate an interrelation in neonates between temperamental excitability attributes and respiratory regulation.

Acoustic Stimulation↗
PubMed1991

[Preventive operations in plastic surgery].

Prophylactic surgery is an operation meant mainly to be preventive but may also be performed in combination with other operations. These procedures should prevent tissue damage or prevent spread and increase of this damage. Examples of such operations are procedures such as after radiotherapy, pressure sores and scar tissue.

Cicatrix↗
PubMed1991

[Functional reconstruction by neurovascular muscle and myocutaneous flaps of the lower extremity].

The management of resurfacing problems is simplified in using free, microvascular flaps in complex trauma or tumor surgery. To restore motor function neurovascular muscle or myocutaneous flaps are imperative. Therefore 29 neurovascular latissimus dorsi flaps in 28 patients among more than 570 free tissue transfers have been applied to the lower extremity. One patient had a monoblock transfer, while another had bilateral latissimus dorsi flaps to both legs. Reanimation of the neurovascular flaps was perceptible at an average of 13.5 months. Of the 29 neurovascular muscle, or myocutaneous flaps 27 developed a joint excurvation according to muscle grading scale: M3 to M5.

Adult↗