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Biomedical subjects

A Lange

Publications and source records attributed to A Lange.

At least 37 records · Page 2Linked to original sources
PubMed2003

Gastro-esophageal reflux demonstrated by radiography in infants less than 1 year of age. Comparison with pH monitoring.

PURPOSE: To correlate gastro-esophageal reflux (GER) demonstrated on radiography, with reflux determined on 24-h pH monitoring among infants of less than 1 year of age. MATERIAL AND METHODS: Twenty-one infants with suspected GER were examined. In the supine position the infants drank 20-60 ml of barium contrast, and the presence or absence of hiatal hernia, gastric outlet obstruction, or intestinal malrotation was evaluated. The infant was placed in the 25 degrees right oblique supine position and fed 2-3 swallows of milk by a feeding bottle. GER was scored as positive on radiography when the contrast column reached a level of at least 3 vertebral segments above the gastro-esophageal junction (GEJ). An antimony intraluminal esophageal pH probe was positioned 2 vertebral segments above the GEJ as identified by the barium swallow, confirmed on radiography after positioning and prior to probe removal. A total time of esophageal pH <4 exceeding 5% was assigned as pathological. RESULTS: The radiological method of GER evaluation showed a specificity of 50% and a sensitivity of 29%, as compared to 24-h pH monitoring. CONCLUSION: The radiological method was of no value among infants of less than 1 year when demonstrating GER.

Female↗
PubMed2002

Characterization and baculovirus-directed expression of a myosuppressin encoding cDNA from the true armyworm, Pseudaletia unipuncta.

Insect myosuppressins are a highly conserved sub-family of peptides which are primarily characterized by the ability to suppress contraction of visceral muscles in a variety of insect species. We have isolated a cDNA from the true armyworm, Pseudaletia unipuncta, that encodes a prohormone containing a peptide identical to ManducaFLRFamide. We have shown that this myosuppressin gene appears to be expressed in late larval and adult insects. In Manduca sexta, a number of extended-FLRFamide peptides have previously been purified including ManducaFLRFamide, F7D (DPSFLRFamide), F7G (GNSFLRFamide) and two larger peptides F24 and F39 that contain the shorter ManducaFLRFamide sequence at their C-terminus. Comparison with the true armyworm prepropeptide characterized here identifies F24 and F39 as partially processed products from the same precursor. Expression in the true armyworm was shown by in situ hybridization to occur in over 150 cells throughout the adult brain and nerve cord, and also to occur in both open and closed endocrine type cells of the gut. Overexpression of the P. unipuncta FLRFamide cDNA from a baculovirus vector in cabbage looper caterpillars was used to assess the potential for myosuppressin expression as a means of enhancing virus efficacy. Viral expression of the armyworm prohormone cDNA resulted in raised levels of RFamide-like products in the hemolymph of infected insects, but the products were found to be chemically distinguishable from authentic mature peptide and probably represent partially processed hormone.

Amino Acid Sequence↗
PubMed2002

High-dose chemotherapy with autologous stem cell transplantation is an effective treatment of primary refractory Hodgkin's disease. Retrospective study of the Polish Lymphoma Research Group.

We analysed the treatment outcome of primary refractory HD patients managed with high-dose chemotherapy and haematopoietic cell transplantation. Data of 65 adult patients who underwent HDC/ASCT in nine Polish centres for primary resistant Hodgkin's disease between June 1991 and July 2000 were collected retrospectively. Response rate to HDC/ASC: CR, 54%; PR, 20%; less than PR, 15%; early deaths, 11%. Actuarial 3-year OS and PFS were 55% and 36%, respectively. In multivariate analysis, lack of bulky lymph nodes and use of immunotherapy were favourable factors for both OS and PFS. IPF <3 at the time of transplantation was predictive for PFS. However, the prognostic impact of immunotherapy should be interpreted with caution since this group included more patients who achieved CR after HDC/ASCT. The results of HDC/ASCT are encouraging and confirm earlier findings. The role of immunotherapy should be further investigated in prospective trials.

Adolescent↗
PubMed2002

Arterial occlusion after total knee arthroplasty: successful management of an uncommon complication by percutaneous thrombus aspiration.

Management of arterial occlusion after total knee arthroplasty is controversial in the literature, in part because of the relatively small number of reported cases. We report a case of perioperative popliteal artery thrombosis after total knee arthroplasty that was treated successfully with percutaneous thrombus aspiration and balloon dilation. Immediate intervention prevented ischemic muscular necrosis, resulting in full recovery of the limb.

Aged↗
PubMed2001

Morphological and functional characteristics of the dominant follicle and corpus luteum in cattle and their influence on ovarian function.

Predicting the functional activity of a dominant follicle (DF) and corpus luteum (CL) might be important before starting a superovulation regime or a synchronization program. The DF and CL were characterized morphologically by using ultrasonography and were characterized functionally by estimating the estradiol-17beta/progesterone (E2/P4) ratio. Their influence on ovarian function was estimated through their ability to ovulate at different stages of development in response to PGF2alpha-application. A total of 47 Holstein Friesian (35 cows and 12 heifers) were used in two experiments. In Experiment 1, 25 animals were examined by daily transrectal palpation and ultrasonography to follow the morphological development of the DF. The status of the DF was categorized into 3 groups (A1, B1, C1). The A1 group (n=7) contained animals with DF in the growing phase or in early static growth phase for less than 3 days. Group B1 (n=13) included animals with DF in static growth phase for 3 to 4 days, while Group C1 (n=5) comprised animals with DF keeping a plateau for more than 4 days or animals with DF in the regression phase. The DF were aspirated transvaginally and the follicular fluid (FF) was analyzed for E2 and P4. In Experiment 2, 22 animals were included. As in Experiment 1, the animals were classified into three groups (A2, n=10; B2, n=5; C2, n=7). They were treated by a single dose of PGF2alpha (25 mg, i.m.) between Days 8 and 12 of the cycle. Results showed that luteolyses occurred in all animals. The DF, which were in growing or in early static growth phase < 3 days were always E2-dominant (E2 > P4) and ovulated after PGF2alpha-application in 6/8 of cases and persisted in 2 (Group A2). The DF persisting > 4 days or that had been in regression were always P4-dominant. This type of DF regressed after PGF2alpha-application (Group C2). The DF in early static growth phase for 3 to 4 days in 5/13 cases were E2-dominant and in 8/13 cases were P4-dominant. This type of DF ovulated in 3/5 cases and regressed in 2/5 cases after PGF2alpha-application (Group B2). These results suggest that the DF is morphologically and functionally defined as long as the DF is in the growing or early static growth phase (A1, A2) for at least 2 days or if the DF is in regression (C1, C2). However, when the DF is in the static growth phase for 3 or 4 days (B1, B2), their morphological and functional characteristics are different. The CL controlls ovulation in the A and C groups and plays an abettor's roll in the B-group.

Animals↗
PubMed2001

Dopaminergic neurons in the brain and dopaminergic innervation of the albumen gland in mated and virgin helisoma duryi (mollusca: pulmonata).

BACKGROUND: Dopamine was shown to stimulate the perivitelline fluid secretion by the albumen gland. Even though the albumen gland has been shown to contain catecholaminergic fibers and its innervation has been studied, the type of catecholamines, distribution of fibers and the precise source of this neural innervation has not yet been deduced. This study was designed to address these issues and examine the correlation between dopamine concentration and the sexual status of snails. RESULTS: Dopaminergic neurons were found in all ganglia except the pleural and right parietal, and their axons in all ganglia and major nerves of the brain. In the albumen gland dopaminergic axons formed a nerve tract in the central region, and a uniform net in other areas. Neuronal cell bodies were present in the vicinity of the axons. Dopamine was a major catecholamine in the brain and the albumen gland. No significant difference in dopamine quantity was found when the brain and the albumen gland of randomly mating, virgin and first time mated snails were compared. CONCLUSIONS: Our results represent the first detailed studies regarding the catecholamine innervation and quantitation of neurotransmitters in the albumen gland. In this study we localized catecholaminergic neurons and axons in the albumen gland and the brain, identified these neurons and axons as dopaminergic, reported monoamines present in the albumen gland and the brain, and compared the dopamine content in the brain and the albumen gland of randomly mating, virgin and first time mated snails.

Albumins↗
PubMed2001

Interapy, treatment of posttraumatic stress through the Internet: a controlled trial.

On-line therapy offers many advantages over face-to-face settings. Interapy includes psycho-education, screening, effect measures and protocol-driven treatment via the Internet for clients. The present paper reports the results of a controlled trial on the Interapy treatment of posttraumatic stress and grief in students, gaining course credits. The participants in the experimental condition (n = 13) improved significantly than the participants in the waiting-list control condition (n = 12), on trauma-related symptoms and general psychopathology. The effect sizes were large. Eighty percent of the treated participants showed clinically significant improvement after treatment. The possibilities for future research with Interapy, including studies into moderating variables, are discussed.

Adolescent↗
PubMed2001

HLA-DRB1*03, DRB1*11 or DRB1*12 and their respective DRB3 specificities in clinical variants of sarcoidosis.

Determination of DRB1 and DRB3 specificities in sarcoidosis patients identified that the presence of DRB1*03 and the absence of DRB1*11 and/or DRB1*12 favors a course of disease that is associated positively with Löfgren's syndrome (DRB1*03) and negatively with stage I disease (DRB1*11 and/or 12). In common with normal controls, DRB1*03 was associated with DRB3*0101 and DRB1*11/12 with DRB3*0201/2. An analysis of DRB1 and DRB3 associations in variants of sarcoidosis revealed that DRB1*03 and DRB3*0101 were associated with Löfgren's syndrome in a combined association fashion. Conversely, a lack of DRB1*11 and/or DRB1*12 but not DRB3*0201/2 favored the clinical course of sarcoidosis.

Adolescent↗
PubMed2001

Three-dimensional echocardiography: historical development and current applications.

Three-dimensional (3D) echocardiography facilitates spatial recognition of intracardiac structures, potentially enhancing diagnostic confidence of conventional echocardiography. The accuracy of 3D images has been validated in vitro and in vivo. In vitro, a detail 1.0 mm in dimension and 2 details separated by 1.0 mm can be identified from a volume-rendered 3D image. In vitro 3D volume measurements are underestimated by approximately 4.0 mL. In vivo, left ventricular volume measurements correlate highly with both cineventriculography (limits of agreement +/-18 mL for end diastole and +/-10 mL for end systole) and magnetic resonance imaging, including measurements for patients with functionally single ventricles. Studies on congenital heart lesions have shown good accuracy and good reproducibility of dynamic "surgical" reconstructions of septal defects, aortoseptal continuity, atrioventricular junction, and both left and right ventricular outflow tract morphology. Transthoracic 3D echocardiography was shown feasible in 81% to 96% of patients with congenital heart defects and provided additional information to that available from conventional echocardiography in 36% of patients, mainly in more detailed description of mitral valve morphology, aortoseptal continuity, and atrial septum. In patients with mitral valve insufficiency, 3D echocardiography was shown to be accurate in the quantification of the dynamic mechanism of mitral regurgitation and in the assessment of mitral commissures in patients with mitral stenosis. This includes not only valve tissue reconstruction but also color flow intracardiac jets. Three-dimensional reconstructions of the aortic valve were achieved in 77% of patients, with an accuracy of 90%. In conclusion, the role of 3D echocardiography, which continues to evolve, shows promise in the assessment of congenital and acquired heart disease.

Cardiac Volume↗
PubMed2001

[Doppler myocardial velocity gradient as a new diagnostic index for the assessment of myocardial disease].

Currently, echocardiography is the technique of choice in the noninvasive assessment of left ventricular (LV) function. Unlike the assessment of LV systolic function, its role is limited in the quantification of LV diastolic function where only global LV filling can be assessed. Tissue Doppler echocardiography (TDE) is a recently introduced imaging technique which allows for direct assessment of LV myocardial contraction and relaxation. Therefore, parameters derived from TDE showed provide a more accurate assessment of LV systolic and diastolic function. Doppler myocardial velocity gradient (MVG) is a new parameter derived from TDE, which enables the measurement of the spatial distribution of transmyocardial velocities over the cardiac cycle. The most studied application of this technique relates to the earlier and more sensitive diagnosis of different forms of cardiomyopathy. Based on the Doppler MVG measurement, patients with ischaemic cardiomyopathy can be differentiated from those with idiopathic dilated cardiomyopathy. In both diseases MVG is reduced in systole, but as opposed to dilated cardiomyopathy, MVG in patients with ischaemic cardiomyopathy is also markedly reduced in early diastole. MVG derived from TDE also provides new diagnostic insights into genetically determined heart muscle diseases. It has been shown that an early diastolic MVG < or = 7 s-1 is characteristic for patients with hypertrophic cardiomyopathy and differentiates this group of patients from 'athletes' heart, independently of the degree of LV hypertrophy. A recent study has also shown that in Friedreich ataxia related cardiomyopathy there is a close relation between the degree of genotype abnormalities and the degree of reduction in the MVG. Also, the assessment of Doppler MVG enables the differentiation of restrictive cardiomyopathy from constrictive pericarditis. Based on available literature it appears that TDE derived MVG enhances the information available from conventional echocardiography and helps to establish an earlier diagnosis in patients with primary and secondary myocardial diseases.

Cardiomyopathies↗
PubMed2000

Echocardiographic characterization of cardiomyopathy in Friedreich's ataxia with tissue Doppler echocardiographically derived myocardial velocity gradients.

BACKGROUND: Conventional and tissue Doppler echocardiographically derived myocardial velocity gradients (MVGs) were used to characterize the myocardium in patients with Friedreich's ataxia (FRDA), and the relationship between MVGs and the mutation in the FRDA gene, a GAA triplet repeat expansion, was investigated. METHODS AND RESULTS: We studied 29 patients with FRDA (10 men, mean age 31+/-9 years) who were homozygous for the GAA expansion in the FRDA gene and were without cardiac symptoms. A comparison was made with a group of 30 age-matched control subjects. In patients with FRDA, interventricular septal thickness (1.17+/-0.26 versus 0.85+/-0.13 cm, P:<0.005), posterior left ventricular wall thickness (1.00+/-0.24 versus 0.88+/-0.15 cm, P:<0.01), and left atrial diameter (3.3+/-0.5 versus 2.9+/-0.3 cm, P:=0.01) were increased compared with control subjects. MVGs were reduced in FRDA during systole (3.1+/-1.2 versus 4.5+/-0.5 s(-1), P:<0.0001) and in early diastole (4.9+/-2.7 versus 8.8+/-1.8 s(-1), P:<0.0001) but increased in late diastole (2.0+/-1. 3 versus 1.1+/-0.9 s(-1), P:<0.01). The strongest relationship was seen between age-corrected early diastolic MVGs and the GAA expansion in the smaller allele of the FRDA gene (r=-0.68, P:<0. 0001). CONCLUSIONS: MVGs offer a means of further characterizing the myocardial abnormalities in patients with FRDA. Early diastolic MVGs appear to relate most closely to the genetic abnormality and the consequential reduction in frataxin protein.

Adaptor Proteins, Signal Transducing↗
PubMed2000

Differentiation between restrictive cardiomyopathy and constrictive pericarditis by early diastolic doppler myocardial velocity gradient at the posterior wall.

BACKGROUND: The differential diagnosis between restrictive cardiomyopathy (RCM) and constrictive pericarditis (CP) is challenging and, despite combined information from different diagnostic tests, surgical exploration is often necessary. METHODS AND RESULTS: A group of 55 subjects (mean age, 63+/-11 years; 36 men and 19 women) were enrolled in the study; 15 had RCM, 10 had CP, and 30 were age-matched, normal controls. The diagnosis of RCM was supported by a biopsy; in the CP group, the diagnosis was confirmed either surgically or at autopsy. All patients underwent a transthoracic echocardiogram that included the assessment of Doppler myocardial velocity gradient (MVG), as measured from the left ventricular posterior wall during the predetermined phases of the cardiac cycle. MVG was lower (P<0.01) in RCM patients compared with both CP patients and normal controls during ventricular ejection (2. 8+/-1.2 versus 4.4+/-1.0 and 4.7+/-0.8 s(-1), respectively) and rapid ventricular filling (1.9+/-0.8 versus 8.7+/-1.7 and 3.7+/-1.4 s(-1), respectively). Additionally, during isovolumic relaxation, MVG was positive in RCM patients and negative in both CP patients and normal controls (0.7+/-0.4 versus -1.0+/-0.6 and -0.4+/-0.3 s(-1), respectively; P<0.01). During atrial contraction, MVG was similarly low (P<0.01) in both RCM and CP patients compared with normal controls (1.6+/-1.7 and 1.7+/-1.8 versus 3.8+/-0.9 s(-1), respectively). CONCLUSIONS: Doppler myocardial imaging-derived MVG, as measured from the left ventricular posterior wall in early diastole during both isovolumic relaxation and rapid ventricular filling, allows for the discrimination of RCM from CP.

Aged↗
PubMed2000

Transthoracic three-dimensional echocardiography in the preoperative assessment of atrioventricular septal defect morphology.

A prospective study of 3-dimensional (3-D) transthoracic echocardiographic definition of atrioventricular septal defect (AVSD) morphology and its dynamic changes during the cardiac cycle was performed. The information obtained from 2-D and 3-D transthoracic echocardiography (TTE) was compared with intraoperative findings in an unselected group of 15 patients with AVSD (median age 22 months). In all study patients, 3-D reconstructions provided anatomic views of the atrioventricular valve(s) en face from either atrial or ventricular perspectives that allowed comprehensive assessment of dynamic valve morphology and the mechanism of valve reflux. Left-sided valve function was correctly assessed by 2-D TTE in 11 of 15 patients (73%) and in 14 of 15 (93%) by 3-D TTE. In 6 of 15 patients (40%), the severity of right-sided valve reflux was described precisely by 2-D TTE and in 12 of 15 patients (80%) by 3-D TTE. Additionally, 3-D TTE supplemented the diagnostic information to that available from 2-D TTE on atrial and ventricular septal defects. Although primum atrial septal defects were depicted by 2-D and 3-D TTE in all 15 patients, the description of defect size was more precise by the 3-D TTE (80% vs. 100%, respectively). The presence of secundum atrial septal defect was correctly diagnosed by both TTE techniques in 10 of 15 patients. Disagreement regarding the size of the defect was present only in 2 of 10 patients by 2-D TTE. In another 2 patients, 3-D TTE described multiple defect fenestrations that were missed by 2-D TTE. Thus, the agreement score was 73% for 2-D and 100% for 3-D echo. The agreement for the presence and sizing of ventricular septal defects was 67% for 2-D and 93% for 3-D echo. We conclude that 3-D TTE provided accurate anatomic reconstructions of the common atrioventricular junction and that the use of dynamic 3-D TTE enhanced the anatomic diagnostic capability of standard 2-D TTE. Medica, Inc.

Echocardiography↗
PubMed2000

Mean myocardial velocity mapping in quantifying regional myocardial contractile reserve in patients with impaired left ventricular systolic function: Doppler myocardial imaging study.

The aim of this study was to use Doppler myocardial imaging-derived mean myocardial velocity (MMV) at baseline and during low-dose dobutamine stress echocardiography (DSE) to quantify regional contractile reserve of the left ventricle (LV). Sixteen patients (mean age 59 +/- 7 years) with coronary artery disease and regional left ventricular wall motion abnormalities were studied. During each increment of Dobutamine infusion, 6 2-dimensional transthoracic apical images were acquired in standard gray-scale and Doppler myocardial imaging modes at 30 degrees steps over 180 degrees. For the analysis, the LV was divided into 18 segments. For each segment, both wall motion score and MMV obtained in systole and both early and late diastole were measured at baseline and at each stage of DSE. In viable segments by wall motion score, MMV increased during DSE in systole and in early and late diastole. In contrast, in nonviable segments, MMV did not change during DSE. Mean myocardial velocity mapping is a promising new approach to quantify regional myocardial contractile reserve of the LV.

Dobutamine↗
PubMed2000

Apoptosis of keratinocytes is associated with infiltration of CD8+ lymphocytes and accumulation of Ki67 antigen.

In 18 allogeneic blood/marrow transplanted (BMT) cases, skin biopsies were taken for acute GVHD diagnosis. In 14 cases clinical and histopathology data were consistent with acute GVHD with toxic lesions in four cases. All skin biopsies were stained for the presence of apoptotic cells (TUNEL technique). Nine patients' skin biopsies were positive for this stain. Apoptotic cells were seen in epidermal cells of the epidermis and in hair follicles. The presence of apoptotic cells was associated with (1) advanced stage (> or = II grade) acute GVHD (P = 0.015) and (2) heavy mononuclear cell infiltration (P = 0.015), predominantly of CD8+ cells (P = 0.025). Ki67 immunoreactivity of epidermal cells was different in the epidermis having and lacking apoptotic cells. Ki67 MoAb staining of epidermal cells revealed that nuclei were enlarged and stained stronger in biopsies with than biopsies without apoptotic cells (P = 0.008). Cyclin A positive cells were in a high proportion and cdc2-positive cells in a low proportion in patients' biopsies with acute GVHD and toxic lesions. In addition cyclin A accumulation was seen in keratinocytes in GVHD biopsies. Therefore, mitosis of skin cells is impaired, likely due to the genotoxic effect of conditioning, which renders the cells susceptible to acute GVHD-associated apoptotic damage.

Acute Disease↗