[News from allied medical fields. Medical genetics. Legal problems in genetic analysis and human genetic counseling].
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Berlin↗
Biomedical subjects
A Schmidt
Publications and source records attributed to A Schmidt.
[Homeopathy: a field of work for the veterinarian].
It is generally known that Homeopathy and other so-called alternative methods of treatment have recently been gaining acceptance. The profession of lay animal practitioner is no longer a rarity in Switzerland. For some, alternative medicine is one phenomenon among others in a saturated health market and thrives on the fact that classical medicine does not yet extend to all areas. For others, the search for alternatives corresponds to a justified demand by the practitioners and denotes an extension of the medical disciplines. The Workshop for Veterinary Acupuncture and Homeopathy (AGVAH) was founded several years ago by veterinarians in Switzerland. It represents the professional interests of its members and upholds their right to practice these forms of therapy. The ensuing debate between classical and alternative medicine questions not only the basis of Homeopathy and similar forms of medicine, but also that of scientific thought. The realization that any scientific approach has its limits can open a door to deeper understanding of traditional occidental medicine.
Animals↗
[Ki 67 growth fraction in carcinomas and benign lesions of the breast].
In 108 cases with benign breast lesions immunhistochemical studies using the monoclonal antibody Ki 67 yielded significantly lower values in comparison to 120 patients with breast carcinomas. The Ki 67 growth fraction showed a negative correlation with tumor size and nodal status and a positive correlation with tumor grading. The possible significance of this method performed on freeze sections in respect to the predictive estimation of nodal negative breast carcinomas and preneoplasias with indeterminate proliferative potential is emphasized.
Adenoma↗
[Surgically treatable chronic constipative defecation disorders. Indications, diagnosis and therapy].
Paediatric surgeons are engaged in different causes of chronic constipation. Aganglionosis usually needs surgical therapy, but in dysganglionosis a distinct differentiation is necessary between patients sufficiently treated by conservative methods and others requiring surgery. Sometimes the operation seems to be an "ultima ratio" in these patients. Otherwise surgery can be necessary early in enterocolitis, ileus or toxic megacolon. In the spectrum of anal malformations constipation may be a primary symptom (anal ectopia, anal stenosis, low anal atresia with anocutaneous fistula) or appears as a post-operative complication (intermediate or high anal atresia). In secondary megacolon, surgery is performed to remove the result of therapeutic negation over many years. The operation may be the supposition to follow up with conservative treatment. In the management of constipated patients an exact diagnostic clarification has a central position. This especially includes anorectal manometry, x-ray examination with contrast medium application and defaecography and as last rectal biopsy.
Anal Canal↗
[Detection of myocardial ischemia in chronic Chagas disease patients with atypic precordial pain by exercise and Holter tests].
PURPOSE: To determine the incidence and characteristics of myocardial ischemia, as detected by stress electrocardiography and Holter monitoring in Chagas' patients whose main complaint was precordial pain. METHODS: Thirty-one consecutive patients with Chagas' disease diagnosed on the basis of clinical and serological tests, and precordial pain severe enough to warrant cardiac catheterization were studied. Mean age was 54.4 +/- 9.6 years, and 51% were males. EKG changes indicative of myocardial ischemia were sought during maximal exercise and also during 24-hour Holter monitoring. The detection of myocardial ischemia by each one of these tests was compared by Fischer exact test, and also correlated to anatomical and functional results of coronary angiography at rest and after standardized hyperventilation for detecting coronary vasospasm. RESULTS: Baseline EKG changes mainly associated with ventricular conduction defects precluded the analysis of the ST segment in 11 patients. Among the other 20 patients, 7(35%) had angina during the exercise test, of whom only 2(10%) showed concomitant ischemic ST changes: one had 90% stenosis in the circumflex branch and the other 50% reduction of luminal diameter in a intramyocardial segment of the left anterior descending coronary artery, undergoing further 30% constriction after hyperventilation, with pain and ST-elevation that responded to nitrate administration. Thus, a positive correlation between a positive EKG exercise test with accompanying symptoms, and organic/functional coronary artery disease was found (p = 0.03). Holter tracings of good quality were obtained in 16 patients. Angina-like symptoms occurred in 25% of these patients, without concomitant ischemic or dysrhythmic EKG changes. Conversely, silent ischemia was detected in 1 (5%) patient during exercise and in 3 (18%) patients during the Holter monitoring. None of these patients had any evidence of organic or functional alterations in the coronary arteries. The absence of significant (> 50%) narrowing of the coronary arteries, at baseline and after hyperventilation, was also documented in the 11 patients in whom no valid EKG tracings were obtained for analysis. CONCLUSION: EKG-based methods for detecting myocardial ischemia are of limited value in the general population with Chagas' disease presenting with precordial pain, due to the high prevalence of baseline ST changes. The overall incidence of significant coronary artery disease, as detected by angiography, was low but not negligible in this population of Chagas' patients with precordial pain (4%). Nevertheless, a positive EKG test based on ST changes and accompanying pain has a 100% positive predictive accuracy for the presence of organic or functional coronary abnormalities. No additional yield was obtained with Holter monitoring, for the elucidation of the pathophysiology of the precordial pain in Chagas' patients with atypical angina. The significance of episodes of silent ischemia in some of these patients, with angiographically normal coronary arteries, remains to be determined.
Adult↗
[Nerve compression syndromes in the area of the elbow joint in patients with chronic polyarthritis. Review of the literature].
This review of the literature reveals pathology responsible for the occurrence of entrapment neuropathies at the elbow associated with rheumatoid arthritis. Clinical symptoms and surgical treatment of ulnar, radial, and median nerve palsies are described.
Arthritis, Rheumatoid↗
[Case histories of therapy of traumatic knee joint dislocation].
The records of eight patients with traumatic knee dislocation and operative treatment in 1981-1991 were reviewed. In this retrospective study the average follow-up was 6 years and indicated good results concerning stability and functional use of the knee. The vascular complications, especially the ischemic syndrome are associated with an emergency situation that requires immediate reduction.
Adult↗
In vitro comparison of bileaflet aortic heart valve prostheses. St. Jude Medical, CarboMedics, modified Edwards-Duromedics, and Sorin-Bicarbon valves.
The hydrodynamic performance of four currently used bileaflet heart valve prostheses (St. Jude Medical, CarboMedics, modified Edwards-Duromedics, and Sorin-Bicarbon) with a nominal tissue anulus diameter of 27 mm were measured in the aortic position. All experiments were performed in nonpulsatile flow and in an electrohydraulic, computer-controlled pulse duplicator simulating the left side of the human circulatory system. Testing conditions were set at cardiac outputs of 3.0, 4.5, 6.5, and 8.0 L/min at a constant heart rate of 70 beats/min. The Sorin-Bicarbon valve had the lowest pressure difference with regard to nonpulsatile (mean 5.4 mm Hg at 30 L/min) and pulsatile (mean 2.2 mm Hg at 8 L/min) flow, followed by the St. Jude Medical, CarboMedics, and modified Edwards-Duromedics valves. The leakage volumes under static and pulsatile flow conditions were lowest for the modified Edwards-Duromedics and Sorin-Bicarbon valves. The energy loss in pulsatile flow was lowest for the Sorin-Bicarbon valve, mainly because its systolic, closure, and leakage energy losses were low. Systolic sequential velocity profiles showed the most even flow distribution pattern for the St. Jude Medical and Sorin-Bicarbon valves. These findings correspond with lower overall Reynolds shear stress levels for the St. Jude Medical and the Sorin-Bicarbon valves than for the modified Edwards-Duromedics and CarboMedics valves.
Aortic Valve↗
[Regional anesthesia techniques and hemostasis disorders].
Hereditary or acquired disorders of coagulation often lead to the question of whether it is permissible to perform regional anaesthetic techniques. Disorders of coagulation that cannot be treated are generally contraindications to regional anaesthesia. The history and clinical findings represent the most important measures before employing a regional anaesthetic technique. The use of anticoagulant agents as well as non-steroidal antirheumatics and acetylsalicylic acid should be determined. In addition to coagulation studies, the use of regional anaesthetic techniques during simultaneous anticoagulant treatment requires a clear arrangement with the operative department in question. In most instances there will be a tendency to perform general anaesthesia, however, considering the fact that general anaesthesia is also associated with complications (intratracheal bleeding), regional anaesthesia represents an alternative method, especially in patients with significant concomitant disorders. In this situation the possibility of peripheral nerve blockade should be taken into consideration.
Anesthesia, Conduction↗
p53 and K-RAS alterations in pancreatic epithelial cell lesions.
We have analysed the expression of p53 at the mRNA level, and extensively at the protein level by immunostaining, Western blotting, and ELISA measurements revealing a p53 increase in 8 out of 14 cell lines established from human pancreatic carcinomas. The mRNA levels closely paralleled the protein levels in most of the cell lines. Overexpression of p53 in tumor cells correlated with mutations in the p53 gene. Immunocytochemistry was also performed with tissue cryosections showing a nuclear p53 staining in 8 out of 12 exocrine, and 2 out of 2 endocrine tumors. In addition, nonmalignant peri-tumoral tissue specimens and cells derived from pancreatic juice of acute pancreatic patients were also positively stained. These findings may suggest functions of p53 in stress situations induced by acute inflammation or tissue regeneration. Genomic mutations in the tumor suppressor gene were associated with point mutations in either codon 12, 13 or 61 in the c-K-RAS oncogene in about two-thirds of cell lines. The frequent activations of a RAS oncogene in combination with mutations of a tumor suppressor gene are likely to contribute to the malignant phenotype of pancreatic adenocarcinomas.
Base Sequence↗
Sensitization of rat alveolar macrophages to enhanced TNF-alpha release by in vivo treatment with dexamethasone.
Treatment of rats with dexamethasone rapidly induced a marked weight loss which occurred within 3 days and persisted for several weeks. The cachectic state was paralleled by increased serum levels of triglycerides, albumin, and protein and a strong reduction of blood mononuclear leukocytes. In lung sections, an increased number of mononuclear giant cells was found but no bacteria, fungi, or Pneumocystis carinii organisms. Quite strikingly, alveolar macrophages from dexamethasone-treated rats, but not from control animals, were highly sensitive to LPS and released large amounts of TNF-alpha ex vivo. Also under in vivo conditions, high TNF-alpha serum concentrations were found in dexamethasone-treated but not control rats when examined 1 1/2 hr after an intravenous LPS injection. These data suggest that the glucocorticoid-induced cachexia of rats may be linked, at least in part, to readily inducible TNF-alpha release from primed macrophages.
Animals↗
The antiproliferative activity of arterial heparan sulfate resides in domains enriched with 2-O-sulfated uronic acid residues.
Heparan sulfate isolated from bovine arterial tissue by a multistep purification procedure or from arterial tissue proteoheparan sulfate by beta-elimination exhibits antiproliferative activity toward arterial smooth muscle cells when added to subconfluent cell cultures in a concentration of 50-100 micrograms/ml medium. Enzymatic disintegration of heparan sulfate by heparitinases I and II and isolation of the resulting oligosaccharides indicate that the antiproliferative activity of the heparan sulfate molecule resides in a sulfate-rich octa/decasaccharide domain which is separated by longer sequences of sulfate-free or sulfate-poor N-acetylglucosamine containing disaccharide units. The octa/decasaccharide fraction has a 3-4-fold higher antiproliferative activity than the native heparan sulfate molecule and contains 45% of a disulfated disaccharide which consists of 2-O-sulfated uronic acid and N-sulfated glucosamine (UA(2S)-GlcNS and 12% of a trisulfated disaccharide (UA(2S)-GlcNS(6S). A sulfate-rich hexasaccharide fraction containing 14% of the disulfated disaccharide but 18% of the trisulfated disaccharide has negligible antiproliferative activity. The results indicate the presence of specific structural determinants in the arterial heparan sulfate molecule which may have the function of an endogenous inhibitor of arterial smooth muscle cell growth.
Animals↗
Melatonin and 6-sulfatoxymelatonin circadian rhythms in serum and urine of primary prostate cancer patients: evidence for reduced pineal activity and relevance of urinary determinations.
The circadian rhythms of melatonin and 6-sulfatoxymelatonin (aMT6s) were analyzed in serum and urine of young men (YM, n = 8), of elderly patients with benign prostatic hyperplasia (BPH, n = 7) and of patients of similar age with primary prostate cancer (PC, n = 9). The data expressed as concentration and in urine also as hourly excreted quantity were analyzed chronobiologically by the single cosinor method and, subsequently submitted to linear regression analyses. Circadian rhythms were detected in all cases except for the excreted quantity of melatonin. The circadian patterns of melatonin and aMT6s in serum were very similar in the different groups and regression analyses showed close correlations between both variables. MESOR and amplitude were significantly depressed in PC (40-60%) as compared to BPH and YM indicating that the depression of serum melatonin in PC is due to a reduced pineal activity and is not caused by an enhanced metabolic degradation in the liver. Acrophases of serum melatonin occurred between 01:34 and 03:26 h and of serum aMT6s between 03:58 and 04:35 h. Circadian rhythms similar to those of serum melatonin and aMT6s were found in urine, particularly for aMT6s excretion as well as melatonin concentration; the determination of both parameters in overnight urine samples closely correlated with the nocturnal peak of circulating melatonin. These results imply that it is feasible to estimate changes in pineal function of prostate cancer patients by means of non-invasive determination using urinary melatonin and aMT6s.
Adult↗
At least three promoters direct expression of the mouse glucocorticoid receptor gene.
We have characterized the gene for the mouse glucocorticoid receptor. The gene spans approximately 110 kilobases, and glucocorticoid receptor transcripts are assembled from nine exons. Expression of the gene is controlled by at least three promoters, resulting in glucocorticoid receptor transcripts with different 5' nontranslated exons. One promoter is cell-specific, found to be active only in T lymphocytes. The other two promoters are active to various degrees in all cell lines and tissues so far analyzed and are located in a CpG island. The promoter activities are accompanied by DNase I hypersensitivity sites in chromatin. In contrast to a conservation of exon-intron structure, differences in promoter organization suggest a divergence between the evolution of regulatory and coding regions among members of the steroid receptor super-family.
Animals↗
Pharmacology of oxytocin and vasopressin receptors in the central and peripheral nervous system.
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Angiotensin Receptor Antagonists↗
Reporter constructs with low background activity utilizing the cat gene.
Reporter plasmids utilizing the cat gene for the analysis of promoter and enhancer sequences in vertebrate cells, were constructed. These plasmids minimize the background of transcription derived from cryptic promoters or cryptic regulatory elements within the vector.
Animals↗
Massive main pulmonary artery embolism diagnosed with two-dimensional Doppler echocardiography.
This report describes the usefulness of echocardiography in the differential diagnosis of acute cardiovascular events. In a 66-year-old patient with known aortic stenosis and mitral valve prosthesis, who suddenly deteriorated with severe dyspnea, a thrombus within the pulmonary artery could be detected with 2-D echo. Pulsed-wave Doppler disclosed the resulting flow-velocity disturbances.
Aged↗
Pressure recovery in aortic stenosis: an in vitro study in a pulsatile flow model.
OBJECTIVES: This study was designed to study pressure recovery in various models of aortic valve stenosis by performing hemodynamic measurements under physiologic conditions in a pulsatile aortic flow circuit. The results were used to validate calculations of pressure recovery based on theoretic considerations derived from fluid dynamics. BACKGROUND: Pressure recovery in aortic stenosis has not been systematically analyzed. METHODS: Stenoses varying in size, shape (circular, Y-shaped, slitlike) and inlet configuration (sharp-edged, nozzle-shaped inlet, artificially stenosed bioprostheses) were used. Aortic pressures were measured at multiple sites distal to the stenotic orifice to determine pressure gradients and recovery. RESULTS: With decreasing orifice area (2, 1.5, 1 and 0.5 cm2) pressure recovery increased (5, 7, 10 and 16 mm Hg, respectively) and the index pressure recovery to maximal peak to peak gradient decreased (56%, 37%, 24% and 14%, respectively). For a given orifice size of 0.5 cm2, this index ranged between 12% for a Y-shaped orifice and 15% for a circular orifice with a nozzle (cardiac output 4 liters/min). Increasing the cardiac output increased pressure recovery, whereas the ratio of pressure recovery to maximal pressure gradient remained constant. CONCLUSIONS: The index pressure recovery to transvalvular pressure gradient, which expresses the hemodynamic relevance of pressure recovery, decreases with increasing severity of aortic stenosis but is independent of transvalvular flow. Thus, pressure recovery is of minor importance in severe aortic stenosis but may account for discrepancies between Doppler and manometric gradients observed in patients with mild to moderate aortic stenosis or a prosthetic valve in the aortic position.
Aortic Valve Stenosis↗