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Biomedical subjects

A Wagner

Publications and source records attributed to A Wagner.

At least 253 records · Page 14Linked to original sources
PubMed1997

Distinguishing vesicular and pustular disorders in the neonate.

Vesicular and pustular disorders are common in the neonatal period. Most are benign, but several serious infectious and noninfectious diseases can present in the neonate. This review focuses on the clinical features of these disorders as well as recent advances in the field. The following diseases are discussed: erythema toxicum, transient neonatal pustular melanosis, miliaria, neonatal acne, eosinophilic folliculitis, mastocytosis, acropustulosis of infancy, incontinentia pigmenti, scabies, neonatal and congenital candidiasis, syphilis, neonatal herpes simplex infections, neonatal varicella, and staphylococcal infections.

Diagnosis, Differential↗
PubMed1997

Comparison of the Shipley Institute of Living Scale and WAIS-R IO scores for a sample of public sector psychiatric inpatients.

This study examined the use of the Shipley Institute of Living Scale as a screening device in an intellectually low functioning psychiatric population of 40 inpatients. Shipley IQ scores were significantly correlated .72 with Full Scale WAIS-R IQ scores. There was no significant difference between the mean IQ scores generated from the two measures. These findings suggest that the Shipley scale may be used in this population despite a caution by the test's publisher that the test should not be used in assessing intellectual functioning in individuals with borderline or lower intelligence.

Adult↗
PubMed1997

Trofosfamide: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in the oral treatment of cancer.

During the last decade, the oxazaphosphorine trofosfamide was underestimated partly due to its unsuitability for i.v. use. Oral daily doses of 150 mg were tolerated well and showed appreciable response rates in the treatment of lymphoma. Furthermore, activity in sarcoma and cancers sensitive to oxazaphosphorines in general seems probable, because ifosfamide is the main metabolite of trofosfamide. Due to its oral mode of application and good tolerance, trofosfamide will be an important option in view of the increasing demand for treatment regimens suited for an outpatient basis. Results of the major in vitro, in vivo and clinical studies are reported for evaluation of its significance in chemotherapy today.

Administration, Oral↗
PubMed1997

[Striatal uptake of I-123-beta-CIT and I-123-IBZM in patients with extrapyramidal symptoms].

AIM: This pilot study deals with the question whether characteristic changes in local cerebral dopamine transporter function and D2-receptor binding capacity can be shown with SPET in idiopathic Parkinson syndrome (IPS) and secondary Parkinson syndrome (SPS). METHODS: In 16 patients (6 with IPS, 6 with SPS except Wilson's disease, and 4 with Wilson's disease) SPET studies were performed using I-123-beta-CIT and I-123-IBZM and a dual-head gamma camera. Images were obtained 20-24 h and 2 h post injection, respectively. For semiquantitative analysis count density ratios of basal ganglia (BG) and cerebellum (CER) were determined for I-123-beta-CIT and ratios between BG and medial frontal cortex (MFC) for I-123-IBZM. RESULTS: The BG/CER ratio in the I-123-beta-CIT studies averaged 3.04 +/- 0.83 in IPS and 7.73 +/- 3.28 in SPS (p < 0.01) (except Wilson's disease). In patients with IPS, the BG/MFC I-123-IBZM ratios of basal ganglia contralateral to the symptomatic side exceeded that of the individual ipsilateral BGs (1.75 +/- 0.12 vs. 1.61 +/- 0.16); these ratios were significantly reduced when compared with those of SPS patients, although the differences were less pronounced than those of I-123-beta-CIT uptake values. In some of the patients with Wilson's disease the BG/MFC ratio for I-123-IBZM was dramatically reduced (as low as 1.29), whereas I-123-beta-CIT uptake was only slightly reduced when compared with that of SPS patients (8.00 +/- 2.90, p < 0.01). CONCLUSION: It is concluded that the neurochemical changes that can be anticipated in the above diseases can be monitored with SPET. I-123-beta-CIT, however, appears to be more adequate to differentiate IPS from SPS than I-123-IBZM.

Adult↗
PubMed1996

Open resection for subvalvular aortic stenosis in dogs.

OBJECTIVE: To describe the surgical technique for open resection of congenital subvalvular aortic stenosis in dogs and to determine outcome of dogs undergoing the procedure. DESIGN: Uncontrolled clinical trial. ANIMALS: 17 dogs with congenital discrete subvalvular aortic stenosis. PROCEDURE: Dogs were placed on cardiopulmonary bypass by catheterizing the femoral artery and both vena cavae. The aorta was cross clamped, and cold cardioplegia solution was administered. The aortic root then was opened with a curvilinear incision. A subvalvular discrete fibrous ring was resected in all dogs. Septal myectomy was performed simultaneously on 11 dogs. RESULTS: 15 of 17 dogs survived the operation and were discharged from the hospital. Mean +/- SD maximal instantaneous aortic systolic pressure gradient measured by means of Doppler echocardiography was significantly reduced from 119 +/- 42 mm of Hg before surgery to 41 +/- 10 mm of Hg 12 months after surgery. Despite substantial reduction in the systolic pressure gradient, 4 of 15 dogs died suddenly between 7 days and 30 months after surgery. Three of the 4 dogs that died suddenly had pressure gradients > or = 180 mm of Hg and ventricular tachycardia before surgery. Eleven dogs were still alive between 1 and 48 months after surgery. CLINICAL IMPLICATIONS: The procedure resulted in substantial reductions in systolic pressure gradients in dogs with severe congenital subvalvular aortic stenosis. However, some dogs with severe aortic stenosis died suddenly after surgery. Thus, this surgery should not be considered curative. Proof of a survival benefit in dogs undergoing this surgery will have to await longer term follow-up.

Animals↗
PubMed1996

[Study of children with urinary tract infections. Does intravenous urography play any role?].

Ninety children referred to hospital with urinary tract infections (UTI) were investigated by intravenous urography (IVU), ultrasonography (US) and 99m-Tc dimercaptosuccinic acid scan (DMSA). Fifty-eight children also had a micturition cystourethrography performed. In 36 (40%) of the children at least one result was abnormal. In 29 children IVU was abnormal, 10 had abnormal US and 16 had abnormal DMSA. Six of the 58 children had vesicoureteric reflux in eight kidneys. In 16 children IVU was the only examination with an abnormal result, and in ten of these the findings were considered important for treatment or prognosis. In conclusion, IVU is an important supplement to US and DMSA in investigation programs for children with UTI. IVU should be performed in cases of renal scarring or dilatation and in children with recurrent infections.

Chelating Agents↗
PubMed1996

Genetic redundancy caused by gene duplications and its evolution in networks of transcriptional regulators.

In various organisms loss-of-function mutations of individual genes with unexpectedly weak or no phenotypic effects in the homozygous state have been observed. In several of these case, independent evidence shows that the respective gene products do have essential biological functions. An explanation emerging from detailed biochemical and genetic studies on such genes is that two or more genetically redundant genes contribute to that function, i.e., a group of genes that is able to substitute partially for a loss of function in one member of that group. The often-observed sequence similarity among redundant genes suggests gene duplications as a frequent source of genetic redundancy. Aside from this observation, the evolution of genetic redundancy is poorly understood. Genetic redundancy is potentially of great relevance to organismal evolution, since it may (i) 'protect' organisms from potentially harmful mutations, and (ii) maintain pools of functionally similar, yet diverse gene products, and thus represent a source of evolutionary novelty at the biochemical level. The question of how genetic redundancy evolves should ideally be answered by experimentation. However, the large time scales involved and insufficient quantitative understanding of the underlying regulatory pathways are likely to preclude such an approach in the foreseeable future. Preliminary answers are sought here by using a biochemically motivated model of a small but central part of a developmental pathway. Sets of transcription regulators are modeled that mutually regulate each other's expression and thereby form stable gene expression patterns. It is then studied how genetic redundancy caused by gene duplications might evolve in such networks. The results obtained suggest that redundancy may, at least in some cases, be a global property of gene interactions within a regulatory pathway, rather than a local property of genes in that pathway. They also raise the possibility that duplications of a whole regulatory gene network, as may have taken place during the evolution of HOM/Hox genes in chordates, are less likely to be reversible (by gene deletions) than duplications of individual network genes. These findings are discussed with reference to experimental evidence on the evolution of HOM/Hox genes.

Computer Simulation↗
PubMed1996

Contrast enhanced computed tomography and magnetic resonance imaging in the diagnosis of recurrent disc herniation.

A positive result of re-operation in patients with recurrent symptoms after lumbar disc surgery is likely only if a new disc herniation is present. An improved ability to differentiate between recurrent disc herniation and scar tissue by contrast enhanced CT and MRI is suggested in earlier studies. In a prospective study 29 patients were selected for operation for suspected recurrent disc herniation. The inclusion of the patients was based on clinical symptoms and signs and myelography or non-enhanced CT. All patients were examined by CT and MRI both with and without intravenous contrast pre-operatively. The examinations were evaluated blind on a five point scale and statistical analysed by a regret function. Intravenous contrast improved the diagnostic power of both CT and MRI. MRI was superior to CT in both non-enhanced and enhanced examinations. MRI with intravenous contrast enhancement is proposed as the primary examination in patients with suspected recurrent disc herniation.

Adult↗
PubMed1996

Influence of pentoxifylline on cytokine levels and inflammatory parameters in septic shock.

OBJECTIVE: To evaluate the influence of pentoxifylline (PTX), a phosphodiesterase inhibitor, on cytokines and inflammatory proteins in patients suffering from septic shock. DESIGN: Prospective study comparing a therapy group to a matched control group. SETTING: Medical intensive care unit at a university hospital. PATIENTS: Twenty four patients fulfilling the criteria of septic shock were included in this study. Twelve patients received PTX (therapy group) and 12 patients matched for diagnosis, age and gender served as the control group. INTERVENTIONS: Pentoxifylline at 1 mg/kg per hour over 24 h in the therapy group. MEASUREMENTS AND RESULTS: Cytokine levels [tumor necrosis factor-alpha (TNF)], soluble TNF receptor [TNF-R], and interleukin-6 [IL-6] and inflammatory proteins [C-reactive protein, alpha-1-antitrypsin (AAT), fibronectin, and haptoglobin], as well as hemodynamic parameters and the APACHE III score were evaluated before initiation of therapy and 24 h-later. After 24 h, TNF levels were significantly lower in the therapy group (p = 0.013), while IL-6 levels were significantly higher in the therapy group (p = 0.030). Within the 24 h TNF declined significantly in the therapy group (p = 0.006), while IL-6 showed a significant increase (p = 0.043). AAT and the APACHE III score tended to differ significantly after 24 h between the groups [AAT levels higher in the therapy group (p = 0.05), APACHE III score lower (p = 0.05)]. In the therapy group, the systemic vascular resistance index was significantly higher after 24 h (p = 0.0026) whereas the cardiac index declined (p = 0.035). CONCLUSIONS: PTX does influence TNF levels in septic shock patients. Nevertheless, inhibiting a single mediator in severe septic shock cannot stop the inflammatory overreaction.

APACHE↗
PubMed1996

Inter- and intraobserver study of radiographic assessment of cemented total hip arthroplasties.

Radiographs are commonly used to identify loosened total hip prostheses. Interobserver and intraobserver variation was studied in an attempt to interpret 60 random pairs of radiographs with a time interval of 6 months to 12 years between the radiographs. Each of the four observers evaluated all pairs of radiographs independently, and the evaluations were repeated after 2 to 4 weeks. Each observer classified the femoral stem and the acetabular cup separately as stable or loose. Radiolucent lines of more than 2 mm were recorded. For the acetabular components, any change in inclination or migration was noted, and for the femoral components, subsidence or any change in varus or valgus of the stem was noted. There was considerable disagreement in observations of the acetabular component; agreement by all four observers was obtained in only 34 of 60 cases (57%). For the femoral component, agreement was obtained in 37 cases (62%). The observers agreed two and two (pairwise) on the acetabular component in 70 to 83% of cases and on the femoral component, in 72 to 82% of cases. Intraobserver variation was great with regard to the acetabular component, with kappa values ranging from 0.489 to 0.633. As to the femoral component, kappa values ranged from 0.737 to 0.800. Interpretation of radiographs of artificial hip arthroplasty is difficult, and comparisons between different series of implants should be made by the same person.

Cementation↗
PubMed1996

Image-guided surgery.

Interventional video tomography (IVT), a new imaging modality, achieves virtual visualization of anatomic structures in three dimensions for intraoperative stereotactic navigation. Partial immersion into a virtual data space, which is orthotopically coregistered to the surgical field, enhances, by means of a see-through head-mounted display (HMD), the surgeon's visual perception and technique by providing visual access to nonvisual data of anatomy, physiology, and function. The presented cases document the potential of augmented reality environments in maxillofacial surgery.

Foreign Bodies↗
PubMed1996

Recurrent mandibular dislocation under neuroleptic drug therapy, treated by bilateral eminectomy.

Acute mandibular dislocations caused by extrapyramidal syndromes under neuroleptic therapy have often been reported in the literature. However, the success of surgical therapy for recurrent mandibular dislocation in patients under long-term neuroleptic therapy has been discussed controversially. In our opinion, modifications in drug therapy--including the administration of so-called atypical neuroleptics--should be considered before advocating surgery. If the revised therapeutic approach proves to be unsuccessful because of psychotic relapse or persistence of extrapyramidal symptoms, good operative results may be achieved by bilateral eminectomy as reported on three psychiatric patients in this paper. In order to avoid postoperative subluxation and internal derangement due to increased muscular tension under chronic neuroleptic therapy, as much bone as possible should be removed when performing eminectomy.

Adult↗
PubMed1996

Treatment of intraosseous high flow arteriovenous malformation of the mandible by temporary segmental ostectomy for extracorporal tumour resection: a case report.

We present a case of intraosseous arteriovenous malformation of the mandible with temporary segmental resection, extracorporal removal of the vascular malformation from the osteotomized mandibular bone and intraoperative osteosynthetic replantation of the avascular bony remnant. In a follow-up after 1 year, when removing the titanium miniplates used for osteosynthesis, the mandibular bone was found to have remodelled completely. There is no recurrence of the lesion in a follow-up after 2 years.

Arteriovenous Malformations↗
PubMed1996

Structural organization and sequence analysis of the globin locus in Atlantic salmon.

Preliminary analysis of Atlantic salmon alpha- and beta-globin genes indicated that these genes are linked in a 3' to 3' orientation, with the RNA-coding sequences located on opposite strands. In this report, we show that two different alpha-globin genes have the same orientation and are encoded on the same strand whereas two different beta-globin genes are encoded on the opposite strand and also have the same orientation. This cluster of globin genes is divided into two subclusters: one for the Bohr globin genes and one for the non-Bohr globin genes. This is the first evidence for this type of arrangement found for globin genes. DNase I footprint analysis of two of the globin promoters show erythroid-specific transcription factor binding sites that have also been found in human and other mammalian globin genes.

Animals↗
PubMed1996

How can acute mountain sickness be quantified at moderate altitude?

Reports of acute mountain sickness (AMS) at moderate altitude show a wide variability, possibly because of different investigation methods. The aim of our study was to investigate the impact of investigation methods on AMS incidence. Hackett's established AMS score (a structured interview and physical examination), the new Lake Louise AMS score (a self-reported questionnaire) and oxygen saturation were determined in 99 alpinists after ascent to 2.94 km altitude. AMS incidence was 8% in Hackett's AMS score and 25% in the Lake Louise AMS score. Oxygen saturation correlated inversely with Hackett's AMS score with no significant correlation with the Lake Louise AMS score. At moderate altitude, the new Lake Louise AMS score overestimates AMS incidence considerably. Hackett's AMS score remains the gold standard for evaluating AMS incidence.

Acute Disease↗