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Biomedical subjects

A Berger

Publications and source records attributed to A Berger.

At least 685 records · Page 38Linked to original sources
PubMedDate not supplied

Excision of the rectum with colonic J pouch-anal anastomosis for adenocarcinoma of the low and mid rectum.

The results of rectal excision with colonic pouch-anal anastomosis are reviewed from a series of 162 patients covering 7 years. All patients have been operated upon in the same institution and consecutively. The follow-up is now sufficient to allow an accurate evaluation of the outcome of the patients. The main goal of this study was to provide a detailed report of the functional results. Continence was satisfactory in 96% of the patients, with either a perfect continence or minor troubles that would not have been detectable other than by a rigorous questioning. The mean number of bowel movements was 2 per 24 hours. Fragmentation of the defecation and urgency were absent. Twenty-five per cent of the patients had to elicit the evacuation of the reservoir with a suppository or an enema. Improvement of function yielded by a reservoir over straight colo-anal and low colo-rectal anastomoses are significant and, as suggested by manometric studies, are directly related to the restoration of a reservoir function.

Adult↗
PubMedDate not supplied

Enterovirus infections in Germany: comparative evaluation of different laboratory diagnostic methods.

BACKGROUND: The diagnosis of an enterovirus infection may be achieved through direct virus detection from fecal or cerebrospinal fluid (CSF) samples by virus isolation or PCR. Serologically, a significant rise in antibody titer may be detected and different enteroviral types can be differentiated using the neutralization assay. PATIENTS AND METHODS: We investigated the contribution of these different laboratory parameters to the diagnosis of enterovirus infections occurring in the Frankfurt am Main area during the years 1997 to 1999, including an echovirus 30 outbreak in a group of children with aseptic meningitis in 1997. Samples were referred from 1,013 patients; virus isolation was attempted from 579 CSF specimens and from 400 stool samples. 208 CSF samples were tested by PCR. RESULTS: During the echovirus 30 outbreak we identified 22.3% of samples as positive, almost exclusively echovirus 30. In 1998 only 7.1% of samples were positive and a rather broad range of agents was isolated. In 1999 10.4% were positive, predominantly coxsackie B5 and echovirus 11. We could show that in acute enterovirus infections, virus detection by cell cuLture and PCR is superior to serological methods (neutralization assay and IgM assay). For virus isolation, there was a higher rate of positives from stool compared to CSF (1997: 27.8% versus 25%; 1998: 14.4% versus 3%; 1999: 17.9% versus 8.5%). When comparing PCR and virus isolation from the CSF, the former yielded a higher rate of positive results but was not clearly superior to virus isolation from CSF. CONCLUSION: The recommended method for the diagnosis of acute enterovirus infections is virus isolation from feces. In cases of suspected aseptic meningitis virus isolation and PCR are valuable for the direct detection of virus in CSF.

Acute Disease↗
PubMedDate not supplied

[Diagnosis and outcome of neurotropic enterovirus infections in childhood].

BACKGROUND: Enterovirus infections are among the most common causes of aseptic meningitis. Worldwide there are reports about recurring outbreaks, especially during the summer. They are favoured by conditions of bad hygiene and contaminated water, transmission is predominantly through the faeco-oral route or by droplet infection. The most common species are Coxsackie B and ECHO (Enteric Cytopathogenic Human Orphan) virus. ECHO viruses have a worldwide distribution and usually occur as "summer flu" or aseptic meningitis and meningoencephalitis in toddlers and infants. Type 30 caused an outbreak of aseptic meningitis in the Rhein-Main region in summer 1997. During five months 63 children younger than 16 years were reported. PATIENTS AND METHODS: During this outbreak 18 children with prooved enterovirus infections were treated at the Frankfurt/Main University Children's Hospital. Standardized infectiological diagnostic procedures were performed and risc factors, clinical symptoms, inflammatory marker, neurophysiological findings (electroencephalography, evoked potentials) and outcome were assessed. RESULTS: The affected children were between 3 and 11 years old. Clinical symptoms were cephalgia, nausea, vomiting, meningism and seizures with fever. Virus isolation from faecal and cerebrospinal fluid (CSF) samples and the use of polymerase chain reaction (PCR) was superior to serological methods. Erythrocyte sedimentation rates showed more significant increase than C-reactive protein (CRP) and blood leukocytes. CSF pleocytosis showed high variation. Clinical course as well as prognosis and outcome were favourable. CONCLUSION: Virusisolation in stool and CSF is most promising in the diagnostic of cerebral enterovirus infections. Usually the outcome is favourable, encephalitis can occur as serious complication.

Adolescent↗
PubMedDate not supplied

Occlusion of internal mammary grafts: a review of the potential causative factors.

The outcome of patient undergoing CABG is largely dependant on the long-term patency of the conduit used. Internal mammary artery (IMA) is considered whenever possible due to its improved long-term functionality over saphenous vein graft. However, a 10% rate of late arterial closure is described without well-known predictors. Chronic competition induced by a moderate coronary lesion on the bypassed native vessel is thought to be a major factor of arterial graft shrinkage even if conflicting data are reported in the available literature. Therefore, the decision to use an IMA to bypass a moderate native coronary lesion should be carefully weighted. When angiography is doubtful, more accurate functional investigations should be considered. Among them, pressure-derived fractional flow reserve could give an immediate answer of whether an intermediate lesion should be bypassed.

Animals↗
PubMedDate not supplied

Procalcitonin as a marker for the early diagnosis of severe infection after thermal injury.

High serum concentrations of procalcitonin (PCT), the 116 amino acid precursor protein of the hormone calcitonin, have been found in patients with various bacterial infections, particularly in those with sepsis. Because recent reports have shown that serum PCT constitutes a useful parameter for the diagnosis of sepsis in patients with several clinical conditions, a temporal analysis of the PCT concentrations in the plasma of 19 patients with severe burns (median body surface area burned, 32%) was conducted retrospectively. Nine patients were classified as septic on the basis of standardized clinical and laboratory parameters. Compared with the nonseptic group, these patients showed higher plasma PCT throughout the study period (median concentrations of septic vs nonseptic patient groups: 0.4 vs. 0.2 microg/L on postburn day 2; 1.0 vs. 0.3 microg/L on postburn day 4; 5.5 vs. 0.3 microg/L on postburn day 7; 10.8 vs. 0.5 microg/L on postburn day 9; 4.2 vs. 0.4 microg/L on postburn day 12; and 1.7 vs. 0.5 microg/L on postburn day 14), with differences considered to be significant (P<.05) from day 7 on. In contrast, differences in the plasma C-reactive protein concentrations were less pronounced and never reached statistical significance. PCT concentrations exceeding 15 microg/L were only observed in the 3 patients who died of sepsis-induced multiple organ failure. In addition to absolute PCT, individual time courses were also of diagnostic value. PCT is a highly efficient laboratory parameter for the diagnosis of severe infectious complications after a burn injury.

Adult↗
PubMedDate not supplied

Epidemiological analysis of Candida yeasts by pulsed-field gel electrophoresis.

The purpose of this study was to determine whether yeast isolates from mothers and their new-borns are of the same genotype. In this investigation, 103 parturient mothers and their children were examined for colonization by yeasts by sampling the vaginal secretions at delivery and by taking swabs from the oral mucosa and the anus of the children on the third day after parturition. The samples were cultured on Sabouraud glucoseagar and incubated for 48 h at 37 degrees C. Differentiation of the isolates was achieved biochemically by means of the Vitek AMS system and morphologically on rice extract agar. Subsequently DNA fingerprinting analysis was carried out by means of pulsed-field gel electrophoresis (PFGE). In six cases we could prove the presence of Candida spp. in the mothers as well as in their children. In all cases the strains isolated from mother and child showed the same banding pattern. Likewise, the strains isolated from the vaginal secretion and the vaginal epithelium of individual women were identical. The differences observed between strains isolated from different women were small to middling. This shows PFGE to be an efficient procedure to demonstrate the relation between strains derived from mothers and their newborns.

Candida↗
PubMedDate not supplied

Oncogenic potential of c-erbB-2 and its association with c-K-ras in premalignant and malignant lesions of the human uterine endometrium.

The aim of this study was to detect activated c-K-ras by gene point mutation and to find c-erbB-2 gene amplification with p185 expression in association with the c-K-ras gene product p21 in the human endometrium. Specimens obtained from 25 normal, 31 hyperplastic and 72 malignant samples of the human endometrium were examined for point mutation in codons 12, 13 and 61 of the c-K-ras by direct sequencing and c-erbB-2 gene amplification with p185 and p21 expression by differential polymerase chain reaction (DPCR) and immunohistochemistry. Neither the normal endometrium nor endometrial hyperplasias were found to have mutations in the c-K-ras gene, although a double mutation of codons 12 and 13 as a single-point mutation was observed in one case of endometrioid carcinoma (2.8%). In each of two other cases of endometrioid carcinoma (2/72), two single-point mutations of codon 13 (5.6%) were shown. Using DPCR, we found c-erbB-2 to be amplified in 15 premalignant (48%) and 45 malignant (63%) samples. We noticed that nonamplification of the c-erbB-2 gene was associated with the absence of immunoreactivity. Our data indicate that, while c-erbB-2 plays a role in the early development of endometrioid carcinomas, c-K-ras gene activation by point mutation does not.

Biomarkers, Tumor↗
PubMedDate not supplied

Effects of nutrition on plasma, liver and muscle amino acids in scalded rats.

This study set out to investigate the effect of three different parenterally administered diets on the free amino acid (AA) levels in the plasma, muscle, and liver of scalded rats. Diet I consisted of AA (1.4 g/100 g weight) and a high glucose dose (6 g/100 g weight), diet II consisted of AA and a low glucose dose (1.4 g/100 g weight) and in diet III only a low glucose dose was infused. Parenteral nutrition was started on the 3rd day posttraumatically. Sampling was performed on the 7th day posttraumatically. Nitrogen balances were significantly different in all three groups, being lowest in group III. Scalded rats fed isonitrogenously, but with different amounts of glucose showed only minor changes in AA concentrations. However scalded rats fed with a nitrogen-free diet exhibited significantly reduced total muscle and liver AA levels. These decreased AA levels were due to a drop of glycine in the muscle tissue (74%) and liver (49%). Contrary to the clinical catabolic situation in scalded and starved rats, it was not intracellular glutamine but glycine which was considerably influenced by catabolism and starvation.

Amino Acids↗
PubMedDate not supplied

Biparietal diameter: an alternative measure of head growth in the low-birthweight infant.

Reliability and validity of biparietal diameter (BPD) compared with head circumference (HC) measurement as an index of cranial growth was assessed. A significant correlation between BPD and HC (r = 0.857; p less than 0.0001) and an interobserver reliability of 92% were found. Infants' age and sex had independent effects on BPD growth rate. Very sick infants had a lower increase in BPD rate than healthy controls. It is suggested that in sick premature infants, when the head is encumbered by various types of apparatus, this technique might prove more feasible than HC measurement.

Cephalometry↗
PubMedDate not supplied

Papilloma virus and c-erbB-2 expression in diseases of the mammary nipple.

PURPOSE: The detection of low/intermediate/high risk genital groups of human papillomavirus (HPV) in correlation with a growth-factor receptor c-erbB-2 in benign tumors of the mammary nipple. MATERIALS AND METHODS: Ten nipple duct adenomas (NDAs) and twenty papillomas, all embedded in paraffin and taken from the breast, were analyzed for HPV DNA of the low- and high/intermediate-risk groups. Polymerase chain reaction (PCR) with HPV consensus primers (types 6/11/16/18/33) and dot-blot hybridization with type-specific primers were used for the detection of these HPV-DNA sequences. Indirect in situ PCR (ISPCR) was also used in one case of an HPV-DNA-positive papilloma. In addition, we examined c-erbB-2 oncogene expression in NDAs and central carcinomas of the mamma from an immunohistochemical perspective. RESULTS: Using PCR and dot-blot hybridization we could not detect the gene sequences that are specific for the low- and high/intermediate-risk groups in any of the ten NDAs. Regarding the 20 cases of papilloma, a positive result for HPV types 6/11 was detected by indirect ISPCR; in one case in combination with a condyloma of the skin around the mammary nipple. The oncogene expression of c-erbB-2 displayed a strong signal in the papilloma cells and in the NDAs of the breast. CONCLUSION: Our results showed that the HPV-DNA types of the low- and high/intermediate-risk groups are without relevance for the pathogenesis of benign diseases of the nipple. It was, therefore, not possible to establish a correlation between the oncogene expression of c-erbB-2 and the HPV-DNA types.

Adenoma↗
PubMedDate not supplied

Acute non A-E hepatitis in eastern Sicily: the natural history and the role of hepatitis G virus.

BACKGROUND: The etiology and the natural history of acute non A-E hepatitis is still undefined. METHODS: We examined the prevalence of HGV viraemia and the long-term outcome in 54 patients with non A-E acute hepatitis. RESULTS: HGV-RNA was found in 19 out of 54 (35%) patients. There was no difference between HGV-RNA positives and negatives in terms of age sex, parenteral risk factors and alanine amino-transferase peak level. Gamma-glutamyl transpeptidase levels were higher in the HGV-RNA positive group. During a 3-year follow up, 10 out of 54 (18.5%) patients progressed to chronic hepatitis and 4 out of 10 (40%) had an histologically advanced disease. None of the 19 subjects infected with HGV showed a chronic evolution of liver disease. CONCLUSIONS: Our results confirm the limited role of HGV as the etiological agent of non A-E acute hepatitis. The great majority of non A-E hepatitis cases are yet of undetermined origin and unfortunately, are characterized by a high rate of progression to chronic active hepatitis.

Adult↗
PubMedDate not supplied

[Results of combined therapy of small cell bronchogenic carcinoma in a 5-year period (1984-1988)].

Within the five-year period (1984-1988) the oat cell bronchogenic carcinoma was diagnosed and treated in 151 patients. Analysed were 74 patients having received complete treatment. Patients with disseminated form received only polychemotherapy in 6 cycles (cyclophosphamide, doxorubicin, vincristine and etoposide) and those with limited disease also received additional, local-regional radiotherapy of 45-50 Gy. In complete respondents preventive brain irradiation was applied. In selected patients with initial forms of the disease surgical resection with additional polychemotherapy were applied. The best survival showed respondents with limited disease and operated patients. Average survival of the whole group was 72 weeks. One year survived 31 out of 74 (41.9%) patients and two years survived 10 out of 74 (13.5%) patients.

Carcinoma, Bronchogenic↗
PubMedDate not supplied

Spontaneous small bowel perforation. A rare cause of acute abdomen.

Spontaneous non traumatic small bowel perforation is a rare cause of an acute abdomen. Preoperative diagnosis is especially difficult, since the symptoms are extremely nonspecific. In most cases, the acute perforation is only diagnosed at exploratory laparotomy. We performed a retrospective analysis on spontaneous perforations of small intestine, occurring in 35 patients, which were treated at our department during a 14-year period from 1974 to 1988. The average age on presentation was 57 years. At the time of operation, peritoneal involvement was already well advanced. In 16 (45.7%) patients, the lesion was oversewn and in 19 (54.3%) cases, resection was required. The difference in mortality between these two methods was statistically not significant.

Abdomen, Acute↗