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Biomedical subjects

A Foerster

Publications and source records attributed to A Foerster.

At least 55 records · Page 3Linked to original sources
PubMed1992

Congenital heart defects, hamartomas of the tongue and polysyndactyly in a sister and brother.

We report a sister and brother with congenital heart defects, hamartomas of the tongue and polydactyly. Both had coarctation of the aorta, which was repaired in early infancy. In addition, the girl had atrioventricular canal. She died postoperatively at age 4 years. The boy had subaortic stenosis and died of pneumonia at age 2 years. Both children had normal psychomotor development. The parents were healthy and unrelated. The familial occurrence could be due to a previously unrecognized autosomal recessive syndrome or parental gonadal mosaicism for a dominant syndrome.

Abnormalities, Multiple↗
PubMed1992

Colonoscopic screening examination of relatives of patients with colorectal cancer. I. A comparison with an endoscopically screened normal population.

First-degree relatives (n = 206) of patients operated on for colorectal cancer (CRC) (n = 181) were offered a colonoscopic screening examination; 169 relatives (82%) attended. The findings were compared with those in a normal population sample with no CRC in first-degree relatives (n = 308), aged 50-59 years, who had been screened by means of flexible sigmoidoscopy. Three carcinomas and 176 polyps were found in 56 of 95 male relatives (57%) and 34 of 74 female relatives (46%). The adenoma prevalence rate was 37 (39%) and 26 (35%) for male and female relatives, respectively. In the 50- to 59-year age group, the adenoma prevalence rates for both sexes collectively and for women separately were significantly higher among relatives than among the population without CRC relatives. Hyperplastic polyps were larger, whereas adenomas were similar in size among relatives compared with the normal population. Colonoscopy may be a suitable method of choice for screening first-degree relatives of patients with CRC.

Adenoma↗
PubMed1992

Colonoscopic screening examination of relatives of patients with colorectal cancer. II. Relations between tumour characteristics and the presence of polyps.

Colonoscopy was offered to 206 first-degree relatives of 181 patients operated on for colorectal cancer (CRC). Findings of polyps in relatives correlated with Dukes staging, extent of dedifferentiation and localization of tumour in the operated patient, and type of family relationship. Adenomas in relatives and Dukes staging of carcinoma in the patients were inversely related. Relatives of patients with Dukes stage A tumour had more than twice as many adenomas as and a higher prevalence of multiple adenomas than relatives of patients with advanced cancer at the time of operation. If the patient had polyp(s) in addition to tumour, the number of adenomas per relative was almost doubled. Hyperplastic polyps in relatives were associated with poorly differentiated carcinoma in their related patients. These results support the theory that not all CRC are derived from polyps and that adenoma-derived CRC may have a better prognosis than 'de novo' CRC. An adenoma prevalence risk table is also presented.

Adenoma↗
PubMed1992

Single lung transplantation. Surgical experiences with the first seven patients.

Seven single lung transplants are reported. The patients were severely disabled and oxygen dependent below sixty years of age with a poor prognosis. Diagnosis were alfa 1-antitrypsin deficiency (3), sarcoidosis (3) and idiopathic emphysema (1). Multiorgan-harvesting including six hearts, was performed in local or distant hospitals (3). Partial cardiopulmonary bypass simplified transplantation. The surgical procedure was modified with a direct transpericardial approach. Soft tissue wrapping by a vascularized pedicle secured the bronchial anastomosis. The four drug immunosuppressive regimen included cyclosporin A, azathioprine, steroids and antithymocyte globulin. Primary graft function was excellent. Six patients survived the postoperative period and are alive 5-19 months post transplant. Transbronchial biopsies and lung function studies have been helpful in detecting pulmonary rejections. Patient rehabilitation is satisfactory in most patients with improvement in physiologic parameters.

Adult↗
PubMed1992

Morbidity risk factors in human cardiac transplantation. Histoincompatibility and protracted graft ischemia entail high risk of rejection and infection.

Data from the first 103 human heart transplantations performed on 100 recipients (aged 14-62 years) at a single center from November 1983 to January 1990 were analyzed in order to detect morbidity-causing risk factors. Cumulative one- and five-year graft survival was 82% and 68%. Multivariate analysis revealed three independent risk factors for early rejection, viz. HLA-DR and HLA-B mismatches and no prior cardiac surgery. Graft ischemic time exceeding 71 min was an independent risk factor for rejection, especially for moderate or severe events, and for infection. HLA-DR mismatch was an independent risk factor for moderate and severe rejection events and for infections. Finally, patients operated on because of end-stage ischemic heart disease were at significantly higher risk of rejection than those with other cardiac disorders. The study has several implications: Prospective tissue typing for cardiac transplantation and selection of donors may have an impact on graft function: Damage to the graft by prolonged ischemia may be reduced by improved organ preservation.

Adolescent↗
PubMed1992

Sensory nerves in adult rats regenerate and restore sensory function to the skin independently of endogenous NGF.

We have investigated the possible roles of NGF, and of impulse activity, in the regeneration of sensory nerves. Unexpectedly, the ability of crushed axons to regrow and to restore functional recovery of three sensory modalities in adult rat skin (A alpha-mediated touch, A delta-mediated mechanonociception, and C-fiber-mediated heat nociception) was totally unaffected by anti-NGF treatment. This finding applied even when the anti-NGF dosage was almost eight times that which entirely blocked collateral sprouting of the undamaged axons of both classes of nociceptive nerves (the A alpha-axons do not sprout in adult animals). In the same anti-NGF-treated animal, regeneration would proceed normally on the one side, while collateral sprouting was prevented on the other. Light microscopic and EM examination revealed that in the denervated skin the regenerating axons utilized the same dermal perineurial pathways followed by collaterally sprouting axons. Regeneration within these antibody-accessible pathways progressed normally during anti-NGF treatment, extending 1-2 cm beyond the former field borders, that is, into territory whose invasion by collaterally sprouting axons was totally blocked. The blood-nerve barrier is absent within the degenerating peripheral nerve trunk, a putative NGF source for regenerating fibers but not for sprouting ones. The NGF-independent regeneration was also found to be unaffected when putative spinal cord sources of NGF were eliminated by dorsal root excision. Anti-NGF treatment also failed to block regeneration across 4 mm excision gaps in the nerve trunk. The daily anti-NGF regime continued to be effective for at least 8 weeks, at which time newly evoked collateral sprouting could still be blocked. Exogenous NGF, in doses that evoke collateral sprouting de novo in normal skin, failed to influence regeneration. Finally, an electrical stimulus regime, which markedly reduces the latency of collateral sprouting, failed to affect the time to arrival of regenerating axons at the skin, or the rate of their arborization in it. We conclude that, in striking contrast to their collateral sprouting, the regeneration of nociceptive axons occurs independently of endogenous NGF and is unaffected by impulse activity. These findings further support the proposal that these two growth behaviors have basically different biological functions in the organism.

Animals↗
PubMed1992

Vascular rejection in cardiac transplantation. A morphological study of 25 human cardiac allografts.

Between November 1983 and January 1990 103 orthotopic heart transplants were performed at the National Hospital, University of Oslo, Norway. Twenty-two patients died. Acute and/or chronic rejection was the cause of death in nine, disseminated infection in eight, cancer in three, and cerebral haemorrhage in one of the patients. Two patients were successfully retransplanted after graft failure due to AB0 blood group incompatibility because of a communication error. One patient with a positive lymphocytotoxic crossmatch died shortly posttransplant due to acute circulatory collapse. The cumulative one- and five-year survivals were 82% and 68%. Follow-up time was 226.6 graft years, survival range from one to 2,306 days (mean 803 +/- 4.12 SEM). A total of 1,343 endomyocardial biopsies were performed, which revealed 181 acute cellular rejection episodes, and 22 biopsies revealed acute and/or chronic vascular rejection. Autopsy studies showed three general types of vascular damage: acute (necrotizing) vasculitis, atherosclerotic disease in the epicardial arteries and diffuse proliferative arteriopathy in the intramural and smaller branches. In several cases acute vasculitis was concomitant with either of the two chronic types of accelerated graft sclerosis. Tissue immunofluorescence analysis demonstrated vascular deposition of immunoglobulin and complement in acute vasculitis, indicative of humoral immunoreaction. Postoperatively early chronic vascular rejection may develop.

Adolescent↗
PubMed1991

[Gastrointestinal cytomegalovirus infection in patients with heart transplants].

Cytomegalovirus (CMV) infection is a major cause of morbidity in organ transplant recipients. Gastrointestinal CMV disease is a serious and potentially lethal complication requiring treatment with antiviral agents. The symptoms and endoscopic findings are nonspecific. The diagnosis may be decided by histological examination, since CMV inclusions can be verified immunohistochemically in routine sections. In a series of 132 heart transplant recipients, 26 developed CMV-infection. Three of these patients had serious gastrointestinal disease. This report describes the patients with gastrointestinal CMV infection, and briefly discusses symptomatology, diagnostic considerations and suggested treatment.

Adult↗
PubMed1991

[Results of 6 1/2 years of heart transplantation at Rikshospitalet].

We discuss our experience from 6 1/2 years of orthotopic heart transplantation at Rikshospitalet (the National Hospital). 112 grafts were performed on 109 patients (19 women and 90 men), mean age 47 years (range 14-63). In the first nine patients the immunosuppressive regimen consisted of cyclosporine A and prednisolone, and in the last 100 azathioprine was added (triple medication). There was no operative mortality. 21 patients died, giving an 81% cumulative survival, with a significantly better prognosis among those who received triple immunosuppressive regimen. The main complications were rejection, infection and arrhythmia. Since our main problem was rejection it is concluded that careful supervision, concentrated on as few cardiologists as possible, and a liberal indication for myocardial biopsy, are decisive for the prognosis.

Adolescent↗
PubMed1991

Risk factors for total and cause-specific mortality in human cardiac transplantation. Prolonged extracorporeal bypass time: a high risk factor for rejection and infection.

Data from the first 103 human heart transplantations in 100 recipients performed at a single centre from November 1983 to January 1990 were analysed to detect risk factors for overall and cause-specific mortality. Twenty-two patients died. Cumulative 1 year graft survival was 82% and 5 year, 68%. Acute and chronic rejection was the cause of death in 9 patients, disseminated infection in 8 and cancer in 3. One patient died from cerebral haemorrhage and 1 from acute cardiac failure. The mean observation time was 803 days (range: 1-2 308 days). Total follow-up was 226.6 graft years. Risk factors were analysed by univariate and multivariate methods. The type of immunosuppression regimen and recipient age above 50 years were independent risk factors for mortality. Histocompatibility mismatching (HLA-DR) and type of immunosuppression were independent risk factors for lethal rejection and a female recipient was an independent risk factor for lethal infection. Prolonged time on extracorporeal bypass was an independent risk factor for both lethal rejection and infection, and also for overall mortality. The impact of extracorporeal bypass time on rejection and infection is discussed, and the importance of prospective HLA matching in heart transplantation is stressed. The association between recipient female sex and infection remains uncertain.

Adolescent↗
PubMed1991

Pre-morbid adjustment and personality in psychosis. Effects of sex and diagnosis.

Pre-morbid schizoid and schizotypal traits and social adjustment were assessed blind to diagnosis by interviewing the mothers of 73 consecutively admitted patients with DSM-III schizophrenia or affective psychosis. Analysis of factors associated with pre-morbid deficits showed a highly significant interaction of diagnosis with sex, such that schizophrenic men showed much greater pre-morbid impairment than either schizophrenic women or men with affective disorder. Poor pre-morbid adjustment predicted an early age at first admission. The results can be explained by a neurodevelopmental disorder in some schizophrenic males.

Adolescent↗
PubMed1989

Senning operation for transposition of the great arteries in the first month of life.

Twelve patients with uncomplicated transposition of the great arteries were operated upon in the first month of life following an initial Rashkind procedure. They were all in a clinically unacceptable condition and were mostly acidotic or bad mixers without acidosis. Two patients died postoperatively from a cerebral haemorrhage not discovered prior to operation. One patient died 5 months postoperatively from bronchiolitis. At postoperative follow-up, all patients were asymptomatic. Cardiac catheterization showed that 1 patient had a significant upper caval vein stenosis, 2 patients had small atrial shunts, and 1 patient had an unimportant pulmonary stenosis. Innocent atrial rhythm disturbances were encountered in 1 case only, whereas 9 patients had normal sinus rhythm at the last examination. The Senning operation remains a good alternative for transposition repair in the neonate.

Acidosis↗
PubMed1989

Enzyme patterns and flow cytometric DNA measurements in colorectal hyperplastic polyps and tubular adenomas less than five millimeters.

Glucose-6-phosphate dehydrogenase (G6PD) activity, lactate dehydrogenase (LD) activity, and cytometric flow measurement of nuclear size and cell cycle distributions were registered in biopsy specimens from adenomas and hyperplastic polyps less than 5 mm. The G6PD and LD activities in adenomas, 36.8 +/- 4 U/g protein and 1580 +/- 163 U/g, respectively, were significantly higher than in hyperplastic polyps, 17.9 +/- 2.6 U/g and 1080 +/- 107 U/g, or in normal mucosa, 14.7 +/- 0.8 U/g and 1174 +/- 56 U/g, respectively. G6PD activity was significantly higher in adenomas with moderate (44 +/- 5.8 U/g) than in those with mild (32 +/- 5.9 U/g) dysplasia, in contrast to LD. No difference in enzyme activity was observed between hyperplastic polyps and normal mucosa. The growth of adenomas and hyperplastic polyps was not significantly different during the 2 years of follow-up study before biopsy specimens were taken. Increased nuclear size, unrelated to grade of dysplasia, was registered in 12 of 20 adenomas, in 1 of 10 hyperplastic polyps, and in 2 of 42 specimens from normal mucosa. Adenomas and normal mucosa from individuals with adenomas showed a significantly increased number of cells in S-phase. The values were 10.2 +/- 3% and 8.8 +/- 4%, respectively. Normal control value was 6.8 +/- 2.2%. An increased number of cells in G2-phase was observed only in adenomas (6.9 +/- 2.7% compared with 4.9 +/- 1% in controls). None of the adenomas showed aneuploidy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1988

Balloon dilatation of pulmonary artery banding in dogs: an experimental study.

The technique at our institution for banding of the pulmonary artery (PA) makes debanding by balloon dilatation theoretically possible. Previously we tested this hypothesis in an in vitro study (see previous article in this issue). This study describes balloon dilatation in dogs. Eight Labrador Retriever dogs had a PA band placed early in life, and when their body weight had doubled, they were restudied and debanded by balloon dilatation or surgical removal. One dog died of a virus infection before debanding and was excluded from the study. Five of the dogs (groups 1 and 2) underwent balloon dilatation with satisfactory relief of the gradient across the PA band. Two dogs (group 3) underwent surgical debanding without a plastic procedure on the PA, and this also produced satisfactory relief of the gradient. All dogs in group 2 and 1 dog in group 3 were studied 3 months later, and 1 dog in group 2 was also studied 6 months after the debanding procedure. The systolic pressure gradient fell from a mean of 54 to 18 mm Hg after the debanding procedure. There was no difference in the gradient after debanding in the balloon group compared to the surgical group.

Animals↗
PubMed1988

In vitro balloon dilatation of the banded pulmonary artery.

The pulmonary artery of unfixated human heart-lung specimens was banded by placing a Dacron tape around the artery and securing the tape with a 5.0 Prolene suture at selected circumferences. The banding was successfully dilated with a balloon catheter in 24 instances. The mean pressure necessary to burst the suture securing the tape was 2.4 atmospheres.

Catheterization↗
PubMed1988

Aortic wall lesion in balloon dilatation of coarctation of the aorta.

A successful balloon dilatation of a native coarctation of the aorta was done in a five-day-old child. Two days later she was operated upon because of critical aortic stenosis, but died. The post-mortem examination showed a lesion of the intima and media at the coarctation site, and it seemed that the adventitia alone was what prevented rupture of the vessel.

Aortic Coarctation↗