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Biomedical subjects

A Steiner

Publications and source records attributed to A Steiner.

At least 145 records · Page 8Linked to original sources
PubMed1993

Early recognition and prognostic markers of melanoma.

Malignant melanoma can be cured if the tumour is recognized at an early phase. Therefore, early recognition is of critical importance and cannot be overemphasized. Epiluminescence microscopy is a non-invasive technique that makes sub-surface structures of skin accessible for in vivo microscopic examination and thus provides additional criteria for the diagnosis of pigmented skin lesions. Thereby preoperative clinical diagnosis can be improved. In order to assess the prognosis of a melanoma patient and to predict the outcome of the disease a number of morphological and immunological parameters these will be reviewed, are helpful.

DNA↗
PubMed1993

Clinical signs, diagnosis and treatment of duodenal ileus in cattle.

The clinical signs, changes in blood and rumen fluid, findings at laparotomy, therapy and course of disease of 23 cows with obstruction or compression of the duodenum are described. The duodenum was obstructed by a phytobezoar in 14 cows and by a blood clot in one cow. In eight cows, the duodenum was compressed by and adhered to a liver abscess. The most important clinical findings included moderate to severe disturbance in the general behaviour and attitude, markedly reduced gastrointestinal activity, no or greatly reduced defaecation and abomasal reflux with metabolic alkalosis. Ten cows were slaughtered after clinical examination or exploratory laparotomy. In 13 cows, the phytobezoar was compressed manually to facilitate normal elimination, and if this was not possible, the phytobezoar was removed by enterotomy. Postoperative therapy consisted of intravenous administration of a solution containing sodium chloride and glucose, potassium chloride and intramuscular administration of metoclopramide, procaine penicillin and flunixin meglumine for three to five days. Two of the treated cows were slaughtered a few days postoperatively. There was a rapid improvement in the remaining 11 cows, and general condition, appetite and defaecation returned to normal within a short time.

Animals↗
PubMed1993

Ultrasonography of umbilical structures in calves. Part I: Ultrasonographic description of umbilical involution in clinically healthy calves.

The aim of the present study was to determine ultrasonographically the size of the umbilical structures in clinically health newborn calves and to evaluate their involution during the first three weeks of life. A total of 13 ultrasonograms were obtained in each of 20 healthy newborn calves using a 7.5-Mhz sector scanner transducer placed across the linea alba of the abdominal wall. The umbilical vein was imaged at five defined cross sections from the umbilicus to the portal vein in the liver, whereas the urachus and the umbilical arteries were imaged at four defined cross sections from the umbilicus to the pelvis. The umbilicus was scanned at three defined locations. All ultrasonographic cross sections were compared to those of a frozen newborn calf. The results were further tested against in a single examination of 20 different calves between 2 hours and 34 days. Standardized ultrasonographic examination is a safe and reliable method to image the umbilical structures in calves. The umbilical vein was imaged between the umbilicus and the caudoventral margin of the liver in calves up to three weeks of age. The umbilical vein, which at first was oval and thin-walled with a wide anechoic center (vertical diameter 11 +/- 3 mm and horizontal diameter 19 +/- 7 mm), diminished in diameter during the first week of life to 5 to 8 mm. The course of the umbilical vein in the liver was imaged in calves up to two weeks of age. The umbilical arteries could only be clearly imaged during the first seven days of life. They had a mean diameter of 8 +/- 2 mm and were seen as round, thick walled vessels with an echogenic to hypoechoic center. In all calves, the urachus was not well-defined and was difficult to image. The data of the umbilical structures accumulated in this study can be used as a reference in the diagnosis of abnormalities of the umbilical structures in young calves.

Animals↗
PubMed1992

Expression of cytokeratins in granulosa cell tumors and ovarian carcinomas.

One of the problems in histopathology of ovarian tumors is differential diagnosis between the poorly differentiated carcinomas and granulosa cell tumors of the sarcomatoid type. Hence we evaluated the expression of various cytokeratins (CK 1-19; CK 10, 13, 14, 15, 19; CK 8, 18, 19; CK HMW 1, 5, 10, 11; CK 8; CK 1-19 Stähli; CK AE1/AE3) immunohistochemically in 53 ovarian malignancies (11 of them poorly differentiated carcinomas and 12 granulosa cell tumors). CK HMW was not detected in granulosa cell tumors, and in only half of the carcinomas. AE1/AE3 was expressed by more than 90% of ovarian carcinomas but by one granulosa cell tumor only. The other keratins we investigated showed higher expression rates in granulosa cell tumors and/or lower expression rates in ovarian carcinomas. We think that cytokeratin immunohistochemistry is of value in differentiating between granulosa cell tumors and ovarian carcinomas.

Antibodies, Monoclonal↗
PubMed1992

Pigmented Spitz nevi: improvement of the diagnostic accuracy by epiluminescence microscopy.

BACKGROUND: Pigmented Spitz nevi have distinct clinical features but often may be difficult to differentiate from malignant melanoma by clinical criteria. OBJECTIVE: The purpose of this study was to use a new noninvasive diagnostic approach to improve the clinical diagnosis of Spitz nevi. METHODS: Epiluminescence microscopy (ELM) is a new, noninvasive technique for which criteria for the diagnosis of melanocytic tumors, benign and malignant, recently have been established. These criteria were tested in an investigation of 54 pigmented Spitz nevi. RESULTS: With ELM the accuracy of clinical diagnosis of pigmented Spitz nevi improved from 56% (clinical) to 93% (ELM). CONCLUSION: Our findings suggest that ELM criteria are useful to improve the accuracy of clinical diagnosis of Spitz nevi.

Diagnosis, Differential↗
PubMed1992

Comparison of staple and suture techniques for partial typhlectomy in the cow: a prospective clinical study of 40 cases.

Two techniques for partial typhlectomy were evaluated on 20 cows each suffering from dilatation/torsion of the cecum. In a preliminary study on two cows the suitability of a stainless steel staple pattern using two TA 90 cartridges of 4.8 mm and 3.5 mm staples respectively was examined and the technique standardized. In the main clinical study the stapling pattern (group I) was compared with a simple continuous full thickness appositional suture oversewn with a continuous Cushing suture (group II). The cartridges with the 4.8 mm staples were used in 7 clinical cases, with intestinal wall edema and the 3.5 mm staples were used in 13 cases. Arterial bleeding from the cecal stump occurred in 20 out of 22 cases (including the results of the preliminary study). The number of arteries that had to be ligated was statistically significantly higher (p less than 0.05) with the 4.8 mm staples than with the 3.5 mm staples. The additional ligation of bleeding vessels prolonged the surgical procedure. Seventeen out of 20 cows (85%) of each group were discharged from the clinic. The duration of the hospital stay was 6 days for both groups. Fourteen cows (70%) of each group were still alive upon inquiry. One cow of the stapling group was slaughtered because of a severe fibrinous peritonitis at the resection site. In the other 11 cows there was no evidence of a connection between the surgery and the slaughtering.

Animals↗
PubMed1992

Comparison of staple and Gambee techniques for enterotomy closure in the normal bovine jejunum.

Two suturing techniques for closure of jejunal enterotomies--the stapling and the Gambee technique--were compared in 7 bulls. Stapling was less time consuming (P less than 0.0001) and reduced the overall duration of surgery by 15%. Furthermore, the lumen diameter was significantly less decreased in the stapled intestine at 8 weeks after surgery (P less than 0.05). The diameter of the intestine increased significantly between 8 and 13 weeks after the Gambee suture had been applied (P less than 0.05) and the difference in diameter between intestines sutured according to Gambee and the stapled intestines disappeared. The intestinal diameter did not change significantly between 13 and 18 weeks in both techniques. The application of Gambee sutures resulted in fewer adhesions (P less than 0.01) and less thickening of the intestinal wall (P less than 0.0001). The surgery did not seem to affect the performance of the bulls significantly.

Animals↗
PubMed1992

Effects of adrenaline, dopamine, serotonin, and different cholinergic agents on smooth muscle preparations from the ansa proximalis coli in cattle: studies in vitro.

The effects of adrenaline, dopamine, serotonin, and different cholinergic agents on isolated muscle strips from the ansa proximalis coli in cattle were studied. Adrenaline (5 x 10(-5) mol/l) evoked a relaxing effect (p < 0.05) on longitudinal and circular muscle strips, mediated via beta- and alpha 1-receptors respectively. High concentration of dopamine (5 x 10(-4) mol/l) caused a non-significant inhibitory effect on longitudinal smooth muscles, which was probably mediated by beta- and not by dopamine-receptors. Serotonin (5 x 10(-5) mol/l) and cisapride (75 x 10(-6) mol/l) had no effect. Carbachol (2 or 10 x 10(-6) mol/l) and bethanechol (5 or 10 x 10(-5) mol/l) caused a dose-dependent (p < 0.05) contraction of both smooth muscle types. This excitatory effect was inhibited (p < 0.05) by metoclopramide (1 x 10(-4) mol/l), as well as the muscarinic agents RS-86 (5 x 10(-5) mol/l) and CGP-37,218 (37.5 or 75 x 10(-6) mol/l).

Animals↗
PubMed1992

Induction of propranolol metabolism in the Hep G2 human hepatoma cell line.

Metabolism of propranolol by the human hepatoma cell line Hep G2 was studied. Although metabolism qualitatively was similar to that in-vivo, the P450-mediated N-desisopropylation clearly predominated. Pretreatment of cells with 3-methylcholanthrene increased the activity of this pathway 14-fold, whereas phenobarbitone had no effect. This is similar to the pathway-selective inductive response observed for cigarette smoking in-vivo. As in-vivo, secondary metabolism of N-desisopropylpropranolol was extensive. This could, however, be completely blocked by 0.1 microM clorgyline, a potent MAO type A inhibitor. As in human liver microsomes, the stereochemistry of propranolol metabolism demonstrated a preference for the R(+)-enantiomer. These observations emphasize the usefulness of the Hep G2 cell line as a model of man.

Carcinoma, Hepatocellular↗
PubMed1992

Nicotinate esters: their binding to and hydrolysis by human serum albumin.

Nicotinate esters were studied for their binding to, and hydrolysis by, human serum albumin. Some esters (ethyl, isopropyl, t-butyl, cyclohexyl, benzyl) were bound but not hydrolysed, while others (2-chloroethyl, 2-butoxyethyl) displayed the opposite behaviour; 1-carbamoylethyl ester was neither bound nor readily hydrolysed. Only p-methoxyphenyl nicotinate was both a ligand and a substrate, and its rate constants of binding and hydrolysis were calculated in a stepwise procedure using a kinetic model.

Chromatography, High Pressure Liquid↗
PubMed1992

Potent inhibition of MAO mediated propranolol metabolism by dimethyl sulfoxide in Hep G2 cells.

This communication reports on the effects of dimethyl sulfoxide (DMSO) on the oxidative metabolism of propranolol by the homogenate of the human hepatoma cell line Hep G2. The formation of multiple metabolites was monitored in the absence and presence of 0.1 to 2.0% of DMSO. For the primary cytochrome P450-mediated pathways, ring oxidation was significantly reduced by 1.3 to 2.0% DMSO, whereas side-chain oxidation was not affected. A gradual inhibition of the oxidative deamination of N-desisopropylpropranolol to its glycol metabolite was seen with 20% inhibition at a DMSO concentration of 0.1% and a maximum 75% inhibition at a DMSO concentration of 0.7%. This highly selective inhibitory effect of DMSO on oxidative drug metabolism appears to be directed towards MAO type A.

Animals↗
PubMed1991

[Hypertension in the old age: how to treat it?].

Therapeutic agents for the treatment of hypertension in the elderly are the well known basic antihypertensive drugs (Diuretics, beta-blocking agents, calcium antagonists and ACE-inhibitors). Choice is determined by concomittant diseases increasing with age. In the elderly patient the assessment of benefit and risk is particularly essential. Drugs should therefore not be installed without exact information of the patient and be started at the smallest possible dose. If tolerance is good the dose may be raised of prescription of an additional drug be evaluated cautiously.

Adrenergic beta-Antagonists↗
PubMed1991

[Hypertension in the aged: how to assess it?].

In the elderly hypertensive patient several of the basic procedures during evaluation should be repeated or performed with particular care. Most importantly multiple pressure measurements should be taken repeatedly, orthostatic reactions have to be sought by taking the blood pressure in the standing and lying patient and the carotid vessels have to be auscultated. If a carotid occlusion or stenosis is suspected, a Doppler ultrasound study is indicated prior to therapy. Generalized arteriosclerosis is probably rarely the cause of so called pseudohypertension. It should be considered when strikingly high blood pressure values contrast with clinical signs of low blood pressure. Finally if hypertension develops rapidly in an elderly patient renal arterial stenosis should be suspected.

Aged↗
PubMed1991

[Hypertension in the aged: when to treat it?].

According to several recent studies prevalence of hypertension in the elderly ranges from 40 to 60%. Both, systolic as well as diastolic increase of blood pressure must be regarded as individual cardiovascular risk factors. Treatment of hypertension in the elderly gains special importance in the presence of additional risk factors. There is no doubt about the benefit of antihypertensive therapy when the diastolic value amounts to 100 mmHg and more. No reliable data exist so far on a beneficial effect of the treatment of systolic hypertension. Whether hypertensive patients older than 80 years and patients with only marginal increases of blood pressure benefit from antihypertensive treatment has not been proven by current studies. If the patient's anamnesis includes cerebral stroke a cautious antihypertensive therapy may reduce cardial insufficiency without increasing the risk for another apoplexia.

Aged↗
PubMed1991

[Febrile state, headache and arthralgia].

A 38-year-old man was admitted to the hospital with complaints of persistent fever up to 40 degrees C, arthralgias, headache and a nonproductive cough. The white-cell count was within the normal range but was markedly shifted to the left and demonstrated toxic granulations. Sonographic examination of the abdomen revealed a slight enlargement of the spleen. A nonspecific reactive hepatitis which was clinically asymptomatic was detected by laboratory evaluation. Diagnosis of an acute Q fever was made by demonstration of antibodies against C. burnetii. Following therapy with doxycycline, the patient became afebrile within 48 hours.

Adult↗
PubMed1991

[Sources of error in the diagnosis and therapy of hypertension].

Possible errors in the diagnosis and treatment of hypertension are discussed. The problems of blood pressure determinations are reviewed by comparing the results of sphygmomanometry in the doctor's office, of automated ambulatory blood pressure recording and of blood pressure self-measurement. In screening for renovascular hypertension one should be aware that no test is yet available which shows adequate sensitivity and specificity. Therefore, the only investigation that should be used to demonstrate a true stenosis is arteriography. When treating hypertensives it must be kept in mind that the benefits of antihypertensive medication, i.e. reducing morbidity and mortality from cardiovascular disease, should exceed the costs and side effects of the treatment. Finally, the effects of reduction in dose and discontinuation of antihypertensive medication are discussed.

Antihypertensive Agents↗
PubMed1991

[Angiosarcoma in a mastectomy scar following irradiation].

A 74-year-old patient who had undergone radical mastectomy and postoperative radiotherapy for invasive ductal mammary carcinoma developed an angiosarcoma in the radiotherapy field without associated lymphedema. The latency time was 178 months after the first and 82 months after the second radiotherapy. The total radiation-dose was 54 Gy. Only a few such cases have so far been described. These tumors are often multifocal and their prognosis is poor. Better known are angiosarcomas appearing after radical mastectomy as a consequence of chronic lymphedema, which are known as Stewart-Treves-syndrome.

Aged↗