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Biomedical subjects

A Berger

Publications and source records attributed to A Berger.

At least 217 records · Page 12Linked to original sources
PubMed1998

Persistence of pedicle blood flow up to 10 years after free musculocutaneous tissue transfer.

The hypothesis of whether or not flap perfusion remains persistent through its vascular pedicle up to 10 years after free tissue transfer was tested. Since 1982, more than 1,000 free tissue transfers have been performed at this institution. Of these, 40 patients were selected with comparable posttraumatic soft-tissue defects of the lower leg and surgical repair by a latissimus dorsi myocutaneous free flap. All patients had a postoperative course free of complications. Measurements of flap perfusion were started in groups 1 through 4 (each 10 patients) 3 to 5 weeks, 5 to 7 months, 4 to 6 years, and 8 to 10 years after free tissue transfer, respectively. Quantitative measurements of local flap perfusion were performed by means of the hydrogen clearance technique (Ameda, Switzerland) at definite sites intracutaneously and subcutaneously within the flap's skin paddle as well as in the adjacent intracutaneous and subcutaneous skin of the surrounding soft tissue. Simultaneously, the vascular pedicle of the flap was visualized by a duplex scanner (Toshiba, Japan). In each group nine measurements were performed before (phase A), during (phase B), and after closing the pedicle (phase C) by manual compression. Each measurement took about 10 minutes. Statistical evaluation of the obtained values was achieved by the Mann-Whitney U test and the Wilcoxon signed rank test. Local flap perfusion showed no statistical differences for phase A and C in all four groups of patients. In phase B, however, a statistically highly significant (p < 0.01) absence of local flap perfusion was registered in all four groups at the site of the flap's skin paddle. No statistically significant alterations of intracutaneous and subcutaneous blood flow was found in the surrounding soft tissue. In our clinical-experimental setting, flap perfusion persisted by means of its vascular pedicle even 10 years after free tissue transfer. Our findings support the importance of an intact vascular pedicle for permanent flap survival after free tissue transfer.

Adult↗
PubMed1998

Reduction of diagnostic window by new fourth-generation human immunodeficiency virus screening assays.

In order to reduce the diagnostic window between the time of human immunodeficiency virus (HIV) infection and laboratory diagnosis, new screening enzyme-linked immunosorbent assays (ELISAs) which permit the simultaneous detection of HIV antigen and antibody have been developed. Two fourth-generation assays, HIV DUO (Biomérieux) and HIV Combi (Boehringer Mannheim), for the combined detection of HIV antigen and antibody, were compared with a third-generation assay (HIV-1/HIV-2 3rd Generation Plus enzyme immunoassay [EIA]; Abbott) and a p24 antigen test (HIV-1 Ag monoclonal; Abbott). A total of 17 seroconversion panels, 15 cell culture supernatants infected with different HIV type 1 (HIV-1) subtypes, and 255 potentially cross-reactive serum samples were tested. Ten seroconversions were detected an average of 8.1 days earlier with HIV DUO and 7.5 days earlier with HIV Combi than with the third-generation ELISA. Overall, in the 17 seroconversion panels tested, HIV DUO detected HIV-1 infection an average of 4.8 days and HIV Combi detected infection an average of 4.4 days earlier than HIV-1/HIV-2 3rd Generation Plus EIA. HIV antigen was detected with HIV DUO and HIV Combi in all of the 15 cell culture supernatants infected with different HIV-1 subtypes, including subtype O. With fourth-generation assays, considerably fewer false-positive results (n = 4 to 6) were obtained, in comparison with the third-generation EIA (n = 18). Fourth-generation assays permit an earlier diagnosis of HIV infection than third-generation antibody screening assays through the detection of p24 antigen, which may be present in serum samples from individuals with recent HIV infection prior to seroconversion.

AIDS Serodiagnosis↗
PubMed1998

Neonatal cholestasis and focal medullary dysplasia of the kidneys in a case of microcephalic osteodysplastic primordial dwarfism.

We report on a male infant who presented with intrauterine growth retardation, severe postnatal failure to thrive, microcephaly, facial dysmorphism, and skeletal dysplasia. The clinical and radiological findings are consistent with former descriptions of microcephalic osteodysplastic primordial dwarfism (MOPD) type I/III. In addition to previously published features, multiple fractures of the long bones, severe neonatal cholestasis, and histological dysplasia of the kidneys were found. The boy died at the age of 8 months. The new finding of focal renal medullary dysplasia further supports the hypothesis of a basic defect in tissue differentiation in the pathogenesis of this rare condition.

Abnormalities, Multiple↗
PubMed1998

Quantification of viral load: clinical relevance for human immunodeficiency virus, hepatitis B virus and hepatitis C virus infection.

Quantitative determination of viral load using nucleic acid amplification techniques represents the most accurate prognostic marker for human immunodeficiency virus type 1 (HIV-1) infection, independently of CD4+ cell count. Overall, the different methods for HIV-1 RNA determination (RT-PCR, nucleic acid sequence-based amplification, branched DNA) show a good reproducibility (0.5 log), however for low copy numbers and in HIV-1-infected children the variability may exceed 0.7 log. In non-HIV-1 subtype B infections the copy number is underestimated. While serology permits an accurate follow-up of hepatitis B virus (HBV) infection, HBV DNA quantification is used for monitoring of antiviral therapy, determination of infectiosity and in combination with serological markers for the resolution of unusual profiles, i.e. isolated anti-HBc reactivity. The prognostic relevance of hepatitis C virus (HCV) RNA determination is of limited value for the long-term prognosis of chronic hepatitis C, however the viral load may predict the outcome of antiviral therapy. Genetic diversity represents a challenge for HCV RNA quantification.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Human immunodeficiency virus and hepatitis B virus infection in pregnancy: diagnostic potential of viral genome detection.

Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) account for millions of cases of vertical infections worldwide. Laboratory diagnosis is essential for the detection of potentially infectious carriers. HBeAg represents the best serological marker for HBV replication. Since 10% of HBeAg-negative carriers transmit the virus to their children, determination of viral DNA is more reliable for the assessment of the risk to vertical infection. Risk assessment of vertical HIV transmission and monitoring AZT therapy during pregnancy are achieved by determination of HIV-1 viral load and CD4+ cell count. HIV-1 RNA or cDNA detection permits a nearly 100% sensitive diagnosis of congenital HIV infection already 2 weeks after birth. While qualitative HBV DNA determination should be limited only to anti-HBe carriers in order to assess infectiosity, HIV-1 RNA measurement represents in combination with the CD4+ cell count the best prognostic marker for vertical HIV infection and for the follow-up of infected children.

Female↗
PubMed1998

[Therapy studies of the Austrian Breast Cancer Group (ABC)].

The Austrian Breast Cancer Group (ABC) consisting of more than 60 participating centers in Austria has randomized more than 5800 patients in 11 randomized trials since 1984. At present, roughly 30% of all patients with the diagnosis primary breast cancer are accrued in protocols throughout the country. Due to specific activities, the breast conservation rate raised from an initial 20% to more than 60% in the last years. Multicenter trials are not only the basis for progress in medicine but also tools for quality control and quality improvement.

Antineoplastic Agents, Hormonal↗
PubMed1998

[In vivo staining with the fluorescence marker PKH26 in experimental fat cell transplantation. Technique and initial results].

Experimental autologous adipocyte transplantation has to cope with the problem of differentiation between transplanted fat cells and local fat tissue of the recipient site. In this paper we present a procedure for marking vital fat cells and for tracking them over more than 6 months. An adipocyte suspension is marked by PKH26 ZynLinker (Zynaxis, Malvern, PA) and reimplanted into the animal. In a confocal microscope, the fluorescent dye is easily detected, and the varying intensity of the signal helps to differentiate between viable adipocytes, necroses, and oil cysts. An image analyzing system (OPTIMAS) allows for automatic planimetry and stereometry for viable and necrotic cells. Hence, the ratio between viable and necrotic transplanted cells can be measured exactly for the first time in fat transplantation research.

Adipocytes↗
PubMed1998

[Fas, fas ligand, immune tolerance, and cancer: implications in cancer of the colon].

Fas and Fas ligand (FasL) are implicated in programmed cell death or apoptosis. In the immunological field, they are particularly important in auto-immunity, graft rejection and anti-tumoral response. Fas ligand expression on thymocytes, activated T lymphocytes, and in sites of immune privilege, suggests the importance of Fas/FasL interactions in negative control of the immune response. The recent description of FasL expression by tumoral cells, represents a new mechanism of immune escape for different cancer, and has been well studied in colon adenocarcinoma.

Apoptosis↗
PubMed1998

[Severe hemorrhagic gastritis of radiation origin].

Severe gastric complications due to radiotherapy are uncommon, in particular hemorrhagic gastritis. A high total dose and, above all, high daily fraction appear to be the main risk factors in gastric injuries. A case of hemorrhagic gastritis induced by radiotherapy requesting a total gastrectomy is reported. The patient was treated for a primary gastric non-Hodgkin's lymphoma. Hemorrhagic gastritis occurred despite a low total dose (40 Gy) and 2 Gy daily fractions. Upper gastrointestinal endoscopy and repeated biopsies are usually insufficient to exclude a tumor recurrence. Endoscopic ultrasonography may argue for a recurrence or for radiation lesions. As the conservative treatment is usually ineffective, these gastrointestinal radiation injuries ought to be treated surgically. Besides it allows to ascertain the benign nature of radiation lesions.

Gastritis↗
PubMed1998

[Meigs' syndrome: is it possible to make a preoperative diagnosis?].

Two cases of Meigs' syndrome are reported, one following an ovarian fibrothecoma and the other an ovarian fibroma. The benign condition was suggested prior to surgery in one of the two patients because of a solid tumor of the ovary without peritoneal implant on CT-scan, and no malignant cells in ascitic fluid and on a fine needle biopsy. To differentiate this benign pathology from a malignant process enables to avoid useless surgical procedures. Preoperative evaluation, including serum CA 125 level, ultrasound examination and CT-scan, allows rarely to suggest the Meigs' syndrome. Nevertheless, this syndrome may be suspected when faced with an important pleural effusion, a very elevated CA-125 serum level, a negative cytologic examination of the ascitic effusion and no peritoneal implant on CT-scan.

Female↗
PubMed1998

[Initial muscle operations in brachial plexus paralysis].

Regeneration after surgical treatment of fresh or delayed brachial plexus injuries is often incomplete, with remaining sensory and motor loss. The aim of reconstructive surgery for these patients is to regain subordinate motor function. Therefore, reconstructive surgery should emphasize the restoration of elevation abduction and external rotation of the shoulder, elbow flexion and flexion of the fingers for basic grasping.

Arm↗
PubMed1998

[Does tissue perfusion after free microvascular tissue transplantation stay autonomous?].

In a prospective study including 60 patients after free latissimus dorsi transfer (FLDT) to the lower leg, we found persistence of pedicle blood flow up to 10 years postoperatively. After uncomplicated FLDT the pedicle supported the flap in all cases, whereas after complicated FLDT (hematoma, thrombosis, infection) we found only 50% of all flaps autonomously perfused by the vascular pedicle.

Adolescent↗
PubMed1998

[Endoscopically-assisted lipoma removal].

Since 1994 we have been removing large capsulated lipomas which are localised in an esthetically exposed and/or functional region using endoscopically assisted technique. This technique is minimally invasive and allows optimal visualisation of the tumour during the removal. Only a small incision is required to prepare the tumour in toto with capsula. With the endoscopic control of the wound we can avoid greater haematomas, which is very important for wound healing.

Endoscopes↗
PubMed1997

SNAP-23 is not cleaved by botulinum neurotoxin E and can replace SNAP-25 in the process of insulin secretion.

The synaptosomal-associated protein of 25 kDa (SNAP-25) is expressed in neurons and endocrine cells. It has been shown to play an important role in the release mechanism of neurotransmitters and peptide hormones, including insulin. Thus, when insulin-secreting cells are permeabilized and treated with botulinum neurotoxin E (BoNT/E), SNAP-25 is hydrolyzed, and insulin secretion is inhibited. Recently SNAP-23, a more generally expressed isoform of SNAP-25, has been described. The functional role of SNAP-23 has not been investigated to date. It is now shown that SNAP-23 is resistant to cleavage by BoNT/E. It was therefore possible to test whether transfection of HIT (transformed pancreatic B-) cells with SNAP-23 reconstitutes insulin release from BoNT/E treated cells, in which SNAP-25 is inactivated by the toxin. The results show that SNAP-23 is able to replace SNAP-25 when it is overexpressed. While these results demonstrate that SNAP-23 is a functional homologue of SNAP-25, able to function in regulated exocytosis, they indicate that SNAP-23 may be inefficient in this process. This suggests that both isoforms may have their own specific binding partners and discrete, albeit mechanistically similar, functional roles within the cell.

Animals↗