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Biomedical subjects

A Frank

Publications and source records attributed to A Frank.

At least 19 recordsLinked to original sources
PubMed1995

Survey of bioavailable selenium in Sweden with the moose (Alces alces L.) as monitoring animal.

Liver tissues were collected from moose (Alces alces L.) from the regular hunting seasons of 1981 and 1982. The material (from about 4300 animals) was stored at -20 degrees C at the National Veterinary Institute (SVA). From this material, 2080 specimens from 12 counties representing 14 regions were analyzed for selenium. The counties included were Norrbotten, Västernorrland (northern region), Uppsala, Kopparberg, Gävleborg, Jämtland (central region), north and south Kalmar (eastern region), Halland, north and south Alvsborg (western region), and Blekinge, Kristianstad and Malmöhus (southern region). The analysis was performed by a combination of continuous hydride generation using a flow-injection technique and atomic absorption spectrometry. The median selenium concentration in the liver in the entire material was 0.15 and the mean (+/- S.D.) 0.25 +/- 0.29 (range: 0.03-3.1) mg/kg wet wt. The highest median values obtained were 0.26, 0.28 and 0.29 mg/kg, in the counties of Gävleborg (central region) and north and south Alvsborg (western region), respectively. The lowest medians, 0.09-0.10 mg/kg, were found in the counties of Uppsala (central region), north and south Kalmar (eastern region), and Jämtland (central region). Intermediate median values were obtained in the other counties: 0.13 mg/kg in the county of Västernorrland (northern region), 0.15-0.16 mg/kg in the counties of Blekinge and Malmöhus (southern region) and Norrbotten (northern region), 0.18 mg/kg in the county of Halland (western region), and 0.23 mg/kg in the counties of Kristianstad and Kopparberg (southern and central regions, respectively). Selenium concentrations < 0.1 mg/kg in the liver of cattle are considered to be deficient. In some of the regions, 50-60% of the moose livers showed values below this level. The results indicate that the moose is useful for monitoring the amount of selenium available for wild-grazing animals and confirm that the Swedish environment is poor in selenium.

Animals↗
PubMed1995

Decision logic for retreatment of asymptomatic lung cancer recurrence based on positron emission tomography findings.

PURPOSE: The purpose of the study was to determine if Positron emission tomography (PET) 2-[F-18] fluoro-2-deoxy-D-glucose (FDG) imaging could detect subclinical local lung cancer recurrence and whether retreatment of such recurrence was feasible and beneficial. METHODS AND MATERIALS: Twenty patients with biopsy proven lung cancer were studied with Positron emission tomography for the purpose of detecting subclinical lung cancer recurrence over a period of 4.25 years. All patients were treated with external radiation as part or all of their therapy. Twenty patients had baseline PET and computed tomography (CT) studies for comparison with later studies. Surviving patients had a total of 40 sequential PET scans and 35 CT scans. The follow-up interval ranged from 5 to 40 months posttreatment. The differential uptake ratio (DUR) was determined for regions of interest of increased FDG uptake. RESULTS: The median DUR value of the 20 baseline PET studies was 5.59. The DUR value of greater than 3 was empirically selected as being positive for tumor detection. On baseline studies, PET had a 100% correlation with the CT findings in regard to detection of the site of primary tumor involvement. Four of 20 patients showed areas of discordance in the mediastinal and hilar areas on initial PET and CT studies. Seven of 17 patients showed discordant posttreatment PET-CT findings. Two false positive PET studies were due to radiation pneumonitis and one to macrophage glycolysis in tumor necrosis. For detection of asymptomatic tumor recurrence, analysis of sequential PET and CT studies, biopsy results, and the patient's clinical course suggested that PET had a sensitivity of 100%, specificity of 89.3%, and accuracy of 92.5%. Computerized Tomography was found to have a sensitivity of 67%, specificity of 85%, and accuracy of 82% for detection of such early-stage recurrence. Five patients went on to have retreatment with external irradiation based upon the PET evidence. Four retreated patients had biopsies that corroborated the positive PET findings, and one patient was retreated on the basis of the qualitative appearance of the posttreatment PET study. Two of the five retreated patients remain alive without evidence of tumor to 34 months following initial therapy. CONCLUSION: Positron emission tomography scanning appears to be effective in detecting and following the progression of recurrent lung cancer. Retreatment of patients with asymptomatic recurrent tumor has resulted in absent or decreased FDG activity. Monitoring of patients with PET may provide prolonged survival in patients who otherwise would fail treatment because of local tumor recurrence.

Adenocarcinoma↗
PubMed1995

[Long-term reduction of intraocular pressure by goniotrepanation or laser trabeculoplasty].

BACKGROUND: Reports concerning the long term efficacy of goniotrephination or lasertrabeculoplasty are still rather inconsistent. Therefore we once again investigated the long term IOP reduction of these two procedures. PATIENTS AND METHODS: In 1983 we started a prospective monitoring of patients having either goniotrephination or lasertrabeculoplasty. We now reinvestigated the patients originally included in this study (mean follow up 7.7 years, n = 116 patients/143 eyes). IOP reduction was defined to be successful if the following two criteria were met simultaneously: 1. IOP post op < 25 mm Hg. 2. IOP post op < 0.8 x IOP prä op. RESULTS: According to the criteria given above the long term success rate of goniotrephination was 67%, the long term success rate of lasertrabeculoplasty was 32%. There were no severe complications. The frequency of mild complications during the early postoperative period was the same for eyes with successful long term IOP reduction as for eyes with unsuccessful long term IOP reduction. When eyes with glaucoma chronicum simplex and eyes with secondary glaucomas were evaluated separately the following success rates were found: goniotrephination in eyes with glaucoma chronicum simplex 68%, goniotrephination in eyes with secondary glaucomas 67%, lasertrabeculoplasty in eyes with glaucoma chronicum simplex 37%, lasertrabeculoplasty in eyes with secondary glaucomas 18%. The correlation between successful lasertrabeculoplasty in the first eye and successful lasertrabeculoplasty in the fellow eye was marginally significant (p = 0.1). CONCLUSIONS: The long term IOP reduction is clearly more pronounced after goniotrephination than after lasertrabeculoplasty. However, long term IOP reduction after lasertrabeculoplasty is still better than expected. Mild complications during the early postoperative period obviously do not influence the long term results of both procedures. The success rate of lasertrabeculoplasty in eyes with secondary glaucomas is clearly worse compared to eyes with glaucoma chromicum simplex. There is no difference between these two groups when goniotrephination was performed. The success of lasertrabeculoplasty in the first eye cannot really predict the success of the same procedure in the fellow eye.

Aged↗
PubMed1995

Tau protein concentrations in cerebrospinal fluid of patients with dementia of the Alzheimer type.

Tau protein concentrations were measured in the CSF of 23 patients with dementia of the Alzheimer type (DAT), 36 patients with multi-infarct dementia (MID), and 23 control subjects. Tau protein concentrations were significantly higher in patients with DAT than in controls (P < 0.001) and patients with MID (P < 0.001). A significantly positive correlation between CSF tau protein and glucose concentrations (r = 0.79, P < 0.001) and evolution of disease (r = 0.47, P < 0.05), and a negative correlation with Folstein's mental state examination test (r = -0.73, P < 0.001) were found in patients with DAT.

Aged↗
PubMed1995

Management of supraventricular tachycardia during hexoprenaline therapy for preterm labour: benefit of cardioselective beta blockade?

A 29-year-old woman presented with preterm labour at 32 weeks of gestation. Tocolytic treatment was started with intravenous hexoprenaline. Twenty-four hours after initiation of treatment, the patient developed supraventricular tachycardia, resistant to digoxin and verapamil. Medical treatment with metoprolol finally restored sinus rhythm. We observed no adverse effects on the fetal heart rate nor on the umbilical cord blood flow.

Adult↗
PubMed1995

Weighing the options: criteria for evaluating weight-management programs. The Committee to Develop Criteria for Evaluating the Outcomes of Approaches to Prevent and Treat Obesity.

The United States is experiencing an epidemic of obesity among both adults and children. Approximately 35 percent of women and 31 percent of men age 20 and older are considered obese, as are about one-quarter of children and adolescents. While government health goals for the year 2000 call for no more than 20 percent of adults and 15 percent of adolescents to be obese, the prevalence of this often disabling disease is increasing rather than decreasing. Obesity, of course, is not increasing because people are consciously trying to gain weight. In fact, tens of millions of people in this country are dieting at any one time; they and many others are struggling to manage their weight to improve their appearance, feel better, and be healthier. Many programs and services exist to help individuals achieve weight control. But the limited studies paint a grim picture: those who complete weight-loss programs lose approximately 10 percent of their body weight, only to regain two-thirds of it back within 1 year and almost all of it back within 5 years. These figures point to the fact that obesity is one of the most pervasive public health problems in this country, a complex, multifactorial disease of appetite regulation and energy metabolism involving genetics, physiology, biochemistry, and the neurosciences, as well as environmental, psychosocial, and cultural factors. Unfortunately, the lay public and health-care providers, as well as insurance companies, often view it simply as a problem of willful misconduct--eating too much and exercising too little. Obesity is a remarkable disease in terms of the effort required by an individual for its management and the extent of discrimination its victims suffer. While people often wish to lose weight for the sake of their appearance, public health concerns about obesity relate to this disease's link to numerous chronic diseases that can lead to premature illness and death. The scientific evidence summarized in Chapter 2 suggests strongly that obese individuals who lose even relatively small amounts of weight are likely to decrease their blood pressure (and thereby the risk of hypertension), reduce abnormally high levels of blood glucose (associated with diabetes), bring blood concentrations of cholesterol and triglycerides (associated with cardiovascular disease) down to more desirable levels, reduce sleep apnea, decrease their risk of osteoarthritis of the weight-bearing joints and depression, and increase self-esteem. In many cases, the obese person who loses weight finds that an accompanying comorbidity is improved, its progression is slowed, or the symptoms disappear. Healthy weights are generally associated with a body mass index (BMI; a measure of whether weight is appropriate for height, measured in kg/m2) of 19-25 in those 19-34 years of age and 21-27 in those 35 years of age and older. Beyond these ranges, health risks increase as BMI increases. Health risks also increase with excess abdominal/visceral fat (as estimated by a waist-hip ratio [WHR] > 1.0 for males and > 0.8 for females), high blood pressure (> 140/90), dyslipidemias (total cholesterol and triglyceride concentrations of > 200 and > 225 mg/dl, respectively), non-insulin-dependent diabetes mellitus, and a family history of premature death due to cardiovascular disease (e.g., parent, grandparent, sibling, uncle, or aunt dying before age 50). Weight loss usually improves the management of obesity-related comorbidities or decreases the risks of their development. The high prevalence of obesity in the United States together with its link to numerous chronic diseases leads to the conclusion that this disease is responsible for a substantial proportion of total health-care costs. We estimate that today's health-care costs of obesity exceed $70 billion per year.(ABSTRACT TRUNCATED AT 400 WORDS)

Body Weight↗
PubMed1994

[The effect of tryptophan on the regulation of food intake in normal and overweight persons].

The neurotransmitter serotonin significantly contributes to the regulation of food intake and appetite behaviour. The cerebral serotonin synthesis depends on the availability of the precursor tryptophan. To examine how diets with different carbohydrate, protein and tryptophan content affect food preferences and the mood, healthy obese and non-obese male adults consumed the following isocaloric diets at breakfast: standard diet (60% carbohydrate), protein-rich diet (35% carbohydrate, 40% protein), carbohydrate-rich diet (80% carbohydrate), tryptophan supplemented diet (standard diet + 1.5 g tryptophan). The plasma concentration of tryptophan (TRP) and large neutral amino acids (LNAA) is determined by their uptake with the diet. In obese and non-obese adults the TRP/LNAA-quotient rose significantly by upto 0.40 to 0.57, following the tryptophan supplemented breakfast. The protein-rich diet reduced the TRP/LNAA-quotient. The preference of protein-rich food after the consumption of carbohydrate-rich diets (60-80% carbohydrate) was diagnosable with the non-obese person and not with the obese person. No obvious connection was detected between nutrient preferences and plasma TRP/LNAA-quotient. There was no influence of the plasma TRP/LNAA-quotient after meals with different nutrient relation on mood. Therefore it is concluded that different carbohydrate and protein content and also additional tryptophan supplementation of single meals is not able to modify the brain serotonin synthesis and release in healthy people in a kind that serotonin induced behaviour would be changed, at least on a short time basis.

Adult↗
PubMed1994

Levels of dissociation and histories of reported abuse among women outpatients.

A total of 99 female patients consecutively admitted to an adult psychiatric outpatient clinic were surveyed about their history of physical and sexual abuse. Sixty-five percent of this sample reported having been physically abused, sexually abused, or both during their lifetimes. Scores on the Dissociative Experiences Scale were significantly higher among those reporting a history of sexual abuse than among those reporting a history of physical abuse or no history of abuse, who did not differ from each other. Dissociative Experiences Scale scores were important predictors of histories of sexual abuse among this sample. The implications of these findings for outpatient evaluation are discussed.

Adolescent↗
PubMed1994

[Endoscopic acromioplasty in total rupture of the rotator cuff].

PURPOSE OF THE STUDY: The authors have conducted a study to evaluate the possible efficacy of endoscopic decompression without repair in the treatment of rotator cuff tears. MATERIAL AND METHOD: We report 42 cases of endoscopic acromioplasty realized for full-thickness rotator cuff tears. Mean follow-up was 28.8 months. The principal presenting symptom was pain, with a mean duration of 29 months. Antero-external acromioplasty was realized by endoscopy using motorized drill bits, with sectioning or resecting the acromio-coracoid ligament. Revision consisted of a standard clinical examination, following the protocol of Constant, and a radiologic examination by sub-acromial frontal and scapular profile x-rays as advised by Liotard. RESULTS: The functional results were very good, with 94 per cent of patients satisfied. The mean Constant score was 67.4 (14-100) corresponding on the average to 84 per cent of the score of a healthy shoulder for the same age and sex. The improvement concerned essentially the score of the pain, which increased on the average 7.4 points out of 15 (10.2/15 at revision) and of the activity level (14.8/20 as opposed to 8/20 initially). Less important was the improvement of the active mobility score (from 25.2 to 34/40 at revision). The force was measured according to the Constant scale, with a mean of 8.3 points out of 25. The mean duration of absence from work for the active patients was 2.4 months. Neither infectious nor neurological complications were noted. The radiographic analysis showed a decrease of the acromial edge, significative as compared to the opposite side. On the profile x-ray, we observed 48 per cent flat acromions in contrast to 80 per cent curved types on the opposite side. The only element influencing the pain score was the size of the rupture, but the statistical result was weak. The final Constant score was strongly influenced by by the size of the rupture, the active mobility, the pre-operative active and passive mobility, as well as by the presence of head excentration on pre-operative x-rays. DISCUSSION: Comparison with other series of endoscopic acromioplasty for full-thickness rotator cuff tears has permitted us to confirm the validity of our series. We have especially evaluated this series in comparison to those with surgical repair. The subjective results, as well as those for pain, are equivalent; results on active mobility and force were not as good. We propose, therefore, this technique of low morbidity, in the presence of total ruptures in older and sedentary patients. The antalgic effect of endoscopic acromioplasty allows, in these patients, a functionally satisfying rehabilitation.

Acromion↗